Gender. Hysteria. Architecture. | “How Did a Diagnosis Learn to Draw Walls?”

Following Hysteria as It Becomes Architecture

If Chapter I traced how women were spatially prepared for confinement before hysteria existed as a diagnosis, this chapter asks what happened once hysteria was named. Specifically: what happens when an idea about the body is translated into a floor plan? How does a diagnosis learn to draw walls?

The emergence of hysteria as a medical category in the nineteenth century did not simply generate new treatments; it generated new spaces. Medical texts, lectures, and case studies were absorbed into architectural typologies. Theory became a corridor. Observation became enclosure. Care became something that could be planned, measured, and enforced through space.

This chapter follows hysteria as it migrates from text to typology, inquiring how architectural decisions—visibility, separation, silence, enclosure—came to stand in for care itself. Rather than assuming architecture responded to illness, the inquiry turns the question around: did architecture help produce the vulnerability it claimed to manage?

From Diagnosis to Typology

By the nineteenth century, the scope of hysteria was broadened chiefly by Paul Briquet, who recast it as a “neurosis of the brain” affecting anyone with a susceptible constitution rather than a disorder confined to women’s reproductive organs. His extensive clinical work helped transform hysteria into a more expansive, gender‑neutral diagnosis, a trend later reinforced by Jean‑Martin Charcot’s studies at the Salpêtrière (F M Mai, H Merskey, 1981). It described not a single condition, but a wide spectrum of behaviours: grief, sexual desire, resistance to marriage, intellectual ambition, trauma, exhaustion, and silence. (Front Neurol Neurosci. 2014) What united these symptoms was not pathology, but deviation from expected femininity.

As hysteria gained legitimacy within emerging psychiatric discourse, it demanded spatial accommodation. The asylum became the primary site where hysteria could be observed, classified, and corrected. Yet these institutions were not neutral containers awaiting patients; they were already shaped by assumptions about visibility, order, and control.

The diagnosis did not merely occupy space—it structured it.

Medical and architectural authority reinforced one another in nineteenth‑century asylum design. Thomas Kirkbride’s “Kirkbride Plan” (Pérez Fernández, F., & López‑Muñoz, F. 2019) argued that a purpose‑built environment—segregated wings, ample ventilation and controlled circulation—was central to curing insanity, reflecting doctors’ belief that “environment—architecture in particular—was the most effective means of treatment” (Yanni, C.2003). Physicians described hysterical women as “impressionable, volatile, and emotionally excessive,” a discourse that fed directly into spatial strategies: quieter, more remote wards for “delicate” patients, deeper corridors that limited visual and auditory contact, and locked passages that regulated movement (Hide, L. 2013).

Michel Foucault’s notion of space as a technology of control is central to understanding how psychiatric diagnosis was translated into architectural form. In the asylum, spatial organisation did not merely house medical practice—it actively produced compliant subjects. Circulation, visibility, segregation, and routine were designed to discipline bodies and normalise behaviour, embedding medical authority into walls, corridors, and thresholds.

This logic is made explicit in George T. Hine’s 1901 paper presented to the Royal Institute of British Architects, where asylum design is framed as an instrument of social regulation. Hine’s work for the London County Council institutionalised gendered spatial hierarchies: women’s wards were more secluded, inward-facing, and domestic in character, reflecting assumptions of female vulnerability, moral instability, and the need for protection through isolation. Architecture thus reinforced medical and patriarchal narratives, spatially encoding gendered norms of behaviour and control.

The contemporaneous rise of moral treatment further fused medical ideology with architectural order. Therapeutic labour, regimented daily routines, and calm, orderly environments were prescribed as part of the cure. Spatial clarity, repetitive layouts, and controlled landscapes were not neutral settings but active tools intended to reform patients through discipline disguised as care.

Together, these theories show that the psychiatric label did not merely occupy space—it organised the very layout of institutions, embedding medical power in bricks, wings and locked doors.

Hysteria learned to draw walls.

The nineteenth-century asylum functioned as a spatial script for behaviour. Its architecture did not simply house patients; it instructed them. Institutional authorities used corridors to regulate movement, choreographing patients’ circulation in ways that maximised surveillance and minimised autonomy, wards organised bodies, and observation points ensured constant visibility. Every spatial decision encoded expectations about compliance, recovery, and discipline.

Asylums were often presented as humane alternatives to earlier forms of confinement (Hide, L. 2013). Yet their layouts reveal a different story. Long, uninterrupted corridors facilitated surveillance. Repetitive rooms enforced routine. Locked doors normalized restriction. Care within these institutions was defined less by interaction than by control.

Women’s presence within these institutions was distinctly gendered. While male patients were often associated with violence or disruption, female patients were framed as fragile, emotional, and morally unstable. Architecture, as a medium without agency of its own, was employed by medical and institutional authorities to respond to perceived female hysteria. Under the guise of protection, these actors intensified observation and surveillance; architectural form did not grant care, but operationalised control.

The asylum became a place where women were not only treated, but trained: trained to be quiet, still, and invisible.

Why Women’s Wards Were Deeper, Quieter, More Watched

One of the most consistent features of asylum design was the spatial differentiation of women’s wards. Female wings were frequently placed deeper within the institutional core, further from entrances and public-facing areas. This depth was not accidental. It reflected the belief that women required insulation—from stimulation, from influence, from themselves.

Silence was often prescribed as therapeutic. Women’s wards were designed to minimise noise, conversation, and external contact. But, this minimisation of contact also reduced opportunities for collective resistance and enforced introspection as compliance. Silence here was not calming; it was disciplinary.

Visibility, paradoxically, increased as autonomy decreased. Observation corridors, internal windows, and centralised nurse stations were used to monitor both female and male patients within asylum architecture. These features allowed attendants to maintain constant visual control over wards, circulation routes, and sleeping areas, reinforcing institutional discipline across genders.

However, the rationale and spatial expression of surveillance differed markedly.

Male patients were primarily monitored to control perceived violence, unpredictability, and physical threat, often housed in larger wards with reinforced materials and restrained movement zones. Surveillance here was justified as a matter of public safety and institutional order.

Female patients, by contrast, were subjected to more intimate and moralised forms of observation. Architectural elements such as internal windows between dormitories and corridors, supervised day rooms, and restricted access to outdoor spaces were designed to regulate sexuality, emotional expression, and bodily comportment. Surveillance was framed as protection—from moral corruption, hysteria, or social deviance—rather than overt containment.

As a result, while both men and women experienced constant watching, women’s spaces were often more enclosed, to be visually penetrable to the institutional gaze, and socially isolating, with diminished access to gardens, work yards, and external views. Architecture thus participated in reinforcing gendered assumptions: men as physically dangerous bodies to be controlled, and women as morally unstable bodies to be corrected.
Privacy was framed as dangerous; surveillance as care.

These spatial decisions reveal a profound contradiction. Women were treated as fragile, yet subjected to relentless monitoring. They were deemed vulnerable, yet denied agency. Architecture resolved this contradiction by substituting control for care.

Henri Lefebvre’s spatial triad—conceived, perceived, and lived space—offers a critical lens for understanding how asylum architecture disciplined women without overt violence. Conceived space comprised the plans, regulations, and design logics imposed by institutional authorities; in women’s wards, these encoded assumptions of emotional excess and moral instability, privileging order over comfort and visibility over privacy. Perceived space emerged through daily routines—rigid schedules, restricted movement, enforced silence, and constant supervision—through which architecture was used to structure behaviour and normalise compliance. Lived space captured the psychological consequences of this regime: for confined women, space produced shame, fear, and erasure, as the loss of bodily and spatial autonomy was internalised as personal failure. Through this triad, vulnerability appears not as an inherent condition but as a spatial outcome—one actively produced rather than merely contained.

Yi-Fu Tuan’s concept of landscapes of fear further clarifies how these environments shaped emotional experience. Fear, as Tuan argues, is learned spatially. In women’s wards, narrow corridors, locked thresholds, and repetitive layouts communicated restriction, authority, and disposability. Without relying on overt punishment, institutional power cultivated anxiety and compliance through spatial cues alone. Over time, fear became internalised; the architecture no longer needed to act, because the body had learned its limits.

Colonial India: Intensified Control as Experiment

Colonial India functioned as a laboratory where European asylum logics were intensified rather than adapted, often under harsher conditions of control. A key example is the Yerwada Mental Hospital (then Yerwada Lunatic Asylum), established in 1889 under British administration. Designed on custodial principles derived from British asylum models, Yerwada emphasised segregation, surveillance, and labour over care. Women patients were housed in more enclosed wards, spatially isolated from public-facing zones of the institution, reinforcing colonial and patriarchal assumptions of female irrationality and moral vulnerability.

Colonial India became a crucial testing ground for the intensified application of institutional architectural logics developed in Europe. Asylum typologies were exported almost wholesale, with little consideration for local climate, cultural practices, or existing community care structures. Rather than adapting to context, these buildings imposed a rigid spatial order in which control consistently outweighed care.

Colonial authorities understood the colonised population through a racialised framework that associated difference with irrationality and disorder. Within this system, colonial legislation such as the Indian Lunatic Asylums Act (1858) enabled the disproportionate institutionalisation of women—particularly widows, those deemed sexually transgressive, or those resisting prescribed social roles. Gendered surveillance merged with imperial discipline, producing asylum spaces where patriarchal control was intensified through colonial law and architecture.

In these colonial asylums, surveillance and segregation were intensified rather than moderated. Wards were strictly classified, movement was tightly regulated, and daily routines were enforced with near-military precision. These institutions functioned not only as sites of psychiatric treatment but as mechanisms of moral regulation and political governance, disciplining bodies that deviated from both colonial and patriarchal norms.

This logic was reinforced through architectural representation. Many asylums presented grand, symmetrical façades—classical proportions, landscaped approaches, and orderly elevations—that projected rationality, benevolence, and institutional competence. These exteriors reassured the public that humane care was being delivered. Yet beyond the threshold, the spatial reality was markedly different. Darkened wards, locked cells, restrictive corridors, and punitive routines directly contradicted the promise of the façade.

This dissonance was not incidental but strategic. Aesthetic order concealed structural violence, allowing coercion to persist behind an image of care. The contrast mirrors the broader cultural treatment of women—valued for appearance, constrained in practice. Architecture thus became complicit in a gendered deception, presenting civility while enforcing discipline.

Across scales—from corridor to colony—the architecture of hysteria reveals a consistent pattern. Space did not merely accommodate illness; it actively produced it. By restricting movement, enforcing visibility, and denying agency, architecture manufactured the vulnerability it claimed to manage. Within these environments, women learned to disappear—not always physically, but socially and psychologically. Silence became a mode of survival. Compliance came to be mistaken for care.

When Care Became Indistinguishable from Control

What emerges from this inquiry is not simply a history of asylum design, but a warning about architecture’s ethical vulnerability. When spatial practice aligns too closely with medical authority, moral judgment, or institutional convenience, it risks abandoning care altogether. Hysteria did not merely occupy asylum space—it was stabilised, rehearsed, and reproduced through it.

It operates through repetition, routine, and normalisation—through corridors that narrow options, through windows that watch without being seen, through silence that passes for calm. These mechanisms rarely announce themselves as violent. They present instead as rational, protective, even benevolent. Yet it is precisely this neutrality that makes them so effective.

For women labelled hysterical, architecture did not offer refuge from social judgment; it materialised that judgment. It translated fear of female autonomy into depth, enclosure, and watchfulness. In doing so, it transformed vulnerability from a lived condition into a designed outcome. What was framed as care trained women to disappear—socially, psychologically, spatially—until absence itself became evidence of recovery.

This history matters because the logics it reveals are not confined to the nineteenth century. Whenever architecture is asked to manage difference rather than engage it, whenever visibility is privileged over agency, and order over dignity, the same spatial patterns resurface—often under new names and contemporary aesthetics. The lesson of hysteria is not that architecture failed, but that it succeeded too well at serving power.

To ask whether these spaces healed women is therefore to ask the wrong question. A more urgent one remains: what kinds of bodies does architecture still assume need correction—and what forms of disappearance does it continue to call care?

References

• Yanni, C. (2003). The linear plan for insane asylums in the United States before 1866. Journal of the Society of Architectural Historians, 62(1), 24‑49.
• Hide, L. (2013). From asylum to mental hospital: Gender, space and the patient experience in London County Council Asylums, 1890‑1910. In J. Hamlett, L. Hoskins, & R. Preston (Eds.), Residential Institutions in Britain, 1725‑1970. Inmates and Environments (pp. xx‑xx). Routledge.
• Pérez Fernández, F., & López‑Muñoz, F. (2019). The Kirkbride buildings in contemporary culture (1850–2015): From ‘moral management’ to horror films. History of Psychiatry, 30(2).
• Hundt, E. (2005). A noble monument of wisdom and mercy: St. Elizabeth’s Hospital, 1852‑1899 (Doctoral dissertation). University of Virginia.
• Bristow, D. (n.d.). Kirkbride’s architectural stigma of mental illness. Priory.
• Yanni, C. (2007). The architecture of madness: Insane asylums in the United States. University of Minnesota Press.
• Mai FM, Merskey H. Briquet’s concept of hysteria: an historical perspective. Can J Psychiatry. 1981 Feb;26(1):57-63. doi: 10.1177/070674378102600112. PMID: 7008930.
• Broussolle E, Gobert F, Danaila T, Thobois S, Walusinski O, Bogousslavsky J. History of physical and ‘moral’ treatment of hysteria. Front Neurol Neurosci. 2014;35:181-97. doi: 10.1159/000360242. Epub 2014 Jun 26. PMID: 25273500.