Those Funny 19th-Century “Reasons for Admission”  to Mental Institutions 

Historical Treasures, Oddities, And Delights
July 15 2014 1:20 PM

Those Funny 19th-Century “Reasons for Admission” to Mental Institutions 

Report of the Pennsylvania Hospital for the Insane, 1841-42.

FromMemorial of D.L. Dix: praying a grant of land for the relief and support of the indigent curable and incurable insane in the United States, Dorothea Dix, 1848;digitized by the U.S. National Library of Medicine.

The Vault is Slate's history blog. Like us on Facebook, follow us on Twitter @slatevault, and find us on Tumblr. Find out more about what this space is all about here.

Ever since seeing this amazing list, which was billed as “reasons for admission” to a 19th-century mental institution in West Virginia, I've been wondering about its meaning. It seemed too funny to be true. Did 19th-century doctors really commit patients because they read novels? 

Bookseller John Ptak recently blogged about an 1848 Dorothea Dix pamphlet, which contains the two shorter, similar lists in this post. Dix, an activist and advocate for kinder treatment of the mentally ill, wrote this pamphlet as a memorial (a petition), asking Congress for a grant of land upon which to build asylums.


Reading the booklet (available in full through the National Library of Medicine), it became clear that these “reasons for admission” were actually the proximate causes to which 19th-century patients or their families attributed their “madness” (which Dix often described in blanket terms as “insanity” or “mania”).

Report of the Massachusetts State Hospital, 1843.

From Memorial of D.L. Dix: praying a grant of land for the relief and support of the indigent curable and incurable insane in the United States, Dorothea Dix, 1848; digitized by the U.S. National Library of Medicine.

So, of course, 19th-century West Virginians weren't committed because their “parents were cousins” or they had “women trouble,” but because they suffered from mental illness. They had cited those life events as answers to questions about the origins of mental instability. At a time when people had stopped believing in demonic possession, but had not yet evolved a more specific way to diagnose and treat mental illness, such intake information reflected a new search for the causes of “insanity.” 

Dix, for her part, thought that the political environment of the United States encouraged “mania”:

Wherever the intellect is most excited, and health lowest, there is an increase of insanity. …This malady prevails most widely, and illustrates its presence most commonly in mania, in those countries whose citizens possess the largest civil and religious liberty; where, in effect, every individual, however obscure, is free to enter upon the race for the highest honors and most exalted stations.

Dix also found sources of “insanity” in “religious excitement” (including Millerism) and civil disruption (“riots and firemen’s mobs in Philadelphia,” “tumultuous and riotous gatherings in Ireland”).


Medical Examiner

Here’s Where We Stand With Ebola

Even experienced international disaster responders are shocked at how bad it’s gotten.

Why Are Lighter-Skinned Latinos and Asians More Likely to Vote Republican?

A Woman Who Escaped the Extreme Babymaking Christian Fundamentalism of Quiverfull

The XX Factor
Sept. 22 2014 12:29 PM A Woman Who Escaped the Extreme Babymaking Christian Fundamentalism of Quiverfull

Subprime Loans Are Back

And believe it or not, that’s a good thing.

It Is Very Stupid to Compare Hope Solo to Ray Rice

Building a Better Workplace

In Defense of HR

Startups and small businesses shouldn’t skip over a human resources department.

How Ted Cruz and Scott Brown Misunderstand What It Means to Be an American Citizen

Divestment Is Fine but Mostly Symbolic. There’s a Better Way for Universities to Fight Climate Change.

  News & Politics
Over There
Sept. 22 2014 1:29 PM “That’s Called Jim Crow” Philip Gourevitch on America’s hypocritical interventions in Africa.
Sept. 22 2014 5:38 PM Apple Won't Shut Down Beats Music After All (But Will Probably Rename It)
Dear Prudence
Sept. 22 2014 3:33 PM Killing With Kindness My in-laws want to throw me a get-well-from-cancer bash. There’s no way I can go.
  Double X
The XX Factor
Sept. 22 2014 7:43 PM Emma Watson Threatened With Nude Photo Leak for Speaking Out About Women's Equality
  Slate Plus
Slate Plus
Sept. 22 2014 1:52 PM Tell Us What You Think About Slate Plus Help us improve our new membership program.
Brow Beat
Sept. 22 2014 9:17 PM Trent Reznor’s Gone Girl Soundtrack Sounds Like an Eerie, Innovative Success
Future Tense
Sept. 22 2014 6:27 PM Should We All Be Learning How to Type in Virtual Reality?
  Health & Science
Sept. 22 2014 12:15 PM The Changing Face of Climate Change Will the leaders of the People’s Climate March now lead the movement?
Sports Nut
Sept. 18 2014 11:42 AM Grandmaster Clash One of the most amazing feats in chess history just happened, and no one noticed.