Ten Days In A Mad-House

“Commitment” refers to the process of admitting someone to an asylum, often against their will. During Bly’s time, this process was particularly subjective, with criteria that could be easily manipulated or misunderstood, especially in cases involving women. Bly’s investigation exposes how commitment was frequently abused, stripping individuals of their freedom and placing them at the mercy of a flawed and oppressive system.

Examinations in the mental health systems were meant to assess a person’s mental stability, but, as Bly’s experience demonstrates, they were often superficial, flawed, and arbitrary. Bly’s exams involved various tests, including having her tongue and eyes inspected, holding out her arms, and answering leading questions about hallucinations. Despite Bly’s rational responses, the doctors’ assessments were perfunctory, often ignoring her statements and physical cues in favor of their predetermined conclusions about her mental state. Bly’s critique of these exams highlights how the medical field’s limited understanding and biases, particularly against women, led to unjust confinement and reinforced systemic neglect.

The term “insane” historically encompassed a wide range of mental and behavioral conditions that were poorly understood. It was often used to label and marginalize those who defied societal norms or displayed behavior deemed inappropriate. Bly’s narrative illustrates how women, in particular, were susceptible to being declared “insane” for reasons unrelated to actual mental illness, underscoring society’s deep-seated gender biases.

The insane pavilion was a specific ward at Bellevue that was used to hold patients awaiting transfer to asylums. Understanding this term helps contextualize the asylum system’s layered structure, where different institutions and wards managed patients with limited, often minimal, oversight and where labels such as “insane pavilion” signaled confinement and stigmatization.

Investigative journalism is a style of reporting that involves deep, thorough research to expose hidden truths and injustices. In the late 19th century, journalists like Nellie Bly pioneered this method, using undercover work to bring attention to societal issues. Ten Days in a Mad-House exemplifies the power of investigative journalism to reveal corruption and effect social change, as Bly’s exposé led to widespread public awareness and institutional reform.

Laudanum is a powerful opiate tincture used widely in the 19th century as a painkiller and sedative. In Ten Days in a Mad-House, laudanum represents the dangerous and often reckless medical practices inflicted upon asylum patients. Administered to Bly without proper regard for her health, the laudanum dosage exemplifies the disregard for patient autonomy and safety. Given its addictive and potentially lethal effects, laudanum symbolizes the systemic negligence within asylums and the casual, sometimes coercive use of powerful drugs to subdue patients rather than treat them.

The phrase “on the rope” describes a disturbing practice in which patients, perceived as “unmanageable,” were tethered together by a single cable rope fastened to leather belts around their waists and to an iron cart at the back of the line. Led by attendants, these restrained patients had to march along designated paths, regardless of their physical or mental condition. The practice, observed by Bly, highlights the inhumane and undignified methods of patient control in the asylum, illustrating the extreme lack of autonomy and compassion afforded to those who were institutionalized.