Nellie Bly’s “Ten Days in a Mad House” exemplifies the mistreatment, neglect, and abuse of women during the 1800’s through first-hand experience. Going undercover, Bly is able to write about the perspective of being a patient and how even a mentally stable woman could spiral into insanity from living in the asylum’s environment. Women who did not uphold the archetype of the ideal woman at the time would most often end up being sent away to a “mad house.” In most scenarios the mental stability of the woman did not even play a part until she had to survive the asylum. The abusive atmosphere would cause the women to revert to survival mode and often a primal state. This new mind-set would transpire and appear as insanity, proving the societal patriarchy correct about female hysteria. This viscous cycle continued for many years to come, despite the knowledge that people like Bly released to the public. 

In Bly’s story she references people such as Miss Neville, who have been admitted to the asylum, yet are not “insane.” According to records from the Trans-Allegheny Lunatic Asylum, many reasons for admittance seem to be normal human behavior for the 21st century while considered crazy for Bly’s time period. These reasons include but are not limited to jealousy, laziness, nymphomania, asthma, and religious enthusiasm. It was also extremely common for women to be admitted as an alternative to divorce eventually leading the women to their survival mode as well. From the neglect and isolation of the women Bly writes about in her story, and the records of the Lunatic Asylum, the reader can understand the transpiration of the insanity. 

Often, explanations for admittance included reasons uncontrollable to the patient. Women who were victims of war, sexual abuse, incest, high fevers or domestic abuse could be sent away without giving consent. Bly writes that there are approximately 1600 women on Blackwell’s Island and describes the women as “crippled, blind, old, young, homely and pretty: one senseless mass of humanity” (292). With all the illegitimate reasons the sheer number of women committed to asylums skyrocketed during the 19th and 20th centuries. In a study done on patients during the years 1869-1872 out of 17 of the documented women, two had unknown reasons for admittance, four were in for religious reasons, another four were in for family issues and seven were admitted for causes they could not help (Oshkosh Scholar). 

In addition to the negligence towards the female patients, many asylums, including Blackwell’s Island, experimented with questionable techniques on the patients. Bly describes a bathing scene where she was forcibly scrubbed in ice water and says, “I think I experienced some of the sensations of a drowning person as they dragged me, gasping, shivering and quaking, from the tub” (287). Along with this experience came malnutrition from horrible and rancid food served in the cafeteria. Although these examples represent terrible treatment, they do not compare to the medical treatment doctors performed on the women. The consensus among many doctors was that the female organs were the part of the body contributing to the insanity findings in women. Since men were not showing such “symptoms” female hysteria became an accepted reason behind mental illness. Doctors began performing hysterectomies on female patients to try and remove the so-called crazy part of a woman. This became a regular procedure at insane asylums even though the procedure generally resulted in fatality. 

The women, such as Bly, who were living in the asylums without mental illnesses, were not given the opportunity to plead their cases. Bly describes a specific case where a patient was from Germany and writes, “here was a woman taken without her own consent from the free world to an asylum and there given no chance to prove her sanity,” because the nurse would not translate (282). This, along with many other illegitimate reasons contributed to the institutionalizing of sane women. Often, the husbands of these women would use the asylum as an excuse instead of divorcing their wives, since divorce was a taboo in the 19th century. These sane women were forced to partake in the already questionable treatments of mentally disabled women, and thus had to learn to survive in a new reality. It was common for the women to refuse to eat the horrid food until starvation and survival mode took over. Reverting to such a primitive state resulted in corrosion of the women’s mental states. Over time the women who were admitted without any real reasons started to show signs of instability. Their new-found symptoms continued to prove the theories right that these women were insane to begin with. In a patriarchal society, the conditions of the “mad houses” transformed the women into the very people the men claimed they were. 

Women were admitted into the asylum by the recommendation of the men in their lives. If a wife disobeyed her husband or did not act as an ideal housewife the husband had the right to send her away for reasons of insanity. During this era “psychiatry claimed male dominance was therapeutic” and that the woman had no rights or need to consent to treatment (science museum brought to life). A common treatment was to find a husband for an unmarried woman who exhibited any signs of so called insanity. Female hysteria became a nerve disease known for strange behaviors. Although “Ten Days in a Mad House” was written in the 19th century the misconceptions behind female hysteria were documented continuing into the late 20th century. Records of asylums or other medical institutions show the drugging of admitted women with tranquilizers. However, it was not until the late 20th century that worries arose about addiction in the female patients. 

Many argued that the conditions of the asylums were not dangerous or problematic for the female patients; however, from Bly’s testimony the reader can see the not only the horrible mistreatment of the women, but the danger of the building itself. According to Bly, “every door is locked separately and the windows are heavily barred, so that escape is impossible,” and she worries in the case of a fire how or even if the nurses would unlock each individual door. With constant fear and isolation, the women’s minds would begin to change. Reverting to survival mode they would have no choice but to succumb to their environment and the neglect that was ensured to accompany them. 

Nellie Bly’s first-handed recordings of the unfortunate mistreatment of women in the 19th century benefits the later generations to understand the “craziness” behind the mad houses. Instead of a place to go for the mentally ill to receive treatment, the insane asylums became a place to send women with almost any problem. In fact, most problems had nothing to do with the patient’s mental state, but with the decision making of their husband or manly figure in their lives. After the men in the “patient’s” life would decide the woman needed help she was sent to an institution such as Blackwell’s Island. When instated the isolation and treatment itself began to affect the mental state of the women. Perfect stable women came in to the asylums healthy and by the time their family could see them their humanity was almost gone. Neglecting these women led to irreparable damage which ended up proving the patriarchy’s theory. Women due to their sensitivity and fragility were more susceptible to mental illness. Instead of receiving treatment, the women, through the eyes of Bly, would eventually go insane from the mistreatment, malnutrition and abuse exhibited in the asylums. 
