
The late 1800s was a period of time that severely lacked strong medical education, especially in the mental health sector. This was also a time period that was dominated by male power and women were viewed primarily as homemakers. Women were seen as weak and fragile. If a woman were to speak out against her husband’s wishes or demands, the husband could easily send his wife to a mental institution to be “cured” of their mental illness (Smith). Nellie Bly, a feminist in the late 19th century and a perfectly healthy and sane woman, decided to feign insanity to experience first-hand the rumored inhumane treatment of the insane asylum’s patients. What Nellie Bly experienced and wrote about in Ten Days in a Mad-House was incredibly shocking to the people living in that time period and to those involved in the medical field today. Along with Dorothea Dix, Nellie Bly helped bring awareness to the poor treatment occurring in these “mad-houses” to spark change in the field of medicine and society. Throughout Nellie Bly’s ten-day stay at the madhouse, she repeatedly highlighted the poor living conditions, ignorant medical treatments, and the asylums hesitance towards spending money.

The staff at any insane asylum should be supportive and at least try to assist their patients with their needs. However, it seems as though the institution Bly was staying at was flooded with unknowledgeable doctors and careless nurses. First of all, Nellie Bly was a perfectly sane woman who decided to fake her insanity. The doctors should have been able to immediately identify that Nellie Bly was not insane. Some of the employees began to notice that Nellie Bly was not insane, however they convinced themselves otherwise that she was indeed suffering from a mental illness (Bly, 282). That should have been a red flag that the institution and its medical employees had not been properly trained.  One day, Nellie Bly visited the doctor and quickly noticed that she was not the main priority in the room. The nurse in the room had trouble measuring Nellie’s height and weight and needed extra assistance from the doctor. The doctor was not hesitant to provide the nurse with assistance in sort of a flirtatious way (Bly,283). These actions were completely inappropriate and allowed for the employees to lose focus on their patient’s illness. Nellie Bly often described how doctors and nurses would purposely ignore severe symptoms of a disease. Bly had a friend she referred to as Miss Tillie Mayard who was suffering from a feverish cold that was getting worse and worse as the days went on. Nurses would either ignore her symptoms or place blame on the patient, omitting care from the patient to “teach them a lesson” (Bly, 295). On occasion nurses would take action so far as to choke and beat patients who complained of illness or of the asylum conditions. Possible reasoning for such aggressive actions could be that the employees of the asylum were not properly trained and would therefor get frustrated easily when a patient was difficult (Hummer). In the late 1800s, many Americans were desperate for jobs and insane asylums were extremely understaffed. The asylums were willing to hire anyone who applied, no matter their job experiences or previous trainings. This allotted for mental asylums to become very corrupt and prevented them from being providing proper care for their patients (Hummer).

Being corrupt and understaffed, insane asylums hesitated to invest in providing the best care for their patients. A German patient who knew not one word of English had been admitted to the insane asylum most likely for not being able to comprehend the English language. When the doctors performed the initial exam on this woman, they would not provide a German interpreter which prevented the non-English speaking patient from telling her side of the story. Nellie Bly watched in amazement of what appeared to be a perfectly normal German woman be identified as an insane woman who could not argue her saneness (Bly, 282). She wondered why the institution would refuse to invest in a German-English interpreter in such a life-changing diagnosis. The institution skimped out on many basic expectancies. When Bly experienced her first bathing episode, what was most shocking, was not the cold water, or lack of shampoo, but the woman who sponge-washed each patient was a patient of the institution herself (Bly, 287). For some reason the institution could not invest in another nurse or a sane employee that could perform the hygienic duties, but instead decided that the next best option would be to allow a completely insane woman be in charge of all the patients’ hygiene. As Miss Tillie Mayard continued to get more and more sick, Nellie Bly wanted to ask an employee to provide her with more clothing. Bly asked multiple employees of the institution to provide them with more clothes and was constantly refused (Bly, 295). The asylum staff was oblivious to the problems surrounding the basic necessities of these women.

The institution described in Nellie Bly’s novel neglected the needs of their patients and created poor living condition that were extremely detrimental to the health of the women. The insane asylum did not provide the women with edible food or comfortable sleeping arrangements. Nellie Bly was always faced with starvation and was prepared to eat anything to cure her hunger. However, each time Bly was presented with a meal she found it more and more challenging to force herself to fulfill her starvation (Bly, 292). “It was not long until the dinner hour arrived and I was so hungry I felt I could eat anything,” mentioned Nellie Bly. However, when presented with unsalted raw fish she found the task to be extremely difficult. Often times the food that was available would be home to all different species of insects. Most foods were so spoiled and covered in mold that the original identity of the food could not be determined (Bly, 293). Not only were the patients in the institution starving, but they were also exhausted and sore from the poor sleeping conditions. Nellie Bly described her attempt at creating a comfortable sleeping arrangement: 

“I was taken to room 28 and left to try and make an impression of the bed. It was an impossible task. The bed had been made high in the center and sloping on either side. At the first touch my head flooded the pillow with water, and my wet slip transferred some of its dampness to the sheet” (Bly, 287).

The bed provided made it extremely difficult to get any type of beneficial rest. Also, when Nellie Bly asked for more clothing for she was wet and freezing, she was refused and told to remain cold like the other patients. The institution had created an inhumane environment depriving the patients of the simple necessities of survival.

Nellie Bly successfully used the rhetorical device irony to portray the ridiculous actions of the mental institution. Repeatedly a character in the book would make a remark such as, “This place is making me go insane” or “I am crazier than when I was first admitted.” This was ironic for mental institutions are supposed to be a places where mentally ill patients get help, not where a mentally ill person has an increase of insanity. Miss Mayard mentions, “My nerves were so unstrung before I came here, and now I fear I shall not be able to stand the strain” (Bly, 290). Miss Tillie Mayard confessed to having a mental illness before she arrived to the institution, but since she has arrived at the institution she fears that her experiences there will permanently ruin her sanity. Nellie Bly was attempting to force food into her system with the encouragement of Miss Neville one day in the asylum (Bly, 286). Miss Neville made the comment, “You must force the food down, else you will be sick, and who know but what, with these surroundings you may go crazy.” Once again Bly mentions an interaction where another patient implies that the situations the institution was placing their patients in were making them crazier than when they were first admitted. The institution used a treatment that was similar to the Resting Cure which was developed in the late 1800s (Bly, 293). Silas Weir Mitchell developed this treatment to cure women of “insanity” such as having any kind of disagreement with their husbands (Stiles). The treatment consisted of the woman to rid of any distractions around her. She was to stay in bed all day, refrain from interacting with any visitors, and avoid participating in any activities including reading or writing. She was not allowed to move or feed herself, someone had to do it for her. This “cure” was meant to clear a woman’s conscious and to be more susceptible in appealing to society’s rules at that time. Many women claimed to have developed mental illness because they were put through the Resting Cure, even though they had not been ill previous to the treatment (Stiles). Nellie Bly mentions that they had to sit still on uncomfortable benches for 14 hours straight. If a patient were to move, talk, or slouch they would be reprimanded immediately and have to return to sitting up straight in silence. “What excepting torture, would produce insanity quicker than this treatment?” Nellie Bly states in response to the sitting treatment. At the end of the excerpt Nellie Bly begins to feel as though her ten days in the mental institution had completely changed her from being a healthy, sane woman to an insane lunatic who would now need help from a mental institution. Nellie Bly states, “Insane? Yes, insane; and as I watched the insanity slowly creep over the mind that had appeared to be all right I secretly cursed the doctors, the nurses, and all public institutions” (Bly, 295). The insane asylums in the late 1800s were doing more harm than good. The purpose of these institutions were to help the mentally ill, but Bly has proved that asylums are harmful to women in America. 

These asylums were made to provide help to mentally ill patients, not to punish them for suffering from a psychiatric disease. Frustration with the patients or desire to make more money should not be considered reasons to abuse or treat a patient inhumanely. The insane asylums in the late 1800s did not cure insanity like its main goal had been, but rather induced insanity and ruined the lives of perfectly healthy women.
