Self-inflicted injury, or ‘self-harm’, has been a topic of much debate in recent years. The media in the Western world has tended to portray the issue as an increasing ‘trend’, relating it to various contemporary concerns, including the so-called ‘celebrity culture’ and urban decline. The past decade in the UK has seen the publication of various clinical guidelines, a National Inquiry into Self-Harm in young people, and almost continual media speculation. In the last two decades of the nineteenth century, speculation also occurred around ‘self-mutilation’, an area newly defined by alienists (asylum psychiatrists). This topic has received little historical attention; yet, had ‘self-harm’ been on the agenda in the 1970s and '80s, nineteenth-century self-mutilation would no doubt have been presented as part of a discourse on professionalisation, in which the creation of a new psychiatric category was presented as part of the ‘medicalisation’ of psychiatry, through observation and classification within asylums. More recently, a changing historiography has led to histories of self-harm being located within a schema for ‘making up’ people, such as attention to the development of a patient profile for the apparently new behaviour of ‘delicate self cutting’ in the mid-twentieth century. This article builds on this concept to explore broader social issues around the creation of the concept of ‘self-mutilation’, which help to explain the occurrence of an impetus for ‘making up people’ in a particular period or culture. In particular, the impetus is related here to changing ideas of what constituted the ‘self’ and the relation of the individual to society in the late nineteenth century.