Eli Hill Case Study VIII:  Supposed Cause
Eli Hill Case Study VIII: Supposed Cause

Eli Hill Case Study VIII: Supposed Cause

Cases from the Asylum Archive

Eli Hill (1832-1877)

Robert C. Allen

Patient #882 

At this point, Eli disappears from available records for three years.  The disposition of the court case following his alleged assault is not noted in Raleigh newspapers.  A search for “Ann Williams” in Raleigh newspapers between 1865 and 1870 yields nothing.  The next event in Eli’s life about which we have evidence is, of course, his admission to Dix on January 27, 1870 as patient #882.  He was the only African American admitted between August 1869 and March 1870.  He is 25 years old and still single.  For the previous four months he had been afflicted with attacks of insanity the supposed cause for which was listed as “self pollution.”  He was diagnosed with “mania.”

There were more than 100 different supposed causes listed at the time of patient admission between 1856 to 1920. Together they form a typological landscape within which individual cases of insanity were situated.  As we might expect, some supposed causes sound familiar or at least intelligible to a twenty-first century inquirer:  grief, physical trauma (a kick to the head), childbirth, syphilis, opium, epilepsy.  Some suggest plausible social or physical circumstances: domestic trouble, ill health.  Some are surprising and would seem to require further historical contextualization: religious excitement, for example.  None, however, elicits as strong and perplexed a response as Eli’s supposed cause, self pollution, or its nineteenth century cognate, masturbation.  Seeing these terms listed as the reason someone might have been involuntarily committed to an insane asylum provokes everything from disbelief to embarrassed titters.   How in the world did masturbation come to be associated with insanity and the asylum?

Newspapers.com demonstrates how masturbation becomes freighted with religious, cultural, and medical meaning over the course of two centuries in the West, and shows us where Eli’s case stands in this process.  The eighteenth-century ur-text on the dangers of masturbation appears in the British popular press as early as 1717 in an advertisement for a book entitled: Onania: Or, the Heinous Sin of Self Pollution and all its frightful consequences in both sexes Considered; with Spiritual and Physical Advice to Those who have already injured Themselves by this Abominable Practice.  (The Post Boy [London], Jan. 9, 1717) The anonymous author very cleverly combines the religious and medical dangers of the practice (it is a “heinous” sin and the cause of physical injury), reveals that both men and women are subject to this “abominable practice,” and suggests that it has “frightful” spiritual and physical consequences of which the practitioner might not even be aware.  He also medicalizes both the condition and its cure by promising therapeutic advice.

A pause here to explain the title of the book as well as the Biblical source upon which it draws.  Genesis 38: 8-10 relates the story of Onan, who was told by Judah to marry his brother’s wife and have a son with her.  But rather than consummate the relationship he “spilled his seed on the ground.”  In other words he practiced masturbation as a form of birth control.  For reasons that we’ll leave to theologians to debate, Onan’s refusal to devote his sperm to a higher procreative cause “displeased the Lord,” and he was slain.  Thus was this minor Old Testament figure made into the eighteenth-century poster boy for the abominable practice of masturbation.  (When literary wit Dorothy Parker was asked why she named her parakeet Onan, she is reported to have said, “because he spills his seed on the ground.”)

H. Hare (“Masturbatory Insanity: the History of an Idea,” Journal of Mental Science 108: 452 [1962]) chronicles what we might call the percolation of the masturbatory thesis into understandings of insanity across the eighteenth and nineteenth century. In 1812 one of the pioneers of nineteenth century psychiatry, Philadelphia’s Benjamin Rush, added consumption, vertigo, and epilepsy to its effects.  In 1838 French physician Jean-Étienne Dominique Esquirol, one of the first advocates for what would become the “moral treatment” approach to insanity, warned that masturbation could lead to dementia (even senile dementia), melancholy, and suicide.

With the establishment of the insane asylum in the United States in the middle decades of the nineteenth century, it became all the more important to recognize masturbators, given the dire physical and psychiatric consequences.  An 1839 article in the Vermont Telegraph entitled “Solitary Vice: An Address to Parents and Those Who Have the Care of Children,” warned mothers that it was their responsibility to prevent their sons and daughter from joining the ranks of asylum inmates.  Cases of masturbatory insanity were on the rise in both young men and women, and once it took hold, cure was almost impossible.”

But how to distinguish practitioners of the “secret vice”?  By the 1860s, some doctors claimed that chronic masturbation produced characteristic symptoms in both men and women. These came to include imbecility (as a symptom and effect), shy habits, surprise, fear, dread, suicidal and homicidal impulses, a scared look, feebleness (particularly among older offenders), conceit, deranged thoughts, nocturnal hallucinations, selfishness, cruelty, deception, a vacant appearance, pallor, blushing, and brooding.  In women the signs of chronic masturbation included anger, timidity in the presence of parents, idleness, lying, and “a certain aspect, a je ne sais quoi, easier to recognize than to express in words.”

Where does Eli fit as a victim of masturbatory insanity?  Although, as we have seen, the term “self pollution” had been in wide circulation for some 150 years, there are only four cases with this supposed cause in the Dix admissions ledgers, and Eli’s is the first.  The second comes a year later, a 28 year-old woman from Halifax County in rural eastern North Carolina, who is discharged “unimproved” seven years later, but who is readmitted shortly thereafter for another seven years, dying in the asylum from paralysis.  There are no further uses of the term self pollution in the ledgers until the early 1890s when two older men (65 and 52) are admitted, one suffering from “poverty, idleness, and self pollution.”

A bit of rudimentary text-mining in Newspapers.com charts the use of the term in public discourse in North Carolina:

However, a closer look shows that national newspapers in 1870 are still running advertisements for doctors who claim to be able to cure “carnal excess or self-pollution,” along with syphilis, gonorrhea, and enlargement of the prostate.  (Times Picayne [New Orleans], Jan. 1868-December 1870)

Masturbation is a much more common and persistent supposed cause, with some 175 cases at Dix between 1856 and 1920.  Patient #18, admitted in April 1856, remained there for more than twenty years, dying from exhaustion in 1878.  All but a few were men, and most of the men were between the ages of fifteen and thirty, the youngest being twelve.  The last patient for whom we have a record was admitted in 1910.  He was noted to be an “imbecile,” and died after two years from exhaustion.

The last fifteen years of the nineteenth century saw a decline in the belief that masturbation could cause insanity.  The influential German psychiatrist Emil Kraeplin argued in 1896 that insanity was never caused by masturbation.  However, (surprise! surprise!) the association of chronic masturbation with psychiatry was not forgotten but rather refigured: as the discipline entered the twentieth century, chronic masturbation was viewed as a neurotic disorder, along with obsessive thoughts, compulsions, and phobias.

In short, in nineteenth century psychiatry, masturbation was not so much an observable practice as an inferred explanation.  It was not necessary for doctors to interrogate parents about physical evidence or to secure an admission of guilt from embarrassed patients at intake.  Masturbation or self pollution could be extrapolated from the stories told about the patient at the time of admission and observations made by the person keeping the admissions ledger.  The ascription of masturbation was also confirmation of the seriousness of the patient’s condition—after all, it could be the cause of any number of maladies.  Because so little was known about the etiology of any form of mental illness, if a patient did develop dementia, melancholia or become suicidal, the “cause” could be retrospectively assigned to masturbation—there was seldom any evidence to suggest otherwise.

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