Gynaecological treatment of melancholia

Domain XVI · Historical, discredited & harmful · Isaac Baker Brown, Robert Battey · 1866 · London

What it is

This guide covers a historical belief, not a therapy anyone should give. Many Victorian doctors held that a woman's reproductive organs were tied to her emotional life and were the most likely cause of her mental illness. From this it followed that treating or removing a womb, ovaries or other…

Format

• Format: individual work, sometimes with family members. Set the number of sessions by clinical need. Phases overlap and you can return to earlier ones.
• The term "Mayer's pessary" is unclear. The Science Museum Group holds india-rubber supportive ring pessaries made by the London instrument makers Mayer and Meltzer, dated 1870–1930. The catalogue entries say nothing about mental illness. Whether a physician named Mayer published an 1870 claim that…

Who practises it, and how they are trained or regulated

• Repair, advocacy and follow-up. Support the client to self-advocate in healthcare, to commemorate, and to use complaint routes. Fulfil your own duties when you encounter colleagues or institutions repeating the error.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Silent withdrawal. It's working when the client re-engages and trust deepens.
• Your own assumptions. It's working when the client feels the full context is acknowledged.
• Presentism and complacency. It's working when the team identifies concrete practice changes.
• The client hearing "it's all in your head". It's working when the client holds a multi-factor view.
• Feeding mistrust of all medicine. It's working when the client feels heard and still engages with care.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.