What was "brain fever" in the 19th century?

I’ve been reading a Sherlock Holmes anthology, and a couple of times someone has come down with “brain-fever”. I found the modern definition (generic term for encephalitis or meningitis), but that doesn’t seem to match the 19th century usage. Then, it seems to be fatigue and enfeeblement caused by excitement or fright or some other strain on the nervous system, can be cured by about two months bed rest, and isn’t fatal.

So what was meant by brain fever, circa 1890?

Well, the OED gives “a term for inflammation of the brain, ‘and also for other fevers, as typhus, with brain complications’”, so perhaps typhus?

It is interesting to read the old descriptions of cuase of death and speculate what their modern, true terminology would be;

‘Apoplexy’ was usually a stroke

‘Neuralgia’ must be chronic depression.

‘Blasphemous female pollution’ probably something to do with periods.

Wild assed guess, but I’m personally going to bet on, “Poor Health.”

I think that in the grand old days, a lot of people were living in unclean surroundings, and drinking unfiltered water that probably had anything and everything in it from sewage and lead, to rotting corpses. Women generally weren’t active and either lived such protected lives as to faint at anything out of the ordinary or more probably simply knew that it was fashionable to seem so, but either way probably they still weren’t terribly set up to handle a lot of stress.* And also, with the state of medicine and medical labelling, probably a lot of people were taking semi-poisonous prescriptions or over-the-counter drugs (like opium.)

Added to that, simply they didn’t even know what was wrong with people a lot of the time, so given that, “brain fever” could be one of any number of things.

And finally, I think that what may have been of much rarer occurence (fainting, “brain fever”, etc.) is more likely to occur in popular literature than real life.

  • I would also somewhat wonder when the height of corset-tightening was. I think I recall reading that these could be rather harmful. I’m pretty sure I’ve seen a picture that showed how such a corset had litterally compacted a woman’s body so that her inner organs even had been squished up and down permanently inside her torso.

I’m betting that you’re reading the Sherlock Holmes story “The Naval Treaty”. In that one , it’s pretty clear that the young official has suffered an immense shock and has gone into a slort of temporary insanity for non-physical reasons. He’s had a breakdown because he managed to lose (or more correectly, to have stolen out from under his nose) a State Secret of vital importance. He doesn’t actually have any illness due to infection, bacteria, or virus. Saying “an attack of brain fever” sounded nicer than “he went crazy” or “He went insane”, and had that encouraging bit of ambiguity that let listeners assume that this was some sort of temporary organic disease.

Fortunately, Holmes was able to bring the case to a satrisfactory and mostly happy conclusion. And Phelps’ “brain fever” was actually a clue. Or at least things associated with it were.

Neuralgia is nerve pain, surely. Do you mean “neurasthenia”?

WAG: Viral meningitis

I’m reading Sherlock Holmes at present as well and was wondering the same thing. It seems to me to be synonymous with a nervous breakdown.


Nothing infectious was implied by the term; it was a Victorian nicety for mental illness.

There’s an academic article about this that is a pretty interesting read, if you have access to JSTOR. It’s by Audrey Peterson, “Brain Fever in Nineteenth-Century Literature: Fact and Fiction,” Victorian Studies 19.4 (1976): 445-464. Peterson examines a whole bunch of literary and medical references to “brain-fever.” What she concludes, basically, is that people in the nineteenth century seem to have conceived of it as a physical disease characterized by “inflammation of the brain,” not just a euphemism for temporary insanity (although temporary mental derangement IS one of the symptoms, making it an especially convenient malady for writers). “Brain-fever” had a recognizable course of symptoms and the potential to be fatal; however, it was caused not by infection, but by a sudden shock or mental distress. (We now know this is medically impossible, but nineteenth-century doctors seem to have fully believed it.)

There are many things that people today think are medically impossible, but they would be shocked at how often they are wrong! For example, based on your comments I would expect you to deny it if asked if depression can cause physical pain. However, according to psychiatrists, that is a fact! There are more than a few cases where mental problems have caused physical disease symptoms and conditions, even death. If their grief at the loss of a loved one is great enough, people can and have decide subconsciously that they “cannot” live without that person in their life. Some would call this dieing of a broken heart, but few doctors would accept that. Instead, thwy would call it something like morbid major depression.

My conclusion is that, whether we understand it or can explain it or not, the mind can be affected in various ways by conditions the person is subjected to and can affect the body in many ways in return. Therefore, although the Victorian doctors’ ideas about brain fever may have been off-base regarding the mechanisms, their ideas about the overall effect were not far from the truth. Victorians may have had some odd ideas, but they were not stupid!

3rd hit on Google, didn’t need to bring it up, was on Google’s snippet:
Brain Fever is usually called meningitis or encephalitis today… The hallmark signs of meningitis are sudden fever, severe headache, and a stiff …

I just want to put paid to the myth of the delicate Victorian woman who would faint at the merest small provocation.

This has arisen because of the literature stereotypes put about during the 19thC especially by the popular authors, Conan Doyle being one, and also by such as the Bronte’s however these delicate women were almost exclusively middle class and being ‘delicate’ was a form of social fashion - which was often blown out of proportion to illustrate some of the absurdities and hypocrisies of Victorian social mores. Such women formed only a small proportion of the population and cannot be taken as representative.

The real Victorian working woman was very much a different thing altogether - their working conditions were often as poor and horrible as their menfolk, but for less money and poor social rights.



Victorian middle and upper class women were liable to fainting, largely because of the impossible tight corsets they wore, which restricted their breathing.

As I pointed out, this is only a small subset of women living in Victorian England, probably not more than 2.5% of the population, or around 5% of the female population.

In other word, that stereotype did not apply to 95% of women, and it may well have been fewer than that.

Ordinary working class folk and especially women were often almost invisible in most of English literature of the time, so the few examplars are taken as the norm, when they very much were not.

“Brain fever” in the Conan Doyle lexicon meant nervous breakdown, not infection, stroke or other malady with obvious pathology. Either you had a shocking experience (like “Tadpole” Phelps), or someone harassed you into a breakdown (like the young woman in the Copper Beeches episode), or you lost it for whatever reason.

As previously noted, it was a “nice” way to describe severe depression or other mental illness that would be diagnosed in a straightforward manner today.

“Brain fever” puzzled me as a young reader of Sherlock Holmes stories, much like other obscure language of the time. For instance, there was a story describing a Lord Something-or-Other who bet on the horses a lot and was described as being “ruined on the turf”, which I originally took to mean that he’d suffered a real bad sports hernia. :slight_smile:

Blather. We’re not talking about what people think - one quick glance at the Internet shows that people are idiots in all eras. The references are to what *doctors *of the day thought. And although the doctors of the day were not stupid, they were 99.7% ignorant about the actual functioning of the mind, the body, nutrition, and disease. We say they were wrong for the simple reason that they were wrong.

Brain fever in the 1800’s was a very vague condition that covered many things like meningitus. In books like sherlock holmes and dracula it is merely a nervous breakdown.
To me this showed how amazing people have advanced because people back then didn’t understand all the differences of the many brain maladies that could affect a person and attributed it to one thing. I’m glad I didn’t have to live in a time where I might die of some small brain disease that I would easily live through today.

Yep–plenty of people living successfully with small brain disease today.

I think about other problems with varied causes but similar symptoms that we lump together (and don’t understand) today but might be understandable and easily treated in the future. For instance, today I discovered that in some cases obesity might be caused by having the wrong bacteria in your gut, and be treatable with a fecal transplant:

Were writers then using “brain fever” the way writers today use “PTSD” and other eras used “shell shocked”? Loosely based off of what we now call PTSD with some stretch to fit the needs of the work?