Patient Barrett, age unknown, born in Ireland. “Thyroid gland much enlarged on right side.” Suffers from anaemia. Has a large tumour in her breast and died in Rockwood Asylum of breast cancer (RG10-20-F-1 VOL 1. Rockwood Female Casebooks 1857-1885, p. 30).
Patient Bergen, 34 years old at the time she was sent to Rockwood Asylum, born in Ireland. “Thyroid gland somewhat enlarged throughout” (RG10-20-F-1 VOL 1. Rockwood Female Casebooks 1857-1885, p. 42).
Patient Tierney, 40 years old when she arrives at Rockwood in 1869, born in Ireland. “She is tormented with witches [and] spirits constantly now… Thyroid gland much enlarged especially on right side” (RG10-20-F-1 VOL 1. Rockwood Female Casebooks 1857-1885, p. 28).
There are many different intersections between women’s health, mental health, and physical health on which one can focus in seeking to gender the history of colonial Canadian asylums, or even to better understand the links between these more generally to this day. While thyroid disease can impact anyone, it disproportionately effects women; the Cleveland Clinic suggests that “a woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man” (Cleveland Clinic, 2020).
“Symptoms of an overactive thyroid (hyperthyroidism) can include:
Experiencing anxiety, irritability and nervousness.
Having trouble sleeping.
Having an enlarged thyroid gland or a goiter.
Having muscle weakness and tremors.
Experiencing irregular menstrual periods or having your menstrual cycle stop.
Feeling sensitive to heat.
Having vision problems or eye irritation.”
(Cleveland Clinic, 2020).
I thought of this, and the many women I know who have thyroid disease, as I kept seeing passing references to this health concern with no mention of a corresponding course of treatment in patient files at the Rockwood Asylum. To me, the overlap between some of the symptoms of “madness” in the asylums and untreated thyroid disease is striking: enlarged thyroid or goiter, anxiety, irritability, vision problems…
Per Ahmed and Ahmed’s “History of disorders of thyroid dysfunction” (2005), “The first description of thyroid diseases as they are known today was that of Graves disease by Caleb Parry in 1786, but the pathogenesis of thyroid disease was not discovered until 1882-86. Thyroidectomy for hyperthyroidism was first performed in 1880, and antithyroid drugs and radioiodine therapy were developed in the early 1940s. Thomas Curling first described hypothyroidism (myxoedema) in 1850 and the cause and suitable treatment were established after 1883.”
The records cited at the beginning of this post place us somewhere on the timeline of a medical awareness of thyroid disease but before causes and treatment were established. It is a difficult experience for a historian to read records from the vantage point of possessing more information about the topic addressed in the primary source material than those who wrote the document in question, or those whom it is about. I am by no means suggesting that I am better positioned to talk about thyroid disease than a trained healthcare professional, nor do I want to attribute causation between patient’s enlarged thyroids and their being “tormented by witches [and] spirits.” Yet, the consistent references to enlarged thyroids in patient records would suggest an acknowledgement that the symptom of hormonal imbalance is noteworthy, even if, tragically, misunderstood in the context of mental health.
There is so much more to uncover about how women’s health issues are connected to mental health. We are still playing catch-up in centering women’s health and mental health in our understanding of overall health, whether it be personal or public, making connections between systems previously considered disparate; ongoing interdisciplinary interventions from a range of stakeholders such as health care practitioners, policy-makers, activists, and, yes, historians, are required to bring women’s health and mental health concerns to the very fore of public health discourse.