Sex, Religion, and the Making of Modern Madness: The Eberbach Asylum and German Society, 1815-1849 (review)

Sex, Religion, and the Making of Modern Madness: The Eberbach Asylum and German Society, 1815-1849. By Ann Goldberg. New York: Oxford University Press, 1999. Pp. vi + 236. $35.00 (cloth).

In 1846, Catharina K. was admitted to the Eberbach asylum in Nassau in western Germany. This poor, peasant woman, who was forty years old and single, claimed that she was pregnant, pleaded to be allowed to give birth, and accosted various men in the village, insisting they were the father of her child. Local officials recorded her behavior as "shameless" and disturbing to the peace, while medical diagnosis recognized that her "mental confusion is great and appears clearly as nymphomania." According to author Ann Goldberg, Catharina's situation and experience typified that "of dozens of female patients at Eberbach: single, poor, unable to marry and hence become independent adult members of society" (pp. 134-35). Goldberg uses this case to demonstrate that the "making of a nymphomaniac . . . involved a complex interplay between village interests, norms and conflicts, on the one hand, and their redefinitions as illness by medical officers, on the other" (p. 124).

Other scholars of the history of sexuality have argued for the importance of understanding the ties and conflicts between individuals, communities, and institutional structures in regulating behaviors, creating identities, and developing sexual pathologies. But Goldberg's contribution is noteworthy for several reasons. First, she is examining a region and a time period for which there is little existing scholarship. Second, her sources are extraordinarily rich but also challenging. She examined, in addition to the usual governmental, institutional, and scientific records of the time, more than 450 case files of the 758 patients who resided at Eberbach between 1815 and 1849. These case files contain the voices and reflect the interests of patients, families, communities, the growing centralized authority of the state, and the increasingly rational world of intellectuals and professionals. The resulting complex dynamics that Goldberg describes provide fascinating reading.

Goldberg rejects an approach that is exclusively either essentialist or social constructionist and hopes to rethink "poststructuralism through attempts to incorporate the experience and agency of historical actors" (p. 8). She begins her work with the history of the region and of the founding of the asylum as part of a more general reform movement aimed at the definition and treatment of lunacy. This is followed by a consideration of broader social and political changes of the time. In particular, Goldberg discusses the conflicting reactions to "religious madness" by local communities, church officials, and the emerging scientific psychiatric profession, as the line between sin and illness became blurred.

Chapter 4 examines medical representations of sexual pathology at the time. Goldberg frames her analysis in terms of "pathologies of opposites" that developed in a world of increasingly separate spheres for men and women (p. 95). For example, when professionals encountered loss of personal control or excesses, they identified these problems in the case of women as nymphomania, but in the case of men as alcoholism, not sexual excess. Similarly, they regarded masturbation for women as lustful and sexually aggressive; for men, it signified enfeeblement and passivity. The cures reflected the diagnoses: women needed to be cooled down, men strengthened and invigorated.

The next three chapters situate medical representations in the broader society and examine their impact on the lives of lower-class men and women. The contrasting narratives and miscommunications between patient and doctor, and between village and physicians, are effectively revealed in Goldberg's analysis of how the diagnosis of "man-craziness" by family and community was transformed into a medicalized version of nymphomania. The male counterpart of this process ended in the diagnosis of masturbatory insanity. Here Goldberg is also careful to describe class differences in both responses to and treatment of this brand of insanity. In my...