{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:37:33Z","timestamp":1777912653736,"version":"3.51.4"},"reference-count":52,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2003,9,1]],"date-time":"2003-09-01T00:00:00Z","timestamp":1062374400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hist Psychiatry"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p>\n                    <jats:italic toggle=\"yes\">Taking case notes as the key source, this paper focuses on the variety of                    interpretations put forward by doctors to explain the incidence of puerperal                    insanity in the nineteenth century. It is argued that these went far beyond                    biological explanations linking female vulnerability to the particular crisis of                    reproduction. Rather, nineteenth-century physicians were looking at other                    factors to explain the onset of insanity related to childbirth: stress and                    environmental factors linked to poverty, family circumstances, poor nutrition,                    illegitimacy, fear and anxiety, and the strains of becoming a mother. The main                    focus is on female asylum patients, but all mothers were seen as being                    susceptible to puerperal insanity.<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1177\/0957154x030143003","type":"journal-article","created":{"date-parts":[[2003,9,25]],"date-time":"2003-09-25T16:10:51Z","timestamp":1064506251000},"page":"303-320","source":"Crossref","is-referenced-by-count":12,"title":["Disappointment and Desolation: Women, Doctors and Interpretations of                Puerperal Insanity in the Nineteenth Century"],"prefix":"10.1177","volume":"14","author":[{"given":"Hilary","family":"Marland","sequence":"first","affiliation":[{"name":"Centre for the History of Medicine, Department of History, University of                        Warwick, Coventry CV4 7AL, UK,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2003,9]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.1093\/shm\/11.2.255"},{"key":"e_1_2_1_2_1","unstructured":"Ashwell Samuel (1845) A Practical Treatise on the Diseases Peculiar to Women Illustrated by Cases Derived from Hospital and Private Practice ( London: Highley )."},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0957154X9300401402"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0957154X9500602102"},{"key":"e_1_2_1_5_1","unstructured":"Brockington I. F. and Kumar R. (eds) (1982) Motherhood and Mental Illness ( London: Academic Press )."},{"key":"e_1_2_1_6_1","unstructured":"Bucknill J. C. and Tuke D. H. (1858) A Manual of Psychological Medicine ( London: Churchill )."},{"key":"e_1_2_1_7_1","unstructured":"Burrows Adrienne and Schumacher Iwan (1990) Portraits of the Insane: The Case of Dr Diamond ( London: Quartet Books )."},{"key":"e_1_2_1_8_1","unstructured":"Churchill Fleetwood (1857) On the Diseases of Women; Including those of Pregnancy and Childbed 4th edn ( Dublin: Fannin )."},{"key":"e_1_2_1_9_1","unstructured":"Clouston Thomas (1887) Clinical Lectures on Mental Diseases ( London: Churchill )."},{"key":"e_1_2_1_10_1","unstructured":"Conolly John (1830) An Inquiry Concerning the Indications of Insanity with Suggestions for the Better Protection and Care of the Insane ( London: John Taylor )."},{"key":"e_1_2_1_11_1","first-page":"349","year":"1846","unstructured":"Conolly, John (1846) Description and treatment of puerperal insanity, Lecture XIII Clinical lectures on the principle forms of insanity, delivered in the Middlesex Lunatic-Asylum at Hanwell . Lancet, (1) (28 March), 349-354 .","journal-title":"Lancet"},{"key":"e_1_2_1_12_1","first-page":"623","volume":"16","year":"1858","unstructured":"Conolly, John (1858) The physiognomy of insanity, No. 8: Puerperal mania . Medical Times & Gazette, 16 (19 June), 623-625 .","journal-title":"Medical Times & Gazette"},{"key":"e_1_2_1_13_1","unstructured":"Cumberland & WestmorlandLunatic Asylum (1869) Annual Reports of the Cumberland & Westmorland Lunatic Asylum 1863-1870 Eighth Annual Report 1869 ( London: Wellcome Trust Library )."},{"key":"e_1_2_1_14_1","unstructured":"Day Shelley (1985) Puerperal insanity: the historical sociology of a disease. Unpublished PhD thesis University of Cambridge."},{"key":"e_1_2_1_15_1","unstructured":"Denman Thomas (1810) Observations on the Rupture of the Uterus on the Snuffles in Infants and on Mania Lactea ( London: Johnson )."},{"key":"e_1_2_1_16_1","unstructured":"Digby Anne (1989) Women's biological straitjacket. In S. Mendus and J. Rendall (eds) Sexuality and Subordination: Interdisciplinary Studies of Gender in the Nineteenth Century ( London: Routledge )."},{"key":"e_1_2_1_17_1","doi-asserted-by":"crossref","unstructured":"Esquirol J. E. D. (1845) Mental Maladies: A Treatise on Insanity translated by E. K. Hunt ( Philadelphia: Lea and Blanchard ).","DOI":"10.1097\/00000441-184507000-00020"},{"key":"e_1_2_1_18_1","first-page":"20","volume":"6","year":"1820","unstructured":"Gooch, Robert (1820) Observations on puerperal insanity. Medical Transactions (Royal College of Physicians), 6, 20-22 .","journal-title":"Royal College of Physicians"},{"key":"e_1_2_1_19_1","unstructured":"Gooch Robert (1829) On Some of the Most Important Diseases Peculiar to Women ( London: The New Sydenham Society )."},{"key":"e_1_2_1_20_1","unstructured":"Gooch Robert (1831) A Practical Compendium of Midwifery; Being the Course of Lectures on Midwifery and on the Diseases of Women and Infants Delivered at St. Bartholomew's Hospital by the Late Robert Gooch M.D. ( London: George Skinner )."},{"key":"e_1_2_1_21_1","unstructured":"Haslam John (1798) Observations on Insanity: With Practical Remarks on the Disease and An Account of the Morbid Appearances on Dissection ( London: Rivington )."},{"key":"e_1_2_1_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107688808100207"},{"key":"e_1_2_1_23_1","unstructured":"Marland Hilary (1999a) Destined to a perfect recovery: the confinement of puerperal insanity in the nineteenth century. In Joseph Melling and Bill Forsythe (eds) Insanity Institutions and Society 1800-1914 ( London: Routledge ) 137-156."},{"key":"e_1_2_1_24_1","unstructured":"Marland Hilary (1999b) At home with puerperal mania: the domestic treatment of the insanity of childbirth in the nineteenth century. In Peter Bartlett and David Wright (eds.) Outside the Walls of the Asylum: The History of Care in the Community 1750-2000 ( London: Athlone Press ) 45-65."},{"key":"e_1_2_1_25_1","doi-asserted-by":"crossref","unstructured":"Marland Hilary (2002) Getting away with murder?: puerperal insanity infanticide and the defence plea. In Mark Jackson (ed.) Infanticide: Historical Perspectives on Child Murder and Concealment 1550-2000 ( Aldershot: Ashgate ) 168-192.","DOI":"10.4324\/9781315252308-9"},{"key":"e_1_2_1_26_1","unstructured":"Mercier C. (1902) A Textbook of Insanity"},{"key":"e_1_2_1_26_2","unstructured":"as cited in Digby Anne (1989) Women's biological straitjacket. In S. Mendus and J. Rendall (eds) Sexuality and Subordination: Interdisciplinary Studies of Gender in the Nineteenth Century ( London: Routledge ) 206."},{"key":"e_1_2_1_27_1","unstructured":"Nakamura Lisa Ellen (1999) Puerperal insanity: women psychiatry and the asylum in Victorian England 1820-1895. Unpublished PhD thesis University of Washington Seattle."},{"key":"e_1_2_1_28_1","unstructured":"Playfair W. S. (1876) A Treatise on the Science and Practice of Midwifery ( London: Smith Elder )."},{"key":"e_1_2_1_29_1","unstructured":"Ramsbotham Francis H. (1851) Principles and Practice of Obstetric Medicine and Surgery in Reference to the Process of Parturition 3rd edn ( London: Lea and Blanchard )"},{"key":"e_1_2_1_30_1","first-page":"128","volume":"1","year":"1858","unstructured":"Reid, James (1858) On the causes, symptoms, and treatment of puerperal insanity . Journal of Psychological Medicine, 1, 128-151, 284-294 .","journal-title":"Journal of Psychological Medicine"},{"key":"e_1_2_1_31_1","unstructured":"Royal Edinburgh Asylum [REA] Case Books (Edinburgh University Library: Lothian Health Services Archive Royal Edinburgh Hospital LHB7\/51):"},{"key":"e_1_2_1_31_2","unstructured":"REA (1851-55) Case book vol. 9 1851-1855: Jane Gardener (LHB7\/51\/9)."},{"key":"e_1_2_1_31_3","doi-asserted-by":"crossref","unstructured":"REA (1855-58) Case book vol. 11 1855-58: Janet Smith (LHB7\/51\/11).","DOI":"10.1038\/scientificamerican10271855-51e"},{"key":"e_1_2_1_31_4","unstructured":"REA (1862-65a) Case book vol. 15 1862-65: Helen McCorkle (LHB7\/51\/15)."},{"key":"e_1_2_1_31_5","unstructured":"REA (1862-65b) Case book vol. 15 1862-65: Margaret Bell ."},{"key":"e_1_2_1_31_6","unstructured":"REA (1862-65c) Case book vol. 15 1862-65: Helen McDonald ."},{"key":"e_1_2_1_31_7","unstructured":"REA (1862-65d) Case book vol. 15 1862-65: Essie McKay ."},{"key":"e_1_2_1_31_8","unstructured":"REA (1862-65e) Case book vol. 15 1862-65: Agnes Jenkinson or Scott ."},{"key":"e_1_2_1_31_9","unstructured":"REA (1862-65f) Case book vol. 15 1862-65: letter of J. Rutherford Turnbull (copied into the Case book)."},{"key":"e_1_2_1_32_1","unstructured":"Royal Edinburgh Asylum and Carlisle Asylum (1873-86) A case of child murder. Royal Edinburgh Asylum and Carlisle Asylum Papers 1873-1886 VIII (Stirling District Lunacy Notes LHB7\/14\/3)."},{"key":"e_1_2_1_33_1","unstructured":"Royal Edinburgh Hospital (1848) Annual Report of the Royal Edinburgh Asylum for the Insane (Edinburgh University Library: Archives of the Lothian Health Board LHB7\/7\/6A)."},{"key":"e_1_2_1_34_1","unstructured":"Saunders Janet F. (1983) Institutionalised offenders: a study of the Victorian institution and its inmates with special reference to late nineteenth century Warwickshire. Unpublished PhD thesis University of Warwick."},{"key":"e_1_2_1_35_1","unstructured":"Showalter Elaine (1985) The Female Malady: Women Madness and English Culture 1830-1980 ( New York: Pantheon Books )."},{"key":"e_1_2_1_36_1","unstructured":"Suzuki Akihito (1999) Framing psychiatric subjectivity: doctor patient and record-keeping at Bethlem in the nineteenth century. In Joseph Melling and Bill Forsythe (eds) Insanity Institutions and Society ( London: Routledge ) 115-136."},{"key":"e_1_2_1_37_1","first-page":"69","volume":"26","year":"1990","unstructured":"Theriot, Nancy (1990) Diagnosing unnatural motherhood: nineteenth-century physicians and `puerperal insanity' . American Studies, 26, 69-88 .","journal-title":"American Studies"},{"key":"e_1_2_1_38_1","first-page":"1013","volume":"10","year":"1864","unstructured":"Tuke, John B. (1864-5) On the statistics of puerperal insanity as observed in the Royal Edinburgh Asylum, Morningside . Edinburgh Medical Journal, 10, 1013-1028 .","journal-title":"Edinburgh Medical Journal"},{"key":"e_1_2_1_39_1","first-page":"1083","volume":"12","year":"1866","unstructured":"Tuke, John B. (1866-67) Cases illustrative of the insanity of pregnancy, puerperal mania, and insanity of lactation . Edinburgh Medical Journal, 12, 1083-1101 .","journal-title":"Edinburgh Medical Journal"},{"key":"e_1_2_1_40_1","unstructured":"Ussher Jane (1991) Women's Madness: Misogyny or Mental Illness? ( Amherst MA: University of Massachusetts Press )."},{"key":"e_1_2_1_41_1","unstructured":"Warwick County Lunatic Asylum (1856-61a) Case book 1856-1861: Ann Stanbridge (Warwick: Warwick County Record Office CR1664\/619)."},{"key":"e_1_2_1_42_1","unstructured":"Warwick CountyLunatic Asylum (1856-61b) Case book 1856-61: Mary Ann Ball. (Warwick: Warwick County Record Office CR1664\/619)."},{"key":"e_1_2_1_43_1","first-page":"262","volume":"13","year":"1867","unstructured":"Young, James (1867-68) Case of puerperal mania . Edinburgh Medical Journal, 13, 262-266 .","journal-title":"Edinburgh Medical Journal"}],"container-title":["History of Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0957154X030143003","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0957154X030143003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:42:29Z","timestamp":1777452149000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0957154X030143003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,9]]},"references-count":52,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2003,9]]}},"alternative-id":["10.1177\/0957154X030143003"],"URL":"https:\/\/doi.org\/10.1177\/0957154x030143003","relation":{},"ISSN":["0957-154X","1740-2360"],"issn-type":[{"value":"0957-154X","type":"print"},{"value":"1740-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,9]]}}}