
I stumbled across this gem courtesy of Kate et al. of Colour of Madness. It lists reasons people were admitted to the Trans-Allegheny Lunatic Asylum in Weston, West Virginia in its first 25 years of existence, from 1864 to 1889. The building is still around, but now it’s a museum/ghost tour operation.
Trans-Allegheny “diagnoses”
There was certainly no DSM around at the time, and diagnosis was a bit of a free-for-all. While the whole list is pretty special, these would be my top 10 picks (I apologize to my visually impaired readers; the list is too long to write out the whole thing):
- jealousy and religion (why are those two combined?)
- masturbation for 30 years (um, so the average 40-something?)
- deranged masturbation (I would what would qualify…)
- novel reading (I would’ve thought 1864 would be too late for this particular version of crazy to be a thing)
- parents were cousins (I suppose that was an issue in West Virginia)
- fever and loss of law suit (another connection I fail to see)
- exposure and quackery (this one fascinates me – what was the exposure and who were the quacks?)
- time of life (um, which time?)
- seduction and disappointment
- sexual derangement
Lady problems
And there needs to be another top picks list for troubles of the female variety that landed people in the loony bin:
- ill treatment by husband
- imaginary female trouble (I suspect that back in the day a woman could have been bleeding profusely after giving birth and they would still call that imaginary female trouble)
- menstrual deranged
- fits and desertion of husband ˆ(Who was having the fits? The husband or the wife?)
- uterine derangement (I’m curious what this would look like, and what the differences would be from menstrual deranged)
- women trouble (hmmm…..)
- rumor of husband murder (Was the husband the murdered or the murderer? If he was engaged in “excessive sexual abuse”, I bet she shot his ass)
- female disease (Is it contagious?/ If so, how do we spread it around to infect the menfolk?)
What killed you in 1632?

There was also this gem that was making the rounds on Twitter with some causes of death from 1632 (where, I’m not sure). My top 10 are:
- affrighted (I suppose that’s where the phrase scared to death came from)
- cancer, and wolf (I’m missing the connection here)
- Cut of the Stone (is this a particular stone, or are stones in general going around killing 5 people?)
- dead in the street, and starved (6 actually seems like a rather low number for that particular time in the world)
- kil’d by several accidents (was this multiple accidents happening to each person?)
- King’s Evil (huh? Are we talking Henry VIII?)
- planet (???)
- Rising of the Lights (???)
- suddenly (how is this a cause of death? Descriptor, yes, but cause, no.)
- teeth (what??? And why is it the 5th leading cause of death?)
Are there any of these reasons for lunatic asylum admission or causes of death that you find particularly interesting/appealing?
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Planet? In the last list. I guess they were from another planet LOL
Must have been!
Thanks for posting this. The first post in particular is an interesting reminder that while 1889 is not all that long ago, it was in another world in terms of medical and psychiatric knowledge. It’s interesting that physical and psychological effects are listed together (e.g. “Gunshot wound” and “Grief”). Likewise with symptoms, underlying causes (“Periodical fits” and “Desertion by husband”). I wonder who was making this list – a doctor, or just some kind of administrator/door-keeper. And did they use any training to diagnose or did they just ask whoever brought the patient in what the problem was and just wrote what they said?
You’re right that proposed links between novel reading and insanity would be something I would expect a century before this, not in the nineteenth century. Interesting.
“Brain fever” is a classic thing you see a lot if you read Victorian novels. It happens a lot in Sherlock Holmes stories, usually as a way of incapacitating a witness so that Holmes has to investigate properly.
Parents being cousins is something that varies really widely. In some cultures it’s absolutely the norm, even positive; in others it’s incest; and in yet others, it’s slightly weird but not really an issue.
I wonder if “Imaginary female trouble” is a phantom pregnancy?
I would assume that “Killed by several accidents” is different people killed by different accidents, where “several” is an archaic way of saying “different.”
King’s Evil is the old name for scrofula, because it was thought the monarch’s touch could magically heal it.
I suspect “Suddenly” means “S/he dropped down dead suddenly and we basically don’t know why.”
This is so funny. I can barely believe they were so far behind back then. Makes me wonder though how people will look at current mental health some 150 years from now.
Yes it really hasn’t been all that long, but I’m glad there’s been so much progress!
Well there’s been progress if you look at this, but I saw a documentary on how psychiatric care works here in the Netherlands currently and it’s shocking. One of the presenters’ colleagues went in to see a shrink at a major mental health agency and ended up with like five diagnoses even though she can f unction pretty well. I mean, the way it works here, your GP has to give you a provisional diagnosis upon referral to mental health, and then when y ou see the provider at the mental health agency, they’ll have to give you a definitive diagnosis within the first appt. Some diagnoses also arent’ covered by insurance (such as adjustment disorder, sleep disorders, etc.). This all changed within the last 10-15 years, since when I was hospitalized in 2007, I was not only just diagnosed with adjustment disorder but thankfully sitll qualified for care because of it. Anyway, sorry for going off on a tangent.
You’re right, there’s still a very long way to go.
“Bad Company” in the asylum list is vague enough that I’m not sure if it means they were criminal or simply boring.
How on earth did sciatica kill someone??
My guess when it comes to “teeth” is that horrific dental care resulted in abscesses and deadly infections. And then they just lumped them all under “teeth” because why not.
Good point. I’m sure everyone’s teeth were rotting, so it made for an easy default answer.
I love stuff like this lol. History is so weird and fascinating.
Yeah it’s bizarre.
OMG, I’m going to read this more later but the first one I glanced at was:
Marriage of son,
Holy f**k! And do they want to understate it anymore!?
I know, right?!
“Guess what I did ‘t weekend!?”
“Dunno”,
“Married my Mum!”,
“That’s nice. You should get down the doctors.”
Sounds like a very logical next step…
xD
Wow, that’s so fascinating and funny! Strange that novel reading was still deemed crazy in 1864 indeed. I wonder who was classified as “menstrual deranged” and who not, was PMS enough or would someone have the symptoms of similar intensity as premenstrual dysphoric disorder, or maybe one argument with one’s husband while aunt Ruby was visiting would be enough? In any case it looks like it was so much easier for a woman to go crazy. 😀 Wasn’t uterine derangement the same as hysteria for them?
Female disease sounds intriguing. 😀
Cancer and wolf? :O I guess people were thinking somewhat differently back then, because I don’t see much of a connection either.
Affrighted… what a picturesque, archaic word!
I think affrighted needs to be brought back into popular use.
And probably at that point they would hysteria and uterine derangement would have been the same thing.
Oh yeah, such descriptive words should be used more often!
Brilliant! Selfishly I’m relieved I wasn’t around then. I’d be arrested, dead or crazy by 21!! 🤪
I don’t know how anyone lived past that age back then.
So 1797 people died of consumption? I knew that they were killing us with all the sales and Black Friday!
They mean chocked or poisoned no?
8 went due to the plague? That seems like a low number, I don’t know what plague they are talking about though.
Consumption was used back in the day to refer to tuberculosis – a little less fun than Black Friday! And why knows, maybe the rats took a vacation that year from the plague-spreading.
Oh tbc that is no fun at all. In the Netherlands it was back two (maybe more) years ago. A form of tbc that was resistant to medication. Brrr.
Not good.
“Excitement as Officer” could be PTSD. “Gathering in the Head” is definitely one of our symptoms. Could “Rising of the Lights@ be auta from migraine or seizure? “Piles” sounds like a dreadful way to go, whatever it be. _Ye Olde Death by Piles_, a dirge in three volumes by Zeberiah Stonecastle.
Maybe “novel” meant “new” and “reading” was Tarot or some forecast of your (obviously discouraging enough to result in death) future
I think back then the future looked pretty bleak regardless…
Easiest job in town: fortune teller? 🔮
I think so! And you get to be all fancy with your crystal ball!
Now there’s a bestseller!
A better question is what didn’t put me in jail? Lol. I’ve never consumed tobacco. And what is deranged masterbation? Also, why do they get you when you “self indulge” but then also get you when you suppress it? Haha
Not jail. I meant institution
Yup
Maybe masturbating in public is deranged?
Hmmmm…… possibly
Wow!!! This is wild! It’s interesting how sexist this list is despite 1864 not being *that* long ago – being left by your husband, leaving your husband, and “imaginary female trouble” are all striking examples.
It’s so bizarre. Probably “imaginary female trouble” could have been slapped on just about anything, but the only ones doing any imagining were the people doing the labelling.
They used the word “quackery”. LOL
I know, right?! Gotta love it!
Overlaid? Did they have too much sex?
Maybe!
I feel mean because some of them did make me chuckle 😂💚
How could you not, really?
🤷🏻♀️ I’m still trying to work out the connection between cancer and wolf
Yeah it’s a stretch…