What shocks one generation can seem so tame  to another, or in those shifting ironies of time what seemed natural is now the shocker. Over the last 100 years in the United States that shifting shock has most often come with the changes in race  and gender relations. But the shifts have also come in the way mental health is approached and some 120 years since its publication Ten Days in a Madhouse is a reflection of those changes and while some part of the writing may seem dated or at best a piece of history much like Jacob Riis’ How the Other Half Lives, Ten Days is not that distant from our time and its subject and the manner of its writing are worth a look.

Briefly, Ten Days in a Madhouse is Nellie Bly’s (Elizabeth Jane Cochrane Seaman) account of her ten days in a madhouse in New York in 1887. Bly, in an act of stunt journalism that wold make her famous, pretended to be mildly insane so she would be sent to an asylum to see first hand what one was like. To begin the process she goes to a rooming house and one night she stays up all night staring at the wall. The stare fest alerts her roommate and scares the homeowner and the next day she fixates on her lost trunk and insists on finding it. At the same time she continually talks about too many foreigners and never having worked, which both seem strange to the working class people she is rooming with. These three things are sufficient for her to land before a judge and eventually in the madhouse where she endures the arbitrary and vindictive rule of the nurses who are little better than street toughs. At the end of ten days a lawyer from her paper the World secures her release.

What strikes a modern reader are two things. The first is the obvious arbitrariness of the commitment and cruelty of the nurses. For the women who are trapped in the asylum there seems to be no way to escape. They have no way to demonstrate their sanity and some are quite sane, only having suffered what might now be diagnosed as a bout of depression after a traumatic experience or a nervous breakdown. To say one was sane was to say one was insane. Many of the women Bly encounters should not be in the asylum by modern standards and it easy to see the asylum as yet another version of Kafka’s Trial or Kesey’s One Flew Over the Cuckoo’s Nest. But one should not let the smugness of a century’s worth of experience suggest that what she was writing about is no longer a problem. Instead, the arbitrariness and, more importantly, what constitutes madness is at the same time silly yet as strange as what could be called mad now. Saying one would not work or that there are many foreigners are quite observational, yet said amongst the working class of New York it seemed a form of obstinance. And in the obstinance you really see the shifting notions of what is strange.

The second area of discord is what Bly takes as normal. She continually winks at the reader, which is mostly stylistic, but then throws in comments that say she is worried about her hair. In a piece of serious journalism it seems a little strange. Yet her preoccupations tell as much about what is normal as is strange. And the reversal comes in how she characterizes women. In the world these events take place women are delicate and there is a continual paternalism.

Given these discords the book can seem at once a Guild Age curiosity and an annoying reflection of time thankfully past. What makes the book valuable is not so much what Bly was reporting, but what she thought of it. There is an earnestness that is not jaded, even though she is doing a stunt, and her solutions for fixing the asylums are hopeful if vague. In her conclusions you sense a belief that these problems are easily fixable if they are just addressed. Though her language is a bit more cluttered, she writes clearly and it serves well to show those shifts in attitude of the last 120 years. In those shifts, too, you can see how arbitrary the care of the mentally ill can be. In reading the book, one should not come away smug, but reminded.