On January 4th 1870, Dr. R. Sephton left his house in Culcheth, travelling about a mile to the house of the Sudworths to treat their daughter, Ellen. Dr Sephton attended to his young patient, finding she had developed a fever. He diagnosed Ellen with febricula and debility and saw her a few more times over the next couple of months while he administered treatment. By March, Ellen had fully recovered, to the relief of her family. However, this relief was short-lived since they noticed that Ellen had developed a severe case of melancholia, which showed no signs of dissipating. A year later, in June 1871, the family called Dr Sephton to once again attend to their daughter who was suffering with headaches; six weeks later she had completely lost her voice. Ellen spent the next five years in a state of catatonia, sleeping frequently and keeping nourished only with soups and milk-puddings. Late in the year of 1875, Ellen developed additional symptoms: she could not open her eyes and blood poured from her eyelids and mouth. Six weeks later, Ellen suddenly sat up and began to speak, for the first time in nearly five years.
The report on this case is told by Dr Sephton in the 11 March issue of the British Medical Journal, titled ‘The Fasting Girl in Lancashire.’ Following the retelling of the above story, Sephton offers his diagnosis, which has remained unchanged through the past five years. Ellen Sudworth, claims Dr Sephton, has had a clear-cut case of hysteria.
Hysteria was a disease associated with women and characterized by a myriad of symptoms including (but not limited to): emotional outbursts, suggestibility, conversion symptoms, and fainting. The treatment given for this condition was dependent on the attending practitioner, since a number of contrasting views regarding hysteria were circulating.
Some believed hysteria to be physiological, caused by uterine or ovarian ailments. Treatment, in these cases concentrated on physical remedies and surgery to relieve the patient.
Alternatively, there were those who classified hysteria as a mental disorder, brought on by a melancholic discontentment with life. In these cases, women were often treated with changes to their routine, including prescriptions of charitable work to busy themselves, or a seaside holiday for a change in scenery.
A third category of hysteria was called ‘simulative hysteria.’ This was diagnosed in women who manifested symptoms of hysteria, but had neither physiological condition, nor any “deficiency in mental power”. These women were malingerers, who sought to hoard the attention of their families while simultaneously avoiding their domestic duties. Unlike patients of the other two categories of hysteria, their symptoms were shrouded in deception. Their treatment included a prescription of moral treatment: a regiment of learning self-discipline through therapeutic restraint. This was the prescription offered by Dr Sephton, who clearly believed that Ellen was using deception to simulate hysterical symptoms. This diagnosis is affirmed by the BMJ which concludes that Dr Sephton was correct in his diagnosis, a typical one for ‘fasting girls.’
Why did Dr Sephton publish this report in the BMJ?
By this time of the publication of Dr Sephton’s report, this story had already become a nation-wide phenomenon. The story was first published by The Blackburn Standards and North East Lancashire Advertiser on Saturday, 19 February. Within two weeks, the same exact article had been published, verbatim, throughout Britain including newspapers in Newcastle, Lancaster, Bristol, Yorkshire, Sheffield, York, and Belfast. The Pall Mall Gazette published a related story on 23 February discussing the regularity with which fasting girls have appeared in the news. Rather than sensationalizing the story, the Gazette expressed skepticism towards Ellen’s plight.
It had been reported that she had not yet recovered her appetite, and the article suggested “it is hoped that no attempt will be made to test the genuineness of the phenomenon by keeping watch …over the afflicted damsel…It is but a little while ago that one of these fasting girls died of starvation owing to her being surrounded by a band of sentinels, and thus being compelled to fast in earnest.”
This is meant to reference the 1869 case of the ‘Welsh Fasting Girl’, another national story about a girl, Sarah Jacobs, who claimed she went without food or drink for a year. To test the veracity of her claim, Sarah was placed under guard by nurses, who ensured she wasn’t being supplied food by her family in secret (and thus, not genuinely unwell). The girl died in just over a week. As a result, the medical practitioners involved in her care were tried for manslaughter.
With this recent case surely on his mind, Dr R. Sephton submitted his report to the British Medical Journal. Although we cannot know, with current evidence, precisely what inspired Sephton to submit this case, we can speculate that he likely published this report to respond to the national press this story was receiving and defend his actions in the case to avoid any accusations of malpractice.
Althaus, J. (1866). A Lecture on the Pathology and Treatment of Hysteria. BMJ, 1(271), pp.245-248.
Anderson, J. (1875). On the Etiology of Hysteria. BMJ, 1(756), pp.838-839.
Archives.li.man.ac.uk. (n.d.). ELGAR: Electronic Gateway to Archives at Rylands. [online] Available at: http://archives.li.man.ac.uk.
Bartrip, P. (1990). Mirror of medicine. Oxford: Clarendon Press.
Coleman, A. (2015). Hysteria. In: Dictionary of Psychology, 4th ed. [online] Oxford: Oxford University Press. Available at: http://Oxford Reference Online [Accessed 23 Mar. 2016].
Digby, Anne. ‘Tuke, William (1732–1822)’, Oxford Dictionary of National Biography, Oxford University Press, 2004 [http://www.oxforddnb.com/view/article/27810, accessed 23 March 2016]
Shaw, B. (1911). The doctor’s dilemma. New York: Brentano’s. [online] Available at: http://www.gutenberg.org/files/5069/5069-h/5069-h.htm.
The Belfast News-Letter, (1876). The Fasting Girl in Lancashire.
The Blackburn Standard and North East Lancashire Advertiser, (1876). The Fasting Girl in Lancashire. [online] p.8.
The Fasting Girl in Lancashire. (1876). BMJ, 1(793), p.329.
The Huddersfield Daily Chronicles and West Yorkshire Advertiser, (1876). The Fasting Girl in Lancashire. p.3.
The Lancaster Gazette, (1876). The Fasting Girl in Lancashire. p.8. Available at: http://British Library Newspapers [Accessed 23 Mar. 2016].
The Morning Post, (1869). Welsh Fasting Girl. p.7.
The Newcastle Courant, Etc., (1876). Another Fasting Girl.
The Pall Mall Gazette, (1869). Fasting Girl in Carmartlienshire.
The Paul Mall Gazette, (1876). Fasting Girl in Lancashire.
The Reynolds Newspaper, (1869). Death of the Welsh Fasting Girl.
The Sheffield & Rotherham, (1876). The Fasting Girl in Lancashire. p.26.
The Standard, (1869). Death of the Welsh Fasting Girl. p.6.
The Welsh Fasting Girl. (1869). BMJ, 2(454), p.315.
The Welsh Fasting Girl. (1869). BMJ, 2(467), p.641.
The Welsh Fasting Girl. (1869). BMJ, 2(469), pp.680-681.
The Welsh Fasting Girl. (1870). BMJ, 1(480), p.271.
The York Herald, (1876). The Fasting Girl in Lancashire. p.7.
Tilt, E. (1871). On Hysteria and its Interpreters. BMJ, 2(572), pp.690-692.
Welshlegalhistory.org. (1870). The Welsh Fasting Girl – Report of the trial. [online] Available at: http://www.welshlegalhistory.org/research-jacob-trial-report.php [Accessed 23 Mar. 2016].