Salvadore Cammarano’s libretto is based on the historical novel The Bride of Lammermoor by Walter Scott and thus invites us to examine the real-life sources for Scott’s published work. In addition, as the Scott work was published in 1819, it follows on the heels of the more famous novel by Mary Shelley, Frankenstein; or, the Modern Prometheus in 1818. Shelley’s gothic novel reveals a similar fascination with the sociopolitical environment of the early Enlightenment, as well as the spectres of madness, murder and the private lives of individuals caught up in vengeful forces beyond their control. Beyond the literary sources for the libretto, the opera also bears witness to the use of medical knowledge in defining the appearance and sound of a mentally ill young woman who has succumbed to hysteria. According to medical treatises of the time, hysteria was a disease that bore physical and emotional symptoms, the severity of which could be diagnosed with the relatively new invention of the stethoscope (1816). As Donizetti’s work premiered during a time of heightened listening, whereby audiences sought to hear within the notes of the music the inner world of the composer or the performer, the sound of pain or latent disease was now understood to reflect a lexicon of medically understood sounds that reveal themselves to the careful listener.