This article traces methods and conventions of performing women’s mental distress before the camera circa 1900. It features an analysis of gestural performances in French, US, Italian, and British films, with special attention given to two pre-1916 Gaumont films that include mad scenes. The topos of the white madwoman presents a valuable lens through which to investigate intermedial relations across performance forms and visual media as early cinema emerged, and gestures signifying madness have been particularly resilient even as approaches to film acting have evolved. Drawing on scholarship from Giorgio Agamben and Rae Beth Gordon, this article questions how techniques of performing female madness intersected with ideologies of race, class, and nationality.