Journal of Medical Humanities

, Volume 32, Issue 4, pp 279-289

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

“A Hideous Torture on Himself”: Madness and Self-Mutilation in Victorian Literature

  • Sarah ChaneyAffiliated withWellcome Trust Centre for the History of Medicine, University College London Email author 


This paper suggests that late nineteenth-century definitions of self-mutilation, a new category of psychiatric symptomatology, were heavily influenced by the use of self-injury as a rhetorical device in the novel, for the literary text held a high status in Victorian psychology. In exploring Dimmesdale’s “self-mutilation” in The Scarlet Letter in conjunction with psychiatric case histories, the paper indicates a number of common techniques and themes in literary and psychiatric texts. As well as illuminating key elements of nineteenth-century conceptions of the self, and the relation of mind and body through ideas of madness, this exploration also serves to highlight the social commentary implicit in many Victorian medical texts. Late nineteenth-century England, like mid-century New England, required the individual to help himself and, simultaneously, others; personal charity and individual philanthropy were encouraged, while state intervention was often presented as dubious. In both novel and psychiatric text, self-mutilation is thus presented as the ultimate act of selfish preoccupation, particularly in cases on the “borderlands” of insanity.


Self-mutilation Self-harm Mental illness History of psychiatry Nathaniel Hawthorne