The Creation of ‘Disordered Emotion’: Melancholia as Biomedical Disease, c. 1840-1900

Abstract

This thesis traces the re-conceptualisation of melancholia as a biomedical mental disease in Victorian medicine, with an emphasis on the uptake of physiology into British psychological medicine. Language appropriated from experimental physiology allowed physicians to speak about ‘disordered emotion’ as a physiological process occurring when the brain was subjected to repeated ‘irritation’. When it came to diagnosing asylum patients, however, internal biological explanations of disease were of little use. Instead the focus was on externally observable ‘symptoms’, chiefly ‘depression’, ‘mental pain’, and ‘suicidal tendencies’. The late-nineteenth-century symptomatology of melancholia was in part constituted through statistical practices put in place by the Lunacy Commission, and which emphasised certain symptoms and nosological categories in the diagnosing of asylum patients. At the same time, the symptoms that emerged as defining criteria of melancholia were theorised within a biological explanatory framework. Thus, diagnostic descriptions of melancholia travelled back and forth between the casebook and the textbook, producing a disease concept that on the surface displayed remarkable coherence yet simultaneously spoke volumes about the negotiations that take place when medicine seeks to neatly label and classify the complexities of human life. In sum, this thesis shows how melancholia was constituted as a modern diagnostic category in nineteenth-century British medicine. In doing so, it also tells the story of how ‘disordered emotion’ was made into a possible and plausible medical concept.