The Lady in the Asylum: Catherine Gilbride at Danville, Part III

by Nancy Gilbride Casey

In Part I of this series, I introduced Catherine Gilbride, my second great grandmother, who was institutionalized at Danville Asylum in 1876. I also looked at perceptions of "insanity" during the 19th century. Part II discussed the Directors of the Poor of Providence and their authority to commit Catherine.

What was Puerperal Insanity?

Without the benefit of a physician’s examination prior to Catherine's Danville Asylum admission, it was up to the resident physicians to diagnose her. Here her illness was named: puerperal mania.¹ To understand this unfamiliar affliction, one must again look to past medical beliefs.

During the 19th century, physicians defined three types of puerperal insanity, occurring at distinct times of pregnancy, or possibly caused by them. Author Nancy Theriot described the various in her article “Diagnosing Unnatural Motherhood: Nineteenth-century Physicians and ‘Puerperal Insanity'.”

“Some physicians preferred to classify puerperal insanity as maniacal, melancholic or depressive, instead of dividing it according to reproductive phase; but in both groups there was consensus as to the type of insanity most associated with pregnancy, parturition and lactation.”²

• “Gestational insanity” occurred during pregnancy itself. “It was thought to be the rarest of the three, and usually involved melancholic (and suicidal) symptoms or depressive symptoms. Nineteenth-century physicians described patients as ‘melancholic’ who appeared to be apathetic, hopeless and prone to suicide; while ‘depressive’ patients were those with ‘low spirits.’ In cases of insanity of pregnancy, the symptoms sometimes lasted only a few weeks or months, but in other cases the patient was only cured by childbirth.”³

• Puerperal mania was triggered by “parturition” (childbirth). Theriot: ‘Usually puerperal mania began within fourteen days of childbirth, but in some cases began within fourteen days of childbirth.” “Characteristic symptoms included: incessant talking, sometimes coherent and sometimes not; an abnormal state of excitement, so that the patient would not sit or lie quietly; inability to sleep…; refusal of food or medicine…; aversion to the child and/or the husband…; a general meanness towards caretakers…; and obscenity in language and sometimes behavior.” These symptoms align perhaps more closely with today’s bipolar diagnosis.⁴

• “Lactation insanity was similar to gestational insanity in its symptoms, melancholic and depressive, but was seen as more frequent.” It differed from the other forms “...in that is seemed to occur most often in women who had several children rather than women going through their first pregnancies.”⁵ Cases usually resolved within six months or so. This type of insanity would later become known as post-partum depression in the 20th century.

Catherine suffered from the second type of puerperal insanity—or insanity of parturition. Her notes stated the onset of her disease occurred about three weeks after her stillbirth, though what exact symptoms she displayed while at home are unknown. Below is the April 14, 1877 entry in Danville's patient register, naming Catherine's diagnosis:

 

Transcription:

1877                                                                                                                  81

April 14th Catharine Gilbride, No 676

Laborers wife, aged 22, native of Ireland and resident of Luzerne Co. Penna.

Youngest child three weeks old, next 14 mos. Cause of insanity

parturition. Duration 3 weeks.

On admission is a woman of less than medium

size, of florid complexion & auburn hair.

Some loss of flesh evident owing to recent

accouchement. The child was stillborn. State of

physical organs normal. Mammars secrete

very scantily. Diagnosis: Mania.

 

To someone who was suffering mentally like Catherine, it must have been a harrowing trip from Providence to Danville, a distance of nearly 70 miles—and a world away from family and friends.

In Part IV, we'll walk into Danville alongside Catherine, and meet the man responsible for a new way to treat mental illness in the 19th century.

* * *

 "The Lady in the Asylum: Catherine Gilbride at Danville," was written as part of The Ancestor Project, sponsored by the Denton County Genealogical Society, 8 September 2022.

Image: The Girl by the Window (1893) by Edvard Munch. Original from The Art Institute of Chicago. Digitally enhanced by rawpixel. In the public domain.

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NOTES

¹ Danville State Hospital, Records of the Department of Public Welfare, Record Group 23, County Registers 1872-1919, 67, line 25, Catherine Gillbride; digital image, "Danville State Hospital (PA) County Registers, 1872-1923," PowerLibrary (https://digitalarchives.powerlibrary.org/psa/islandora/object/psa%3Adshcr_187 : accessed 19 March 2021), image 45/187; citing Pennsylvania State Archives, Harrisburg.

² Nancy M. Theriot, “Diagnosing Unnatural Motherhood: Nineteenth-Century Physicians and ‘Puerperal Insanity.” American Studies, vol. 30, no. 2, 1989, 73; image copy, JSTOR, http://www.jstor.org/stable/40642344 : accessed 11 July 2022).

 

^3-5 Ibid.