Preferred Citation: Gilman, Sander L., Helen King, Roy Porter, G. S. Rousseau, and Elaine Showalter Hysteria Beyond Freud. Berkeley: University of California Press, c1993 1993. http://ark.cdlib.org/ark:/13030/ft0p3003d3/
Hysteria Beyond Freud Sander L. Gilman Helen King Roy Porter G. S. Rousseau Elaine Showalter UNIVERSITY OF CALIFORNIA PRESS Berkeley · Los Angeles · Oxford © 1993 The Regents of the University of California
Preferred Citation: Gilman, Sander L., Helen King, Roy Porter, G. S. Rousseau, and Elaine Showalter Hysteria Beyond Freud. Berkeley: University of California Press, c1993 1993. http://ark.cdlib.org/ark:/13030/ft0p3003d3/
vii
INTRODUCTION— THE DESTINIES OF HYSTERIA Hysteria, it is often said, has disappeared this century, its problems solved by Freud, or its investigation discredited by the antics of Charcot. And accompanying its alleged disappearance there has been a declining interest in its history among most historians. Yet hysteria was extraordinarily prominent in nineteenth-century medicine and culture. [1] It posed in direct and personal form the key questions of gender and mind/body relations, and, as Henri Ellenberger has shown in his Discovery of the Unconscious , it formed the springboard for the discovery of the unconscious in psychoanalysis. [2] In this light, it is odd that only two full-length scholarly surveys of its history have been published within the last half century: Ilza Veith's Hysteria: The History of a Disease (Chicago: University of Chicago Press, 1965), and Etienne Trillat's Histoire de l'Hysterie (Paris: Seghers, 1986). There have been, of course, other approaches, for example, in the work of practicing doctors, amateur historians, and psychoanalytic theorists. [3] Yet these two books have had a curious lack of influence. In the late 1960s, broad cultural and contextual approaches had not yet been developed within medical history, and there was little sense of the wider implications of Veith's newly published and widely praised history. Veith wrote as an internalist medical historian who construed the history of hysteria in its realist dimension only, without casting an eye on its forms of representation or its broad social and cultural subtleties of class, gender politics, and ideology. [4] Trillat too took an internalist approach, meticulously consulting the history of a medical condition without considering the cultural, contex-
viii tual, or discursive resonances that have come to preoccupy humanists and historians in the last decade. In any case, because it was published in France, never translated into English, and not widely publicized, Histoire de l'Hysterie had little impact on the anglophone academic community. Over the last decade, scholarship has, of course, been changing—enormously. Medical history has moved from a positivist to a critical phase and has begun to shift from the scientific history of disease to the cultural history of diseases and the study of illness as metaphor. [5] The history of therapeutics now takes more account of the complex dynamics of doctor/patient relationships. [6] The mind/body problem is no longer regarded as a technical or logical problem, focusing on canonical texts, for historians of philosophy or philosophers of mind to study. One could claim without exaggeration that in our time the social construction of both mind and body have come into their own. [7] And above all, feminist scholarship has lavished great attention upon demystifying the gender and social control encoded in women's diseases, especially the hysteria diagnosis, in the age of Freud. [8] No less important, the role played by language and discourse in the analysis of virtually all medical conditions, ancient and modern, has been magisterially enlarged and problematized, and recent discourse theory has taught historians of all territories, medical and nonmedical, that the social history of language cannot be overlooked when tracing the rise and fall of medical conditions: plague, gout, dropsy, consumption, cholera, influenza, as well as the more psychosomatic conditions. [9] More specifically, the face of hysteria has itself altered, at least implicitly, in light of the work of such psycholinguists and psychoanalysts as Jacques Lacan, Hélène Cixous, and Julia Kristeva. [10] Each has provided insight into the language-gender dimensions of contemporary hysteria and its semiotic groundings. In their work, word and image, doctor and patient, speaker and listener, have gathered new identities. Kristeva has argued with particular force that medical appearances can never be considered entirely apart from their linguistic moorings, any more than from their gender-based dimensions. And as a decade of new interdisciplinary research has marched forward during the 1980s, the interface of literature and medicine has become one of the most frequently played-upon themes in scholarship on both sides of the Atlantic. [11] This broad movement has also intensified exploration of the semiotic and linguistic dimensions of recent, or at least relatively modern, hysteria. But even if the medical diagnosis of hysteria has languished, for
ix reasons this book attempts to explore as an ancillary theme, the condition of hysteria as a state of mind has been revived through the intersections of these newly developing fields of inquiry. "Hysteria as a state of mind" especially describes thinkers of all types, not just patients, who concern themselves with the intersections of bodies and texts, and with medical conditions and discursive practices. Hysteria has thus been fragmented: everyone now seems to own a piece of it. Its grip is not confined to one field; its monopoly not limited to medicine. No longer, and perhaps never again, will it be the narrow province of medical doctors or a handful of medical historians. Hence the time seemed ripe for a reexamination and reassessment, not merely to chronicle hysteria's fragmentation or to narrate the fraught and tangled interplay between Charcot and Augustine, Freud and Dora, but to describe the entire career of the disease entity, or at least the problematic label and curious category: its long-term rise and alleged fall, its invention, construction, development, ascendency, obsolescence, and now relatively sudden disappearance. [12] It seemed to us particularly germane as these transformations occurred in the 1980s to demonstrate that Freud was not the beginning of anything new in the history and conception of the condition but rather the end of a long wave. Though we are in no sense whatever compiling a complete history of hysteria, we wanted to extend our gaze to cover European civilization over three thousand years, while simultaneously concluding our narrative with the launching of psychoanalysis from the base of medical hysteria as it was construed in the late nineteenth century. The Viennese founder of psychoanalysis was not the kingpin of a new province of hysteria —however the condition or the category was defined—but the thinker best able to marshal the resources of an already rich kingdom that had seen itself rise and fall many times in the past. [13] In the popular imagination hysteria begins and virtually ends with Freud, his antecedents and sequels accorded relatively minor consequence; much cultural history is conceptualized and written out as if all psychiatric thought before the 1890s consisted of footnotes leading up to the work of the one—and only one—great transformer, Sigmund Freud. [14] Professional historians of science and medicine often link hysteria to a "mechanical revolution" and "nervous revolution" that transformed the face of modern science, but even they remain uncertain how the scientific revolution impinged upon the development of hysteria. [15] We believe this corrective should be launched as a historical discussion as well as a case study in the relations of realism and representation to this baffling human condition. We are sensitive to the differences be-
x tween so-called "real hysterics," who still present themselves as patients in clinics and waiting rooms, and the wide repertoire of metaphors that has attached to the condition over the centuries, just as other metaphors have attached to consumption, cancer, and now AIDS. Our treatment weaves the real and the representative, especially when we launch into far-ranging discussions of the social history of hysteria. We want to replace existing notions with more accurate, less mythologized, and less heroic ones about Sigmund Freud. Although this book is a five-hander, it has been our aim from the start to produce not a collection of disparate essays but a consecutive and coherent synoptic interpretation, tracing the story forward from antiquity into the present century. The five of us hold different ideological viewpoints and come from different disciplines and nationalities; allegiance to the various theoretical bents of our disciplines prompts us to differ from one another more than we agree. But we are also bound by the shared views that, first, now is the time to reconsider hysteria; second, our differences will bring a type of balance to the evolving discourses (by which we mean all types of writing by hysterics and their doctors, as well as writings by nonmedical figures) of hysteria that will stand the reader—the imagined, ideal reader of this book—in good stead. Finally, we are united by our common interest in the linguistic and semiotic aspects of medicine at large, and by the internal contradictions, silences, and gaps we find in this remarkable discourse of hysteria. [16] We saw both historical and critical elements as essential to the book. In our conceptualization there had to be copiously documented sections on the historical development of hysteria: one dealing with the ancient world, a second located in the period from the European discovery of the ancient medical texts in approximately the fourteenth century (when Hippocrates and Galen were being translated into Latin and read anew) to the end of the Enlightenment (construed as "the long eighteenth century"). Whatever small overlap might exist on the boundaries of these first two parts (around the fourteenth and fifteenth centuries), both sections were necessary for our revisionism and for thorough analysis of the development of hysteria over eighteen hundred years. But after chronological surveys guiding the reader from the Athenian world to the high European Enlightenment, Hysteria Beyond Freud intentionally veers into another mode. From this point forward there was no need to chart and plot hysteria as the first two historical sections do. Instead, we required discussions of three seminal but by no means exhaustive topics. All of us realize that we have been coaxing out the representations of hysteria, rhetorically searching for its metaphors and
xi metonymies, visually following its iconographic relations and imagery—all this out of a belief in the significance of the cultural representations of illness within society. This is not to say that we discard realist medical analysis, empirical cause and effect, the patient in therapy, diagnosis and cure, much less the genuine neurochemical and technological advances that diminish human suffering and increase longevity. But the five of us are nevertheless persuaded that realism and representation, ideology and gender, have been held too far apart in the discussions about human bodies and their so-called pathological states; we are also united in the belief that medical material adds a valuable dimension to the understanding of the creation of social categories in all these different epochs. [17] The boundary between the historical first section (King and Rousseau) and the thematic second one (Porter, Showalter, Gilman) marks the turning point in the book's architecture. One condition of this shift is the new version of historicism King and Rousseau wish to impose. This is not the new, upper-case Historicism—if there is one such version—but a more contextualized and, in Helen King's case, more scrupulous philological examination measured against the reigning cultural trends of the ancient world. [18] King examines the early history of hysteria in antiquity, more precisely explaining why Classical hysteria is in reality but a mare's nest, a spurious entity invented by later physicians in the Middle Ages and Renaissance and legitimated after the event by medical historians. [19] This view overthrows Veith's and will no doubt disturb medical historians who consider the older views gospel. But King also demonstrates why the category is so doubtful and supports her argument with the verbal and historical documentation of a classicist with her particular joint training and expertise in ancient history and anthropology. After King's revisionism it may well be that studies of Hippocrates will never again be the same. Certainly no one will ever again be able to reiterate the now discredited notion that Hippocrates is the father, the discoverer, the inventor of a Western hysteria that has endured with constancy over the course of many centuries. George Rousseau explores the legitimation of these later doctors and medical historians and—crucially—the implications of this dire legitimating for Renaissance and Enlightenment culture. Rousseau's task is to chart the fate of hysteria as the body's anatomical model gradually moves away from a one- to two-sex model, and as Cartesian and Newtonian science sweeps through Europe. [20] In this sense he, too, necessarily imposes the mold of realism on his revisionary historical task. But as Western culture was transformed in the seventeenth and eighteenth
xii centuries under the weight of science, secularism, and economic and political reform, as the cults of certainty, progress, and optimism gradually replaced those of uncertainty, pessimism, even gloom-and-doom, hysteria found itself at the center of a debate about melancholy and the nerves, and about gender, sex, and the fabric of human culture far exceeding its own local, anatomic, and medical domain. And in this sense it was hysteria construed as a category —almost a philosophical category—rather than as a medical diagnosis or set of therapies. [21] But as certain tenets of Enlightenment culture gained strength, especially the reliance on reason, observation, logic, predictability, secularism, and the waning of a faith in superstition and magic, hysteria continued to find itself reinvigorated and regenerated. [22] A self-renewing discourse, it was capable of transforming itself both as diagnosed disease, medical category, and—linguistically—as a critique of malefemale relations. Rousseau shows that hysteria's uniqueness lies specifically in these acts of transformation, especially under the teachings of Dr. Thomas Sydenham, the so-called "English Hippocrates" and medical associate of John Locke, the doctor-philosopher. Sydenham, according to Rousseau, is the unacknowledged hero of hysteria: the first doctor to see beyond its ironclad gender boundaries, the first to apply the illness to men, the first to gaze into its psychogenic origins. Sydenham alone made the unique transformative power of hysteria his first principle: on this fundamental belief he built everything else in his theoretical medical scheme. [23] Despite the similarity of historical approaches taken by King and Rousseau, a counterpoint exists between their chapters, and then again between these chapters and the rest of Hysteria Beyond Freud . Yet for our discussion of hysteria after 1800 it seemed best to make thematic divisions along clearly defined lines. After traversing the nineteenth-century border, it was no longer necessary to provide a full "history of hysteria" except to glance at areas that had been underdeveloped or misconstrued. For this period extending from approximately 1800 to the overlaps of Charcot and Freud, mountains of writing have, of course, already accumulated. The physiological aspects of hysteria circa 1800 had been developed by all sorts of medical commentators in the period and during the next two generations of doctors (i.e., between 1780 and 1840). [24] Georges Didi-Huberman, a contemporary medical historian in France, discussed its diagnosis and appearance in the light of visual images and artistic representations; [25] Wolfgang Lederer, its sexual implications in Gynophobia ou la Peur des Femmes . [26] And a veritable host of scholars dealing with Charcot and Breuer had written about nineteenth-century hysteria. But the philosophical, epistemological, ethical, and even more cru-
xiii cial literary, social, and pictorial traditions had not been well-studied. Nor had hysteria been construed as a "discourse," or as overlapping discourses, in the brilliant way that critics such as Hayden White and other hermeneutical theorists have looked at historical pasts, as partaking of the same attributes as all other discourses: rhetoric, metaphor, voice, speaker, speech act, and the implied power relations vis-à-vis race, gender, and sex established within the discourse. [27] Furthermore, these previous students of hysteria had not understood what more culturally oriented scholars began to see in the 1980s: that the developing metacritique of hysteria had inscribed all sorts of power relations as well as developed a subcritique of gender arrangements that often masqueraded as a pure, objective, realistic, and scientifically validated discourse of hysteria. [28] These are developments still awaiting due amplification. They are among the ones we seek to revise and amplify here. Toward this specific goal Elaine Showalter, author of The Female Malady (1987) and recently of Sexual Anarchy (1991), examines hysteria over the last two centuries as an expression of the inscription of gender relations within medical discourse. Throughout its history, hysteria has been primarily constructed as a female malady, but it has also been a disorder of men. Applying feminist methods and insights to the symptoms and studies of male hysteria, Showalter shows that issues of gender are as significant in masculine experience as in the history of women. Not only the treatment, but also the historiography of hysteria, has been influenced by the traditional gender roles assigned to the therapist and the hysteric. When feminists occupy the roles of doctor, psychoanalyst, or historian, the narratives of hysteria change. [29] If medical discourse has assumed a whole set of gender relations in the last two centuries, the discourse of hysteria has been the chief site of debate over matters related to sex and gender relations. This localization within hysteria is the theme of Roy Porter's chapter. It is a point that seems accessible but is knottier and more elusive than it at first appears. It is not at all surprising that the old Cartesian mind/body dualism should have endured as long as it has, nor that mind and body should have played such a magisterial role, as Rousseau shows, in the commentary on Enlightenment revelations (and, as often, obfuscations) on hysteria. [30] But Porter proceeds further than this point: he shows how the old mind/body questions became attached to the self-definition of medicine itself as a sphere of exclusive cognitive expertise. At the beginning of the period that forms the backdrop of his thematic study—approximately 1800—medicine still hovered in self-conscious doubt as a domain
xiv of knowledge. At the beginning of the period, doctors and the paramedical world had begun to professionalize and gather in institutional and organizational ways that would continue throughout the nineteenth century; a century later, medicine's claims were bolder. Medicine now claimed to be more a rational science than an inexact art: shorn of its older magical and irrational tendencies, it was now the sister subject of philosophy, science of the cognitive. Yet in medicine this application had to be grounded within a specific discourse that was already controversial. Where to locate the site of hysteria in a safe medical discourse in which there was neither fierce debate nor professional divergence? In manias, for example, or gout (now moribund after three centuries of tireless writing and speculation)? Better to place it in an already controversial zone, as Porter shows us in his chapter, and let hysteria be fought about within the already bloody battlefields of Regency and Victorian philosophical discussions of mind and body. [31] From the complex relation of clinical medicine and philosophy, an ancillary question presents itself: the matter of speculative thought in relation to realism, and medicine in relation to representation. [32] If medicine had become cognitive by the nineteenth century, it could claim to be exclusively so because its models of representation were then so monolithically realistic. Set the chronological dials earlier, to 1840 or 1860, for example, and one glimpses an England or France in which the medical doctors are virtually certain that medicine is a rapidly advancing science in which much more was known to them than had ever been available in the history of mankind, and that soon even more would be discovered. A science as positivistic and progressive as midnineteenth-century medicine worried little about the representational—metaphoric, imagistic, artistic—versions of its wisdom. Yet paradoxically and almost as a counterpoint to this certainty about the knowledge of all (even in theories of hysteria) was the concomitant sense that medicine still had an arduous road to hoe before it would be a rigorous science like mathematics, physics, or astronomy. Most of those who viewed medicine as an art were usually willing to concede a large portion of ambiguity to the medical situation, medical predicament, the scenario, case history, toute la chose medicale in the hysteria diagnosis. More specifically for our purposes, if hysteria had significant representational dimensions, how had it been pictured in art? In what sets and constellations of images? And how had its victims become figures in drawings and other media? This is the question Sander Gilman pursues in his illustrated chapter. Given his previous work on the iconography of disease, [33] it is not surprising that he has set hysteria in a wide context, viewing its sufferers
xv as one instance among many of the stigmatization of the pathological. Beginning with the late eighteenth century, many types had been stigmatized—not merely hysterics, but diverse "lunatics" over the broad spectrum of race, religion, and gender. Sodomites as well as hermaphrodites; the mad as well as the moody; Jews as well as blacks; and many other social pariahs as well—all were differentiated and eventually stigmatized. Stigma, indeed, was an ingrained habit of the hegemonic thought of the nineteenth century, a region of the imagination well understood by thinkers as diverse as Vico, Kierkegaard, and Nietzsche. [34] But the stimatizing of the hysteric was something else: more pronounced if also more elusive. The label hysteric became a key encodement of difference and danger, not just in respect to nubile girls or frustrated widows, but in the larger evaluation of cultural, national, and racial characteristics at a time when nationalism was on the ascendency. Thus the eclectic representations of hysteria, as explored in this book, look inward to a developing micro history—of doctor/patient pairings in the clinical setting, playing their games of power, control, and liberation—while simultaneously looking outward, treating hysteria as a language for assimilating yet pathologizing the unknown, the unacceptable, the uncontrollable. The hysteria diagnosis has long been the frail and unsuccessful attempt to frame the fearful symmetry of one of the most potent tigers of the mind. Yet the beast, so to speak, is even larger than this. Once it becomes clear to what degree the pathology of the unknown became encoded in the hysteria diagnosis it also becomes evident that the category hysteria must never be far from the historian's imagination. Otherwise, all human relations, not merely the pairings mentioned, take on attributes of "hysterical discourse," in one medium or another. The reader will notice a multitude of lacunae in this book—omissions of more types than one. For example, it will be observed that no professional psychoanalyst has been included among the authors, and that psychoanalysis and approaches fundamentally psychoanalytical are not included. The omission is by design: whereas none of us has any particular aversion to psychoanalysis as a therapy or method, our collective strategy was to provide a historical and representational approach that led up to, not followed from , Freud. [35] We attempted to gaze at our various forms of representation with the eyes of historians of psychology or psychiatry rather than as scholars living in the aftermath of the Freudian revolution, and even less as scholars persuaded of the claims of psychoanalysis itself. We have also said relatively little about religion and religious experi-
xvi ence. There can be no doubt of its importance in the medieval world and beyond. But no matter how central religion was during the early period, this is not a book about the interface of religion and medicine, or of hysteria and possession, subjects that no doubt merit more attention than they have received but which cannot be fully treated here. The theme of possession—whether or not leading to hysterical symptoms—has itself been the subject of recent scholarship, as Rousseau notes, none of which we hoped to include in any detail in our eclectic approach. Possession is such a large canvas to survey that to focus on it would have fatally diverted us from the real focus of this book. Our eclecticism may also be faulted for omission of any thorough, or systematic , treatment of the recent fortunes of hysteria in the work of Lacan, Kristeva, and other deconstructionists and poststructuralists. The reply is that here, too, as in the case of Freud, we have tried to see things primarily from a pre -Lacanian point of view. We are sensitive to Lacan's concept of the Other and to the work of the Lacanian analysts at l'Ecole de la Cause Freudienne. But surely a pre-Kristeva angle of vision will not exonerate us, any more than it will please our critics to know that we have not tried to deconstruct hysteria. [36] References to these figures do appear in our text as early as Rousseau's chapter, which explores a theory of "female numbness" in relation to hysteria partly derived from the works of the French writer Marguerite Duras. But Elaine Showalter's chapter makes better use of these figures, even if they do not play a central role in her conception of what is to be privileged about hysteria. A thorough illumination of the linguistic representations of hysteria by other scholars would enrich our discussions. Although this book devotes itself to the history and representations of hysteria, it has not unearthed the hidden metaphors of hysteria. A whole book could have been written, and we hope it will be, merely on these metaphors of control, pathologization, stigmatization, castigation. An example drawn from the field of metaphors of incorporation is Dorothy Kilgour's From Communion to Cannibalism: Metaphors of Incorporation . [37] Hysteria has given rise to metaphors worthy of study in their own right, in much the way that Susan Sontag has identified those in the domain of illness and AIDS. We hope others will build on our work and trace the evolution of these languages of hysteria. The bibliography of hysteria is by now a developed province in itself. The previous histories never provided their readers with a proper bibliographical essay or the equivalent, delineating the enormous amount of writing devoted to this subject. Indeed, so much has accumulated that it would require an expert and systematic bibliographer to perform the task. Only Mark Micale has undertaken any of this work, and his writing
xvii on the subject is exemplary and in the bibliographical area second to none. [38] Micale has studied male hysteria in particular and demonstrated its trajectory from the Greeks to the present. Whether or not we acknowledge it explicitly in the following chapters, all five of us have profited from his studies and from his presentation at the Wellcome Institute in 1990 (see paragraph that concludes this introduction). This then is not a full-scale history of hysteria, proceeding in linear time, each chapter surveying a period or historical unit. Nor is it an attempt to rewrite Veith under contemporary circumstances where the new ideologies and critical methodologies prevail, nor will it survive a strict and rigid post-Foucaldian application. The age of Foucault has passed, and with it the sense that mere representation apart from historical contexts is sufficient; in its wake a new commitment has arisen to historical rigor and accountable epistemological threshold. [39] This is especially true in such fields as the history of psychiatry and in discussions of the discourses on madness, wherein scholars can be radically "historical" without writing proper "histories of madness." All five of us are admittedly the children of Foucault in ways extending beyond our ability to verbalize them, especially insofar as we concur that in our contemporary world, power, authority, and marginalization are mirrored in the overlaps of hysteria, madness, and psychoanalysis. And we were also fortunate, as we pondered ancient and modern hysteria, to profit by the fruits of Foucault's labors in his multivolumed histories of sexuality. But we write here neither as converted Foucaldians nor as primarily historical revisionists intent upon correcting a fallible record. If our first two chapters appear to do just that, the reason—as we have already indicated—arises out of our belief that something fundamental in the historical tradition had to be corrected before we could proceed to our thematic analyses. Many books could be and will be written about hysteria. We believe our groupings are richer for some of the reasons given above. No readers, or potential authors of such books, can close the covers of this book without questioning the disappearance of hysteria after so many centuries, or without being persuaded by our central theme: that Freud inherited a tradition surrounding hysteria. Freud came to hysteria at the end of a three-thousand-year-old lineage: he was not its progenitor—a truth more easily stated than applied and a historical fact often forgotten. Early versions of these essays were presented at a conference held at the Wellcome Institute for the History of Medicine in London in April 1990. We are grateful to the Wellcome Trustees for making funds avail-
xviii able for this meeting, and to Steve Emberton and Frieda Houser for the smooth running of this fruitful occasion. George Rousseau is grateful to Leila Brownfield and Linda Benefield for their kindness in accomplishing various of the tasks associated with the production of a book of this size. We owe particular thanks to William Schupbach and David Brady of the Wellcome Institute for their efforts in obtaining and organizing the many illustrations so necessary to Sander Gilman's chapter. We are equally grateful to our editor at the University of California Press, Elizabeth Knoll, for her encouragement throughout this project. G. S. ROUSSEAU ROY PORTER
1
PART I— HISTORICAL
3
One— Once upon a Text: Hysteria from Hippocrates Helen King
Labels and Origins: a Name Without a Disease? In the beginning was Hippocrates, the Father of Medicine, who freed the emerging science from the chains of superstition, introduced empirical observation and the bedside manner, and both identified and named "hysteria." So runs the established wisdom on the Hippocratic origins of both medical science in general and of the diagnosis of hysteria in particular. Yet recent work on Hippocratic medicine has called into question much of this tradition. Once it was an acceptable scholarly pursuit to debate the inclusion of particular treatises in the canon of "The Genuine Works of Hippocrates": now it is widely accepted that not a single text of the Hippocratic corpus can be attributed with any certainty to the Father of Medicine. [1] In place of a canon of "Genuine Works," we have a diverse set of multi-author texts. Once the Hippocratic doctor was seen as a model of medical etiquette and morality: now he can be restored to his own historical and cultural context, where he becomes only one of the numerous brands of healer competing for clients in the ancient world, unafraid to improve his chances of employment by the use of tactics questionable by later standards. [2] With the improved visibility made possible by the new Hippocratic studies, the time has surely come to reexamine the texts so confidently labeled by the nineteenth-century Dr. Robb as "Hippocrates on Hysteria" [3] and to review the relationship between the text of the Hippocratic corpus, its interpreters over time, and the discussions of hysteria. Since the Hippocratic texts are so often quoted—and misquoted—in
4 contemporary debates on the status of the diagnosis hysteria, such a study will not only contribute to the growing body of work on Hippocratic medicine and its place in ancient society but also inevitably feed into these debates. Eliot Slater, questioning the value of the diagnosis in our own times, has argued that "the justification for accepting 'hysteria' as a syndrome is based entirely on tradition and lacks evidential support." [4] This tradition goes back to the alleged origin of the diagnosis of hysteria in the Hippocratic corpus, and it is only by reclaiming the relevant texts from their use in the tradition that we can understand and question the diagnosis in later centuries. If a fresh reading of the ancient texts shows that their use by the tradition is unwarranted, this will have important implications for the history of hysteria in general. Recent work on hysteria in the Hippocratic corpus by medical historians, psychologists, and physicians is, almost without exception, based on the history of hysteria published in 1965 by Ilza Veith. On the name itself she wrote,
In the Egyptian papyri the disturbances resulting from the movement of the womb were described, but had not yet been given a specific appellation. This step was taken in the Hippocratic writings where the connection of the uterus (hystera ) with the disease resulting from its disturbance is first expressed by the term "hysteria." It appears in the thirty-fifth aphorism, which reads: "When a woman suffers from hysteria . . ." [5]
Since the publication of Veith's book, these points have achieved canonical status. For example, R. A. Woodruff states that "the name, hysteria, has been in use since the time of Hippocrates"; P. B. Bart and D. H. Scully refer back to "the time of Hippocrates, who coined the name"; and S. B. Guze cites Veith as his only source for the "information" that "disorders diagnosed as hysteria have been encountered for about 2,500 years" and furthermore that, "as everyone knows, the term hysteria originated in Greek antiquity." [6] These apparently confident assertions cover not only the origin of the word "hysteria," but also the very essence of ancient Greek gynecology. R. Satow, a psychotherapist and sociologist, asserts that "'hysteria' has been a label used for a potpourri of female ailments and non-ailments alike since antiquity. . . . The Greeks and Romans called almost all female complaints hysteria and believed the cause of all these female maladies to be a wandering uterus. . . . In various Hippocratic texts the term hysteria is applied to a large variety of female complaints." [7] What "everyone knows" is, however, not necessarily true. The earth is not flat, although once "everyone knew" that it was. Even leaving aside
5 the attempt to use Egyptian evidence, which has already been widely questioned, [8] Veith's claims for Greek medicine are seriously flawed. As only one recent writer on hysteria, E. Trillat, [9] has recognized, the "various Hippocratic texts" applying the term "hysteria" to many different complaints simply do not exist; moreover, to suggest that Hippocratic gynecology is about calling almost everything "hysteria" is a gross over-simplification. A total revision of our understanding of the tradition is thus long overdue. Let us return to the text claimed by Veith as the inaugural moment of hysteria, "the thirty-fifth aphorism." It is a significant choice, since the Aphorisms is one of the most widely translated and best-known works of the Hippocratic corpus, believed for many centuries to have been written by Hippocrates himself as a distillation of the wisdom of a lifetime's clinical experience, and thus taken to be one of the most genuine works. [10] Immediately, however, we encounter a difficulty; there is no "thirty-fifth aphorism." A. Rousselle[11] has criticized Veith for reading back contemporary ideas into antiquity, but the problem is greater than this would suggest; Veith puts too great a trust in poor secondary sources. What she is referring to here is, in fact, Aphorisms 5.35 (L4.544), which does not use the term "hysteria" at all; instead, using the plural form hysterika , it begins Gynaiki hypo hysterikon enochloumenei , and it may be translated as: "In a woman suffering from hysterika , or having a difficult labor, a sneeze is a good thing." What are these hysterika , and what is so good about a sneeze? Such questions plunge us directly into the heart of the hysteria debate. It is tempting to translate hysterika as "hysterics," but an apparently familiar word does not necessarily convey the meaning we would most naturally expect. Galen of Pergamum noted the difficulties of translating this aphorism (K 17b.824-825). Hysterika , he wrote in his commentary on the Aphorisms , could refer to all diseases of the womb[12] or to only a particular condition called hysterike pnix (best translated "suffocation of the womb"), described by a number of post-Hippocratic writers and which will be discussed at length below, or to problems with the afterbirth, also known as ta hystera . He favors setting the aphorism in the context of hysterike pnix , for the following reasons. First, hysterika cannot refer to the afterbirth, because hystera and hysterika are not the same word. Second, it cannot refer to all diseases of the womb, because Hippocrates says that it is helped by sneezing. Clearly, not all diseases of the womb are helped by sneezing and, since Hippocrates cannot be wrong, Galen concludes that the passage must refer to hysterike pnix . There is, however, no reason why we must follow Galen's line of ar-
6 gument since, despite his objections, there is nothing to prevent translating the phrase as "When a woman suffers from diseases of the womb." The argument that not all such diseases are helped by sneezing does not necessarily apply to pre-Galenic medicine. A sneeze expels various kinds of matter that may cause disorders, and thus has value in many situations; in a specifically gynecological context, substances such as mustard, black or white hellebore, and castoreum were widely recommended in the ancient world to promote menstruation or the expulsion of the afterbirth. [13] Since retained menses were thought to be the cause of many female disorders, the expulsive value of a sneeze could often be beneficial. It is in a passage of Pliny the Elder, written a century before Galen, that the sternutatory powers of mustard appear in the narrower context of "suffocation of the womb." Mixed with vinegar, mustard was thought to rouse women suffering from an epileptic fit or "vulvarum conversione suffocatas," [14] translated in the Loeb edition as "fainting with prolapsus" but more literally meaning "suffocated by the turning of their wombs." This may suggest another value of the sneeze, which was seen as being of particular importance in "suffocation." Many ancient writers discuss the difficulty of knowing whether a sufferer from the condition they call "suffocation of the womb" is, in fact, alive or dead. Pliny himself gives the case of a woman who lay as if dead for seven days with "conversio vulvae," turning of the womb. [15] In such cases, it was necessary to test for life by holding a feather or a piece of wool at the nostrils. A sneeze was welcomed as evidence of the presence of life. Sneezing, due to its expulsive powers, can thus be "a good thing" for many disorders affecting women, but by the first century A.D ., when Pliny was writing, it had come to be seen as particularly valuable in "suffocation of the womb" because it could recall to life a patient lying as if dead. It is thus possible that it had the first meaning in Aphorisms , but that this had been overlaid with the second by the time of Pliny. Galen, writing a hundred years or so after Pliny, put together the broad context of the Aphorisms passage and the more specific context of Pliny; the example thus makes us aware of the possible changing interpretations of a text over time. Regardless of how we choose to translate the passage, it should above all be noted that this is not what Veith called "a specific appellation": a disease label. Veith admits that the form hysterikos , "from the womb," "connected with the womb," or, when applied to a woman, "liable to disorders of the womb," is "more frequently used," [16] but she does not acknowledge that it is in fact used exclusively, and moreover that the Aphorisms example is only a further case of this general type.
7 It is not difficult to find the source for this particular misconception on the part of Veith. The idea that it is in the Hippocratic corpus that hysteria is not only described but also given its name can be traced back beyond her to the Emile Littré edition of 1839-61, the gynecological volumes of which—numbered 7 and 8—appeared in 1851-53. For the present purpose, a study of these must concentrate on the additional French material supplied by Littré. This appears in two forms. First, for many of the Hippocratic texts he provides section headings for each chapter; these have no analogue in the Greek manuscripts. This applies to the three volumes of the Gynaikeia , known in English as Diseases of Women , [17] where several passages are headed "Hystérie." Second, additional material appears in the translation itself, where Littré uses the medical categories of his own time. The misplaced confidence of the title used by Robb in his article "Hippocrates on Hysteria" [18] is based on translating Littré into English while simultaneously incorporating distinctions made only in the headings. [19] As Rousselle has recently suggested, these owe far more to nineteenth-century debates and theory than to the Hippocratic texts they are supposed to summarize. [20] Just as Adams aimed to make the Hippocratic texts that he selected as "The Genuine Works of Hippocrates" intelligible to "any well-educated member of the [medical] profession at the present day," [21] so Littré "read Hippocrates in his own image and in the image of the medicine of his time," [22] with the explicit intention of using Hippocratic wisdom to improve the medical practice of his own day. "Until the nineteenth century, medicine nourished itself on Hippocrates—or at least on that which it believed it could find in Hippocrates." [23] The section headings written by Littré go further than merely labeling certain sections "Hystérie." In addition to this, Littré distinguishes between imagined movement of the womb, which he classifies as hysteria, and real movement, which he describes as displacement. He thus makes such comments as, "This section appears to be a confusion of imaginary with real movements of the womb"; "This appears to be some displacement of the womb rather than hysteria"; and "The fact remains that there is confusion between imaginary and real displacements." [24] He believes that the Hippocratic texts do not make sufficiently clear the distinction he seeks, in contrast to Veith, who—again, wrongly—claims that "the Hippocratic physician was aware of the importance of a careful differentiation between hysterical symptoms and those of organic disease." [25] The writers of these ancient texts make no such distinction. They describe what is, for them, a real and organic condition: the movement of the womb (hystera ) to other parts of the body. Since it is Littré, rather than any Hippocratic physician, who is interested in the distinc-
8 tion, it may be suspected that Veith is basing her remarks on the Littrean section headings rather than on the Greek text. The origin and process of transmission of the error in translation should now be plain. Littré read the Hippocratic corpus in the context of the mid-nineteenth century, in which hysteria was a recognized condition of debated etiology; he expected to find hysteria in the text, duly found it, and drew it out in the headings he wrote for the various sections. Robb translated into English the passages headed by Littré as "Hysteria," and subsequent readers of the Hippocratic corpus have accepted the categories imposed by Littré on his material. Taking only the Aphorisms passage, Littré translates "Chez une femme attaquée d'hystérie. . ." while Francis Adams gives "Sneezing occurring in a woman with hysterics," and J. Chadwick and W. N. Mann have "When a woman is afflicted with hysteria." In giving "When a woman suffers from hysteria. . ." Veith is following the widely available Loeb translation. [26] Thus the diagnosis of hysteria is one made not by the ancient authors of the texts, but rather by the nineteenth-century translator of the Hippocratic corpus. At this point it would be possible to argue that this is of only minor importance; granted, the tradition is wrong to claim that the Greeks invented the name and thus the diagnostic category of hysteria, but if the Hippocratic texts nonetheless contain the first clinical descriptions of hysteria, should we much concern ourselves with the origin of the name? As a result it becomes necessary at this point to begin to consider what we are to understand by "hysteria." When a translator reads the diagnosis into a text, this would seem to suggest the belief that there is a fixed entity called hysteria, constant over time and place, so that we can say with Chariot that "L'hystérie a toujours existé, en tous lieux et en tous temps," [27] and with D. W. Abse that "in fact, east and west, hysteria continues unabated in various guises." [28] If we believe this, it will be of relatively little significance that the name "hysteria" is not Hippocratic. A concept may exist even if it is not named; as G. Lewis points out, the ancient Hebrews had no word for what the Romans were to call lex talio , the law of retribution in kind, but they did say "An eye for an eye and a tooth for a tooth." [29] Further general questions about hysteria will also need to be addressed. Is it a disease like any other, and thus a fit subject for medical study and treatment? Is it a disease at all?[30] If hysteria is constant, found throughout history, worldwide, we can begin to talk about whether or not Hippocratic medicine recognized it, regardless of whether the Hippocratics named it, just as we can talk about whether tuberculosis, epilepsy, and gonorrhea were recognized. Furthermore, if it is historically constant, a body of text of the length of
9 the Hippocratic medical corpus should, statistically, contain some cases of it. Any decision that it is constant therefore prejudges the question of whether or not it existed in Hippocratic times: by definition, it must have done, and our task is only to find the sections in the texts which provide a more or less accurate match with our chosen clinical picture. This task, however, is complicated by the belief that hysteria, like chlorosis, is a disorder that apparently disappeared in our own century; as Trillat says, "L'hystérie est morte, c'est entendu." [31] This could lead us to apply more stringent criteria to the Hippocratic texts, to conclude that hysteria was not present in classical Greece, and thus to revise our views on the significance of its apparent disappearance from the medical scene. There are however two main obstacles standing in the way of a decision to treat hysteria as a historical constant. The first is that, unlike tuberculosis, epilepsy, and gonorrhea, hysteria is in no way a clearly defined disease entity for which most medical practitioners in our society would draw up the same list of symptoms; the second, that an integral part of the definition of hysteria often consists in its supposed ability to mimic symptoms of other diseases. Contemporary medical writers on hysteria fall into two main groups. One group accepts that hysteria is "a valid, independent syndrome" [32] and, in applying this label, makes use of the Perley-Guze criteria, which list over fifty symptoms in ten areas; exhibiting twenty-five symptoms in nine out of ten areas qualifies as hysteria, in the absence of any other diagnosis. [33] One area is entirely concerned with menstrual difficulties; [34] since menstrual suppression is by far the most common symptom in Hippocratic gynecology—for reasons that relate to the belief that amenorrhea indicates the presence of a dangerous reservoir of unshed blood[35] —it should not be surprising that retrospective diagnosis of hysteria in the Hippocratic texts is common. The second group's position is conveniently summarized by Slater's (1965) lecture "Diagnosis of 'hysteria.'" [36] The single quotation marks around "hysteria" say it all. Slater picks up the Perley-Guze point that the label hysteria is applied "in the absence of any other diagnosis" and concludes that the diagnosis merely indicates the "absence of relevant physical findings"; it is "a disguise for ignorance and a fertile source of clinical error . . . not only a delusion but also a snare" and "a way of avoiding a confrontation with our own ignorance." [37] Edward Shorter suggests that diagnoses such as hysteria have often covered an undetected uterine infection. [38] C. D. Marsden, too, points out that a high percentage of patients diagnosed as having hysteria turn out to have an underlying organic disease and concludes
10 that "there can be little doubt that the term 'hysterical' is often applied as a diagnosis to something that the physician does not understand." [39] Slater therefore argues that "the justification for accepting 'hysteria' as a syndrome is based entirely on tradition and lacks evidential support." [40] F. Walshe's response to Slater, significantly using the same title but omitting the quotation marks around the word "hysteria," defends "the concept of hysteria as a nosological entity in its own right." [41] The debate in medical circles continues, and Slater's contribution is discussed at length in Alec Roy's (1982) collection of essays, Hysteria . [42] R. Mayou gives a fair summary of the medical situation when he writes that there is at present "no agreement about diagnostic criteria" for hysteria. [43] The second difficulty encountered in regarding hysteria as something constant is that, if anything is a widely accepted part of the definition, it is the suggestion that it can mimic the symptoms of any other disease. [44] In this case, how can hysteria itself be a disease, and what is to prevent it from taking such radically different forms in different epochs as to be almost unrecognizable as the same condition? The corollary is also true; as Shorter puts it, "every organic disease imaginable . . . has at one time or another been classified as hysteria." [45] Does a condition with such indistinct and shifting borders exist in any meaningful sense? As Trillat puts it, hysteria is "une maladie qui n'en est pas une, tout en l'étant . . ." [46] Nineteenth-century medical literature suggests that hysteria can manifest itself in a highly dramatic form; in the ideal type of Charcot's "grande hystérie," violent muscular contractions culminating in the arched posture (arc-en-cercle ), paralysis, loss of voice, retention of urine, anesthesia, and blindness. In a recent study of admissions for hysteria to the Edinburgh Royal Infirmary in the late eighteenth century, however, G. B. Risse found that only a minority of alleged victims had fits of this kind; most women sufferers had loss of appetite or other digestive problems, menstrual difficulties, and fainting spells, symptoms suggestive of many organic diagnoses. [47] Yet one relatively constant feature of the diagnosis of hysteria in modern times is that it implies that the physical symptoms so labeled, whether dramatic or not, have no recognized organic cause. It should now be clear why hysteria has been described as "that most unsatisfactory of psychiatric syndromes." [48] Marsden's recent discussion shows the widest possible extent of the definition of "hysteria." "Physicians use the term to describe the symptom (conversion disorder or disassociation state), the illness (somatization disorder or Briquet's syndrome), the personality (histrionic), a form of anxiety (phobic anxiety after Freud), an epidemic outbreak (mass hysteria) and irritating patients (if female they are hysterical; if male they
11 are psychopaths)." [49] The irritation felt by doctors toward hysteria patients is eloquently expressed in the words of a doctor writing in 1908, a time when the contracture or "drawing up" of a limb was a common symptom: "As Vance cut off the plaster cast from a 14-year-old girl whose leg had 'drawn up' a year previously, she cried, 'It is going to draw up; it is going to draw up,' at which Vance said severely, 'If it does draw up, I will break your d____d little neck.'" [50] Other contemporary writers argue for a restriction of the definition of hysteria, excluding the syndrome and the personality type and using hysteria only for a universal human reaction, comparable to anxiety or depression. [51] Shorter's suggestions may be helpful here, insofar as they permit a degree of universality, while incorporating variation among cultures. He accepts that "'hysteria,' it appears, is a real psychiatric disease, in addition to being an epithet with which men have stigmatized women across the ages." However, he goes on, "the presentation of 'hysterical' symptoms tends to be molded by the surrounding culture" to a greater degree than that of, for example, the symptoms of schizophrenia. A major question to ask therefore concerns the social construction of the disease: Why is it that, from a wide repertoire of the possible, "certain symptoms are selected in certain epochs"?[52] I will return to this important question, in relation to the Hippocratic texts.
Definitions: the Textual Tradition Thus the questions raised by hysteria are not only legion but often directly contradictory. Is hysteria another word for ignorance, or the perfectly adaptable mimic? Is it a dramatic performance or a minor gynecological disturbance? Is it caused by the womb or has it no organic cause? Is it a wide-ranging category, a "non-verbal language," [53] or something universal but very specific? Beneath these questions lies the major one for anyone trying to write about the history of hysteria: that is, what definition should be used for the purposes of the present work? J. M. N. Boss takes what may appear to be an attractive option when tackling this problem; he writes, "In this paper the word 'hysteric' is used in the manner of the period of the writings referred to." [54] As I have already shown, however, in the ancient period the word "hysteria" is not used at all; hysterikos , "hysteric," is used, but with the very specific meanings "coming from the womb"/"suffering due to the womb." One way around this problem would be to restrict the present study to those sections of the corpus traditionally seen as descriptions of hysteria; for example, those so labeled by Littré. As I have already shown, the diffi-
12 culty here is that Littré imposes his own distinction between "real" and "imaginary" movements of the womb, a distinction alien to the ancient Greek writers. An alternative would be to study all sections of the corpus in which the womb is described as moving to another part of the body, but this only reiterates the point that later writers use hysteria for symptoms with no organic cause, whereas the Hippocratics regard womb movement as something entirely organic. The difficulties of deciding what constitutes hysteria for the purposes of a historical study are by no means unique; indeed, they are directly comparable to those encountered by J. Gabbay in his discussion of the disease concept "asthma." Gabbay asks how far we "can rely on present-day knowledge of asthma to analyse historically the social nature of medical knowledge" [55] and concludes that we cannot assume that all writers in the past who used the term were referring to the same thing. With hysteria, of course, the problems are greater, because our sources are not even using a common name. Gabbay raises the question whether a diachronic study of a disease concept investigates a constant natural entity, or a vast range of different concepts, [56] and shows how this question all too easily leads the historian to the stage of "historical paralysis." [57] Like Medusa's head, the question, What exactly are we studying? turns the onlooker to stone. Although it has this malign power, the question must at least be addressed, even in a negative way. To clarify: in the present work I am discussing neither all texts in which the writers name the condition they describe hysteria, nor all texts mentioning a particular combination of symptoms that I choose to label hysteria. Instead, I have chosen here to concentrate on a set of early texts conventionally linked by subsequent writers: a finite series of texts, each drawing on an increasingly fixed group of those written by earlier writers, yet each simultaneously—to some extent incorporating the ideas of its own age. I am thus studying hysteria from the perspective of a developing tradition of reading the Hippocratic corpus, a textual tradition that culminates in Littré. In order to illuminate the growth of this tradition, I will also draw on texts produced outside it in order to provide the necessary context for its origin and development. Before turning to a more detailed study of the Hippocratic texts conventionally used as evidence for hysteria in ancient Greece, it is worth considering what implications the use of the label "hysteria" may have, for Littré and other writers. The Greek adjective hysterikos means "from the womb"; as such, it is a purely physical description of cause, showing the part of the body from which other symptoms emanate. In a woman, as another Hippocratic
13 text puts it, "the womb is the origin of all diseases," [58] so it would be fair to say that, in Hippocratic gynecology, all diseases are hysterical. But this word cannot have the same nuances for us as for an ancient author. Littré uses hysteria in a rather different way. In his Dictionnaire de la langue française (1863-77) he defines hysteria as follows: "Hystérie: maladie nerveuse qui se manifeste par accés et qui est characterisée par des convulsions, la sensation d'une boule qui remont de la matrice dans la gorge et la suffocation" (Hysteria: nervous disorder that manifests itself in the form of a fit and is characterized by convulsions, by the sensation of a ball rising from the womb into the throat, and by suffocation). To understand Littré's position, we must first understand the debate within which he is situating himself. Boss has traced the etiology of hysteria up to the seventeenth century. [59] He argues that, before about 1600, the "hysteric affection" was, as the name implies, attributed to the womb. In the early seventeenth century hysteria was linked not only to the male condition known as hypochondria, in which the spleen was thought to give off vapors, but also to melancholy, found in both sexes. Robert Burton saw hypochondria and hysteria as forms of melancholy; Sydenham believed that both sexes could suffer from hysteria, but that in women it was the most common condition next to fever. [60] Thus there was a shift in "the limits of hysteria, as it united with hypochondria and annexed parts of melancholy's crumbling empire." [61] At the same time the cause of hysteria came to be seen as being the brain, or the whole person. In the eighteenth century, hysteria was increasingly classified as a neurosis; the excess blood naturally present in the female body led to increased nervous irritability, especially under the influence of too much meat, coffee, or tea and insufficient exercise. [62] At this time, "According to the conventional medical wisdom, hysteria was a chronic, quintessentially feminine, disease resulting from the peculiar constitution and physiology of women." [63] The only certain way to make sure one's fragile nerves were not further weakened was to conform to the "prevailing social and biological notions of womanhood." [64] By the mid-nineteenth century, when Littré was writing, some doctors believed that the cause of hysteria was a physical disorder of the womb; others did not. [65] For most writers of this period, however they may have envisaged the mechanism of its production, hysteria nevertheless "was rooted in the very nature of being female." [66] Pierre Briquet rejected the idea that the womb was responsible, preferring the explanation of a "neurosis of the brain" in someone of the "hysterical type"; in other words, the hysterical personality was a necessary part of the development of the disorder. [67] In some historical periods the implications of the label hysteria are
14 thus that the disease originates in the womb, while in others the implications are very different, hinting that there is no organic origin for the symptoms. Littré's dictionary makes his own position clear; he follows writers such as B. C. Brodie, who in a lecture published in 1837 wrote that "hysteria. . . belongs not to the uterus, but to the nervous system." [68]
Hippocratic Hysteria: the Womb and Its Destinations For the Hippocratic writers, however, the texts that have been used in the construction of hysteria described something resulting from a firmly organic cause, the movement of the womb. It is to the role of the womb that we must now turn. The Hippocratic texts suggest that movement of the womb is caused by menstrual suppression, exhaustion, insufficient food, sexual abstinence, and dryness or lightness of the womb, and that it can be cured by marriage and/or pregnancy, scent therapy, irritant pessaries, and various herbal concoctions administered by mouth, by nose, or direct to the vulva. Since the womb is believed capable of movement around much of the body, these texts attribute a wide range of symptoms to womb movement. In searching for Hippocratic hysteria, we could therefore narrow down the field by identifying some combination of symptoms which so closely resembles the picture of hysteria in later historical periods that the problem of the absence of a disease label might be dismissed. The question raised by this approach is, of course, which historical period's image of hysteria we should take as our ideal type against which the Hippocratic texts are to be measured—hysterike pnix in the early Roman Empire? or the hysteria of the mid-nineteenth century? Another, more productive, way of approaching the problem is to start from the opposite end, asking which sections of the Hippocratic corpus have traditionally been used as evidence that hysteria was found in classical Greece. Robb's "Hippocrates on Hysteria" [69] translates the Aphorisms passage and five chapters of the gynecological treatises: Nature of Woman , chapter 87; Diseases of Women book 1, chapter 7, and book 2, chapters 123-125. He also gives brief summaries of Diseases of Women book 2, chapters 126-127. It is significant that these chapters are among the very small group of Hippocratic texts used in recent discussions of hysteria, the other major chapter most commonly brought into the debate being Diseases of Women 1.32. [70] Robb also cites the appendix to Regimen in Acute Diseases , which distinguishes between pnix —a breathing difficulty usually translated as "suffocation"—caused by the womb and that caused by spasm
15 or convulsions: if the patient feels pressure from the fingers, it is from the womb; if not, it is a convulsion. [71] However, close study of the above passages from Diseases of Women and Nature of Woman , so often the only examples of Hippocratic hysteria given in contemporary discussions, reveals that they have in common only a reference to the womb moving to another part of the body, and the symptom of pnix . The affinity between these is not, however, constant. For example, the womb may move in the absence of pnix , as in Diseases of Women 2.127 (L 8.272-274); this section is headed "Hystérie" by Littré. It is also worth noting that such features of nineteenth—and twentieth-century hysteria as grinding the teeth, loss of voice, cold extremities, and limb pains or paralysis do feature in the Hippocratic texts, often in the company of movement of the womb and suffocation, but may be found in the absence of either or both and may be attributed to a named organic cause; for example, in Diseases of Women 2.110 (L 8.234-238) they arise from a red flux. The difficulties of finding a passage in the Hippocratic texts to serve as a paradigm for Hippocratic hysteria are increased when we look at Littré's classifications and at the texts themselves. Thus, of the six texts used by Robb, [72] only four are in fact headed "Hystérie" by Littré: one chapter from Nature of Woman , 87 (L 7.408), and three from Diseases of Women , 2.123-125 (L 8.266270). Not only do they give largely different combinations of symptoms and prescribe different remedies, but in none of them does even the adjective hysterikos , "from the womb," appear. This last point is of particular interest. Since the noun is not used in this period, it is entirely irrelevant for M. R. Lefkowitz, in a discussion of fourth-century medicine, to claim that "the term hysteria means 'wombiness'." [73] Maybe it does; but since it is not used, this is of little importance. One also searches for it in vain in the later gynecological writers of antiquity, such as Soranus and Aretaeus of Cappadocia, in whose work there does exist a condition thought to originate in the womb and to cause symptoms of suffocation, tooth grinding, loss of voice, and so on, but which is called not hysteria but hysterike pnix , "suffocation caused by the womb." The classic description of the symptoms that came to be collected under this label is Soranus's Gynecology 3.26-29; section 2.11 of Aretaeus is also headed "On hysterike pnix " (CMG vol. 2, PP. 32-34) but, unlike Soranus, he lists the remedies in a separate section, 6.10, "Treatment of hysterike pnix " (CMG vol. 2, pp. 139-141). [74] The theories of Aretaeus and Soranus will be discussed in detail below. However, it is worth discussing why neither the category of hysteria nor that of hysterike pnix has a place in Hippocratic medicine. Not
16 only does pnix exist as a symptom in the Hippocratic gynecological texts, and hysterikos as an adjective, but one of the sections used by Robb and many others—Diseases of Women 1.7 (L 8.32) —even introduces the description with "If pnix suddenly occurs." Nevertheless, in these texts the two are not explicitly brought together. Why should this be so? One of the reasons why neither hysteria nor hysterike pnix is a Hippocratic category is simply that Hippocratic gynecology does not work by fitting collections of symptoms into preexisting categories. We can learn a great deal from studying the ways in which the Hippocratic writers choose to describe and to name disease. In many cases, ancient gynecology distinguishes and separates different combinations of symptoms according to cause and treatment, rather than subsuming many symptoms under a single disease label that "covers over all the clinical detail"; [75] it emphasizes description of symptoms rather than diagnosis. [76] Any attempt to impose the diagnosis of hysteria on the Hippocratic texts may therefore risk distorting their approach to illness. Indeed, looking at the Hippocratic corpus in general, not all Hippocratic texts name the diseases they describe. V. Di Benedetto distinguishes four ways of presenting a disease in these texts: as "another disorder," as "if" or "when" followed by one or more symptoms, as "if" or "when" followed by the name of a disease, or by giving the name of the disorder at the very beginning of the section. He suggests that these different ways of presenting disease reflect a culture in which the relationship between doctor and disease is defined in more than one way. The "if symptom x, therapy y" form is the most ancient, found also in Assyrian and Babylonian medicine, but in Hippocratic medicine it is slightly modified because the patient and the disease are separated and the possibility admitted that different patients may suffer in slightly different ways from what is nevertheless the same disease. Turning this last point on its head, the Hippocratic writers thus have the notion of a disease as something unitary which, due not only to the differences between patients in age, sex, temperament, and coloring, but also to variations in climate and season, may nevertheless manifest itself in a variety of ways. One disease: different symptoms, according to other factors affecting its presentation. [77] When the Hippocratic texts give a specific name to a disorder, it may be taken from the affected part; from the way in which the disorder presents itself; from the specific sensation caused; or from something that happens in the course of the disease. [78] Although there is no name given to the disorder, or disorders, in the texts usually seen as "Hippocratic hysteria," their opening words are relevant here. These fall into two
17 categories. Some start by describing the movement of the womb: "When the womb turns to the head" in Diseases of Women 2.123 (L 8.266). Others start with the symptoms of pnix , suffocation: the opening of Diseases of Women 1.32 (L 8.76) translates as "If pnix suddenly seizes a pregnant woman." The later name hysteria comes from the part believed to be affected: the womb. However, in the Hippocratic texts being considered here, the focus is either on the part that causes the symptoms or on the symptom that seems to have a central position: pnix . I will shortly return to the specific significance of this sensation in classical medicine. The texts traditionally used as examples of hysteria in the Hippocratic corpus exhibit several features that make it difficult to merge them into one picture. I now propose to discuss those most commonly used by later commentators in order of their appearance in the gynecological treatises, and to set them within the context of the imagery associated with "woman" in ancient Greece. The first description of interest is the second chapter of Diseases of Women book 1 (L 8.14-22), a discussion of menstrual suppression in a childless woman. Menstrual suppression is of central importance in Hippocratic gynecology, [79] due to a physiology of the female outlined in the previous chapter, Diseases of Women 1.1 (L 8. 10-14). Regular menstrual bleeding is seen as essential to female health—after maturity, outside pregnancy, and before the "drying out" of the menopause—because of the quality of female flesh. In women who have given birth, the body is "broken down" and its internal channels opened by childbirth and the lochia. A woman who has not given birth will suffer more pain if the flow of her menstrual blood is obstructed; because her body is more resistant, firmer, and more "thickly-packed," there is less open space into which the blood can travel. The writer of this chapter goes on to say that a woman's flesh is softer and of a looser texture than that of a man, and draws an analogy between female flesh and sheepskin, and between male flesh and a rug. If a fleece and a rug of equal weight are placed over water or in a damp place for two days and nights, the fleece will be found to have become much heavier than the rug. This is because sheepskin has a greater capacity to absorb water: a capacity shared with female flesh. [80] Aristotle's characterization of woman as "a deformed male" and "a mutilated male" is well known, as is its persistence in Western culture. [81] However, Aristotle's biology may be seen as only one manifestation of the classical Greek belief that women are both fundamentally different from, and inferior to, men. In the seventh century B.C ., the poet Hesiod expressed this belief in chronological terms; women, the genos gynaikon
18 or "race of women," were created later than men. Before Zeus sent the first woman and mother of the "race," Pandora, as one stage in the sequence of gift and counter-gift between gods and men, men lived like the gods. The arrival of Pandora and her daughters creates the need for sexual reproduction and agricultural labor, since women are voracious consumers of all that a man can produce. [82] In the Timaeus , Plato too presents women as a late addition to the human race; in the second generation of humanity, men who acted in a cowardly or unjust way in the first are reborn as women. [83] Defining the female in terms of the male is one way of expressing difference; chronology is another. Other images of male/female relations express it in other ways but show similar persistence: the agricultural metaphor, in which man ploughs the field that is woman and sows the seed in her passive body, or the war/childbirth opposition, in which man sheds the blood of others to defend the city in war, while woman bleeds from her own body and replenishes the city's stock of men. [84] By locating female difference at the level of the flesh, Hippocratic medicine incorporates the ideas of fundamental difference, sexuality, and bloodshed into its image of woman. The direct consequence of the difference between the flesh of the two sexes is that women absorb more fluid from the digestive process, needing menstruation to remove the excess from their bodies. As a result, in the Hippocratic texts women are often described as "wetter" than men. Women are loose-textured and soft to the touch, thus by their very nature retaining moisture, and this retention is even presented as the explanation for women having breasts. [85] A further factor mentioned in Diseases of Women 1.1 is their way of life. A man does more strenuous and tiring work, which dries out any excess moisture he may have accumulated; women live sedentary lives, leaving menstruation as the only way of purging them of the excess fluid building up in their bodies. It is in the context of these beliefs about the female body that Diseases of Women 1.2 should be read. In certain circumstances, even in the wet body of a woman, the womb may be deprived of sufficient moisture. The childless woman, due to the lack of spaces in her body in which moisture can be stored, is at particular risk, above all if she abstains from the "moistening" activity of sexual intercourse. In such a woman, the "dry and light" womb may suddenly "turn around" [86] and move up in search of moisture. Menstruation stops, and if it does not occur for three months there will be pnix from time to time, intermittent fever, shivering, and pain in the limbs. If there is no bleeding by the fourth month, these symptoms will worsen and will be joined by those of thick urine,
19 a swollen abdomen, grinding the teeth, loss of appetite, and difficulty in sleeping. In the fifth month all symptoms will be worse; if the condition persists into the sixth month with no menstrual loss, it will have become incurable, and the woman will suffer the additional symptoms of vomiting phlegm, extreme thirst, discomfort if touched, gurgling sounds from the blood in the womb which is unable to come out, loss of voice or difficulty in making herself understood, and irregular breathing. Finally the abdomen, legs, and feet will swell: death is imminent. The disorder described in Diseases of Women 1.7 is similar, although it does not follow this month-by-month pattern, but the explanation for the symptoms is different, since the central point seems to be that they depend on the location to which the dry womb moves. The affected group is described as women not having intercourse, but older rather than younger women because their wombs are lighter in weight. Elsewhere in these texts it is explained that the younger the woman, the more blood there is present in her body. [87] If a woman's vessels are emptier than usual and she is more tired, the womb, dried out by fatigue, turns around and "throws itself" on the liver because this organ is full of moisture. This causes sudden pnix , by interrupting the route of the breath through the belly. During this pnix , the whites of the eyes are turned up, the woman is cold, and her complexion is livid; she grinds her teeth and has excess saliva, like a sufferer from Heracles' disease, another name for the condition that the Hippocratics usually called the sacred disease and which we would probably call epilepsy. Sometimes phlegm will run down from the head, causing the womb to leave the liver and return to its proper place, and the pnix will stop because the womb is now full of fluid and heavy. If the womb stays on the liver or in the area of the hypochondria for a long time, however, the sufferer will be choked; if it moves to the mouth of the bladder, it will cause strangury; or it may go to the limbs or side. Diseases of Women 1.32 (L 8.76) gives an almost identical etiology for pnix and a very similar picture of symptoms, but it concerns the condition in a pregnant woman. Not only fatigue but also insufficient food can cause the womb to move; the womb itself is described as being overheated as well as dry. As in 1.7, phlegm—described as cold—may run down from the head and cause the womb to return to its proper position; if the womb does not return quickly, there is danger to the fetus. The alleged hysteria texts in Diseases of Women 2.123ff. are much shorter than those so far discussed and give little information on the women most likely to be affected or on the mechanisms by which the
20 symptoms are produced. Instead, they start by naming the location to which the womb has moved (without saying why it has traveled there), then give a short list of "signs," and finally outline the treatment. Diseases of Women 2.123 (L 8.266) opens: "When the womb moves to the head and the pnix stops there, the head is heavy." The signs are that the patient says she has pain in the channels in the nose and under the eyes: there is lethargy and foaming at the mouth. The first treatment is to wash her with warm water; if this does not work, cold water or cooled boiled laurel or myrtle water should be put on the head, and the head anointed with rose oil. Sweet smelling fumigations should be applied below, foul smelling substances to the nostrils; she should eat cabbage and drink cabbage water. Diseases of Women 2.124 (L 8.266-268) has an identical format and concerns movement to the heart; Diseases of Women 2.125 (L 8. 268-270) and 2.126 (L 8.270-272) concern movement to the hypochondria, for which drinks of castoreum and fleabane[88] are among the recommended remedies. As is usual in these texts, a range of different substances is given, perhaps in order to aid the doctor in catering for a range of abilities to pay, or to allow for seasonal difficulties in obtaining the substances. In general, in addition to pessaries, washing, bandages around the body to keep the womb in place, [89] oiling, and drinks, these texts make much use of fumigation, a frequent remedy for gynecological conditions. The most detailed description of fumigation occurs in a text that is not traditionally used by later writers on hysteria: Diseases of Women 2.133 (L 8.284-286). This covers a forty-day program of pessaries and fumigations for a condition in which the womb moves to the hip joint, the mouth of the womb is closed and tilted, and the menstrual blood, unable to leave by its usual route, moves instead to the breasts. It is worth translating in full not only because of the details of the fumigation process, recommended to return the womb to its place and open it so that the menstrual blood can come out—part of the treatment for hysterical suffocation for many centuries—but also because it is only one of many chapters that could be used to show the existence of womb movement texts, the details of which the hysteria tradition chooses to ignore. Contributing to its neglect by the hysteria tradition is the fact that Littré diagnoses it not as hysteria but as "Obliquité latérale devenant chronique" leading to menstrual suppression, swollen breasts, and, eventually, breast cancer. The description of fumigation reads as follows.
21
First give a fumigation to the womb. Take an earthenware pot with two-sixths capacity, put on it a dish, and fit them together so that no air can get in. Then pierce the bottom of the dish and make a hole. Put in the hole a reed, about a cubit long. The reed must be properly inserted in the dish so that no vapor escapes. When you have prepared this, place the dish on the pot and plaster it round with clay. When you have done these things, dig a hole in the ground, two feet deep, large enough to make room for the pot. Then burn firewood, until you have made the hole red-hot. When it is red-hot, take out the wood and the biggest and hottest pieces of charcoal, but leave the ashes and embers in the hole. When the pot is heated up and vapor rises, if the vapor is very hot, hold back; if not, she is to sit on the end of the reed, and pass it into the mouth [of the womb], then fumigate. If it cools, throw on red-hot charcoal, taking care that the fumigation is not too fiery. If, by adding the charcoal, the fumigation becomes more fiery than it should be, take away the charcoal. One should construct the fumigation in fine, still weather, so she is not cold: she should be covered with garments. In the pot you should put dry garlic, and pour in water so that it rises two digits above, and soak it well, and pour in seal oil too. Heat this. The fumigation must go on for a long time. After the fumigation, if she is able, she should wash her whole body as she pleases, the lower back and below the navel in particular. Give for dinner barley cake or wheat bread, and boiled garlic. On the next day, if she is weak from the fumigation, intermit that day: if not, go back to the fumigation. While she is being fumigated, if she is able to examine it, order her to touch the mouth [of the womb]. The fumigation itself inflates the womb, makes it more upright and opens it. It is because it is like this, and can do such things, that you should use a fumigation.[90]
On the constituents of this fumigation, it is noteworthy that elsewhere in this treatise seal oil is described as the best substance to use in a fumigation for movement of the womb to the hypochondria. [91] Garlic, like castoreum and fleabane, features because of its strong smell. In descriptions of therapy for womb movement, the olfactory qualities of substances often account for their use. The pattern is usually that fragrant substances are applied to the vulva, in order to attract the womb back, while foul-smelling substances are placed under the nostrils to drive the womb away from the upper parts of the body. [92] In addition-and in apparent contradiction—fragrant oils may be rubbed on the head and strong-smelling substances drunk, often in wine. Littré's diagnosis apart, there seems little reason why the womb movement described in 2.133 should have been omitted from the construction of the hysteria tradition. That section demonstrates the prevalence
22 of the combination of womb movement and menstrual suppression throughout Diseases of Women . Returning to the alleged hysteria texts, Diseases of Women 2.127 (L 8.272) is another description of movement of the womb to the liver, which defines the affected group in a way different from that of the writer of 1.7. Where 1.7 saw the most likely sufferer as an older woman not having intercourse, 2.127 suggests movement to the liver is more common in older unmarried women and young widows, especially the childless and the sterile, because these women lack the beneficial purging of childbirth and the lochia. Here the argument is more reminiscent of 1.2. Section 2.128 (L 8.276) discusses movement to the hypochondria, for which a fumigation followed by intercourse is recommended, and 2.129 (L 8.276) covers movement to the ribs, which can cause a cough, pain in the side, and what feels like a ball in the side. Section 2.130 (L 8.278) concerns movement to the hips or flanks, and 2.131 (L 8.278) movement to the middle of the waist, in which the drawing up of the limbs is mentioned as a symptom. A further set of texts concerning womb movement may be found at 2.200ff.; two significant points for the later history of hysteria occur in 2.201 (L 8.384), where it is recommended that the patient's groin and inner thighs should be rubbed with aromatics to cure movement of the womb to the diaphragm, and 2.203 (L 8.388), where we read, "When the womb causes pnix , light a lamp and snuff it out under the nostrils" and, later in the same chapter, "Take a lamp, throw on it a little oil, light it, and when it is extinguished hold it near the nostrils." The first therapy is used in a famous passage of Galen, which will be discussed below: the second, also found in one of the texts used in the hysteria tradition, Nature of Woman 87 (L 7.408), [93] occurs in many later discussions of hysteria. It can be seen that the Hippocratic texts do indeed work by describing symptoms rather than giving a single disease name to these chapters, and that where they group symptoms and therapies together they do so according to the part of the body to which the womb is believed to have moved. Of these therapies, the recommendation of marriage/pregnancy occurs only in the discussion of womb movement to the hypochondria in Diseases of Women 2.128 (L. 8.276), which ends by saying that, after fumigation, the patient should sleep with her husband: "release from this disease, when she is pregnant." Nevertheless, it is this treatment for womb movement that has received most attention in the secondary literature, above all in the work of the psychoanalyst and classicist Bennett Simon, in his Mind and Madness in Ancient Greece . This includes a chapter titled "Hysteria and Social Issues," which opens with the familiar error:
23 "Hysteria, the disease of the 'wandering uterus,' was given its name by the Greeks." [94] Simon's overall approach to hysteria combines that of I. M. Lewis's study of spirit possession, trance, and shamanism, which presents the possessed state as an indirect mode of protest used by powerless and peripheral sectors of society, [95] with a Freudian model. According to what Simon calls a "psychodynamic understanding of hysteria," "a hysterical symptom, for a Greek woman, permitted a safe expression of certain unmet needs," as a result of which expression the doctor would intervene on the woman's behalf as the "wished-for good father." [96] To summarize the "culturally sanctioned dumb show" [97] that Simon envisages, an unmarried or widowed woman is supposed to feel sexually frustrated and to express this frustration by hysteria: the doctor then legitimates her wish by announcing that the cure consists in letting her have what she wants, since it is precisely marriage and childbirth that will make her healthy again. This approach is inadequate because it shows little understanding of the institutional position of women, the ideal of marriage as universal, the ideal age at first marriage of fourteen for girls, and so on. [98] It also fails to come to terms with the fact that, in most of the texts labeled "Hystérie" by Littré, the marital status of the sufferer is not given[99] or she is explicitly described as married. [100] In his discussion Simon cites only one Hippocratic passage, Diseases of Women 2.151 (L 8.326), in which the woman patient is said to suffer in the same way as those who are struck with the sacred disease. In another passage on this last disease, Simon reveals that, like Veith, he has not studied the Greek text of the Hippocratic corpus in sufficient detail. After a brief discussion of the "madness of Heracles," which "was considered by some to be a case of epilepsy," [101] Simon states, "To my knowledge, the Hippocratic corpus contains no mention of the mythical characters who went mad and were portrayed so vividly on the Athenian stage and in vase painting." However, as I have mentioned above, in Diseases of Women 1.7 (L 8.32) the writer states that women with the condition he describes resemble sufferers from "Heracles' disease"; hypo tes herakleies nousou , which Littré translates "aux épileptiques." The characters of myth, who had influenced the folk names of diseases, are thus present even in the Hippocratic corpus. It is, furthermore, inappropriate to describe hysteria as a "safe expression" of a woman's needs when loss of voice, grinding the teeth, and "movement of the womb to the liver," far from being a safe way of attracting attention, may be the signal for the Hippocratic doctor to tie bandages around the patient's waist, place foul-smelling substances under her nose, insert beetle pessaries, inject hot oil into the womb, or
24 shower her with cold water. As examination of the texts has already shown, and contrary to what Simon implies, marriage and childbirth are rarely the prescribed remedies for this combination of symptoms, [102] and it is also unusual for the remedy to consist of something that could be seen as a form of indirect sexual gratification; for example, fragrant ointments to be rubbed on the vulva[103] or the vaginal insertion of objects specifically described as resembling the male sexual organ. [104] Finally, it is inappropriate to use Simon's "psychodynamic model" when in Hippocratic medicine there is no line drawn between psychological and organic illness. [105] A similar approach to that of Simon is taken by Rousselle, who states that "Greek women had no legal right to make any decision regarding their own marriage: they could not ask a man to marry them, or even decide that they wanted to be married or to accept an offer of marriage, so it is perhaps not surprising that their impotent anger should take the form of a disease in which their womb was literally suffocating them." [106] D. Gourevitch traces the disappearance of "the hysterical virgin from medical literature" between the Hippocratics and the medicine of the Roman Empire; she attributes this disappearance to institutional change since, if the age at first marriage falls even further, fewer girls will remain to become hysterical. [107] However, such approaches are rooted in our own society's views on what is normal for a woman, on the nature of hysteria, and on the relationship between medicine and sexuality. Yet for the writers of the Hippocratic texts—and probably for the patients they treat—intercourse and pregnancy rightly belong to the domain of the pharmacopoeia, due to their dramatic and beneficial physical effects. Not only does intercourse moisten the womb, thus discouraging it from moving elsewhere in the body to seek moisture, but it also agitates the body and thus facilitates the passage of blood within it. Furthermore, childbirth breaks down the flesh throughout the body and, by making extra spaces within which excess blood can rest, reduces the pain caused by the movement of blood between parts of the body. It causes complete purgation (katharsis ) of excess blood and may thus cure many women whose problems originate in menstruation. Since all disorders of women ultimately result from their soft and spongy flesh and excess blood, all disorders of women may be cured by intercourse and/or childbirth, to which marriage and pregnancy are the necessary precursors. There is thus nothing special about the prescription of these in cases of movement of the womb. Hippocratic medicine thus gives a pharmacological interpretation to
25 what we may be tempted to see as the social processes of marriage and motherhood. We should, of course, never forget that the Greek word for mature woman, gyne , also means "wife." Womb movement, however, calls up a battery of other therapies, many of which-like the fumigation described above—make use of foul—and sweet-smelling substances. These therapies lie behind the assertion frequently made in later writers—but not in such authors as Soranus and Galen—that the Hippocratic womb was thought to be an independent living being, fleeing from foul smells but moving to seek out more pleasant odors. We must now decide whether any such belief is necessarily implied by the use of scent therapy. Such therapy relies on the idea of connections existing between parts of the body, and in particular in the gynecological texts on the presence of a hodos or "way" from the nostrils and mouth to the vagina. [108] This is never anatomically described but is implicit in many therapies used. For example, a test to determine whether a woman can conceive involves putting a clove of garlic or another strongly scented substance at one end of the hodos and discovering whether the scent reaches the opposite end. If so, there is no obstruction present, and the woman can conceive. [109] Disorders of the womb can also be treated by using the hodos . A summary of treatments of the womb in Diseases of Women 2.137 mentions the top and the bottom of this tube as appropriate sites for the administration of medication. [110] If the womb has moved upward, foul-smelling substances are held at the nose, pleasant-smelling substances to the vulva, so that the womb is simultaneously repelled from above and attracted down to its correct place. [111] If the womb moves down, or starts to come out of the body through the vulva, foul smells are placed there and sweet smells at the nostrils to draw it up again. [112] There is no explicit discussion of the mechanism by which such therapy is supposed to work.
Plato and Aretaeus: the Wild Womb? It is significant for later medicine that these descriptions of scent therapy also contain no suggestion that the womb is animate; that is, that it is a living being with a desire for sweet smells and a revulsion for foul smells. This brings us to a further important passage, Plato's Timaeus 91a-d, a description of the womb as animal, which has been highly influential in the history of hysteria. The womb is seen by Timaeus of Locri as a living creature desiring union, which, if it remains unfruitful (akarpos ) beyond its proper season, travels around the body blocking passages, obstructing breathing, and causing diseases. C. M. Turbayne says "Plato's account
26 follows that of Hippocrates who, in his Sicknesses of Women , coined the word 'hysteria' and ascribed hysteria to the wandering womb." [113] As one would expect, Veith is cited in a footnote. [114] Furthermore, this link between womb and animal is taken by F. Kudlien to be the assumption behind the "well known ancient concept" of uterine suffocation. [115] Plato lived from about 498 to 347 B.C . and was thus writing at the same time as the authors of Diseases of Women , or a few years after. Is it therefore valid to merge his theories with theirs and conclude that the Hippocratic scent therapy necessarily implies the belief that the womb is animate, "a living thing inside another living thing," as the second-century A.D . medical writer Aretaeus later wrote?[116] The difficulty with this approach is that there are clear differences between the gynecology of Timaeus and that of the Hippocratic corpus, and there is ample evidence that the idea of the womb being—or being like—an animal was disputed even in antiquity. Its best-known expression, apart from the passage in Timaeus , is in Aretaeus, who states that movement of the womb mostly affects younger women, whose way of life and judgment are "somewhat wandering" so that their womb is "roving" (rhembodes ). Older women have a "more stable" way of life, judgment, and womb. This in itself varies from the Hippocratic theories, which tend to link movement of the womb with older women, whose wombs are lighter. [117] It is in this section too that Aretaeus describes the womb as hokoion ti zoon en zooi , usually translated as "like some animal inside an animal" but which could be less emotively rendered "like a living thing inside another living thing." It has been suggested that the words of Aretaeus are based on a recollection of having read Timaeus at school: [118] as may be seen from the work of Soranus, also writing in the secondcentury A.D ., this was certainly a very outdated idea in second-century medicine. Soranus explicitly rejects the claim of "some people" that the womb is an animal, although he admits that in some ways it behaves as if it were, for example, in responding to cooling and loosening drugs. He reinterprets the success of therapy involving sweet—or foul-smelling substances to attract or repel the womb, saying that these work not because the womb is like a wild animal emerging to seek pleasant scents and fleeing from foul ones, but because the scents cause relaxation or constriction. [119] Galen, writing shortly after Soranus, discusses and rejects what he regards not as Hippocrates' but as Plato's theory of the womb as a living creature in On the Affected Parts 6.5. After quoting from Timaeus he writes, "These were Plato's words. But some [physicians] added that, when the uterus during its irregular movement through the body touches the diaphragm, it in-
27 terferes with the respiratory [movements]. Others deny that the uterus wanders around like an animal. When it is dried up by the suppression of menstrual flow, it extends quickly to the viscera, being anxious to attract moisture. But when it makes contact with the diaphragm during its ascent, it suppresses the respiration of the organism." [120] It is thus clear from Soranus and Galen that, at least by the second century A.D ., medical opinion was split on whether womb movement necessarily entailed assigning the status of "living thing" or "wild animal" to the womb. It may further be questioned whether Plato's account—or, perhaps, the Locrian's account, since it is by no means certain that the passage represents Plato's own views [121] —is in any way following the Hippocratic Diseases of Women , as Turbayne argues. In general, Timaeus shows a strong humoral theory of disease in which the four humors are linked to the four elements: earth, air, fire, and water. The use of humoral theory in the Diseases of Women is minimal, perhaps because the female body is so heavily dominated by blood. The description of the womb and of conception in Timaeus should be read in the context provided by the preceding sections on the human body, which show that analogies in which certain parts of the body are compared to living creatures are common in Timaeus . That part of the soul which is concerned with bodily desires is tied up in the body "like a wild creature"; [122] a disease is described as being like a zoon , in that it has a natural span of life. [123] At the start of the second generation of mankind, all those who have proved cowardly or unjust in the first become women; it is at this point that the gods put into all human beings a zoon that desires sexual union. In males, the penis has a disobedient and selfwilled nature, "like a zoon " and, like the savage part of the soul, it does not obey reason, the logos . [124] When the womb is described, all that is different is that it is no longer put beside the zoon in a simile, but appears in a metaphoric relationship; not "like a living thing," but "a living thing desiring to bear children." [125] In both cases what is significant is that the organ moves independently of the will, in an uncontrolled way. Since Plato/Timaeus has already mixed apparently nonfigurative uses of zoon (the gods put a living creature in all humans) with obvious similes (the penis is like a zoon ), it would be unwise to make too much of the way in which the womb is described. It should also be noted that animal analogies are used elsewhere for the organs. Not only woman is thought to have a zoon inside her, since Plato himself likens the penis to an animal, and in Aristotle it is the heart that is like an animal, this in turn being likened to the genitals in a further analogy. [126] In men, the zoon empsychon that makes the penis behave "like an ani-
28 mal" is in the seed, which comes from the spinal marrow. [127] The theory of the origin of the semen is consistent with Hippocratic anatomy, which traces its path up the spinal cord, behind the ears and to the head. [128] In the description of the corresponding part in woman, the womb, there are however some obvious differences from Hippocratic theories. Timaeus says that in coitus minute invisible and shapeless zoa are sown in the womb, where they will grow to maturity. Apart from the very general sowing analogy, this does not correspond to anything in the corpus; indeed, in the Hippocratic Generation 6 and 8, both male and female contribute seed, the sex of the child being determined by the strongest seed. [129] Aretaeus's analogy is thus not characteristic of the medicine of his time but, on the contrary, stands out as an anachronism: Plato's (or Timaeus's) medicine, while sharing some anatomical features with Hippocratic theories, demonstrates many individual points. Galen and Soranus mention the belief that the womb is not just like an animal, but is an animal, yet Galen ascribes this only to Plato. From the list of treatments of which he disapproves, Soranus apparently thinks that the use of scents in therapy tends to imply the belief that the womb is an animal. However, the central role of scent therapy in disorders of the womb in the Hippocratic texts does not mean that the Hippocratic writers would inevitably have regarded the womb as an independent animate part of the body; as Soranus's own explanation of why scent therapy works shows, it would be possible to use this technique within an entirely different conceptual framework, openly rejecting the animate womb theory. I would also question whether we would be so ready to read into Hippocratic medicine ideas of the womb as an animal, were it not for the influence of the imagery of Timaeus on Aretaeus and on other writers to the extent that Galen finds it necessary to refute the theory. Our own medical theories play a part in this: because it is self-evident to us that the womb not only is not a living creature, but also cannot move around the body, any suggestion that it does so move is startling, demands explanation, and may be given more weight than it deserves.
Stifling and Suffocation: the Development of the Textual Tradition In my discussion of the ways in which the Hippocratics classify disease, I have emphasized that the disease label hysteria, far from being applied in these texts for the first time, is a much later invention. The developing hysteria tradition uses only a selection of the Hippocratic texts on womb
29 movement; within this selection, it ignores the disagreement on such matters as the most susceptible category of woman, and the variation in symptoms according to the part of the body that the womb reaches in its quest for moisture. It also takes and merges distinctive images and therapies from these texts, regardless of their relative importance in Hippocratic medicine. In the texts used to support this developing tradition, the symptom that stands out, and that is indeed sometimes used to introduce the Hippocratic disease description, is pnix , usually translated as suffocation. It is now necessary to consider the significance of this symptom in some detail. If we are to take seriously Shorter's suggestions that "the presentation of 'hysterical' symptoms tends to be molded by the surrounding culture" and that we should therefore be asking why "certain symptoms are selected in certain epochs," [130] we need to reject our fascination with womb movement—which was, after all, seen as unproblematic by classical Greek writers—and instead explore the implications of pnix in the very specific context of classical Greek medicine. In his recent history of hysteria, Trillat poses a very pertinent question: is it the womb or the woman who suffocates in these texts?[131] He suggests that this is not clear from the Hippocratic texts; however, unlike the Littré translation, the Greek text is often relatively straightforward on this issue, due partly to the convention by which Hippocratic writers often used plural terms for the womb. This enables us to see that, although in some cases it is the woman who suffers from the pnix , [132] it is generally the womb that is "stifled"; for example, "When the womb (sing.) stifles"; "If the womb (plural) arrives at the heart and stifles (plural)." [133] I am proposing the translation "stifles" rather than "suffocates" for reasons that will shortly become clear. In order to grasp the implications of pnix , the stifled womb that in turn stifles the woman, it is necessary to return to the question of what the Hippocratic writers—and the culture within which they practiced—understood to be the nature of woman. "Not only was the cause of hysteria rooted in the very nature of being female, but also in the belief that that nature was prone to disorder": thus W. Mitchinson, in a recent article on nineteenth-century Canadian medicine. [134] This interest in nature takes on a different coloring in the key hysteria text of the early seventeenth century, Edward Jorden on "the suffocation of the mother," which was written to show that this disorder should not be "imputed to the Divell" but rather has "its true naturall causes." [135] In Jorden's sense, nature is also fundamental to the Hippocratic texts. One of the achievements of Hippocratic medicine which it is common-
30 place to admire is its movement away from explaining disease as divine in origin—the result of displeasing a deity, as in the opening of the Iliad , or of failing to fulfill a ritual obligation—in favor of natural explanations. [136] The Hippocratic text usually quoted in this context is On the Sacred Disease , in which the alarming symptoms of epilepsy are shown to have a natural explanation, making it no more and no less sacred than any other disease. In the Hippocratic Diseases of Women 2.151[137] an explicit comparison is drawn between a group of symptoms classified by Littré as hysteria and the sacred disease. It would be wrong to conclude from this that medical writers in the ancient world had correctly understood the similarity between the mechanisms by which these two disorders, as we define them, are produced; what is important is the suggestion that there is a natural explanation not only for the symptoms produced by womb movement but also for that movement itself. [138] For the history of medicine, it does not matter that the "natural" explanations given—the movement of the womb around the body, the constitution of the female—are ones in which we do not believe; what is important is that nature, not the gods, is thought to be responsible. There is however a further aspect of the production of the symptoms which explains why they naturally affect only women; women, by nature, have wombs, and "the womb"—implying both "not the gods" and "no other part of the body"—"is the origin of all diseases" according to the Hippocratic text Places in Man . [139] Menstruation is, as the second-century A.D . writer Soranus puts it, "the first function" of the womb, [140] and the writer of the Hippocratic text Nature of the Child describes as "simply a fact of her original constitution" the naturally wetter and more spongy flesh of the female which makes a woman produce excess blood. [141] This blood moves to the womb every month prior to leaving the body in that flow that is, among other names, called he physis , "nature," [142] or ta kata physin , "the natural things." [143] For the Hippocratic writers, then, menstruation and nature are synonyms; all diseases of women come from the womb and thus from the nature of female flesh, the wet and spongy texture of which causes the accumulation of large amounts of blood, making menstruation necessary to female health. As Generation 4 puts it, "if the menses do not flow, the bodies of women become sick." [144]
The symptom of pnix arises from the nature of woman. There is some disagreement in the ancient medical writers as to whether women are by nature hot or cold. For Aristotle, whose ideas on this point were historically more influential than those of the Hippocratics, women are cold, too cold to concoct blood into semen. [145] Difficulties arise with this
31 position because, in humoral pathology, blood is hot and wet. If women have more blood than men, surely they should be hotter than men? In the debate given by Plutarch in Moralia , [146] a doctor takes up precisely this position in order to argue that women are the hotter sex; this is also the argument used to prove women's hot natures by "Parmenides and others," according to Aristotle, [147] and a related argument appears in the Hippocratic Diseases of Women 1.1, [148] which says that "the woman has hotter blood, and because of this she is hotter than the man." It is however possible to argue that women are cold, despite their excess blood. Other speakers in the Plutarch passage claim that menstrual blood is not normal, "hot" blood, but a cold and corrupt form. The Hippocratic writer of Regimen 1.34 does not go this far; he accepts that menstrual blood is hot but argues that, since they purge the hot every month, women end up being cold! [149]
There is also a third option; the womb, due to the way in which its role in conception and gestation is imagined, can be classed as hot, whether or not the menstrual blood or the woman herself is considered cold. Aristotle, for whom women are cold, can thus retain the traditional analogy by which the womb is compared to an oven. [150] This analogy appears in a wide range of types of source material. By committing necrophilia, the tyrant Periander of Corinth was—in the words of the historian Herodotus—"putting his loaves into a cold oven." [151] In the Dream Book of Artemidorus, an important source for ancient imagery, a hearth (hestia ) and a baking-oven (klibanos ) can represent women, because they receive things that produce life. Dreaming of seeing fire in a hearth means that your wife will become pregnant. [152] In the Hippocratic texts Generation and Nature of the Child there are several occasions in which the womb is described in terms of the heat it generates, in one of which the embryo is compared to bread baking in an oven. Intercourse heats the blood and thus produces heat in the whole body, and the development of the seed in the womb is due to its being in "a warm environment." [153] Whether women are classified as hot or cold, they have within them an oven to heat the seed. How should this influence our understanding of pnix? The sensations of suffocation and stifling are not necessarily identical. Suffocation implies an obstacle preventing breathing; in this it resembles strangulation but, whereas the former suggests to us something over the mouth and nose, the latter suggests something around the neck. Stifling additionally implies heat, which is why it is to be preferred as a translation of pnix . Overlap is of course possible, since pressure around the neck or over the mouth may also cause a feeling of heat. Greek words related to pnix ,
32 such as pnigos and pnigmos , mean stifling heat, while a pnigeus is an oven. Support for the importance of heat in pnix in the period of the Hippocratic texts may be gained from Aristophanes' play Frogs , in which the god Dionysus asks the hero Heracles for a way to Hades which is neither too hot nor too cold. Heracles suggests "by rope and stool"—that is, to hang oneself. Dionysus replies, "No, that's stifling." [154] Heracles goes on to suggest hemlock, which is rejected as "too cold." The use of a hot/cold opposition again associates pnix with heat. It is thus because the Hippocratic writers have absorbed the traditional and powerful image of womb as oven that they associate its movement with the production of excess heat. This suggests a further aspect of the common recommendation of pregnancy as the best cure for many disorders of the womb; if nothing is cooking in a woman's oven, its heat will overwhelm her in some way unless something is done to use up that heat. The underlying image of womb as oven in these texts could account for other symptoms. Women with pnix feel cold at their extremities, perhaps because all their body heat moves toward the womb. In the cultural context of Hippocratic medicine, pnix thus implies something more than "difficulty in breathing." It points us to something fundamental to that culture's image of the female, as an oven in which the seed is cooked. The supposed movement of that oven to other parts of the body in search of moisture to dampen down the fire can therefore be seen as causing heat in the affected part; the womb itself is stifled, and this can be transmitted to the woman sufferer. Being a woman, for the Greeks of this period, means having an oven inside you; an oven that is a natural —and socially acceptable—target when a physical cause is sought for dramatic somatic manifestations. [155] I have already demonstrated the variations within the Hippocratic corpus on such questions as the heat or coolness of the woman and the most likely category to suffer from womb movement. There is one Hippocratic passage in which pnix is explicitly linked to physical obstruction of breath. This is Diseases of Women 1.7, in which the womb, dried out by fatigue, moves to the liver because this organ is full of moisture. The result is sudden pnix , due to what is described as the interruption of the route of the breath through the belly. It is this etiology, rather than the general image of woman, or womb, as hot, which is taken up by later writers seeking to account for pnix . However, due to their general beliefs about the role of breath, heat still plays a part in such theories. In later classical medicine pnix apparently becomes simply obstruction of respiration; however, nothing in the history of medicine is really simple. The implications of the shift in terminology require further explo-
33 ration of the conceptual universe of these writers, since respiration itself does not have the meaning we would most naturally assume. The difficulty of using words such as respiration, veins, arteries, and pulse is that we regularly employ them within an anatomy and physiology completely different from those of ancient writers. Furthermore, theories of breathing, nutrition, and blood movement were themselves changed many times before William Harvey, and not necessarily as part of a linear process of experiment and discovery. To translate the Hippocratic phlebs (channel) as "vein" is to imply it is different from another sort of channel that is an "artery." The distinction between arteries and veins was probably first made by Praxagoras of Cos in the late fourth century B.C ., not in the context of an emerging theory of the circulation of the blood around the body, but instead because he believed blood and pneuma traveled through different systems. [156] Respiration is an excellent example of these difficulties, which also allows us to look at the presentation of hysteria in one of the immediately post-Hippocratic writers most relevant for the hysteria tradition: the fourth-century B.C . philosopher Heracleides of Pontus (ca. 390-310 B.C .). Although we may use respiration to mean breathing in general, behind the word inevitably lies our knowledge of the process by which oxygen is taken in and carbon dioxide given out. If we translate the title of a treatise by Galen, De usu respirationis , as "On the use of respiration," it may be difficult for us to appreciate the implications of the term within the science of the second century A.D . and before. A theory once widely held however is that of skin-breathing, discussed from before the time of Hippocrates to that of Galen. In the mid-fifth century B.C ., the philosopher Empedocles proposed that all living things breathe through the pores of their skin. [157] Plato preserves a version of skin-breathing that also accounts for the movement of blood in the body; air enters through the skin to replace that exhaled through the nose and mouth, while also entering through the nose and mouth to replace that exhaled through the skin. The resulting movement, rather than the heart, is thought to be responsible for sending blood to those parts of the body requiring its nutriment. [158] When Galen uses words for respiration, he includes within it skin-breathing. Aristotle suggests that the function of respiration is to cool the innate heat generated in the body by food; Galen goes further, arguing that breathing occurs "for the sake of the innate heat" and, elsewhere, that "the use of breathing is the conservation of the innate heat." [159] By this he means that breathing regulates the innate heat either by fanning it or by cooling it.
34 Skin-breathing and innate heat play an important role in Galen's theory of "hysterical suffocation," especially in relation to a story that becomes part of the hysteria tradition: the apparently dead woman whose revival is described in a lost work by Heracleides of Pontus. In his discussion of the most severe form of hysterical suffocation in On the Affected Parts 6.5 Galen refers to this story as follows:
For [Heracleides] says that that woman who had neither breath nor pulse could only be distinguished from a corpse in one way: that is, that she had a little warmth around the middle part of her body.[160]
After Heracleides, Galen says, doctors developed tests for the presence of life: wool held at the nose, or a vessel of water on the navel. In the later tradition a deep concern remains over the ability of hysteria to mimic death—particularly since one of the symptoms is supposed to be the absence of any pulse—and stories are told of women mistaken for dead who revive on the edge of the grave. [161] Although Apnous is lost, the story of the woman is repeated in several other writers of antiquity. The closest to Galen in both wording and time is Diogenes Laertius, a writer of the third century A.D ., who states that the woman's body was apnoun kai asphykton , "without breath or pulse," for thirty days. As well as this last detail, Diogenes Laertius adds further information about the circumstances, and this is duplicated in other writers. [162] The story told by Heracleides apparently concerns Empedocles, who told his friend Pausanias how he had realized the woman was not dead from observing the innate heat. Clearly she was able to breathe through her skin, and eventually recovered, much to the amazement of the onlookers who attributed this to a miracle performed by Empedocles. This story was very popular in the sixteenth century; one medical writer of that period who used it was Pieter van Foreest. Instead of following Diogenes Laertius, who said that the woman was without breath or pulse for thirty days, he uses the version given prior to Galen, by Pliny in the first century A.D . [163] This sets the story within a discussion of souls that leave the body and return to it, which is in turn followed by accounts of people who recovered from apparent death. Pliny writes, "This topic is the subject of a book by Heracleides, well known in Greece, about a woman who was seven days without breath but was called back to life." Van Foreest repeats the "seven days" as well as Pliny's remark that "the female sex seems particularly liable to this disease, since it is subject to turning of the womb." [164] In his scholia on this section, van Foreest follows Galen's theory on the innate heat, which is also used to account for the coldness of the extremities. He then states that learned authorities
35 all agree that patients with this condition should not be buried until the third day. [165] Why should he give the third, rather than using seven or thirty? Perhaps the solution is to be found in the use of the story in early Christian writing. Origen (ca. A.D . 185-ca. A.D . 254) refers unbelievers to it in the context of Christ's resurrection from the dead: although Origen does not say how long the woman in the story in Heracleides lay dead, the figure of three days may come from this analogy. [166] Galen was thus not the only ancient writer to associate the story with a condition of the womb; however, where Pliny merely says that women are more likely to suffer in this way because their wombs move, Galen gives a full etiology accepting the theories of innate heat and skin-breathing.
Galen and His Influence: Winners and Losers in the Textual Tradition Thus far, this chapter has covered the Hippocratic origins of the hysteria tradition in detail, while also mentioning the distinctive contributions of a small group of other writers: notably Plato and the second-century A.D . medical writers Aretaeus, Soranus, and Galen. It is however important to consider the question of the significant period between the fifth/fourth century B.C ., when the Hippocratic texts used here were being written, and the second century A.D . This is not an easy question to address. For the period immediately after the Hippocratics, literary medical sources are sparse. Works cited in later writers have not survived; we often read the extant fragments through the hostile eyes of an opponent, so that it is difficult not only to trace and date significant changes, but even to know what exactly was written. Heracleides of Pontus (390-310 B.C .), whose lost work Apnous —mentioned by Pliny, Galen, and Diogenes Laertius among others—has already been discussed, is the only fourth-century writer other than Plato who is incorporated into the hysteria tradition. Other writers of the period are briefly introduced to the tradition, only to be rejected. Thus, for example, Soranus describes and criticizes the therapy used for hysterical pnix by Diocles of Carystos, who also worked in the fourth century B.C .; he "pinches the nostrils, but opens the mouth and applies a sternutative; moreover, with the hand he presses the uterus toward the lower parts by pressing upon the hypochondriac region; and applies warm fomentations to the legs." [167] In the third century B.C . important advances in anatomy were made in association with the medical school of Alexandria; the work of He-
36 rophilus of Chalcedon in particular is said to have included dissection of animal and human subjects, neither of which was practiced by the Hippocratics. For the history of hysteria, even more important than the fact that Herophilus is credited with being the first to identify the Fallopian tubes and ovaries is the attribution to him of the first description of the ligaments (which he called membranes) anchoring the womb in the abdominal cavity, a discovery which, in a positivist science, would have proved false the theory that the womb is capable of movement around the body. [168] No discussion by Herophilus of suffocation caused by the womb survives. His follower Mantias, who lived from around 165 to 90 B.C ., wrote on pharmacology, and one of the two surviving fragments of his work with a gynecological theme concerns hysterical suffocation. This fragment too is transmitted in the work of Soranus, who tells us that Mantias recommended playing flutes and drums when an attack was imminent, and giving castoreum and bitumen with wine when an attack was over. It is interesting that the discovery of the "membranes" does not appear to have significantly changed the therapy. [169] A further source for the period from the third to the first centuries B.C . consists of the surviving papyrus fragments from Greco-Roman Egypt, giving recipes, some of which may be identified as originating in the Hippocratic corpus. One very ancient collection of recipes, largely based on Diseases of Women and dating to the third or second century B.C ., mentions "suffocation from the womb" but recommends dried otters' kidneys in sweet wine—the only time this recipe occurs in Greek literature. [170] A further recipe is given for a cough after the suffocation. Another papyrus dated to around 260-230 B.C . is too fragmentary for any reconstruction of the recipe, but it concerns a "hysterical woman" (gyne hysterike ); in the following line it is possible to read the word pnigmos . [171] A papyrus from the early first century B.C . is even less legible, but the editor's reconstruction includes the words hysterikai and hysterikais . [172] Papyri therefore show that Hippocratic recipes and variations on them continued to circulate in the ancient world; taken with the fragment of Mantias, they give further support to the proposal that the disease category hysterike pnix existed as a diagnosis in the second century B.C . The next significant literary source comes from the Roman world: Celsus, writing in the early first century A.D . Book 4 of his work is arranged according to the parts of the body, and includes a chapter on diseases of the womb. [173] This begins with a description of an unnamed but violent (vehemens ) illness that comes from the womb, an organ Celsus regarded as second only to the stomach in its influence on the rest of
37 the body. The condition he describes takes away the breath, so that the woman falls down as if she had epilepsy; however, unlike in epilepsy, the eyes are not "turned," there is no frothing at the mouth, and the sinews are not stretched. Instead, the patient sleeps. Some women suffer from this throughout their lives. Celsus does not investigate the etiology of the condition, but he gives recommendations for treatment: venesection, cupping-glasses, an extinguished lamp wick or other strong-smelling material held to the nostrils, cold water poured over the patient, hot wet poultices, and massage of the hips and knees. To prevent further attacks he recommends that the woman should abstain from wine for a year, be massaged regularly, and put mustard on her lower abdomen daily so that the skin reddens. He adds some suggestions for emollients, drinks (including castoreum), purges, and fumigations. Some of this material is familiar; the cold water, lamp wick, and castoreum, for example, are no different from the Hippocratic recommendations, nor is the concern to distinguish the condition from epilepsy. Other suggestions are new; in particular, venesection, although used in the Hippocratic corpus, has not previously been discussed in association with this condition. As P. Brain has recently shown, although Galen gives the impression that venesection was a common therapy in the Hippocratic texts, it is in fact found only about seventy times in the entire corpus, and Diseases of Women contributes only one example. [174] In Soranus it is recommended for hysterical suffocation, while for Galen it is the remedy of choice for menstrual suppression. [175] In the second century A.D . three medical descriptions of hysterical suffocation were produced, of differing importance to the growth of the hysteria tradition. By far the most influential in subsequent centuries was the work of Galen of Pergamum, although his triumph was not complete until after the eleventh century A.D ., when the translation of Arabic texts into Latin returned Galenic theory to the West. Until that time, although Arabic physicians were heavily influenced by Galenism, the many short gynecological treatises produced in the West were largely based on Soranus's Gynecology . However, this work was also disseminated in the East, through the Byzantine encyclopedists who used Soranus for their gynecological summaries. Its subsequent fortunes have been influenced by the fact that, although writers such as the sixth-century Aetius used it extensively, it survives in just one manuscript: the late fifteenth-century Paris BN gr. 2153 (Paris, Bibliothéque National, Greek manuscript number 2153), only discovered and identified by Dietz in 1830. The second-century writer most heavily influenced by Hippocratic sources was however neither Galen nor Soranus, but Aretaeus of Cap-
38 padocia, who had considerably less impact than either of the others on the later history of hysteria. Neither Soranus nor Aretaeus was translated into Arabic; nor, however, were the Hippocratic Diseases of Women and Nature of Woman , so that the Arabic descriptions of uterine suffocation derive from the Galenic version and its later interpreters: Oribasius, Aetius of Amida, and Paul of Aegina. The triumph of Hippocrates over Galen was delayed until the availability of printed Latin editions of the Hippocratic texts in the late sixteenth century. [176] I now propose to look in turn at the texts of Aretaeus, Soranus, and Galen, establishing their contribution to the tradition, before turning to their use in late antiquity and beyond. As has been discussed above, the description of hysterike pnix in Aretaeus's Of the Causes and Symptoms of Acute Diseases is today best known for its description of the womb as being "like an animal inside an animal," less emotively rendered as "like one living thing inside another." Like the Hippocratic writers, Aretaeus not only believes that the womb can move within the body but also advocates scent therapy, in which foul odors such as pitch, burned hair, an extinguished lamp, or castoreum are applied to the nose and fragrant substances rubbed into the external genitalia; unlike them, however, he knows of the membranes anchoring the womb in place. [177] To us, the children of the "scientific method," these points may seem contradictory, but Aretaeus manages to combine them. He describes the womb—"the seat of womanhood itself"—as being "all but alive," moving of its own volition upward to the thorax, or to left or right within the lower abdomen. It is when it moves upward and remains there for a long time, pressing violently on the intestines, that the patient experiences pnix , described as being like epilepsy [178] without the spasms. Pressure is put on the liver, diaphragm, lungs, and heart, causing loss of breath and voice, while the carotid arteries are squeezed as a result of "sympathy" with the heart, causing a heavy head, loss of sensation, and deep sleep. Aretaeus then mentions a similar condition, characterized by pnix and loss of voice, which does not arise from the womb; the two differ in that only in cases arising in the womb will scent therapy help, and only in these cases do the limbs move. When the womb moves up the body there will be "hesitation in doing her tasks, exhaustion, loss of control of the knees, dizziness, and her limbs are weakened; headache, heaviness of the head; and the woman feels pain in the channels at either side of her nose." [179] The pulse will be weak and irregular, the breathing imperceptible, and death follows suddenly; it is difficult to believe that it has occurred, since the patient
39 has such a lifelike appearance. Recovery, too, happens suddenly; the womb rises up very easily, and just as easily returns to its place. Here Aretaeus uses another image, as vivid as that of the "living thing inside another living thing": the womb sails high in the water like a tree trunk floating, but it is pulled back by its membranes, of which those joining the neck of the womb to the loins are particularly capable of distending and contracting in a way that is likened to the sails of a ship. [180] The condition is more likely to affect young women, since their way of life and understanding are "wandering," less firmly based. Aretaeus thus combines womb movement with anchoring membranes, while continuing the exploration of a number of key themes in the hysteria tradition; for example, the difficulty in telling whether a sufferer from this condition is dead or alive, and the resemblance to epilepsy. Although much of the therapeutic material is Hippocratic, in particular the use of scent therapy, fumigation, and sneezing, [181] he follows Celsus rather than the Hippocratics in recommending venesection from the ankle, while adding that one should pull out hairs from the patient in order to rouse her. [182] He introduces the idea of "sympathy" in order to explain how the highest parts of the body can be affected by the womb; although the membranes prevent it from traveling that far, the womb can nevertheless exert an influence on these parts. The survival of such Hippocratic ideas in the late antique and medieval worlds will be discussed later. However, as I have already mentioned, the main influence on late antiquity came from Soranus, the Hippocratics being read largely through the eyes of Galen until the mid-sixteenth century and beyond. [183] Sections of Soranus's work were translated from Greek into Latin by Caelius Aurelianus in the fifth century, and—more important in terms of his later influence—by Muscio in the sixth century, thus making his ideas available in the Latin-speaking West. As for the Greek East, Soranus was the main source for the gynecological sections of the encyclopedias of Aetius of Amida in the mid-sixth century and Paul of Aegina in the seventh century, becoming in the East "la bible de la gynécologie et de l'obstétrique jusqu'à la Renaissance." [184] What did Soranus contribute to the textual reservoir drawn on by the hysteria tradition? The ideas of Soranus, in contrast to those of Aretaeus, are set in the context of the theories of the "methodist" medical sect. This arose in the first century A.D . in response to the dogmatist and empiricist positions. The fundamental difference between the latter two sects lay in their beliefs concerning the best way of acquiring knowledge. Where the dogmatists, despite some differences of opinion, agreed on the use of obser-
40 vation, dissection, and experiments in order to speculate on the "hidden causes" of diseases, the empiricists believed that no form of research could ever lead to an understanding of nature, and thus that the only route to knowledge was through the accumulated experience of past cases, which the practitioner could combine with his own experience in order to choose the correct therapy. Where the dogmatist was interested in causes, the empiricist looked for cures. Methodism, in contrast to these sects, was based on a strict division of causes of symptoms into three conditions of the body: status laxus , in which the body or affected part is lax and wet, leading for example to a flux; status strictus , a constricted and dry state, of which amenorrhea was seen as a case in point; and status mixtus , a combination in which some parts of the body are constricted and others lax. Treatment characteristically began with a three-day fast, then built up the patient through diet and exercise, before moving on to aggressive treatments such as vomiting, shaking, or sneezing. [185] While Soranus is never a slave to the "method," [186] it is methodist theory that leads him to reject some commonplaces of Hippocratic medicine. For example, there is no place in the method for Hippocratic ideas of the superiority of right over left. Nor does Soranus accept the theory that the female body is qualitatively different from the male in terms of the porosity of its flesh; women are the same as men, except that they have some different organs, but even these organs are made of the same substance and subject to the same conditions. As a result of this reasoning, there is no place in Soranus's gynecology for the Hippocratic theory that menstruation is essential to female health as a means of purging the excess blood that naturally accumulates due to the wet and spongy consistency of female flesh. On the contrary, Soranus goes so far as to say that menstruation is bad for a woman's health, except insofar as it is necessary to conception. Intercourse is harmful, and permanent virginity is best for both men and women. Pregnancy, thought by earlier writers to relieve certain gynecological disorders, is in fact bad for women; it leads to exhaustion and premature old age. Soranus also rejects the Hippocratic idea that the womb moves to other parts of the body. The womb cannot move; although he rejects dissection in principle, he quotes Herophilus of Chalcedon's research as proof that it is held in place by membranes. [187] Soranus nevertheless accepts that there is a condition in which the major symptom is pnix , but he attributes it to inflammation of the membranes around the womb causing a status strictus . [188] In particular he rejects any idea that the womb is an animal; it "does not issue forth like a wild animal from the lair,
41 delighted by fragrant odors and fleeing bad odors," [189] and he attributes this misunderstanding to its ability to respond to certain agents by stricture or relaxation. In treating the condition, he completely rejects the usual list of substances employed in scent therapy (they cause torpor and upset the stomach), together with sneezing (too violent) and intercourse; sexual intercourse cannot cure disease, since it has such bad effects on even a healthy body. Venesection is acceptable, however, after the patient has been warmed and rubbed with olive oil in order to relax her. The condition exists in both an acute and a chronic form, and treatment should take account of this. [190] While the gynecological theories of Soranus continued to circulate widely in both East and West through their use by the encyclopedists, the dominant influence on medicine as a whole in the Greek East was not Soranus but Galen. Where suffocation of the womb is concerned, Galen's descriptions eclipsed those of Soranus; writing as late as 1937, P. Diepgen describes Galen's picture of the hysterical attack as still being recognizable. [191] In his treatise On the Affected Parts , Galen himself calls the condition either hysterike pnix or apnoia hysterike , "absence of breath caused by the womb." Aretaeus had managed to combine the anchoring membranes with movement of the womb, while Soranus rejected womb movement and attributed the symptoms to inflammation of the membranes; Galen's new etiology was, however, to prove the most influential in the history of hysteria. He accepts that the womb is indeed the origin of the condition, but in place of movement to another part of the body, or inflammation, he blames retention of substances within the womb. The disorder manifests itself in a number of different forms—sometimes through lying motionless with an almost imperceptible pulse, sometimes through weakness while the patient remains conscious, and sometimes through contracture of the limbs. [192] A much-quoted section of On the Affected Parts reads: "I myself have seen many hysterikai women, as they call themselves and as the iatrinai call them." [193]Iatrinai , literally "female healers," may also be translated as midwives. Hysterikai is usually translated as "hysterical" but, in view of what has already been said about ancient medical terminology, it would be more accurately translated as "suffering from the womb." In a recent article, Trillat attaches great significance to this passage. As has already been mentioned, Trillat recognizes that the word hysteria never appears in the Hippocratic corpus; however, on the basis of this passage of Galen, he asserts that it is in Galen's work "qu'apparait le mot d'hystérie," albeit in adjectival form. [194] Of course, this is not particularly
42 significant since, as I have already shown, the adjective hysterikos also appears in the Hippocratic corpus. However, Trillat goes on to use the Galenic passage as the basis for his statement, "Hippocrate adopte la théorie populaire et rejette le nom. Galien rejette la théorie mais adopte le nom" (Hippocrates adopts the popular theory and rejects the name. Galen rejects the theory but adopts the name). This raises many questions. There is little evidence for the theory of the wandering womb in classical Greek "popular thought" apart from Plato's Timaeus , and Plato is hardly the Greek equivalent of the man on the Clapham omnibus. In the Roman Empire of Galen, there may be better grounds for believing that women described themselves as hysterica . A relevant passage from outside the medical corpus is Martial, Epigrams 11.71, where Leda tells her aged husband she is hysterica as a device to make him summon young doctors to carry out what was then thought to be the standard treatment, sexual intercourse. Moreover, can we accept that it is Galen who "adopte le nom"? We have already seen that the evidence of papyri from the third and second centuries B.C ., taken with the fragment of Mantias preserved in Soranus, suggests on the contrary that the category hysterike pnix existed at least four hundred years before Galen. Indeed, elsewhere Galen distances himself not only from the word hysterikos —referring to "the so-called hysterical symptoms"—but also from pnix , saying that apnoia , absence of breath, is a more appropriate term. [195] The passage from Martial is also of interest in that Galen too—unlike Soranus—regards sexual intercourse as beneficial for sufferers, and in his new etiology of the condition this therapy, mentioned in the Hippocratic corpus but only as one of many recommendations for suffocation caused by the womb, is given a central role. He considers that those most vulnerable to the disorder are "widows, and particularly those who previously menstruated regularly, had been pregnant and were eager to have intercourse, but were now deprived of all this." [196] This passage is interesting, not only because it omits the childless, seen as particularly susceptible in several Hippocratic texts, but also because it points Galen toward the cause of the problem. He does not accept the Hippocratic etiology of womb movement in search of moisture, since dissection proves that it cannot occur; the womb may seem to move, but "it does not move from one place to another like a wandering animal, but is pulled up by the tension" of the membranes holding it in place. [197] Why do these membranes become tense? He suggests that it is because they are filled with menstrual blood, unable to move into the womb either because of its thickness or because the orifices through which the
43 blood passes into the womb are closed. Thus one cause of the condition is menstrual retention. This is not however the origin of the most severe form of hysterike pnix . Galen believes that women too contribute "seed"; this is not an entirely new idea, since some Hippocratic writers believed in its existence. For Galen, female seed does not elevate the female to an equal position with the male, since it is naturally inferior to male seed. [198] Seed too can be retained in the womb, where it presents far more of a threat to health than retained menses. [199] Galen goes on to compare the effect of such retained substances to that of the bite or sting of a poisonous creature; small amounts cause dramatic and possibly fatal symptoms. [200] Retained seed can rot, causing noxious humors to affect the rest of the body through "sympathy"; for Galen, as for Aretaeus, this is how the breathing can be affected without the womb moving to put physical pressure on the diaphragm. It is an infinitely malleable concept that can claim Hippocratic credentials: On Joints (57) describes the "brotherly connections" that exist between parts of the body, permitting, among other things, the wanderings of the womb. [201] Thus, where the Hippocratics attributed different groups of symptoms to the different organs to which the womb could move, Galen suggests that the basic cause is retained matter, different symptoms owing most to the nature of this matter; for example, black bile leads to despondency. [202] Monica Green has pointed out that it is of particular interest that, despite his rejection of the belief that the womb is a wandering animal, Galen nevertheless manages to retain the use of the full scent therapy. On the Method of Healing, to Glaucon includes a brief reference to its use in treating a "rising" womb, while in another treatise Galen lists substances—including castoreum and burned hair—to be placed at the nose of a woman with this condition. [203] In a passage from On the Affected Parts taken up by the hysteria tradition, Galen describes the case of a woman who had been a widow for a long time and who was told by a midwife that her symptoms were due to her womb being "drawn up." The woman applied to her external genitalia "the customary remedies" (details of which are not given here) for this condition and passed a quantity of thick seed; the suggestion appears to be that rubbing in the traditional scented ointments causes orgasm, and thus releases the retained matter. [204] For Galen, both menstrual blood and seed must be evacuated, otherwise they will become toxic and poison the body; scent therapy continues, but its rationale changes. The third century A.D . is, in many ways, a hiatus in the development of the hysteria tradition. One source that should be considered here is a papyrus from Greco-Roman Egypt, which has been dated to the third
44 or possibly the fourth century A.D . In a collection of magical spells, one is included to be used in cases of "the rising up of the womb." It calls upon the womb to "return again to your seat, and that you do not turn into the right part of the ribs, or into the left part of the ribs, and that you do not gnaw into the heart like a dog, but remain indeed in your own intended and proper place." [205] This fascinating source shows that the idea of a mobile and animate womb continued to flourish in the context of popular belief; the reference to it gnawing "like a dog" should perhaps be read in the context of Greco-Roman ideas concerning the insatiable sexual appetites of dogs—and women—together with the connection between kuon , meaning dog, and kuein , meaning to be pregnant. In this spell we are not very far from the womb of Plato's Timaeus , running through the body when its desire to conceive is thwarted. [206] In the late fourth century A.D ., a further literary source is of interest because it makes explicit the identification of the Greek hysterike pnix and the Latin suffocatio . This is the Book of Medicines of Marcellus Empiricus, which gives remedies for the disorder in a section on acute and chronic conditions of the head. It identifies only two symptoms—severe head pains and suffocation—which, if originating in the womb, "the Greeks call hysterikg pnix ." The condition is considered comparable to epilepsy, frenzy, and dizziness, except in its organ of origin. [207]
Further Contributions to the Tradition The Greek East Returning to the set of connected texts which makes up the hysteria tradition, the Byzantine empire preserved many medical ideas of antiquity through the work of encyclopedists such as Oribasius, Aetius, and Paul of Aegina. [208] Such writers, often dismissed as "the medical refrigerators of antiquity" working in "une époque de stagnation," were nevertheless more than compilers whose labors have preserved for us the work of earlier writers; "not dumb copyists," they selected and paraphrased, added and cut material, according to the specific needs of their audience. [209] Although they may add little new to our picture, they are of interest because they combine the elements of Soranus's and Galen's accounts in different ways. Thus, for example, it will be seen that both Aetius and Paul use Soranus, but—like Galen—bring back the scent therapy that he had rejected. Both use Galen's ideas of retained matter that must be expelled, while Aetius repeats the story of the widow. It is also in the work of these encyclopedists that certain remedies for the condition become standardized, while it is through them that many of the ideas of earlier writers reached Islamic medicine.
45 In the upper echelons of the Byzantine world, knowledge of classical literature was regarded as the mark of an educated man. Medical education too was largely textual, traditional, and classical. We know of very few teaching centers in the fifth to seventh centuries A.D .; those students who neither came from a medical family nor were apprenticed to a physician were obliged to rely largely on texts for their instruction in both theory and practice. [210] Alexandria again became an important medical center from the late fourth century A.D .; the medical student there would read about eleven Hippocratic treatises—including the Hippocratic Aphorisms and Diseases of Women —and fifteen or sixteen texts from the Galenic corpus. The Hippocratic texts were, however, read through a "Galenic filter." [211] Alexandria is associated with the seventh-century encyclopedist Paul of Aegina, whose work was itself based to a large extent on the fourth-century, seventy-volume work of Oribasius. It is easy to underestimate the work of Oribasius, Paul, and their successors. N. G. Wilson summarizes: "Very little can be said of any positive achievement of Alexandrian medicine. Paul admits openly in his introduction that he contributes practically no original material of his own." However, he goes on to point out that Paul's work circulated widely, [212] and it is important to see which parts of the hysteria tradition were strengthened by the choices made by such writers. Oribasius's compilation, derived from the work of Galen, Soranus, and a number of lost works, was itself summarized in two editions of nine and four books respectively. His description of the anatomy of the womb and other female sexual organs, explicitly taken from Soranus, survives in the seventy-volume version of his work. [213] For his discussion of hysterike pnix , which survives in the nine-volume Synopsis , Oribasius uses the lost work of Philumenos of Alexandria, [214] which recommends bandaging the extremities, rubbing the lower limbs, and scent therapy; foul odors at the nostrils, and sweet oils injected into the womb. Shouting at the patient and provoking sneezing are also acceptable, with bleeding once she is conscious. Castoreum is also highly recommended; even on its own, it may produce a cure. In an earlier chapter Oribasius gives further remedies for pnix , including the by now familiar list of foul-smelling substances, namely bitumen, castoreum, gum resin, pitch, cedar resin, extinguished lamp wicks, burned hair, rue, asafetida, onion, and garlic. [215] This closely resembles the list of substances Soranus criticized earlier writers for using; and, of course, Soranus also disagreed with the use of loud noises to rouse the patient. Thus, despite following Soranus's anatomy of the womb, Oribasius takes his remedies from the traditions Soranus despised.
46 The capital of the Byzantine empire, Constantinople, was another medical center. Oribasius worked there in the fourth century, and it was later to be associated with Aetius of Amida—whose sixteen-volume compilation, made in the sixth century, was based on Oribasius and others—and with Alexander of Tralles, whose twelve-volume Therapeutica was probably written a few decades after Aetius. [216] The work of Oribasius, Aetius, and Paul was later transmitted through the collection of medical knowledge compiled by Theophanes Nonnos in the tenth century. Nonnos worked as part of a deliberate program to stimulate learning, initiated by the emperor Constantine Porphyrogenitus, who was concerned with encouraging education and himself wrote several books and poems. [217]
Aetius based his description of hysterike pnix on Galen's On the Affected Parts , merging this with the Philumenos material preserved by Oribasius. [218] He accepts that the womb, which only seems to move, causes the condition, the higher organs being affected through "sympathy." Using the Galenic model of the body, he describes how spasms reach the heart via the arteries, the brain through the spinal marrow, and the liver through the veins. [219] As a means of discovering whether or not the patient lives, he repeats a test given in Galen, by which either a woolen thread was placed at the nostrils, or a bowl of water on the navel. [220] However, even if no movement occurred in the wool or the water, he warned—again, following Galen—that it was possible that life remained. He sees the disorder as seasonal; it happens mostly in winter and autumn, especially in young women who use drugs to prevent conception. [221] This appears to be a special concern of Aetius, although it recalls Plato's image of the womb deprived of the offspring it desires, running wild through the body. For Aetius, as for Galen, the cause of the symptoms is the decay in the womb of seed or other material, which cools: the coldness is then passed on to the brain and heart. [222] He cuts out the story from Heracleides, but repeats—indeed, claims as his own eyewitness account [223] —Galen's story of the widow who felt "pain and pleasure at the same time" before expelling the corrupt seed; here, however, a little more detail is given by Aetius, so that we are explicitly told that the remedies used consisted in sweet ointments rubbed into the genitalia, something that is recommended again later in this passage. [224] Like Philumenos and Oribasius, Aetius recommends shouting at the patient and repeats word for word the advice of Philumenos-Oribasius that "castoreum alone often cures." [225] The status of scent therapy is reinforced, even increased. The description of hysterike pnix given by Paul of Aegina[226] in the
47 seventh century follows Aetius closely, but states that the womb itself "rises up" [227] to affect by sympathy the carotid arteries, heart, and membranes. The patient loses her senses and her power of speech, the limbs being "drawn together." The cause—as in Galen—is the womb being full of seed or of some other substance that becomes rotten. [228] Most sufferers die suddenly during the spasms; the pulse becomes frequent and irregular, and asphyxia then follows. Breathing, at first faint, is cut off. The condition is most prevalent in winter and autumn, and most affects the lascivious, and—in almost the exact words of Aetius—those who use drugs to prevent conception. [229] During the attack the extremities should be bandaged and the patient rubbed all over. Foulsmelling substances—including stale urine—should be placed at the nostrils, and cupping and anal suppositories used. Sweet-smelling substances should be employed in order to draw the womb back to its proper place. To rouse the patient, one should shout at her roughly and induce sneezing with castoreum, soapwort, and pepper. [230] Like Soranus and Oribasius, Paul separates treatment for the fits, or paroxysmoi , from treatment for the whole body; the latter begins with venesection[231] and goes on to purging, exercise, and baths. Although the tendency in the East was toward the compilation of encyclopedias, one independent Greek text, probably from the sixth century, survives in a ninth-century manuscript. This is the Book of Metrodora , a practical treatise in many ways reminiscent of Hippocratic medicine. It includes some remedies for hysterike pnix , which make use of the traditional foul- and sweetsmelling substances, namely castoreum, rue with honey, and pig's dung with rose water. [232] Thus in Byzantine medicine a composite picture of hysterike pnix was built up, incorporating the Galenic belief in retained substances poisoning the body, Soranus's anchoring membranes, Hippocratic scent therapy, venesection as in Celsus, and a belief in the value of sneezing, derived from the Hippocratic Aphorisms and Galen's commentary on them, which will be discussed in detail below. Although the main authorities, Soranus and Galen, had vigorously denied that the womb could move, this idea came close to being reinstated by Paul of Aegina. Aetius preserved the Galenic tests to determine whether the patient still lived, while writers with otherwise divergent views agreed on the therapeutic value of castoreum.
The Latin West In the West, meanwhile, the picture was in some ways very different. Although the Aphorisms circulated widely, few of the works of classical
48 medicine survived, especially after knowledge of Greek declined during the fifth and sixth centuries. Although in northern Italy some Byzantine commentaries and encyclopedias were adapted into Latin during the sixth century—among them, the work of Oribasius—most "new" medical texts were short works based on Soranus. [233] The late fourth- or early fifth-century [234] Latin version of Soranus by Caelius Aurelianus survived into the Middle Ages, while the fifth- or sixth-century version by Muscio circulated more widely. Muscio plays down Soranus's attack on the idea that the womb moves around the body, going so far as to add to Soranus's introduction to the condition a new phrase claiming that the womb rises up toward the chest. [235] Thus the versions of Soranus that circulated in the West included womb movement from an early date. Several of the texts produced in the West originated in Africa, among them the works of Caelius Aurelianus and Muscio. Predating these is the late fourth century Euporiston of Theodorus Priscianus, a pupil of Vindicianus, whose own Gynaecia was a text on parts of the body and their development in the womb. Originally written in Greek, the Euporiston was translated by Theodorus Priscianus himself into Latin. [236] This version contains a section entitled De praefocatione matricis , which follows the constriction/relaxation approach of Soranus, omits womb movement, but includes scent therapy. In A.D . 447 another African writer, Cassius Felix, took a different approach, publishing an encyclopedia allegedly based on Greek medical writers of the logical, or dogmatic, sect, but in fact owing much to Soranus as translated by Caelius Aurelianus; this contains a very Hippocratic description of hysterical suffocation, incorporating womb movement as well as scent therapy. [237] Other Latin texts of this period survive and are probably more representative than the African works of medicine in the West after the fall of Rome. A dialogue allegedly between Soranus and a midwife, apparently designed as a midwives' catechism, is preserved in a ninth-century manuscript but may date to the sixth century; this is the Liber ad Soteris . [238] Another short text from this period is the Gynaecia by pseudo-Cleopatra. [239] It mentions a condition called suppressiones vulvae , the main symptom of which is difficulty in speaking and which thus may be identified with hysterike pnix ; however, womb movement is not mentioned, nor is scent therapy advised. The ancient Hippocratic theories were not, however, entirely lost to the West. Between the fifth and seventh centuries A.D . many Hippocratic texts were translated into Latin at Ravenna, among them Aphorisms and Diseases of Women (1.1, 1.7-38, and extracts from 2). [240] Several texts on womb movement and suffocation are included in such translations. [241]
49 Also translated was Galen's On the Method of Healing, to Glaucon , with its reference to scent therapy for a moving womb; the Ravenna commentator considers that, by using scent therapy, Galen is apparently endorsing the wandering womb theory. [242] It is, however, as misleading to regard the work of the scholars of Ravenna only as translation as to dismiss the Byzantine writers as mere compilers. It is important to understand the purposes for which they used these texts, since these in turn influenced the translation. These purposes fall under two headings: practice and instruction. Hippocratic medicine was seen above all as being of immediate relevance for medical practice; the Ravenna texts are thus not academic editions, but manuals. As a result the more theoretical or speculative Hippocratic texts were neglected, while those selected for translation were adapted according to the different moral and historical context within which they were now to be used. [243] The second, closely related aspect instruction led to the recasting of some texts in new formats in which extracts were set out in question-and-answer form, as dialogues like the Liber ad Soteris , as calendars, as visual representations, or as letters. The letter format, direct and personal, was very popular, an example being the Epistula ad Maecenatem , the Letter to Maecenas . Also known as the De natura generis humani , this comprises extracts from the Hippocratic Diseases of Women (1) and from Vindicianus. The Epistula ad Maecenatem is found in the ninth-century manuscripts Paris BN Lat. 7027 and Paris BN Lat. 11219, and in these manuscripts it includes two passages of Diseases of Women used in the hysteria tradition: 1.7, on movement of the womb to the liver, and 1.32, on movement of the womb in a pregnant woman. [244] The late eighth century/early ninth century manuscript Leningrad Lat. F.v.VI.3 is a handbook including Latin translations of sections from Diseases of Women , one of which is our 2. 127, a further description of the movement of the womb to the liver. In the recipes given for cures, substitutions are made in the pharmacopoeia according to what was available in the period. [245]
The Arab World Another route of transmission of Hippocratic ideas to the West was through the Arab world. The most obvious contact between medical systems took place after the Arabs took Alexandria in A.D . 642, possibly while Paul of Aegina was there; the medical school at Alexandria continued to exist until around A.D . 719, probably still using Greek as its language of instruction. [246] The great age of translation began in the ninth century; Greek manuscripts were taken as booty in conquest, and
50 those translating them into Arabic—sometimes through the medium of Syriac—enjoyed royal patronage. From this time onward, versions of Hippocratic texts, based on several manuscripts, were produced; the most famous early translator was Hunain ibn Ishaq al-'Ibadi—known to the West as Johannitius—the Christian son of a druggist, who was also responsible for translating works by Galen, Oribasius, and Paul of Aegina. Hunain also listed all the works of Galen that had been translated into Arabic or Syriac by about A.D . 800; these included such key works in the hysteria tradition as On the Affected Parts, On Difficulty in Breathing , and the commentary on the Aphorisms , from which the Hippocratic Aphorisms themselves were excerpted and then transmitted separately. [247] There thus exists a striking contrast between East and West in the ninth century; as R. J. Durling puts it, "Whereas European knowledge of Galen was limited to a few Galenic works, and those either unimportant or clearly spurious, Arabic translations of almost all his writings were made." Something similar occurs with regard to much of the Hippocratic corpus; in contrast to the Latin West, where emphasis was placed on translating those texts of immediate practical value, the Arabic translators did not neglect the more theoretical and speculative treatises, so that the "Arabic Hippocrates" is more complete than the "Latin Hippocrates." [248] This does not, however, apply to Hippocratic gynecology; neither Diseases of Women nor Nature of Woman was translated into Arabic, although two Byzantine commentaries on Diseases of Women 1.1-11 were in circulation in the Arab world before the eleventh century, together with Byzantine medical encyclopedias. [249] The main means by which Greco-Roman ideas were transmitted was through the compilation of new encyclopedic works. The Firdaws al hikma (Paradise of Wisdom) of 'Ali ibn Rabban atTabari (810-861) was completed in 850 and includes approximately 120 quotations from the Hippocratic corpus, and a large amount of Galenic material, together with extracts from other Greek and Islamic writers such as Aristotle and Hunain. [250] At-Tabari believes that the essential wetness of woman leads to menstrual loss; retained moisture sinks to the lowest part of the body and then comes out, "just as in a tree the excess moisture comes out as gum." [251] In his section on uterine disorders, he includes suffocation of the womb. He writes, "Sometimes, through damming-up of menstrual blood and lack of sexual intercourse, vapours develop." He explains that the retained blood becomes thick, and produces vapors that then affect the whole body, causing such symptoms as painful breathing, palpitations, head pain, and suffocation of the womb. A further discussion of suffocation occurs in the context of womb
51 movement. The womb can lean to one side, but sometimes it actually rises up until it reaches the diaphragm, causing suffocation. "Then the woman loses consciousness, with the result that her breath is stopped. Then one puts a bit of wool under her nostrils in order to see whether she is alive or dead." The cause here is not menstrual blood, but accumulated seed; if there is an "excess, lack or absence" of intercourse, seed will accumulate in the womb, rot, and become poisonous and thick. The womb then moves to the diaphragm and the woman suffocates. [252] Thus womb movement was readily combined with a Galenic etiology of retained seed or menses, but to this mixture at-Tabari added the explanatory device of vapors. Where Greco-Roman writers employed the concept of sympathy to account for the effects of the womb on other parts of the body, writers in the Arab world also used vapors; as we shall see, this development entered the western hysteria tradition when texts were translated from Arabic to Latin from the eleventh century onward. The next writer from the Arab world who should be considered here is Muhammad ibn-Zakariyya' ar-Razi (Rhazes), whose Kitab al-Hawi , a twenty-four-volume collection of excerpts from Greek, Arabic, and Indian writers known in Latin as the Continens , was written around A.D . 900. [253] Also translated into Latin was his Kitab al-Mansori , which includes a chapter on uterine suffocation. Here Rhazes gives a basically Galenic account of the condition, including retained menses and seed, the patient falling down as though dead, and scent therapy; he includes the recommendation that a midwife should rub the mouth of the womb with a well-oiled finger. He does not say that the womb moves, although he describes a sensation "as if something is pulled up." [254]
The work of 'Ali ibn al-'Abbas al-Majusi, known in Europe as Haly Abbas, was produced in the tenth century A.D . It too combines Hippocratic etiologies with a predominantly Galenic approach, often read through the eyes of Paul/Aetius; but al-Majusi plays down the membranes anchoring the womb, claiming instead that the womb can move around the body. He includes both sympathy and vapors. He explains that suffocation of the womb is a very dangerous condition because sympathy leads to the vital organs, the brain and heart, being affected. If a woman does not have intercourse, a large quantity of seed will collect and will "stifle and extinguish the innate heat." Retained menstrual blood has similar effects. [255] In a separate section on treatment, he retains the Hippocratic scent therapy, but explains its success partly in terms of vapors. Bad smells administered to the nose rise to the brain, "warming, dissolving and diluting the cold vapors," but also driving the womb back down. [256] For
52 al-Majusi, the womb is "more or less an independent living being," yearning for conception, annoyed by bad smells and leaning toward pleasant smells. Plato's description of the womb as an animal desiring conception was known to the Arab world through Galen. [257] Al-Majusi also recommends sexual intercourse as a cure, especially for virgins, whose strong desire for sex and thick menstrual blood predisposes them to the condition. [258] In the absence of this, he repeats the Galenic therapy of instructing a midwife to rub sweet-smelling oils on the mouth of the womb, and states explicitly that this has the same effect as intercourse, in warming and thinning the seed, so that it can drain away and the woman can "find peace." [259] Also working in the tenth century was Ibn al-Jazzar, whose main work was the Kitab Zad al-Musafir in seven books. This was a particularly important source for medieval European medicine; it was translated into Latin, Greek, and Hebrew, and is known in Latin as the Viaticum . [260] Book 6, chapter 11, describes suffocation of the womb; the condition begins with loss of appetite and the chilling of the body, which is attributed to corruption of retained seed, particularly in widows and young girls of marriageable age. From the seed a fumus —a smoke, or vapor—rises to the diaphragm, because the diaphragm and womb are connected; then, since further connections exist between the diaphragm and the throat and vocal chords, suffocation ensues. similar problems may result from retained menses, and scent therapy and the application of fragrant oils to the mouth of the womb are recommended. Repeated here is a version of the story given in Galen of the woman who lay as dead but was known to be alive by the presence of innate heat; here, however, Galen rather than Empedocles becomes its hero! [261] Finally, Ibn Sing (Avicenna), born in A.D . 980, included discussions of hysterical suffocation in his Qanun (the Canon ); translated into Latin by Gerard of Cremona in twelfth-century Toledo, this influential text was printed thirty-six times in the fifteenth and sixteenth centuries. [262] He devotes four successive chapters to the condition, its signs and cures, and the preferred regimen for sufferers. He bases his description on Galen as interpreted by Aetius, favoring sympathy (communitas ) over vapors, and including the test for life with a piece of wool and the story of the widow; cures include phlebotomy and the rubbing of scented oil into the vulva, while the regimen includes the use of foul-smelling substances at the nose and sweet scents at the vagina. [263] Thus it can be seen that the distinctively Hippocratic features of womb movement, scent therapy, and the therapeutic value of sexual intercourse survived even in the directly contradictory environments of
53 Galenic theory and Islamic culture. Despite the rejection of the moving womb by both Soranus and Galen, it soon returned to the fore in the explanations of hysterical suffocation given by writers and compilers in both East and West. In the Arabic world, Soranus's Gynecology may not have been translated, so his attack on the theory of the mobile womb may have remained unknown; [264] as for Galen, although he explicitly rejects Plato's womb-as-animal theory in On the Affected Parts , he implicitly accepts it in To Glaucon , thus leaving the matter open for future commentators. Such elements of the hysteria tradition as the wool test for life and the story of the widow and the midwife, retained by the Byzantine encyclopedists, continue to survive in Arabic medicine; the story of the woman raised from apparent death by Empedocles is found in Ibn al-Jazzar but plays a minor role, perhaps because the short reference to it in Galen is insufficient for its reconstruction. In terms of the most likely victims for the condition, it is of interest that Galen's preference for widows is ignored; virgins become a prime target. This is not a return to Hippocratic etiology since, as I have argued above, the Hippocratic hysteria texts rarely give a particular target population for womb movement; furthermore, when a particular group is specified, this tends to be the childless in general (since their flesh is not "broken down"), older women not having intercourse, or young widows. The Hippocratic text that may be at the root of this interest in virgins is one that was available in the Arab world, since it is cited twice by Rhazes: the Diseases of Young Girls . [265] This is a short and vivid description of a condition that arises not from womb movement, but instead from retention of menstrual, or possibly menarcheal, blood. The target population consists of parthenoi —meaning young girls, unmarried women, and/or virgins—who are "ripe for marriage" but remain unmarried. Their blood is described as being plentiful due to "food and the growth of the body." If "the orifice of exit" is closed, the blood that has moved to the womb ready to leave the body will travel instead to the heart and diaphragm, causing visions, loss of reason, and a desire to commit suicide by hanging. The author states that he orders girls with this condition to marry as quickly as possible; if they become pregnant, they will be cured. I would suggest that this text, retrospectively diagnosed as hysteria by several writers during this century, lies behind al-Majusi's interest in the thick blood of a virgin and in intercourse as a cure, as well as explaining Ibn al-Jazzar's target population of girls of marriageable age. [266] Finally, in these writers, a new explanatory device is used to account for the effects of the womb on other parts of the body: vapors. Yet the
54 concept of sympathy continues to exist, sometimes—as in Ibn al-Jazzar—involving very precise connections between particular organs of the body.
The Meeting of Three Worlds Returning to western Europe, most of Galenic medicine had been lost with the decline, from the late fourth century onward, in knowledge of the Greek language. [267] Soranus dominated gynecology in general; his writings, perceived as shorter and more practical than those of Galen, were preserved in abridged Latin versions that reinstated the womb movement he had so vehemently rejected. Hippocratic medicine fared worse, although Aphorisms continued to circulate after its translation into Latin in the sixth century; the Ravenna translations also included some of the sections of Diseases of Women describing womb movement. Some Galenic treatises, too, were translated at Ravenna; however, whereas 129 works of Galen were translated into Arabic, only 4 existed in Latin before the eleventh century. One of these was the practical work On the Method of Healing, to Glaucon but, as has been discussed above, this can be read as a further reinstatement of the wandering womb. The third volume of Paul of Aegina's encyclopedia, which includes his largely Ga-lenic description of hysterike pnix plus details of scent therapy, was translated into Latin, but probably only in the tenth century. [268] The emphasis in the West lay firmly on the instructional and practical aspects of ancient medicine; thus the traditional therapies for hysterical suffocation were transmitted when discussions of its causation were not. The category of suffocation of the womb appears in several anonymous collections of texts from the eighth to the twelfth centuries. I have already mentioned Leningrad Lat. F.v.VI.3, a Latin manuscript dating from the eighth or ninth century which contains several short texts on gynecology, all of which show some resemblances to the second book of the Hippocratic Diseases of Women . [269] Of these, De causis feminarum gives practical advice on what to do "si vulva suffocantur" (if the womb is suffocated), giving the Greek name for the condition as "styrecersis": is this a garbled form of hysterike pnix or hysterika ? The patient should be given burned and pulverized stag's horn in wine or, if she has a fever, in hot water. [270] Another text in this collection, the De muliebria causa , claims that "uribasius"—Oribasius, the only authority named in these texts—recommends one drachma of agaric for suffocation of the womb. [271] This is repeated in a section of the following text, the Liber de muliebria , which later gives a more complex recipe for suffocation of the womb, in which the patient is choked at the neck, so that it is turned back to the chest. [272]
55 It was in the eleventh and twelfth centuries that Galenic treatises were returned to the West, through the translations from Arabic into Latin made by Constantine the African in the late eleventh century at Salerno and Monte Cassino; a few Galenic treatises were translated directly from Greek into Latin in the twelfth and thirteenth centuries, and these translations are usually of higher quality. [273] The effect of Constantine on the history of medicine cannot, however, be overemphasized; his arrival in Italy with a cargo of books of Arabic medicine, which he translated into Latin at Monte Cassino, transformed the "theoretical impoverishment" into which medical knowledge in the West had fallen. For our purposes here, what is most significant is that his translations included Galen's commentary on the Hippocratic Aphorisms , and works of al-Majusi and Ibn al-Jazzar. [274] Constantine translated much of the Kamil of al-Majusi as the Liber Pantegni ; this work was translated again in the early twelfth century by Stephen of Pisa as the Liber Regius and was printed in 1492 and 1523. The Kitab Zad al-Musafir of Ibn al-Jazzar was translated in an abbreviated form as the Viaticum , while Constantine's Expositio Aforismi is a translation from the Arabic of Galen's commentary on the Hippo-cratic Aphorisms . [275] What effect do these texts have on the hysteria tradition in the West? We have already seen the wide range of variations that can occur on the theme of womb movement. In the Hippocratic texts a dry, hot, and light womb rises in search of moisture; Soranus believes that the anchoring membranes prevent any movement, while for Aretaeus, although the womb moves it is pulled back by its membranes, thus affecting the higher parts of the body only through sympathy. In Galen the problem is a womb filled with retained seed or menses, rotting to produce coldness. In Arabic medicine a Hippocratic mobile womb becomes a mobile womb with Galenic contents, and vapors as well as sympathy explain its effects on the higher parts. In the Latin West the focus on Soranus had been combined with acceptance of womb movement; while some extracts from Hippocratic gynecology circulated, Galenic theory was lost until the eleventh century. The return of Galenic medicine from the Arabic world led to yet another variation on this theme of womb movement and its mechanisms. It was in the twelfth century at Salerno in southern Italy that the texts of the Hippocratic corpus, Soranus, and Galen finally came together after their varied travels through the Latin West, the Greek East, and the Islamic world. [276] The result was not a critical comparison of these traditions, but instead the decline of Soranus and the rise of the Galenic medical system of humoral balance and imbalance. One of the "masters"
56 of the school of Salerno in the twelfth century was Johannes Platearius. In his description of suffocation of the womb, in the late twelfth-century encyclopedia and textbook De aegritudinum curatione , he combined Galen and Paul of Aegina with Ibn al-Jazzar's claim that the symptoms were caused by vapors rising from the corrupt seed, menses, or other retained humor. However, Platearius went a step farther than this, suggesting that it was not the vapors, but the womb filled with vapors, that rose in the body to put pressure on the organs of breathing. Green has argued that, since the Latin translations of al-Majusi's Kamil omitted the later section in which he describes scent therapy in terms of the womb as an animal annoyed by foul smells and seeking pleasant scents, this particular merger of the mobile womb with Galenic theory may come, not from Islamic medicine, but from the survival of the idea in popular thought in the West. [277] Other features of Platearius's description are more familiar, showing the overall dominance of the Galenic material found in the newly available Arabic sources; he recommends the Galenic tests of the woolen thread at the nose of the patient, or a glass flask full of water placed on her chest, and among his suggested cures one finds sneezing provoked with castoreum or pepper, and the use of foul scents at the nose and sweet scents at the vulva. However, here too Green points out that non-Galenic ideas surface; although Galen never specifically advised marriage as a cure, Platearius recommends it if the cause is retained seed. Again, al-Majusi did explicitly prescribe sexual intercourse as a cure; but, again, this was omitted from the Latin translation of his work. [278] It seems that the survival of Hippocratic theories—the wandering womb from Diseases of Women and the therapeutic value of intercourse from sections of that treatise and from Diseases of Young Girls —should not be underestimated. Another writer associated with Salerno in the twelfth century is the female physician Trota, whose name is associated with a number of treatises of this period which are found in nearly a hundred manuscripts from the thirteenth to fifteenth centuries. [279] Suffocation of the womb is mentioned in both the more empirical Ut de curis , which refers to it occurring in young girls with epilepsy, and the more theoretical and Ga-lenic Cum auctor . [280] The Cum auctor version owes much to Ibn al-Jazzar, although it does not specify conclusively whether suffocation results from vapors, or the womb itself, rising up inside the body. Scent therapy is recommended, and the story of the woman who lay as if dead but was known to be alive through the presence of the innate heat, is transmitted through the Cum auctor ; as in Ibn al-Jazzar, Galen becomes its hero. [281] The influence of Galenic theory grew with the translation of other
57 important Arabic texts into Latin; in particular, Ibn Sina's Qanun . The work of Soranus became "virtually obsolete by the thirteenth century"; [282] the gynecological works of the Hippocratic corpus languished in the wings until the sixteenth century. However, one Hippocratic text remained in the center stage: the Aphorisms , including the section on gy-necology with the text with which this chapter began, the alleged origin for the label/diagnosis hysteria , 5.35: "In a woman suffering from hysterika , or having a difficult labor, a sneeze is a good thing." Aphorisms circulated in both the Latin West and the Arabic world; in the latter, from before A.D . 800, it was coupled with the commentary of Galen, In Hippocratis Aphorismi . This commentary, probably written in A.D . 175, was restored to the West when Constantinus Africanus translated it from Arabic into Latin in the eleventh century. In terms of its printed editions in the Renaissance, it was the third most popular Ga-lenic treatise after Ars medica and De differentiis febrium . [283] The central position of the Aphorisms from the eleventh century onward results not only from its perennial popularity as a series of practical tips, [284] but also from its inclusion in the Articella , a group of medical writings "used for centuries at Salerno and elsewhere as a textbook for introductory courses in medicine." [285] The central text of the group is Hunain ibn Ishaq's Isagoge , in Constantine's translation from the Arabic; in addition to the Aphorisms , the nucleus also contains Galen's Tegni (the Ars parva ), the Hippocratic Prognostics , Theophilus on urines, and Philaretus on pulses. I have argued that the opening words of Aphorisms 5.35 can best be translated "In a woman suffering from hysterika ," where hysterika means disorders of the womb. But this translation depends on reading the text without the Galenic commentary that instead pushes for a very specific translation, hysterike pnix . By looking at changes in the Latin translation of this aphorism, it is possible not only to trace its gradual incorporation into the hysteria tradition, but also to provide a test case for the period in which the humanists began to carry out philological work on the Galenic and Hippocratic texts. When were these texts read as the object of serious study? It is the brief Aphorisms , not the lengthy Galenic commentary, which occupied a central place in the medical curricula of the Renaissance. Despite its impressive printing history, I would argue that Galen's commentary was little read before the sixteenth century. The earliest Latin translations of Aphorisms , found in manuscripts dating from the eighth to the twelfth centuries A.D ., can be traced back to fifth/sixth-century Ravenna. [286] Such Latin translations are very literal, the writers apparently having an equally weak grasp of both Greek and
58 medicine. The translation reads "Mulieri de matrice laboranti aut diffi-culter generanti, sternutatio superveniens, optimum" (In a woman troubled by the womb or giving birth with difficulty, a sneeze coming on unexpectedly is best). [287] At this period, then, the aphorism was not associated with hysteria or suffocation of the womb. The Articella uses a different Latin translation of the Aphorisms , possibly produced in the eleventh century, and linked to the name of Con-stantinus Africanus. It is not known whether this was made from a Greek manuscript of Aphorisms , or by merely extracting the aphorisms from a copy of Galen's commentary. Whatever its source, it gives for 5.35, "Mulieri que a matrice molestat aut difficulter generanti: ster-nutatio superveniens bonum." It thus differs little from the Ravenna translation; a sneeze becomes "good" instead of "the best thing," and the womb continues to "distress" or "trouble" the woman. Fifteenth-century printed editions of the Articella retain slight variations on this translation, which remains the most commonly used well into the sixteenth century. [288] Some editions give two translations, setting this so-called versio antiqua beside the traductio nova of Theodorus Gaza. The new translation runs, "Mulieri quam vitia uteri infestant, aut que difficulter parit, si sternutamentum supervenit, bono est." The opening words, "In a woman in whom disorders attack the womb," again keep this aphorism within a very general gynecological context. Another variation in printed editions of the Articella is to print both translations together with a rearrangement of the Aphorisms by the part of the body discussed, on a capite ad calcem lines; thus the edition of 1519 gives this aphorism under "Concerning sneezing" and "Concerning the female generative organs." [289] A further development in the printed versions of the Articella is that, where the manuscript versions gave only the Hippocratic text of the Aphorisms , the printed editions from 1476 give Galen's commentary beside it. Galen is thus "given a privileged status compared with other commentators." [290] However, an important question remains: Did anyone read the lengthy commentary, which sets it firmly in the context of hysterike pnix , as opposed to uterine disorders in general? Galen considers that apnoia , or absence of breath, is more accurate than "suffocation," seeing a spontaneous sneeze both as a "sign" (semeion ) that the patient has revived, and as a "cause" (aition ) of recovery, since in itself it revives the patient. [291] However, despite Galen's conclusion that hysterika is equivalent to hysterike pnix , the connection with the translation of the Hippo-cratic aphorism is not made. Neither the terminology of suffocation nor that of hysteria appears in the Latin of the Aphorisms ; instead, the woman
59 is said to be "troubled by the womb" or to have "disorders attack the womb." Reading the long discussion of the meaning of hysterika in Galen's commentary should lead to a change in the translation of the aphorism, away from this general terminology and toward that of hysterical suffocation, but no such change is made at this time. It is in the fifteenth century that the first signs of close study of Galen's commentary and its implications for the translation of the aphorism appear, in the work of Ugo Benzi (1376-1439). Benzi wrote commentaries on the Canon of Avicenna, the Tegni of Galen, and the Hippocratic Aphorisms , omitting books 3 and 7; this last was probably first published in 1413 or 1414 while he was lecturing on medicine in Parma, but it was later revised. Like his contemporaries, of course, he still based his translations not on the Greek, but on "the medieval Latin versions from the Arabic." Although he follows the versio antiqua translation, he improves the Latin, discusses the views of Galen and Avicenna on uterine suffocation—in particular, on whether it is the womb or merely vapors that rise up the body—and also glosses the aphorism as follows: "Sternutatio superveniens mulieri suffocationem matricis patienti aut difficulter pari-enti est bonum" (A sneeze spontaneously occurring in a woman suffering from suffocation of the womb or a difficult labor is a good thing). [292] The translation of Theodorus Gaza is used by Lorenzo Laurenziani (ca. 1450-1502), [293] while Niccolò Leoniceno (1428-1524) gives both this and the verso antiqua beside his own translation, which begins with another variation on the theme of general uterine disorders, "Mulieri qua uterinis molestant." [294] The connection between text and commentary is made conclusively only in the 1540s, when the Aphorisms are first the object of detailed philological interest. The availability of printed Greek and Latin editions of the Galenic and Hippocratic works from the 1520s onward had no immediate impact but, after twenty years, comparison of the text both with the Greek manuscripts of Aphorisms and with Galen's commentaries is made, and the aphorism becomes explicitly "hysterical." Antonio Brasavola's annotated edition of the Aphorisms and its Ga-lenic commentary was printed in 1541 at Basel. It discusses not only Galen's commentary but also the use of hysterika in Marcellus's commentary on Dioscorides, Philotheus, and Paul of Aegina. Brasavola (1500-1555) reasserts the identity of hysterika as hysterikg pnix , but still he does not take the step of adjusting the translation of Aphorisms 5.35, instead giving a variation on Leoniceno's translation, which reads: "Mulieri, quae uterinis molestatur, aut difficulter parit, superveniens sternutatio, bonum." [295]
60 The earliest translation I have found in which the terminology of the suffocation of the womb is directly applied to Aphorisms 5.35 is that of Leonhart Fuchs (1501-1566). Printed in 1545, this gives "Mulieri quae ab uteri strangulationibus infestatur, aut quae difficulter partum edit, sternutamentum superveniens, bonum." Here, for the first time, the translation itself becomes "hysterical"; "in a woman who is attacked by uterine suffocation," a translation justified by Fuchs on the grounds that Galen and Philotheus explain that hysterika equals suffocation here. He goes on to demonstrate that the basis of his translation is the comparison of Greek manuscripts, discussing whether a word in Galen's text should read lunga or pniga . [296] The edition of Guillaume Plancy (1514-ca. 1568) takes the process a stage further. In this publication of 1552 the Latin reads "Mulieri hys-tericae, aut difficulter parienti, sternutamentum superveniens, bonum." A note justifies the translation by a reference to Galen's On the Affected Parts 6.5. [297] The connection has been made, not only between aphorism and commentary, but between the Galen of the commentary and the Galen of On the Affected Parts . Once the aphorism has reentered the hysteria tradition, it is—with a few exceptions—there to stay. Claude Champier (fl. 1556) also mentions "vulvae strangulatus," while Jacques Houllier (ca. 1510-1562) follows Plancy's translation. [298] In keeping with his general interest in a return to the Greek classics in order to end error in medicine, Houllier also recalls Hippocratic ideas, giving a further type of suffocation due to a dry womb seeking moisture, for which a sneeze is less beneficial than baths. [299] Thus, once the aphorism is read—rather than merely printed—in the context of Galen's commentary, it ceases to be understood as a reference to disorders of the womb in general, and comes to be absorbed into the hysteria tradition, that set of connected texts repeated by successive commentators on suffocation of the womb. Glancing at its fortunes in vernacular editions, the English translation of the Aphorisms of 1610 by "S. H." gives "Sneezing hapning to a woman grieved with suffocation of the wombe, or having a painfull and difficult deliverance is good." [300] This is also found in a seventeenth-century manuscript in the British Library, Sloane 2811. [301] A commonplace book of the seventeenth century includes a Latin translation of the Aphorisms , giving "Mulieri hysterica, aut difficulter parienti sternutamentium su-perveniens bonum"—a variant of Plancy—and an English translation, reading "Sneezing happening to a woman seized with suffocation of the womb: or that hath a difficult deliverance: is good." [302] The comment on
61 this aphorism is that sneezing shakes off noxious humors and restores the natural heat that was almost extinguished. In the same book appears a work entitled "Select Aphorisms concerning the operation of medica-ments according to the place." This contains a section (pp. 121v -122r ) on "Hystericalls" which describes how the womb is drawn to aromatics and repelled by their contraries. It discusses how this mechanism works, and roundly rejects the belief of "some sotts" that the womb possesses "the sense of smelling." Even in the seventeenth century scent therapy is defended, but this does not mean that the womb is regarded as an animal. If the old discussion of the implications of scent therapy for the status of the womb as, in the words of Aretaeus, "a living thing inside another living thing" is still itself alive and well in the seventeenth century, has the hysteria tradition made any progress over the two thousand or so years of its existence? I would argue that some change has, by this time, occurred. The tendency before the sixteenth century was toward an accumulation of descriptions, explanations, and remedies. Some features—such as scent therapy at both ends of the body, the use of an extinguished lamp wick to rouse a patient, and the application of aromatic oils to the sexual organs—went back to Hippocratic medicine, as transmitted by Galen. Others, although derived from the Hippocratics, were transformed by Galen's reinterpretation; for example, Hippocratic pnix concerns a hot womb seeking moisture to douse its fire, yet after Galen it becomes "obstruction of respiration," and the womb is seen as being filled with cold and corrupt substances rather than being hot and light. Other features remained in the tradition despite all that could be said to condemn them, most notably, the wandering womb, in coexistence with apparently contradictory features such as anchoring membranes.
Tradition or Truth? By the mid-sixteenth century, the hysteria tradition was complete: the translation into Latin of texts from the Arabic and Greek made available virtually the full range of authors discussed above. Every commentator on suffocation of the womb knew which ancient authorities to consult for a description. Since these ancient authorities had themselves known and used the work of many of their predecessors, it is not surprising that the result was often merely further repetition. Latin and Middle English treatises from the thirteenth to fifteenth centuries tend to be heavily dependent on the Arabic writers' versions of Galen, and retain the features of scent therapy, provoking a sneeze as a cure (as opposed to
62 welcoming a spontaneous sneeze), venesection, and therapeutic intercourse. [303] However, in the mid-sixteenth century something new does occur: the stated desire to compare authorities, not only with each other, but with reality. As an example of this we may take the work of Pieter van Foreest (1522-1597), Observationum et curationum medicinalium , Book 28 of which concerns women's diseases. [304] As the title suggests, rather than simply repeating the authorities, he also presents cases that he himself has seen. Observations 25-34 concern suffocation of the womb, covering cases due to retained seed or menses in widows, in pregnant and other women, and of varying severity. Rhazes, Ibn Sina, and Galen are cited; Galen is particularly favored and, although he is a supporter of the Hip-pocratic revival, van Foreest accepts Galen's attack on the Hippocratic theory that the womb dries out and seeks moisture. [305] He notes that the ancients believed the womb itself traveled the body, whereas "more recent writers" believe it is vapors that rise. The motif of the woman who uses hysteria to manipulate men is reintroduced, echoing Martial's epigram on women who announce they are hysterica in order to have intercourse with a young doctor; van Foreest states that some women simulate hysterical suffocation by imagining sexual intercourse, and he cites the "notorious poem" mocking this. [306] His use of his own observations is first suggested when, after repeating Galen's statement that the symptoms from retained seed are worse than those from retained menses, he adds, "And this is true." [307] Even Galen must be tested against experience. Observation 27 repeats the story of the woman who lay as if dead, based on Pliny, and gives the standard tests for life, adding that a sneeze is more reliable than the wool or water tests. Observation 28 includes Galen's story of the widow who was cured after passing some thick seed. In Observation 30, on hysterical suffocation in pregnancy, he gives two cases he himself has seen, one dated to October 1589, while in Observation 31 he describes the case of a woman called Eva Teylingia, who was married in 1561 and was known to his wife. She was unsuccessfully treated by several named doctors for suffocation, and "on the third day I myself was called." Van Foreest's therapy—based on foul-smelling substances placed in the navel—was successful. In Observation 33 he gives the case of a girl of twenty, treated in September 1579, and in Observation 34 he gives a case dated March 1566. Such works as this were used by Edward Jorden in his treatise of 1603, A Briefe Discourse of a Disease Called the Suffocation of the Mother . [308] What is most striking about this work, in which he sets out to show "in a vulgar tongue" that symptoms "which in the common opinion are imputed to
63 the Divell" are in fact due to the suffocation of the womb, is not the use of authorities such as Hippocrates, Galen, Pliny, and Ibn Sina, but his citation of recent cases seen and reported by men such as van Foreest, Amatus Lusitanus, and Andreas Vesalius. Is this, then, the triumph of experience over tradition? It is not. As T. Laqueur puts it, "Experience, in short, is reported and remembered so as to be congruent with dominant paradigms." [309] Many elements of the hysteria tradition have an extraordinary vitality as paradigms, continuing to be repeated well into the nineteenth century. To take one example, Jorden himself repeats the story of the woman who lay as if dead but was known to be alive by the presence of the innate heat; he uses the version given by Pliny. [310] This story has inordinate staying power, turning up many times in seventeenth-century literature; for example, Guillaume de Baillou (1538-1616) claims that many women are being buried alive because it is wrongly assumed that the absence of a pulse indicates death. [311] In the nineteenth century, Thomas Lay-cock's Treatise on the Nervous Diseases of Women has a section on "Apparent Death" citing Diogenes Laertius's version of the same story, here diagnosed by Laycock as hysteria. As a general rule, Laycock recommends delaying burial in such cases until there are signs of decomposition. [312] He refers readers to Leigh Hunt's play A Legend of Florence , first performed in 1840, the year of publication of Laycock's own work. In this play, the moral and married Ginevra, receiving letters from a nobleman who declares his love for her, has a fainting spell and is mistakenly buried—fortunately, in an open vault. She wakes up but has difficulty persuading the people of Florence that she is not a ghost:
I am Ginevra—buried, but not dead, And have got forth and none will let me in. (act 4, scene 4)
This highly popular piece of drama, seen by Queen Victoria a number of times and regarded as Leigh Hunt's greatest dramatic success, was in turn based on Shelley's "Ginevra," published in 1821. [313] In Shelley's version, Ginevra marries a man she does not love and, on her wedding night, falls into a trance that drifts into death itself, in order to keep faith with her disappointed lover.
They found Ginevra dead: if it be death To lie without motion or pulse or breath, With waxen cheeks, and limbs cold, stiff, and white, And open eyes . . . (lines 145-148)
64 Shelley's words echo Diogenes Laertius's third-century A.D . account of the woman "without breath or pulse" but preserved, according to Galen, by her innate heat. Such powerful motifs as apparent death weave in and out of the medical accounts of suffocation of the womb and of later hysteria. Do such elements survive simply because they make such good stories? Or is the persistence of certain parts of the tradition evidence for the accuracy of that tradition, and thus for the accuracy of the diagnosis of hysteria? Throughout this chapter I have emphasized how medicine worked as a series of texts. Medical education, particularly where it concerned women's bodies, was based on the text in the Byzantine, Islamic, and medieval worlds; even after publication of Vesalius's De humani corporis fabrica in 1543, "anatomy and surgery continued to be taught from books rather than from experiment and observation." [314] Specifically, in the texts of the Hippocratic corpus, neither the diagnosis of hysterike pnix nor of hysteria is made. The womb moves, causing a range of symptoms according to its eventual destination. At an unknown date, possibly—from the medical papyri—in the second century B.C ., a disease category of suffocation of the womb is created by the merger of a number of discrete Hippocratic texts giving symptoms, causes, and therapies. Galen challenges the label, but keeps the concept and develops a different explanation based not on womb movement so much as retained blood and seed. In the early Roman Empire, further stories are added to the disease picture, surviving in the different cultural climates of the Latin West, Greek East, and Arabic world. Particularly resistant to change are two of the original Hippocratic components, womb movement and scent therapy: so too is the need to give the concept antiquity by tracing it back in its entirety to the father of medicine. I would suggest that what we hear in such texts as those discussed here is not the insistent voice of a fixed disease entity calling across the centuries, but rather what Mary Wack has called "the rustle of parchments in dialogue." [315] Indeed, it is rarely even a true dialogue. Deaf to pleas from anatomy and experience, the texts continue to tell one another the traditional stories. The language may shift—the womb travels, vapors rise, sympathy transmits symptoms through the body—but the message remains the same: women are sick, and men write their bodies. Nineteenth-century hysteria, a parasite in search of a history, grafts itself by name and lineage onto the centuries-old tradition of suffocation of the womb, thus making Hippocrates its adopted father. It is time that father disowned his hybrid child.
65
Acknowledgments Sections of this chapter have been presented to the Pybus Club (Newcastle, 1985), the Classical Association Triennial Meeting (Oxford, 1988), a conference organized by the Wellcome Institute for the History of Medicine (London, 1990), and the Liverpool Medical History Society/Society for the History of Science (Liverpool, 1991). I am grateful to all who made suggestions as to its improvement on these occasions, but above all to the careful and generous scholarship of Monica H. Green and Mark Micale.
91
Two— "A Strange Pathology": Hysteria in the Early Modern World, 1500-1800 G. S. Rousseau
Some will allow no Diseases to be new, others will think that many old ones are ceased; and that such which are esteemed new, will have but their time: However, the Mercy of God hath scattered the great Heap of Diseases, and not loaded any one Country with all: some may be new in one Country which have been old in another. New Discoveries of the Earth discover new Diseases . . . and if Asia, Africa, and America should bring in their List, Pandoras [sic] Box would swell, and there must be a strange Pathology. —SIR THOMAS BROWNE, "A Letter to a Friend, Upon Occasion of the Death of his Intimate Friend"
It will always be a mistake . . . to treat past philosophies in a decontextualized way, viewing them simply as addressed to a canonical set of distinctively philosophical themes. Even the most abstract intellectual systems cannot be regarded simply as bodies of propositions; they must also be treated as utterances, the rhetorical aims and purposes of which we need to recover if we are to understand them properly. Moreover, once we commit ourselves to recontextualizing the great scientific and philosophical systems of the past in this way, we must guard above all against the tendency to reconstruct their intellectual context with anachronistic narrowness. —QUENTIN SKINNER, New York Review of Books
I Even in the earliest historical periods in the murky ages between 1300 and 1600, old man Proteus offers a steadfast clue to understanding the evolution of hysteria. In its progression from the Greeks to the medieval world, hysteria—as Helen King suggests—was transformed many times, such that by 1400 it was understood as something different from the conceptions given it by Hippocrates and Soranus. Vast cultural shifts—religious, socioeconomic, and political—as well as the growth of medical theory in the Renaissance, prompt hysteria to continue its prior altera-
92 tions and constructions after approximately 1500; so that by the period of the French and American revolutions it assumed a different set of representations altogether. These historical transformations and representations—specially their protean ability to sustain the existence of a condition called hysteria without a stable set of causes and effects or, more glaringly, a category identifiable by commonly agreed upon characteristics—constitute the substance of this chapter. Throughout I will be attempting to explain how a category—hysteria—evidently without a fixed content can endure throughout the course of history. [1] Furthermore, among all medical conditions hysteria formed the strongest critique of the traditional medical model up to the advent of psychiatry and psychoanalysis. Before approximately 1800 its discourses were compiled by doctors who were themselves often terrified of their hysterical patients, as is evident in the early Malleus Maleficarum . Hysteria is a unique phenomenon in the entire repertoire of Western medicine because it exposes the traditional binary components of the medical model—mind/body, pathology/normalcy, health/sickness, doctor/patient—as no other condition ever has. My purpose here is dual: to show what hysteria was thought to be, as well as trace its representations. Within this goal I have a set of alternatives: whether to focus on what doctors chose to make of hysteria, or to gaze at its representations by those who were not doctors. Inevitably I work here sporadically as a historian of science and medicine whose eye is never far from the medical alternatives doctors chose to take, while inquiring into the representations of hysteria made by those who were not doctors. This is the "as is" (history) and the "as it could have been" (representations) of hysteria, strewn with a broad range of metaphors and language that attached to the condition. But even in a historical and representational treatment like this one, it is easy to forget that for the modern era the history of hysteria extends over a period of four centuries (1400-1800), and because this somewhat synchronic view enables us to chart the flow of hysteria in its recorded versions, we possess certain advantages over both the doctors and the patients who were entrapped in their particular moment. This angle of vision is, of course, double-edged: we are also entrapped by our moment, and many voices of hysteria must have been lost over the centuries. Nevertheless, modern methods of research permit access to a wide body of knowledge about this condition not available before. [2] Furthermore, some disjointed concepts pertinent to hysteria's transformations must be considered: in our time, when the revolt against Freud has been so vehement, it is important to remember that he launched
93 his psychoanalysis exclusively on the basis of his studies of hysterical women. As a consequence, hysteria in our century has assumed a more important role in psychiatry than have other categories. [3] Although the diagnosis of hysteria in both women and men has virtually disappeared in our time, in practice its symptoms have been transformed into the medically sanctioned "conversion syndrome" and then (mysteriously and perplexingly) have gone underground. [4] It is easy to forget that the ancient threat of an invasive and irrepressible female sexuality, a patent menace in epochs studied in this chapter, is in the lay imagination today far from having been removed in our own time. [5] Indeed, the social oppression of women throughout history has only recently—since the eighteenth century—been acknowledged in any organized way, and this restraint bears serious implications for hysteria. Finally—and it will seem extraneous in this discussion about a complex but nevertheless presumed-medical category—because so much of hysteria in the period 1500-1800 is embedded in discursive practices, much more sensitive attention must be paid to language if we hope to disentangle hysteria's transformations. We are thus presented with something of a paradox. On the one hand, hysteria appears to be a category without content; on the other, hysteria has an amorphous content incapable of being controlled by a clear category. The history of hysteria (pace Dr. Ilza Veith, the already-mentioned Freudian medical historian who amassed a great deal of information about hysteria) is therefore only a part of the story I tell here. Its representations count as much. No matter how complete any history, its discursive facet can only hope to be one part, its total realism requiring a larger canvas than historical narrative. The challenge I face is that I aim to "fill up" both categories (the medical category and its broader nonmedical representations) at the same time—a double task. But both require amplification, even when conjoined as they are here. Moreover, the medical category itself is so inadequate for the early period (1500-1800) that I often rebel against its constraints. The history of hysteria is as much the "his-story" of male fear—in this case literally his-story—as the history of Dr. King's hysterie pnix or any other wandering wombs. It is also the history of linguistic embodiments, rhetorics, and emplotments, many of which remain to be decoded and interpreted here. [6] Two truths then seem to emerge with rather startling disparity: first, that Dr. Thomas Sydenham, acclaimed as the "English Hippocrates," rather than Charcot or Freud, is the unacknowledged hero of hysteria (his entrance to my story is necessarily delayed until a later section as my organization is essentially chronological); second, that language,
94 rather than medicine (either theory or therapy), is the medium best able to express and relieve hysteria's contemporary agony. (The same conclusion can be drawn concerning other conditions, such as depression, but conventional hysteria or twentieth-century conversion syndrome is different in that its somatic involvement is much greater.) This is the conjunction of language and the body: hysteria's radical subjectivity. And as I shall suggest below, hysteria is also the most subjective of all the classifications of disease. These are bold assertions, and no one at this time wants to promote a history of medicine based on heroes and heroines. But writing—perhaps self-expression through any of the arts, rather than treatment with drugs or psychotherapy—alleviates the modern hysteric's pain and numbness best. [7] To validate this claim we will prove that there remains no better medical therapy for contemporary hysteria, certainly no more effective remedy when hysteria is, as in Sydenham's version of the 1680s, presented as a "disease of civilization" rather than as organic lesions caused by psychogenic factors. [8] If we ask what the three hundred years between 1500 and 1800 can teach us about hysteria, the answer can be found by looking at two factors: gender-based pain and social conditions, neither of which falls within accepted categories of modern medicine. It is consequently no small wonder that to its observers hysteria has continued to be one of the most elusive of all maladies; [9] less so—as I suggest—to writers, poets, or artists, who have often adopted a gaze that differs from the traditional medical one. If we assign to hysteria a broad repertoire of gender-based pains caused by social conditions, we have the beginnings of a definition that pleases few medical theorists. We provide a set of contents incapable of being bound together by any logically constructed and demonstrably coherent category, [10] and so our contents will be unsatisfactory to philosophers. Moreover, of all the diseases classified in this early modern period, hysteria has been the medical condition most likely to generate private languages and discourses—languages that capture the cries and whispers of unspeakable agonies, most of which do not remain as single narratives because patients never recorded them. This was as true in the sixteenth and seventeenth centuries as it is of the twentieth. Hysteria's expressions of physical and emotional numbness and of chronic pain were captured in a personal, often disjointed, medium, most striking in its intrinsic subjectivity. Subjectivity, above all, has been the teleology of the annals of hysteria in Western civilization. [11] More specifically, mourning and melancholia, especially the grief and ecstasy associated with hysteria, are the shadow-categories that have haunted modern theories of subjectivity and representation since Freud. But even Freud intuited the history of this development in his inau-
95 gural linking of Hamlet and Oedipus Rex in his discovery of the Oedipus complex, in which Hamlet came to represent the figure that proves (and ruefully denies) the Oedipal rule, as much as literary criticism has taken Hamlet as its exemplary defective (hence modern) tragedy. And modern theorists (including Jacques Lacan, Walter Benjamin, and Nicolas Abraham) have repeatedly returned to Hamlet's disordered grief as touchstones for their insight into subjectivity and representation. From these positions it is only a short step to the feminist, psycho-analytic, and deconstructive attempts to articulate a supplementary position before, within, or beyond the interpretative paradigms practiced in Freud's (and Oedipus's) name. In our time, these have embraced—in brief—the literary, psychoanalytic, and deconstructive symptoms of hysteria: in Hamlet's famous phrase, the "forms, moods, shapes of grief." [12] But if mourning and melancholia have haunted modern categories of subjectivity and representation, language alone has recognized the silences beyond itself (i.e., beyond verbal language and discourse) to which the (usually female) hysteric has had to ascend if her desire, not always limited to the sexual realm, was to be acknowledged. The point is admittedly elusive, even if concretized in a tangible history of medicine. Historically speaking, hysteria has been the condition beyond others that wedded the body to body language, especially to gestures, motions, gaits, nonverbal utterances. As such, it never reflected—certainly not in the Renaissance or Enlightenment—a simple ontology of the mind or of mind functioning together with body, but rather captured the chronic numbness and ineffable despair usually incapable of being grasped in the subtleties of written language. [13] Ever since the Cartesian revolution of the seventeenth century and perhaps even before then, the philosophical concept of body had been of little use to theories of hysteria—viewed, as we shall see, as a metaphysical medical category—nor have mind and body, in conjunction, offered solutions to unravel the riddle of hysteria. Perhaps the difficulty arises from the suppressed desire of those who have presented themselves with hysterical symptoms. Language and desire; more precisely, desire in language; Julia Kristeva's yoking of these loaded words and their difficult concepts proved more useful, especially for the unspeakable realms of pain that she believes transcend language: the metalinguistic spaces. [14] Language and desire may ultimately be the only categories through which the hysteric can arrive at self-understanding: language used in the act of self-analysis and offering balm to heal the hysteric. The traditional remedies discussed later in this book have usually produced little improvement. Michel Foucault speculated in his history of madness about the "hys-
96 terization of women's bodies" through which the pejorative image of the "nervous woman" had been constituted. [15] Such negative imaging was necessary in patriarchal cultures that confined power solely in the males to ensure civic cohesion. But Foucault's analysis would have been richer, and certainly more complete, if he had included the "hysterization of women's language," especially as it had been muted with the passage of time. For hysteria has been the condition paradoxically both constituted by and consistently misinterpreted by medical observation; the condition that neither the mere presence of the physician (whether appearing as savior or soothsayer) nor the persistence of his therapy can control. Sequences of despair, pain, numbness, and conversion syndrome ultimately could not be cured by makeshift remedies or the herbal concoctions of the Renaissance and Enlightenment apothecaries. Today, instead of examining the fabric of the society perpetuating this chronic physical and mental pain, [16] we deny (perhaps imprudently) that hysteria exists. We drug patients until the pain is obliterated, the despair forgotten; until physicians can claim that questions such as "where has all the hysteria gone?" cease to exist as valid medical concerns.
II I have suggested that a broad overview such as this cannot be narrated without remembering that we today are subject to all the tensions and confusions of contemporary culture. [17] Our versions of modernism necessarily differ from those of other readers, but a narrative of the evolution of thought about hysteria without interjections and self-conscious reflections, sans broad contexts and even problematic digressions, will not proceed much further than Veith's narrowly conceived diachronic history. This may seem small justification, but it actually advances the understanding of hysteria. In this context it makes sense to inquire eclectically into the cultural transformations that affected hysteria as the world moved from the Middle Ages to the Renaissance, and from there to the period of the seventeenth century, when so many of the salient features of Enlightenment hysteria were established. The relation of hysteria to witchcraft is also germane here. Set the chronological dials to the tenth or eleventh century, and few witches are to be found in Europe. By the fourteenth and fifteenth centuries they roam the continent, having over-taken it. [18] To which specific conditions is their proliferation to be attributed? And, more significantly, were these witches female hysterics in disguise? The question is hard to answer authoritatively, but it assumes (rightly I think) that hysteria has a content that can be misinterpreted
97 or disguised. Even more crucial to the culture of the Renaissance, it was hysteria more than any other phenomenon that played a major role, as I maintain below, in the demystification of witchcraft. Despite the variety of explanations for the historical rise of witchcraft, none is satisfactory, and given that the matter is central to the evolution of hysteria and its growth in the Renaissance, it merits discussion here. So many explanations have been tendered, with so many agendas underlying them and in so many historical contexts ranging from political history to the role of women in early European society, that no one theory has prevailed. [19] Nor, on balance, does one explanation seem more reasonable than another. The account offered by Jules Michelet, the great French social historian of the nineteenth century, may therefore be as valid as the alternatives, although Michelet recounted it as myth rather than fact, and his narrative suggests a playful naughtiness as well. [20] Michelet claimed that during one of the interminable medieval crusades, women, who had been left alone on their farms, out of boredom began to converse with the animals and plants, the trees and birds, even the clouds and the moon. [21] Apparently no one objected to this behavior. But eventually the men returned and found their women talking to the creatures of nature, to the trees and the wind. It was then, Michelet says, that men, finding this babbling intolerable, invented witchcraft. From the start, witchcraft was—he suggests in the parable—a male idea, even a male invention. To silence the women, the men burned them and branded them witches. This explanation for the genesis of witchcraft seemed as reasonable to Michelet as any other version. But for Marguerite Duras, the contemporary French writer who retells Michelet's myth fable in several of her short stories and uses it as a leitmotif, it becomes a potent myth that captured the essence of the masculine suppression of female desire and female discourse. Whether in its Micheletian or Durasean version (or in some other form), the fable suggests a direct line from the late Middle Ages to fin-de-siécle Vienna; from the women who once knew how to speak freely to the wind and the clouds to those now—like Duras, Kristeva, and other feminists—whose crusade in our century seeks to retrieve the female speech (Kristeva's utterances of jouissance ) that once was theirs. [22] Considering the degree to which phallocratic and patriarchal discourse continue to be major concerns of our contemporary intellectual dialogue, as Elaine Showalter shows in chapter 4, the historical discourse of hysteria cannot be conceptualized or reconstructed as a specialized province of medical history. Hysteria, even in its early medical versions among the ancient Greeks, represented more than a set of
98 medical diagnoses and pharmaceutical therapies. From the start it was emplotted in discourses that extended beyond the medical domain and opened to a vision embracing a wider culture and broader civilization than the medical one could ever imagine. It was the public language embodying the female's plight. And it was for good reason then, as we shall see, that Sydenham observed that hysteria was, and always had been, "a disease of civilization," a seemingly mysterious pronouncement requiring broad contextualization before we can understand what he meant. The salient historical point is that modern hysteria or conversion syndrome, as distinct from ancient hysterike pnix , first rises to prominence as an explicit diagnostic category within the development of demonology. This is why the relation between content and category, already mentioned, is so crucial for an understanding of hysteria's development before Freud, and why its anomalous mixture of gender and social conditions (especially religion) makes it a unique malady throughout the realm of medicine. By the time of Chaucer and Boccaccio, Christianity had affirmed a cosmology that viewed creation as embodied with spiritual powers, both angelic and demonic. Christ's disciples and their followers over the centuries had been locked in an apocalyptic struggle against the armies of the night, as every English epic from Spenser to Milton and Blake had acknowledged. Satan could possess the human soul, turning victims into demoniacs, and individuals— especially witches—could enter into compacts with the devil. From the late fifteenth century, in a movement peaking in the seventeenth, authorities, ecclesiastical and secular alike, comandeered the courts to stop the epidemic spread of witchcraft, and concomitantly clamp down on the rise of hysteria it was engendering. [23] It was then impossible to distinguish between individual and mass hysteria, or even to know if the two categories existed. The wrath of the rabble, the crowd, the mob, was not understood as it would be in the eighteenth century. Besides, mass hysteria is a nineteenth-century invention that exists nowhere in the vocabulary or intellectual purview of the periods surveyed here, even if its effects were often felt. [24] Though some witches were self-confessed, most were identified through public accusations. To sustain the charge of witchcraft, certain standard behavioral and physical identifications (especially the stigmata diaboli ) normally had to be proven. Given that witchcraft was held to be a mortal offense everywhere in the realms of Christianity, it was crucial that such tests be judicially convincing. Meticulous courtroom procedures were developed throughout Europe to winnow true demoniacs and witches from those erroneously or falsely accused—those whose
99 prima facie manifestations of possession were due to other causes—to illness, accident, suggestion, or even fraud. Expert witnesses were heard, especially physicians; often these were the same physicians who were compiling medical definitions of hysteria. [25] The doctors by 1400 had generated no single theory or even multiple theories of hysteria. [26] They continued to ponder the links among sexual physiology, pleasure, and love, but they were uncertain of the proper emphasis to be given to any of these, let alone the roles of cause and effect. Mary Wack's conclusion about women and lovesickness in the Middle Ages and early Renaissance is surely correct. "In any case," she writes, "it is clear that a certain branch of medical writers on lovesickness began to consider it a disease linked to the sexual organs and their humors." [27] Hysteria had not yet become the exclusive medical category it would be in the early decades of the seventeenth century. There is no reason to assume that in the legal domain doctors entertained greater doubts about the existence of diabolism than did other experts: indeed, physicians' testimony was often accusatory and ended in executions. But familiarity with the vagaries of the human organism, especially when sick, fevered, or maniacal through the ravages of natural disasters such as floods, storms, earthquakes, and so on, and the opportunity to vie with the clergy for authority over the human body, often led doctors to insist that supposed signs of possession—tics, convulsions, anesthesias, swoonings, hypnotic trances—were the work of illness rather than Satanism. [28] Substitute "nervous" or "neurotic" for "demonically possessed," and a remarkable parallel between this early modern world and our own develops. [29] That is, the physicians then were asked to distinguish between real and false witches based on certain anatomical conditions; our doctors, at least since Freud altered the face of hysteria through his psychoanalytic reforms, distinguish between genuine conversion syndrome and somatic derangement caused by neurotic or psychotic agency. The first variety (conversion syndrome) entails so-called genuine hysteria, the latter no hysteria at all. Yet such demarcation clarifies the entire point of conversion syndrome. And here, precisely at this impasse between the two, our feminists have contributed a perspective that cannot be ignored despite their patent lack of medical expertise. Indeed, it may be that the feminists' psychological distance from this professional medical world, where so much other than scientific cause and effect is at stake, has permitted their deep insight into this matter. The feminists have demonstrated that Marguerite Duras's writings, for example, thrive on notions of the transformation of hysteria—espe-
100 cially the intuition that hysteria in our century is alive and widespread, though often invisible to the gazer who cannot read its signs, but it is transformed, like Proteus, in its signals and modern dress. [30] Although Duras has not pursued the social consequences of her argument (she is, after all, no sociologist), it would not be hard to do so. For if the medieval hysteric's geographical locale was the farm on which she toiled and conversed with family and neighbors; if the Georgian woman's world was the Ranelagh and Vauxhall Gardens where she paraded, and the town and country houses where she sought pleasure; [31] if the Victorian woman's interior purview was the dark bedroom in which she pretended to see nothing at night, certainly not her husband's naked body and aroused sexual organs; then today these locales have not disappeared but have been transformed into other social locations: the health club, the bedroom with its paraphernalia of biofeedback machines, the therapists' waiting rooms, the pain clinics, even the beauty salons and ever-proliferating malls. [32] Paradoxically, it seems today that these are the locales of health and therefore of pleasure and happiness. Yet it may be, upon closer observation, that they are merely the places where modern hysteria—what our vocabulary calls stress—has learned to disguise itself as health . The method used in the detection of witches in the early period also bears such close parallels to methods of the last two centuries that they cannot be overlooked, not merely because of their similarities but also because they provide clues to the nature of hysteria itself. Here it is interesting to note that the signs and symptoms of hysteria have remained constant over many centuries. From the late Middle Ages to the Salem witch-hunting trials in New England (and even later), the same methods to detect witches were used to detect other medical conditions. [33] In the early period, women were pricked with sharp needles to locate the devil's claw: that insensitive patch of skin was considered the infallible sign of witchcraft. Five centuries later—in the late nineteenth century—the great medical clinicians like Dr. Pierre Janet in Paris were still declaring that medical practice had gone no further: "In our clinics," Janet proclaimed, "we are somewhat like the woman who sought for witches . We blindfold the subject, we turn his head away [notice that the pronoun has changed its gender], rub his skin with our nail, prick it suddenly with a hidden pin, watch his answers or starts of pain; the picture has not changed." [34] Numbness—an unfeeling patch of skin—was still the sign of possession and witchcraft five centuries later. The concept of numbness altered its versions during the Enlightenment, as we will see, but it remained a
101 constant test at the peripheries of the early and late period (Renaissance and modern), and there is even evidence that the condition existed in the middle period (Enlightenment), despite the absence of the word numb from the hysterical patient's vocabulary. A century after the appearance of the nineteenth-century narratives about women like Charlotte Perkins, who as a hysteric became permanently numb , Duras continues to write stories about the literal physical numbness of contemporary women, and our finest feminist critics continue to proclaim that hysteria, although officially diagnosed by the physicians as having disappeared, is still with us . The evidence lies in some of the titles of their recent work: Alice Jardine, Gynesis: Configurations of Woman and Modernity; Roberta Satow, "Where Has All the Hysteria Gone?"; Dianne Hunter, "Hysteria, Psychoanalysis, and Feminism: The Case of Anna O"; Patricia Fedikew, "Marguerite Duras: Feminine Field of Hysteria." [35] The questions raised by this development may appear less than scholarly but must be put nevertheless. Why all this writing about hysteria if hysteria has disappeared? How can numbness have been the semiotic of hysteria as long ago as the sixteenth century, disappeared for centuries, and reappeared in the last century? Stated otherwise, what has been the middle zone of hysteria —its high Enlightenment versions? Has it returned, so to speak, in the modern witch's (i.e., today's hysteric) numb patch of skin?[36] What is the pathology of hysteria if numbness has continued (admittedly with major lapses in the Enlightenment) to be its major sign—the basis of its semiology—over seven or eight centuries? And how does Helen King's Hippocratic story relate to this lingering malaise? Even holy women and saints of the early period—the Margery Kempes and Saint Theresas—had presented themselves with signs that were interpreted as hysterical by those who examined them, further evidence of the many physical shapes and forms that numbness could take in its religious guises. [37] Here it is wise to remember that King left us with hysteria as a condition capable of afflicting women only . Seven centuries later, Victorian women remained its main victims despite abundant new research conducted in the century from 1750 to 1850 demonstrating that male hysterics also abounded then. And in our time one has to look very far indeed to find a male correlative of the feminist position that hysteria still abounds but has gone underground. [38] The explanation for the persistence of hysteria throughout history lies in the concept of imitation. However, because imitation thrives on complex notions of representation (an elusive concept to begin with), this matter of the "content" of hysteria is incapable of swift and simple presentation. [39] Representation is further complicated by the mysterious-
102 sounding notion, propounded by Sydenham, that "hysteria imitates culture" ; a discovery that makes him, rather than later physicians often associated with hysteria, the unacknowledged hero of that illness before Freud and Charcot. [40] Sydenham was the first to proclaim that hysteria imitated other diseases, and he maintained—by implication—that hysteria was itself somehow an imitation of civilization: an idea as well as a linguistic construction that we shall need to explore if we are to grasp the evolution of hysteria in the early modern period. But how can an organic derangement, a bodily disorder, even a medical disease (if hysteria can be classified in this fashion in comparison to other organic diseases) imitate a society, a civilization, a culture? What can be meant by such a notion of imitation? Sydenham observed that the crucial hysterical symptom was always produced by tensions and stresses within the culture surrounding the patient or victim. That is, the symptoms themselves (the conversion symptoms the patient presented) proved to be constant over time (involuntary swoonings, faints, fits, twitchings, nervous tics, eating and sleeping disorders), and the symptoms clearly differed from a more general "numbness." But the cultural tensions producing these symptoms varied enormously. Sydenham was not a cultural historian—he was a radical empiricist more than anything, an observer but he realized that the human conditions varied greatly from one period to another. [41] In this context, because of him the concept of hysteria held by physicians over the previous two hundred years was transformed. For him the symptom leading to the condition of hysteria "imitated" the culture in which it (the symptom) had been produced. It was not simply chance that the precise aspect of civilization producing the symptom should have been identified by Sydenham and applied by his followers in nervous categories and nervous language. Tension, stress, and the large constellation of concepts aligned to these words—all derive from a revolution in thinking about the body which occurred in the late seventeenth century. [42] In amalgamating an old medical condition (hysteria) with new cultural beliefs and practices (especially the body's mechanico-nervous organization), Sydenham was not merely displaying that he was an original thinker but was himself enveloped in the science and society of his era. [43] That much is patently clear. But it has been much less evident that the new footing on which he placed hysteria owed as much to the scientific milieu of his day—a post-Cartesian radical dualism that called attention anew to the nerves—as it did to any concept of imitation and representation, whether construed in medical or nonmedical terms. [44] Furthermore, my own intrusion of Sydenham—
103 introducing him into the narrative long before his chronological appearance justifies itself is essential if his achievement as the major transformer of Enlightenment hysteria is to be understood. If we construe hysteria in this imitative way rather than viewing it narrowly as an neuropsychological puzzle, we begin to glean why women have been demonized for so long and why women continue to express their own brand of contemporary numbness in the twentieth century. For the condition that arises by the production of symptoms that imitate the stresses inherent in a civilization requires social—even sociological—as well as medical analysis. Even further, the gaze must be extended to mentalities other than the exclusively medical, such as that of Julia Kristeva, the physician who writes about language and desire, and about language itself imitating the raging desire of women.
III These leaps from witches in the Renaissance to Dr. Sydenham, switching from Sydenham to Kristeva and Duras, are not as disjointed and disconnected as they may appear, for only by possessing some sense of the synchronic hysteria does the richness of its diachronic development emerge. [45] This synchronicity amounts to the convergence of all theories of hysteria, past and present, as if one beheld them simultaneously in the mind. The chronological view is, naturally, less confusing. Even for a condition as perplexing as hysteria, the diachronic or chronological view suggests focus and precision even when there is none; it gives the illusion of a well-wrought argument when there are only a myriad of theories and dozens of fractured images of the hysteric. Three hundred years after Sydenham wrote his dissertation on hysteria, [46] Duras presented hysteria as imitation in terms of a female numbness; Sydenham—in contrast—generated his theory of hysteria as imitation without any sense that he was the first "doctor" to have happened upon this insight. He merely observed from the hundreds of cases he treated that this was the truth. Sydenham and Duras may seem odd partners with no commonality; in the realms of hysteria, however, they share much territory. Duras's novels and poems capture the persistent anesthesia of modern women living on the verge of nervous breakdowns as a result of their socioeconomic, marital, and sexual duress. Sydenham's notion is that pathological conditions of the female nervous system produce the hysterical symptoms with which the patient presents herself, but like Duras—he believes the symptoms arise from social conditions that enslave not only women but also, as we will see, men. Duras's numb pain,
104 like the witch's claw, is the basis of three of her works: the short prose/poem The Malady of Death, La Douleur , and The Ravishing of Lol Stein , a story about two women (Lol Stein and Tatiana Karl), both of whom have settled for loveless marriages. Sydenham's women are not usually chronicled in this detail; few of his case histories survive apart from his medical notes. [47] Duras's women are characterized by a numbing pain that has few somatic symptoms, except the sense that they are suffocating and (according to her female protagonists) the indescribable sensation characterized by the words void and death-in-life . [48] Duras strives to describe the mental agony produced by the unrelenting, numbing pain. Unlike Sydenham's hysterics and those of Charcot, for her victims, no physical cause of their disturbances can be found. Duras's hysterics suffer nevertheless, sunk into their private hells, where they exist on the edge of total despair. Duras's view opposes that of Ilza Veith, the medical historian who saw hysteria as an elusive medical disease whose code had never been cracked. Veith and Duras are contemporaries, Europeans of the same generation who lived through the Nazi holocaust and a revolution in the professionalization of women. Even so, Veith never explained why it was so important to crack the code in the first place. The medical historians of her generation, whose mind-sets were formed in the aftermath of the Freudian revolution in psychoanalysis, took it upon faith that hysteria was the most elusive, and therefore challenging, psychosomatic illness. [49] In her noble attempt Veith summoned as her protagonists the major doctors in history: Hippocrates and Sydenham, Thomas Willis and Franz Anton Mesmer, the celebrated Charcot and Freud, on grounds that they had moved closer to its psychogenic etiology. But Veith left many questions unanswered and took a narrow, almost parochial, view. She never explored the role of women in society, their traditional, phallocratic image as creatures with an insatiable and voracious erotic appetite, nor did she probe the implications of Plato's view (Timaeus 91c), expanded by Aretaeus, that the womb was an animal capable of wreaking destruction, [50] as it was exemplified in Euripides's Hippolytus , where it rages over Phaedra's body like an animal in heat. In this play, it seems never to have occurred to the stubborn patriarch, King Theseus, to relieve Phaedra's agony and (as Duras would claim) numbness, any more than it would have occurred to the Renaissance biologists to relieve the hysterical symptoms of their female patients by acknowledging the social stresses and the thwarted sexuality that produced this condition in the first place. Throughout these early periods women were regularly placed on trial by men for witchcraft, regularly perceived as fallen Eves
105 and despised for their seductive propensities; repression of their sexuality by authoritative men (in medicine, theology, the law) became the visible, public sign of an allegedly raging womb: a private gynecological disorder the men themselves claimed never to understand fully. [51] These differing opinions hardly complete the picture of hysteria but they do serve to bring out significant aspects of the medical condition and its social contexts that have usually not been addressed in the now dormant annals of European hysteria. For the history of hysteria has been so bogged down in the technical anatomy of uterine debility that its larger pathology and its cultural resonances have been overlooked. [52] The Greeks did not employ a vocabulary of female numbness, any more than the horror-struck observers recoiling from Renaissance witches suspected numbness in the witch's claw, but a long-range view of hysteria demonstrates a continuity of its symptoms down through the ages despite its protean ability to transform itself. No matter what its medicalization has been, hysteria, at least until the early nineteenth century, has been so inextricably entwined with the lot of women that the two can hardly be separated. Unquenchable sexual appetite was long thought to lie at the very root of the malady, especially by theologians and moralists in early Christian times. [53] And the noteworthy aspect of this voracious female desire in both its pagan and Christian forms is that besides being inherently contagious it was conceptualized as morally dangerous (to the individual, family unit, state, world community). Other women, observing its effects, would imitate it and develop their own versions. This voraciousness instilled male fear (engendering a type of male hysteria); the other dimension—contagion—was construed as a virulent form of miasma which patriarchy has always opposed, whether it be the patriarchy of the Athenian city-states or Nazi Germany, Stuart England, or the Fourth Republic of France. But what is the source of this raging female appetite? Is it in fact ultimately theological ? Was it due to an innate lewdness within the female anatomy or psyche arising out of the labia over which women had no control, and which was living proof of a postlapsarian world whose irrepressible, erotic appetite was the scar women bore for the sin of the edenic apple? Or was the perception of this female appetite something else? Something culturally ordained? Something socially constructed? These are the types of questions uniformly avoided in the discussion about hysteria, revealing one reason why its reconsideration "before Freud" has been so long overdue. Only in our poststructuralist time, and in full view of the feminist avalanche of scholarship and dialogue, has the approximation of an answer begun to emerge. But—with a polite
106 riposte to the narrowly Freudian Veith—conventional explanations about sexual repression, depression, grief, virginity, and widowhood have been insufficient to fit the historical facts of the last twenty centuries. Hysteria may indeed be, as Alan Krohn has suggested, "the elusive disease"; [54] it has also been the transformative, protean condition par excellence.
IV If this approach has validity, then hysteria will always be present in society unless some miracle occurs—it can never disappear altogether, because its essentially protean nature compels it "to imitate " other diseases. [55] According to this line of reasoning, the unwritten history of hysteria—the history that lies beyond the narrow medical gaze—is not Veith's chronological summary of medical theories narrowly conceived, but rather a social history of hysteria placed in large cultural contexts that do not mute the gleanings of literary and artistic voices. This broad record, if appended to the medical one, is more revealing than the narrow "medical gaze" because hysteria itself is a reflection of the cultures it imitates. [56] The matter to be dealt with in an approach such as this book hopes to promote thus raises the nature of the problem of hysteria itself . And hysteria the category, rather than the set of patients presenting symptoms over many centuries, becomes par excellence the barometer responding, through its finely tuned antennas, to the perpetual stresses of gender and sexuality. As such, it is also a barometer of the cultural stresses weighing on sexual relations and gender formations. The forms of the barometric responses in the Renaissance and Enlightenment constitute much of the contents that follow. (In this view the panic and presenting symptoms of the AIDS patient who internalizes his sickness and moral condition deserve the classification hysteria, although it is rarely given in our time and cannot, of course, apply to all AIDS patients.) Moreover, hysteria will always elicit controversy among so-called "internalist historians" as well as among positivistic doctors who remain unconcerned with its cultural dimensions [57] —those who merely want to diagnose its symptoms and prescribe medications for its abatement, versus those observers, like Sydenham and Duras, who locate it in larger cultural contexts. The controversial dimension penetrates to every aspect of hysteria's "internalist history," and must not imply any criticism, for example, of Helen King's methodology. The point rather encompasses the difference between textual traditions of hysteria that persist over the centuries, and socially constructed categories that necessarily keep fashioning hysteria anew. The material I cover suggests that
107 hysteria continued to be redefined in the early modern world according to the terms of changing cultural dynamics, while always serving the interests of its somatizers and diagnosticians. Viewed sociologically, mass hysteria is not a category apart from personal, individual hysteria, but is rather another version of the same protean, imitative stress brought out into the light of public groups, private agony having gone public. [58]
V This approach, then, entails a social reconstruction of hysteria. In it, the hegemony of Hippocrates and his wandering womb, as we have seen in the previous chapter, is diminished and limited; it is to be read as another imaginative, if erudite, patriarchal voice in what will become during the Renaissance and Enlightenment a litany of voices making pronouncements grounded in imagination and observation but ignoring their cultural contexts. Male voices, such as those of Hippocrates and others discussed by Helen King who came later, cannot be omitted from the evolution of hysteria, but they must be located in larger contexts if hysteria is ever to transcend its local, internalist histories. Hippocrates could not have written as he did had he been female (Hippocrata), any more than a female Plato would have viewed the womb as an animal: voracious, predatory, appetitive, unstable, forever reducing the female into a frail and unstable creature. These views are those of men with little firsthand knowledge of this part of the female anatomy. [59] Once the Renaissance and Enlightenment are considered, it becomes evident that considerations other than those of paganism and Christianity must be brought to light if hysteria is to be fully explained. We must understand the relation of hysteria to inspired personal vision, to shamanism, and in extremely cold climates to socalled Arctic hysteria, said to be the natural habitat of shamanism, a subject deemed of the first importance to comparative anthropologists in the early part of this century. [60] Gradually it becomes clear that few topics in this narrative are as important as the conception of women held throughout the course of history. The views of antiquity were not uniform, of course, but they seem to be so in contrast to the chaos of the early modern period, especially in the transition from medieval culture to the Renaissance. By the Elizabethan period, roughly 1600, it is no longer possible to invoke any major view of women, despite our postmodern temptation to do so. [61] Women have already acquired a "history" that permits them to be seen from different perspectives, each view claiming to be equally valid. It is even said that this new diversity is one certain proof of female frailty, a
108 trait made especially resonant by the Shakespearean line: "Frailty, thy name is woman!" This view of woman as the quintessence of frailty is the one the Renaissance grapples with. Woman, whether viewed in theological or medical contexts, whether by the ancient scholiasts or the derivative Aristotelian biologists and philosophers, whether concretized as weak virgin, bride of Christ, or as deranged Ophelia (another hysteric of course), continues to be conceptualized as part animal , part witch ; part pleasure-giver , part wreaker of destruction to avenge her own irrationality—anything but as strong, rational creature resembling homo mensicus , this view coexisting while men of the Renaissance debate the heresies of Gallilean astronomy and the subtleties of Cartesian physiology. [62] For these reasons, and others not provided here for lack of space, it serves no purpose to compile further narrow internal histories of hysteria classified according to various chronological periods or taxonomic schemes. Old man Proteus has been too sly for that. Although a route such as the mind/body relation appears on the surface to hold out infinite promise for theories of hysteria in the late Renaissance, it is also limited. The notion that mind/body dualism can crack the code, so to speak, of the "elusive neurosis" is doomed to failure, if anything resembling a complete explanation of how the patient proceeded from initial symptom to eventual physiological dysfunction is expected. Ultimately Descartes is a minor figure in our story, major though dualism is for hysteria in the epoch of its most formative transformation (as we shall see). Cartesianism did not change hysteria's destiny other than to erect a new, and long insurmountable, roadblock in the form of mental torment versus physical pain. But hysteria's definition had been troubled before the advent of the great dualist and would continue to be long after his demise and the decline of his philosophy in Europe. [63] Before Descartes's famous discovery of the pineal gland, the human amalgam of mind and body was thought to have made man unique among living creatures. Cartesian hysteria —if one can posit such a medical configuration—must be turned inside out to be seen for what it really is, or to ponder how it could have been conceptualized by its seventeenth-century viewers. Cartesian discussions of hysteria that got bogged down in mind and body, mind or body, as virtually all did, ultimately contributed little to the therapy or recovery of its victims, and, even worse, revealed nothing about its etiology. It was not Descartes or any other radical dualist who penetrated deeply into the nature of the disorder, but a practicing physician who, however dualistic his own intellectual formation had been, was not especially Cartesian in his approach
109 to medicine. This physician, moreover, laid more emphasis on experience and observation than on theory and philosophy, and for all his obeisance to the major scientific and philosophical currents of his time, recognized that in some profound way hysteria was culturally conditioned. [64] This physician was Thomas Sydenham, and it is important that he should be viewed both diachronically and synchronically: located within his time as his place and time are historically approached, and also viewed synchronically and backward, as if the entire history of hysteria converged at the point where Sydenham's theory of hysteria sits poised directly in the center.
VI An approach to hysteria which is at once broadly historical, cultural, and contextual but also recognizes the central importance of discourse and rhetorical encoding to this narrative continuum requires a high threshold of cultural explanation and a discussion of the role of realism and representation in the explication of the malady. The discourses of hysteria cannot be viewed as neutral texts generated independently of the considerations of gender, ideology, politics, religion, nationalism, and professional authority, as if (when considered in clusters by centuries or periods) they were so many neutral corpuses or bodies (here, too, the metaphors). It is sinful enough to consider hysteria in Western society only—a white European's version. [65] To interpret these Western discourses on their own terms, without standing apart from their own systems and gazing at the role played by these narratives in the power structures in which they were generated, commits a crime that violates the first principles of the new enriched history. Produced under specific conditions at particular historical junctures, these narratives naturally reflect their moment as well as does any other writing, and it is therefore naive to imagine that the intricacies of realism and representation besetting other genres (especially prose genres) should disappear here. On the contrary, those dimensions of representation are all the more stringent here in view of the imitative nature of the condition of hysteria, and the temptation to rewrite the history of hysteria as a set of commentaries on a finite number of physicians—as Veith did—should be resisted. Sydenham's genius was the intuitive leap that recognized that culture and imitation—society and representation—could have the direst medical consequences for a malady that had bewildered doctors for centuries. He may not have been a sophisticated critic of language or its
110 representations; nevertheless, he gazed deeply into the copula of disease and representation as each had been generated by the culture. Concomitantly, if Sydenham's theory of hysteria as imitation has scientific and medical validity, the most thorough student of hysteria, the one capable of explaining the most about the labyrinths of its historical evolution, will be the cultural historian who inquires into the gender-based origins of female suffering with an eye always vigilant to hysteria's discourses. It is not only that the history of medicine is incomplete; even cultural history is inadequate to the challenge of hysteria if discourse and representation are omitted. We may well inquire why this should be when so many other maladies have remained the exclusive territory of the medical gaze. Yet even these less perplexing illnesses have been poorly represented by their chroniclers. Despite the intuitive literary analyses of Susan Sontag in Illness as Metaphor , as yet there are no satisfactory cultural accounts of, for example, consumption, cancer, or even such seemingly monolithic medical conditions as the almost risible gout. [66] The diseases of the plague—bubonic fever, cholera, typhoid fever, influenza—have fared better than the above maladies in their narrative representations because it has been impossible to imagine and then represent them narratively apart from the historical conditions in which they arose. They are, of course, social diseases precisely because of their communicability, and their essential nature as "communicable conditions" mandates viewing them in social contexts. Even the novice historian sees that the first great European wave of bubonic plague cannot be considered apart from fourteenth-century socioeconomic conditions; that the advent of cholera in the Indian subcontinent cannot be narrated without focusing on empire and colonialism. But those maladies less apparently intrinsic to particular cultures have not fared so well. [67] Loosely speaking, there has been a sense, strengthened by Susan Sontag, that each era has somehow produced and then mythologized a particular malady: the Enlightenment had its gout (was there ever a disease more indigenous to a culture?); the Romantics, consumption (well captured in the Keatsian aesthetic implied by the famous line, "Ah, what ails thee knight, alone and palely loitering?"); the decadents and aesthetes, tuberculosis; our own twentieth century, cancer and AIDS. [68] However, although there is something in the notion, it remains loose: a figment of the historical imagination, a mere chimera; a metaphoric and analogous reading of medical history; a description of disease in relation to culture no one would want to construe literally. The geography of hysteria lends itself to no such facile sets of interpretations. Occurring neither under conditions of contagion (like plague)
111 nor as the product of a culture's elusive mythology (we must never forget that the hysteric's pain is somatic, bodily, not imaginary), the hysteric's pain is real (the problem of realism again). Yet hysteria has been less tied to its cultural dimensions than any of these medical conditions, this despite Sydenham's notion that it always imitated that culture. Until the last two centuries, hysteria was the female malady par excellence, and when our best modern female critics reiterate that women writers must be hysterical, that they have no choice in the matter, they bring together the key signposts of the malady when viewed historically: feminism, the body, culture, and discourses. Thus an authority no less insightful than Kristeva has pronounced that "women's writing is the discourse of the hysteric"; Juliet Mitchell has added that in our time—and perhaps she would extend the claim to include all time—"the woman novelist must be an hysteric, for hysteria is simultaneously what a woman can do to be feminine and refuse femininity, within practical discourses." [69] Therefore, as we approach the next historical period after King's, we extend our gaze into the realm of the Renaissance and Enlightenment woman. How did her status differ from that of the medieval woman? Was her hysteria therefore different? We inquire into the new stresses creating numbness and panic and ask, Why was Renaissance woman thought to be so influenced by the moon and so possessed of the devil? We can readily see that the pathological symptoms of her hysteria would imitate the symptoms of other conditions: the fits and faints, as well as the tremors, tics, coughs, hiccups, grimaces, gnashing of teeth, pulling of hair, bashing of head, and all the other aberrations occasioned by the five senses. Other conditions may have produced the last of these symptoms, yet what caused the numbness and panic in the first place, and how did they get represented?[70] The feminist historians have demonstrated in a vast and important body of new scholarship that Renaissance women were experiencing profound stress and frustration; that as women were promised and therefore expected more, they found themselves actually receiving less in an increasingly complex society within an often confusing religious milieu. [71] Woman's role was still seen as entirely domestic: centered on her household, often her farm, perpetually surrounded by her children, viewed as odd if she took time out for anything other than devotions and even more peculiar if her time was used for writing or painting or secular subjects. It was all too easy to denounce her as overly sexed, and label or stigmatize her behavior as deviant by pointing to the somatic signs noted by her male doctors: apothecaries as well as physicians and surgeons. [72] In the Renaissance and again in the nineteenth century, these somatic
112 dysfunctions were often called "stigmata" by physicians searching for the "stigma" of hysteria. The line from the fourteenth century to the nineteenth is almost continuous in this sense. Stigma was eventually altered to symptom in the semiology of clinical analysis—in the seventeenth century—and this may be why so many medical lectures appeared in the nineteenth century (like that of the French neurologist, Pierre Janet) entitled "the major symptoms of hysteria." [73] But hysteria had also been construed as the first cousin, so to speak, of medieval love sickness, a condition about which doctors of all types, theological as well as medical, had pronounced for centuries. [74] During the Middle Ages love sickness was said to afflict both women and men, although women were said to have the much greater propensity for affliction. Among women, retained seed that became corrupted and poisonous was construed as the direct cause; this construction continued in the time of Johannes Weyer and Edward Jorden. Once love sickness was linked to female sexual organs by the sixteenth century, it was all too easy for medical doctors to construe it as a pathological condition of women only. The genderization of many of these conditions in the Renaissance—hysteria, love sickness, but not melancholy, which was often viewed as male—has never been told in any detail. [75] Nevertheless, gradually over three or four centuries, the European doctors accomplished this feat of genderization for reasons that have been described as "patriarchal" by feminist historians but whose precise details elude even the best of this group of researchers. The result was a genderizing of love sickness that made it the favorite malady of diseased female genital physiology, usually said to lead directly to the furor uterinus with which doctors such as Jorden and Robert Burton will become obsessed. The larger sexual and cultural dimensions of love sickness were as implicit in the Middle Ages as they would be through the eighteenth century, especially in the moral stigma attached to purging of the female seed from the vagina lest it wreak havoc. Both purging and retention were harmful to the woman once she had undergone puberty; sexual intercourse, in marriage, was the only acceptable option to her. In a Western anatomical model that had women ejaculating internally, there was no healthy space for a retained seed. Female orgasm was essential to the process of conception because the orgasm released the female seed, just as sexual intercourse was required if this seed were to combine with the male seed. Female seed constantly retained, whether through lack of sexual intercourse or excessive female masturbation, contained the source of anatomical imbalance and led to derangement. The only circumstances under which the male seed had to be purged were reli-
113 gious or moral, as when pubescent boys were encouraged to masturbate to diminish their sexual aggressivity, or when adult men were advised to do so while their wives were pregnant. There was no place for such male purging in the anatomical or medical sphere. The codes pertaining to purging of seed and arousal to ejaculation were grounded in beliefs about the differences in male and female anatomy. As Mary Wack has commented, "the arousal was often achieved by a woman who manipulated the [female] patient manually," [76] and there was no equivalent among males of purging the seed from anywhere in the scrotum. The object was, of course, to arouse the woman to orgasm so that she ejaculated the retained putrifying seed. But such a highly charged practice could hardly have been expected to flourish in Christian lands, where the church vehemently objected to it and where medical doctors dared not state what they really believed about its medical efficacy for fear of ecclesiastical retaliation. Wack is no doubt correct in noticing that some of the medieval doctors—her excellent example is the fourteenth-century Bona Fortuna's Treatise on the Viaticum —did not write entirely in elisions but actually recommended masturbation by an obstetrix , and some even described the manual techniques to be used. [77] Still, the discourse on sexuality from the fourteenth to the seventeenth century was not so liberal as to permit female masturbatory practices for the purgation of seed to flourish. [78] More direly for the lot of women, female sexuality was checked and impeded in other ways than the recoil shown among male doctors when faced with the prospect of describing on paper an allegedly curative female masturbation therapy. But female morbidity was not limited then to the sexual organs. It also extended to the soul, which would soon also be genderized and pathologized in the form of possession and diabolic ecstasy. The common metaphor in all these applications was morbidity: whether of the sexual organs, the whole body, the eternal soul, or merely the passions of the mind. The trope of the pathological was reinvigorated as it had never been in ancient discourse. [79] What was said about men ? Their love suffering was rarely, if ever, linked to pathology of the sexual organs. Even Jacques Ferrand, the already mentioned author of the most widely read treatise on love sickness (1623), and Felix Platter (Platterus) are silent on this matter in their medical works on the subject, and Foucault` who understood the genderization of the sexual organs all too well, is less explicit than his inquisitive readers like. [80] The explanation given to the few cases recorded is almost entirely psychological. Men were said to be amorous and suffer unrequited love just as women do, but the combination of work and respon-
114 sibility compelled them to drown their unrequited love in anger. Anger was their primordial passion: everything in history confirmed it. In fact, all known history could be interpreted, it was said, as responses to this male anger, which had been alternately unbridled and restrained: wars, peace, aggression, fear of annihilation, the lot. [81] Besides, men were too busy in the workplace and arenas of politics to have the leisure—the argument went—for erotic reverie. Burton reflects this progression all too clearly in the psychological portions of The Anatomy of Melancholy . For men, a cycle was thus set up of erotic infatuation, unrequited love, love sickness, anger, and, finally, melancholy. Hysteria was preempted: nowhere did the sexual organs enter into the sequence, nor was there space for priapic phalluses or morbidly wandering scrotums. The key for men, as theorists of melancholy such as Burton understood all too well, was repressed anger . Their erotic disappointment centered on anger well suppressed and culturally validated, always predictably re-suiting in melancholy. Women were permitted no such amplitude. The role of anger was hardly considered a possibility for their erotic ills. Fear and terror consumed them, as did the nocturnal visions and spectorial world of incubi and succubi so common among those suffering from the hallucinations of love sickness and hysteria. [82] But a female love sickness predicated mainly on psychological causes was unknown before Weyer and Jorden. Like the larger and more prevalent hysteria, love sickness continued to be conceptualized by the male physicians as something anatomical, physiological, humoral, pathological—an irreducibly feminine medical condition. No wonder that love sickness thrived, reaching something of a national epidemic in Western Europe by the time Ferrand published his medical classic work on "erotic melancholy" in 1623 and Shakespeare began to write plays. Already by the sixteenth century Johannes Weyer (Weir), the Dutch physician, pronounced that hysteria was a bodily disease like all other medical conditions and must be semiologically construed (i.e., through signs and symptoms). [83] A half century later, in 1603, Edward Jorden, the author of an influential work in the Galenic humoralist tradition titled A Briefe Discourse of a Disease Called the Suffocation of the Mother , claimed that the diabolic could be translated into the natural —that hysteria could have natural causes. This step was significant because it pointed the way for the largely male-authored medical discourses on hysteria that followed for three centuries, but it was less innovative than it may seem on the surface. Helen King provided some reasons in chapter 1, especially in discussing the doctrine of "vapors," but there are other reasons as well.
115 Veith summarized the works of these figures, especially Weyer, Ambroise Paré (the French physician), and Jorden, and has commented on their importance as successors to the Malleus Maleficarum (1494), the so-called "Witches Hammer," which she sums up as "the most extraordinary document to emanate from the witch mania." [84] No reason exists to doubt her conclusion that "a careful study of this fantastic document reveals beyond doubt that many, if not most, of the witches as well as a great number of their victims described therein were simply hysterics who had suffered from partial anesthesia, mutism, blindness, and convulsions, and, above all, from a variety of sexual delusions." [85] She has been persuasive in explaining the medicalization of hysteria in the light of its cultural and narrative dimensions. Veith also points out that Weyer took unpopular positions on hysteria. Having little theological or political ambition, he could pursue clinical observation with relatively little regard for the reception his views would receive. But it must also be noted that while Weyer was a shrewd observer, he made few theoretical advances when compared to Hippocrates and Harvey, Feuchtersleben and Freud, who were able to take more leaps than he did. Veith analyzes the story of the young hysteric, discussed in Weyer, said to vomit ribbons that she claimed had been inserted daily into her stomach by the devil. After praising Weyer for detecting the fraudulent nature of the account, Veith states: "Weyer was a superb observer, and though a skeptic, he was credulous." [86] Veith's appraisal captures Weyer's double bind: on the one hand, he was doubtful of these supernatural explanations and resisted them; on the other, he remained a creature of his time, unable to extricate himself from notions of possession in hysterical cases. For his ambivalence, Weyer had to withstand the attacks of authoritative contemporaries such as Jean Bodin, the prestigious philosopher and economic thinker attached to the court of Henry III, who championed the theory of demonic possession in hysteria. [87] In establishing hysteria as a natural disease rather than a theological condition of the soul, it must be noted that Weyer and Jorden performed similar functions, but that Weyer saw more deeply into the female condition. He exonerated hysterics from the charge of diabolism and pronounced them innocent of witchcraft; he broke away from the regimens of physical and mental cruelty advanced by the Malleus Maleficarum (tortures of many types); [88] and he sympathized with the predicament of women and compassionated with their violent dreams and phantoms, treating them as victims and patients rather than as malingerers and accomplices. Not enough is known about Weyer's life to ground these views securely in larger biographical contexts; still, whatever the
116 particulars of that Dutch life of the sixteenth century, Weyer can be viewed as a type of Renaissance Philippe Pinel or J.-E.-D. Esquirol who, rather than wishing to see these mentally ill women tried and punished, pitied them and commiserated with their misery. [89] Within the context of hysteria, Weyer was foremost a humanitarian who paved the way, however small, to improve the lot of these disturbed women. Even so, he had few, if any, clues into the nature of the phenomenon itself, much less into its natural history in the way that the eighteenth-century physicians were to construct these "case histories": the causes of these natural (i.e., conversion) symptoms; what these women have in common; and why these symptoms appear preeminently in women. Weyer's humanitarianism is incontestable: his writing abounds in it as it does in close observation of hysterical symptoms. But detection is not tantamount to insight, and the process of medicalization, while admirable for its empiricism and humanitarianism, cannot be compared with the deep vision of the sort Thomas Sydenham demonstrated. Weyer's contemporaries, however, fared no better. Timothy Bright, for example, an English physician trained in medicine at Trinity College, Cambridge, chased melancholy rather than hysteria, the two conditions then being closely allied. Bright's approach was partly physiological, partly psychological, mainly concerned—as the title of his treatise on melancholy says—with discovering the "reasons of the strange effects it [melancholie] worketh in our minds and bodies." [90] Even so, Bright's main approach led him to explore "nourishmentes," or the transformation of food into "the melancholicke humour." As he says: "Whether good nourishmente breede melancholie by fault of the bodie turning it into melancholie, & whether such humour is founde in nourishmentes, or rather is made of them" (title of chap. 3). There was in the humoralist Bright no sense of demonic possession—melancholy was also medicalized in Bright's treatment—nor was there reference to a gender-based condition; rather Bright attributed the cause to an all-powerful soul wreaking havoc on the body's bile through these nourishments. By contrast Jorden, a humoralist born two generations after Weyer, developed a uterine pathology exclusively based on the wandering womb and the bodily production of vapors. Jorden was summoned with three other doctors to testify in the case of Elizabeth Jackson, arraigned on a charge of bewitching the fourteen-year-old Mary Glover. [91] This young girl began to suffer from "fittes. . . so fearfull, that all that were about her, supoosed that she would dye." She grew speechless and occasionally blind; her left side was anesthetized and paralyzed. These were the classic symptoms, recognized before Jorden compiled his narrative, but
117 was their source sorcery or illness? Magic or disease? Glover was diagnosed and then treated by leading doctors from the Royal College in London. When she failed to respond to their therapies, usually herbal concoctions and other chemical preparations, they pronounced, all too predictably, that something in the case was "beyond naturall" in her symptoms. Jorden demurred, finding for disease. When Justice Anderson—a notorious hammer of witches—overrode his evidence, Jorden felt compelled to defend his theory that Glover's symptoms constituted a disease (insensibility, choking sensations, difficulty in eating, convulsions, epileptic and periodical fits: conditions, he insisted, physicians alone were qualified to determine). This defense became the substance of the already mentioned Briefe Discourse . Jorden named Glover's condition the "suffocation of the mother" (i.e., matrix or womb), more simply called the "mother," preferring this usage to the older medical term "hysterica passio." [92] In seventeenth-century parlance these phrases became interchangeable with "hysteria," or its more common adjectival form, "hysterical." All referred back, medically and etymologically, to the womb, anatomy and language converging on the same part of the body that had been the source of hysteria from its inception. For Jorden, such conditions (not to be confused with symptoms) as the esophagian ball, respiratory and digestive blockages, panicky feelings of suffocation and constrictions, all pointed clearly to a uterine pathology. One can readily imagine how this approach shocked ecclesiastical authorities. Even Jorden's medical colleagues revolted against the theory of a uterine pathology as the sole source for the genesis of a medical condition. Harvey had not yet made his discoveries about the heart and the circulation of the blood; another generation would have to pass before Descartes infused anatomy and physiology with radical mechanism and materialism. Jorden's expectations about the reception of his medicalization of hysteria are unknown, but if he thought his radical medicalization would meet with receptive arms he was mistaken. In a religiously crazed world in which Galileo had recently been tried and others before him beheaded for heresy, it was not easy to claim that uterine debility was the single and sole cause of disturbances thought for so long to be the work of the devil. [93] Jorden recognized that his views in Briefe Discourse would be controversial, if not heretical, although his fundamental notion about disease itself, especially the idea that illness is always cured by its contrary (hot by cold, dry by wet, and so forth), was thoroughly traditional and commonplace. As he wrote in Briefe Discourse : "Diseases are cured by their contraries . . . and the more exact the contrarietie is; the more proper
118 is the remedy: as when they are equall in degree or in power." [94] To establish his case for uterine debility as the major cause of hysteria, he drew heavily upon ancient authority, especially the Hippocratic and Galenic ideas with which he was familiar. Jorden did not subscribe to the notion, mentioned above as held by Plato and perhaps popular in ancient folk belief, of the womb as an "animal within the animal," [95] perhaps the somatic prototype of Freud's free-floating unconscious, the "mind within the mind." Instead he aired the idea, found in Hippocrates and discussed by Plato, of the wandering womb—the extraordinary belief that the uterus, when deprived of the health-giving moisture derived from sexual intercourse, would rise up into the hypochondrium (located between the stomach and the chest) in a quest for nourishment. Such predictable wandering, he believed, provoked painful sensations of oppression, constriction, and choking, sometimes leading to vomiting, forced breathing, and spasms. [96] It was a fanciful geography of hysteria, based only in part on Hippocratic tradition, medical reading, and a certain amount of erudition in the later classics, but there was more supposition than observation in its construction, even in those premicroscopic days when anatomy was not what it would be after the seventeenth-century microscopists and nineteenth-century cell theorists performed their experiments. Although Jorden did not intend it, his hypothesis of the wandering womb further fueled the fiction of female inadequacy, in which women were salvaged and restored by male complementarity—further because it had been circulated since ancient times and was now reinvigorated by Jorden. Nowhere is his fable more transparent than in the positive value placed on the healthful vaginal moisture that allegedly secured the womb and held it in place. But this fluid was provided only by the presence of the male seed—otherwise the cavity remained hollow and dry. [97] The anatomy of this dry and unsafe condition had, as we have seen, been discussed throughout the Middle Ages. Consequently, all uterine mania and pathology derived from this unhinging and subsequent "wandering" of the womb. As long as it remained secure, so Jorden's theory went, the female retained her healthful balance: no amount of personal anguish or grief (Jorden's "affections of the mind") could dislodge her equilibrium, for hysteria was entirely a matter of the derangement of her vaginal cavity, and for precisely this reason Jorden and his contemporaries believed hysteria could never be a male disease. Although meat and drink, the humoralist Jorden believed, were "the Mother of most diseases, whatsoever the Father bee, for the constitution of the humours of our bodies is according to that which feedes us," [98]
119 the cause of this illness was a life-threatening dryness in the vaginal cavity. The health of the female, therefore, depended primarily on retaining a balanced vaginal moisture, best provided by male seed through sexual intercourse. It was an extraordinary theory laden with mythic qualities, not least the notions of solitary wanderings and life-threatening peregrinations. What better way to portray female frailty than by using the organs of reproduction themselves—a notion the poets and playwrights of the time will repeat, metaphorize, and mythologize. Jorden's language, especially his vivid and dramatic images of solitary female journeys and his constant analogies of the role of gender in these dramatic wanderings (as in the mother and father of disease), confirms the degree to which his fiction of the "suffocation of the Mother" is gender-based. [99] Constructed on the rock of female anatomic inadequacy (i.e., compared to the male), it suggests the idea that nature and perhaps even the deity had intended from the beginning to program, as it were, the female species for hysteria. Throughout the early modern period, Western medicine, especially medical theory rather than its applied therapies, was based on hypotheses generated in a dense jungle of verbiage, including abundant neologisms, which later proved to be more proximate to the fictions of the poets than to those of radical empiricists. Jorden's theory of the pathological "mother" was itself a metonymy loaded with cultural significance at the turn of the seventeenth century. [100] Furthermore, Jorden claimed that all uterine irregularities—menstrual blockage, amenorrhea, the retention of putrescent "seed," and assorted other "obstructions"—generated "vapours" that wafted through the body, inducing physical disorders in the extremities, the abdomen, and even the brain. [101] For this there was no empirical evidence; even the alleged "vapours" would later prove to be imaginary. The vapors were said to wreak bodily havoc and induce pathological states that were facilitated by the symbiotic interactivity of the entire organic system. A power of "sympathy," Jorden reasoned, linked the womb to the rest of the body: to the head (then thought to be the seat not of the brain—that came later in the seventeenth century—but of the imagination); [102] to the senses (which determined feelings); and finally to the "animal soul" that governed motion, thereby producing twitches, paroxysms, palsies, convulsive dancing, stretching, yawning, and other terrifying behaviors. Many accidents could trigger the condition, Jorden admitted, since "the perturbations of the minde are oftentimes to blame for this and many other diseases." [103] Veith, noting Jorden's inclusion of such "perturbations of the minde"
120 and his advocacy of therapeutic comfort, counsel, and support, extols the Elizabethan doctor for anticipating the conception of hysteria as a psychological malady. [104] She commends him as well for "extraordinary perceptiveness" in recommending pharmacological prescriptions for hysteria, while claiming at the same time, and seemingly contradictorily, that "he was the first to advise anything resembling psychotherapy for hysteria." Some of Jorden's prescriptions were traditional herbs and natural medicines that seem inappropriate today but were common at the time. The originality of Jorden's analysis of hysteria lay in his grasp of the power of the mind over the body. For that reason he urged the physician to confirm the patient's fantasies, even when the doctor knows better. For example, Jorden recounted the successful treatment of the Countess of Mantua, who believed her acute lingering melancholy and hysteria resulted from her having been betwitched. Her physicians placed nails, needles, and feathers "into her close stoole when she tooke physicke, making her believe they came out of her bodie." [105] Jorden also demonstrates his familiarity with Galen's remarks on hysteria. Recounting the case history of a male patient who believed he was impotent, Jorden reports that his physician prescribed "a foolish medicine out of Cleopatra , made with a crowes gall and oyle . . . whereupon he recovered his strength." [106] Jorden lists many superstitious remedies that he believed could be effective because of the great power of the mind over the body to cure hysteria. Jorden epitomized it this way: "According to the saying of Avicen , that the confidence of the patient in the meanes used is oftentimes more available to cure diseases than all other remedies whatsoever." [107] The confidence patients placed in these and other remedies—prayers, offerings, exotic rituals—nabled Jorden to feel confident in his own prescriptions. Jorden's modernity was incontrovertible when compared to his contemporaries. Nevertheless, his remedies did not entail an essentially psychological approach. The main thing in his treatment was to "let the bodies bee kept upright, straight laced, and the belly & throat held downe with ones hand . . . apply evil smells to their nostrils, and sweet smells beneath . . . tie their legs hard with a garter for revulsion sake." [108] In an anticipation of psychotherapy, he advised appeasing inflamed passions by "good counsell and perswasions: hatred and malice by religious instructions, feare by incouragements, love by inducing hatred, or by permitting them to enjoy their desires." [109] Although Veith would like to establish Jorden's therapies as precursors to the modern treatments of hysteria, her interpretation is misleading and, what is more, overlooks its rather pedestrian medical traditionalism. Jorden's recognition of the role played by consciousness in the genesis of disease was neither new
121 nor properly psychogenic, as Veith claims. The Briefe Discourse was conventionally couched within the framework of the then current humoral medicine in its perception that all manners of disorders arose from a concurrence of certain physical complaints with the passions and senses. In this capacity there is nothing "psychogenic" about the theory of the "wandering womb" or the "suffocation of the Mother." Moreover, it is anachronistic to claim, as Veith does, that a staunch Galenic humoralist such as Jorden could have wished to advance either an exclusively somatic , or an essentially psychological , account of the "Mother": his concern was rather to establish a natural theory, based upon the integrated operations of the entire organism, so that "the unlearned and rash conceits of divers [persons who proportion] the bounds of nature unto their own capacities . . . might be thereby brought to better understanding and moderation." Not that he would, of course, preclude supernatural agency in principle: [110]
I doe not deny but that God doth in these days worke extraordinarily, for the deliverance of his children, and for other endes best knowne unto himself; and that among other, there may be both possessions by the Devil, and obsessions and witchcraft, &c. and dispossession also through the Prayers and supplications of his servants, which is the onlely meanes left unto us for our reliefe in that case. But such examples being verie rare now adayes, I would in the feare of God advise men to be very circumspect in pronouncing of a possession: both because the impostures be many, and the effects of naturall diseases be strange to such as have not looked thoroughly into them.
Aiming to prove to the vulgar, "who are apt to make every thing a supernaturall work which they do not understand," that Mary Glover's "passio hysterica" was a mundane disorder, Jorden explained that each of the tell-tale symptoms of witchcraft could easily be proven by the expert physician to be naturally caused. This position differs from the one Shakespeare was to take in King Lear (see section VII). Shakespeare is less monolithically consistent than Jorden about fraud and natural genesis. "Consider a little," Jorden invited readers, "the signes which some doe shew of a supernaturall power in these examples":
One of their signes is insensibilitie, when they doe not feele, being pricked with a pin, or burnt with fire, &c. Is this so strange a spectacle, when in the Palsie, the falling sicknesse, Apoplexis, and diverse other diseases, it is dayly observed? And in these fits of the Mother it is so ordinarie as I never read any Author writing of this disease who doth not make mention thereof.[111]
122 What Jorden proved in relation to anesthesias was applied to other symptoms, in addition to pointing out the connection between mind and body in hysteria:
There also you shall find convulsions, contractions, distortions, and such like to be ordinarie Symptoms in this disease. Another signe of a supernaturall power they make to be the due & orderly returning of the fits, when they keepe their just day and houre, which we call periods or circuits. This accident as it is common to diverse other chronicall diseases, as headaches, gowtes, Epilepsies, Tertians, Quartans &c. so it is often observed in this disease of the mother as is sufficiently proved in the 2nd Chapter. Another argument of theirs is the offence in eating, or drinking, as if the Divell ment to choake them therewith. But this Symptom is also ordinarie in uterin affects, as I shew in the sixt Chapter: and I have at this time a patient troubled in like manner. Another reason of theirs is, the coming of the fits upon the presence of some certaine person. The like I doe shew in the same Chapter, and the reasons of it, from the stirring of the affections of the mind.[112]
The passage continues to emphasize that mind and body, working together, play a major role in hysteria. Like other passages, this one offers an abundance of signs, especially in the reference to the "affections of the mind," that Jorden primarily aimed to translate the "diabolical" into the natural, working within a familiar explanatory scheme that saw no reason to polarize or select between the organic and the mental. In this process he was simply an educated man of his times. When evaluating Jorden and Weyer, we can say that both physicians "medicalized" hysteria but, from our perspective, neither recognized the role played by the patient's cultural environment, especially as related to the lot of women. Both doctors were persuaded that hysteria arose from bodily ailments and somatically grounded emotional distresses; women were anatomically more pliant and imaginative than men and thus more suspectible to the condition, a disease of the reproductive organs. Yet neither considered the domestic and social stresses with which these female patients were unable to cope. Neither considered the kinship between the hysteric's "affections of the mind" and her emotions stirred in relation to the socioeconomic factors involved: a women's domestic situation, sexual status (and the double standard vis-á-vis that sexuality), her legal and economic misery, her persistent disappointments, the lack of hope in a hard life rarely abated by anything except death. It may be expecting too much for doctors of the sixteenth century to be social scientists, but it can also be said, on balance, that neither doctor seems to have had a glimmer of insight into hysteria in relation to class structure and social
123 stratification, of which there was then an abundance, even in their agrarrian European and English civilization. According to the views of Weyer and Jorden and the many other Renaissance physicians who wrote about hysteria (i.e., the Swiss Aureolus Paracelsus, the French Paré, and Laurent Joubert, the chancellor of the University of Montpellier, among dozens of names now forgotten or unmentioned here), [113] the female patient (to the degree that she was medicalized and removed from her mythic and diabolic status) was an integrated, organic hierarchy: a symbiosis of soma and psyche to be viewed apart from the social and economic reality in which she functioned. The Renaissance humanists had viewed her more totally: as a creature with a past and present history, with a future determined as much by cultural as biological forces. The great humanists—the Petrarchs, Erasmuses, and Mores—lived before Jorden, and those to whom Weyer's theories were available seem not to have incorporated the medicalization of hysteria into their system of thought. For the Renaissance humanists, the condition of hysteria still lingered in the twilight of a supernatural and diabolic world: a zone all the more perplexing to them inasmuch as medicine, as the Rabelais scholar Georges Lote has noted, was "the science of the sixteenth century, exercising great influence and inspiring confidence." [114] In addition, ideas about hysteria were then fermenting in a religious and intellectual milieu in which medicine was rapidly being revolutionized anyway. Learned and imaginative thinkers such as Rabelais, who had also been medically trained at Montpellier, probably absorbed more than we think about this process of medicalization. [115] Rabelais himself comments ironically in Gargantua and Pantagruel (through the mouthpiece of the witty Dr. Rondibilis) on the womb as an "animal," parodying the Platonic tradition discussed above. [116] But not even Rabelais, Mikhail Bakhtin has suggested in Rabelais and His World , with all his (Rabelais's) sophisticated medico-anatomical training, linked hysteria to the sociocultural position of women. The Dr. Rondibilis who wants to purvey his point about only women having a womb, and a womb that it is moreover just "an animal," is far more concerned with the gulf that lies between realism and literary representation than with any socioeconomic bases of female hysteria. (Rabelais and Shakespeare later classified women according to their virtue and modesty, their courage and beauty, but neither saw the correlation between health and wealth.) Rich women, whether virgins or widows, were given no dispensation when sunk in the depths of hysteria's abyss. There is no sense anywhere in Weyer and Jorden, for example, that the melancholy of the affluent differs from that
124 of other groups. Class-based hysteria enters the discussion later, at the end of the eighteenth century, as the symptoms of the affluent are said by doctors such as the Scottish Cheyne and James M. Adair and the French Joseph Lieutaud, to arise from different causes. [117] In the period from approximately 1450 to 1700, the only distinction is bodily sign; as long as the sign is evident, all else proves irrelevant: so imbued with certainty is the semiology of the hysteric. By 1600 or 1650 medicalization became widely assimilated, as evidenced in the thought of a physician such as Thomas Fienus, especially the notion that hysterics are no longer witches to be detected, tried, and burned at the stake. [118] In our twentieth-century, post-Freudian sense of female numbness viewed through the discourses of hysteria composed by Kristeva and Duras, this medicalization of hysteria caused a regression in woman's lot rather than advancement and brought little understanding of the plight of women that had lain at the heart of the condition in the first place. Once medicalized, hysteria became the deviant sport of Renaissance and Enlightenment doctors who justified any therapy in the name of calming female fits and faints. Viewed from the perspective of muting the more genuine causes in woman's lot, it was a short step from Dr. Jorden's therapies of foul smells, tight garters, and "crow's gall and oyle" to the clitoridectomies and ovariectomies of the nineteenth century. Women would have to wait for male physicians to liberate them—wait even after Freud and his colleagues arrived in Vienna.
VII The conjunction of hysteria and modernity thus arises at the moment of its medicalization at the turn of the seventeenth century. Once hysteria became medicalized, its theory was not significantly revised except for the alteration of its somatic locations. Many decades were to pass before a majority of doctors became persuaded about the naturalness (as distinct from the demonization) of the condition. Here and there, as we shall see, there were some major discoveries of insight, for example Sydenham's, but the new hypothesis always leaned upon, and reflected, the prevailing medical theory of the day, hysteria being always a remarkably elusive disease. [119] The larger matter about hysteria in the seventeenth century essentially entails the repetition of its medical diagnoses. After Weyer's and Jorden's medicalization, there was no significant insight into its nature until the advent of Willis and Sydenham. During that period (ca. 1600-1660), the voices of the nonmedically trained prove to offer as much insight as those of physicians and other caretak-
125 ers. If we want to understand seventeenth-century hysteria, we do well to consult the social history of women of all classes: a record revealing as much as the medical treatises that commonly crib from one another without having engaged in empirical research or brought forth anything new to the main argument. [120] The personal records of hysteric patients in that period—the non-medical voices we want to hear—are virtually nonexistent. [121] It is not that the historian-archaeologist of hysteria has forgotten to listen to them but rather that the doctors in the seventeenth century did not record what their female patients said or did in any detail. For example, Richard Napier, an early Stuart parson-physician, compiled in a career spanning many decades casebooks of hysterical patients, but even here his voice speaks more forcefully than the patient's. [122] Napier, as Michael MacDonald has demonstrated, habitually explained hysteria and all manner of melancholy states as proceeding from particular concatenations of bodily ailments and emotional distresses. Nor had Napier broken entirely free of the old supernaturalism or magic, occasionally linking hysteria to possession despite his clear awareness of its medicalization. By way of remedy, he prescribed "physick"—usually herbal purgatives, together with supportive advice and prayers. Missing from his compilations are comprehension of, or compassion for, the domestic travails of his female patients—the social conditions alluded to above. Class and rank figure nowhere. He discovered hysteria everywhere in the female world: all diagnosis and therapy originate, he believed, in the pathological body (the wandering womb) and in emotional grief (usually loss and depression); never was the distress seen as socially or economically determined. Napier found no examples of hysteria among malingerers. Indeed, those pretending to be ill, to be hysterical, to escape poverty and duty by faking fits and starts are remarkably absent from the early seventeenth-century world: its medicine as well as its imaginative literature and art. [123] The degree to which Napier anticipated the modern view is extraordinary. Compare Napier on malingerers to Dr. Alan Krohn, for example:
It should be stressed that hysterics are not faking, playing games, or simply seeking attention. . . . The hysteric is neither a malingerer nor a psychopath in that the sorts of parts he plays, feelings he experiences, and actions he undertakes have predominantly unconscious roots—he is usually not aware of trying to fool or deceive. When the hysteric uses cultural myths or lives out a cultural stereotype, he is usually not making a conscious choice of identity.
126 Moreover, in Napier's world there were two almost conflicting intellectual tendencies destined to keep women in biological chains: on the one hand, a persistent demonization of her as part witch, part animal, with a "wicked womb" (not so different from the one flaunted in Germaine Greer's The Female Eunuch[124] ); on the other, a more humane view derived from the recent medicalization of her most emblematic disease (i.e., hysteria), which served to demystify her gender status. The theological and religious consequences of these views were significant: even there, medicalization played a significant although clearly more osmotic role. [125] Nevertheless, throughout the seventeenth century, women remained slaves, so to speak, of their biology, a fate similar to that which they experienced in antiquity; more time was needed to erase their image as voracious wombs paradoxically embodied in decrepit witches or insatiable pleasure-givers. [126] Furthermore, the seventeenth-century conception connected the "spell" created by the older demonic frenzy to the "spell" of the menses, or menarche , rampaging furiously through the female body, causing violent paroxysm and anatomic upheaval. So long as woman was biologically mythologized, there was no hope of grounding her hysteria—her anxiety and panic, her twitches and epileptic convulsions—in a social fabric where she could be viewed as a rational being. The radical medicalization of hysteria, culminating in the eighteenth century, was well on its way by the time Jorden and his medical colleagues had died. By then, the representations of the female body had, as it were, been turned inside out; charted as ugly in anatomical drawings as well as idealized as beautiful on canvases and in literary texts, and within this paradoxical relationship covertly placed within the "uglybeautiful" tradition in which the late Renaissance basked. But male fear of demonic female sexuality would not be quelled so quickly. Perhaps a word such as hystero-phobia should be coined to describe the male response to female sexuality in the period between the world of Harvey the anatomist and that of the radical Enlightenment physiologists, between the 1620s and the 1690s. [127] In any case we will see that this male fear was no irrelevant obstacle on the road to the radical medicalization of hysteria. These developments are clearly mirrored in thinkers as diverse as Shakespeare and Robert Burton, the scholar-author of the 1621 Anatomy of Melancholy . Burton, who had read Weyer, Jorden, and many other sources on hysteria, believed that fits of the "Mother" could be occasioned equally by body disease and by inordinate passions, appetites, and fancy, and similarly advised a dual package of pills and precepts. Burton gazed deeply into the class filiations of both melancholy and hysteria, believing that "hired servants" and "handmaidens"—no matter
127 what their age—were rarely afflicted. The "coarser" the woman, the less likelihood of her presenting with hysteria. Shakespeare, who may not have heard of either Weyer or Jorden, nevertheless responded acutely to "the Mother" as one of the important ideas of his time, metaphorizing it and even building it into the fabric of several of his plays. His sources are complex and deeply interfuse with the ideological dimensions of hysteria in the late sixteenth century and its troubled relation to magic and witchcraft. For example, there is no doubt that Shakespeare was familiar with Samuel Harsnett's antipapist pamphlet A Declaration of Egregious Popishe [sic] Impostures . . . Under the Pretence of Casting Out Devils (1603). Harsnett, a churchman with a checkered past by the time he wrote the Declaration early in life, had served on various commissions to inspect those who claimed to exorcise devils. He had heard vivid accounts of possessed women. From the time he was a student at Cambridge, he pondered the boundaries between fraudulent witchcraft and natural possession, especially in cases in which female hysteria was claimed to have manifested itself as a natural disease. His Declaration spoke loudly to his generation, especially to Shakespeare, who took the names of the spirits mentioned by Edgar in King Lear from it. Harsnett also recounts in the Declaration the case of a man afflicted with hysterica passio , a term he uses interchangeably with "the Mother," and he writes as if the case were an anomaly. But other Elizabethans had also commented on "the Mother," under different circumstances and in contexts other than political or medical ones, and had written about it both as natural illness and natural metaphor for female sexuality. A decade or so later the poet Drayton invoked "the Mother" as a simile for "a raging river" in his well-known Poly-Olbion (1612-1622)—no doubt a poetic trope for unbridled female sexuality —as well as considered it a genuine female malady:
As when we haplie see a sicklie woman fall Into a fit of that which wee the Mother call, When from the grieved wombe shee feeles the paine arise, Breakes into grievous sighes, with intermixed cries, Bereaved of her sense; and strugling still with those That gainst her rising paine their utmost strength oppose, Starts, tosses, tumbles, strikes, turnes, touses, spurnes and spraules, Casting with furious lims her holders to the walles; But that the horrid pangs torments the grieved so, One well might muse from whence this suddaine strength should grow.[128]
Thus by the turn of the seventeenth century the confluence of several streams of thought vis-à-vis hysteria had, so to speak, coagulated. M. E. Addyman considers Shakespeare's assimilation of the doctrine of hys-
128 teria to be sufficiently important to have warranted a book-length study. [129] "It seemed to me," she claims, "that, while hysterica passio formed a potent symbol in Lear and offered a detailed vocabulary for certain effects, its role was limited; but of Leontes [in The Winter's Tale ] one could say that he was a hysteric, and the elucidating of that comment would reveal much of interest about the nature of the play." [130] For Addyman, hysteria and its natural progression to insanity constitute the essence of Lear's disintegration. After Lear's mode of being and basis for authority have been irrevocably shaken, he inquires: "Who is it that can tell me who I am?" (I. iv. 250). When he no longer knows himself, he exclaims to the fool, "O fool, I shall go mad!" (II. iv. 289). After expressing his anguish over his rejection by his daughters and the sight of his servant in Regan's stocks, Lear cries out:
O, how this mother swells up toward my heart! Hysterica passio, down, thou climbing sorrow, Thy element's below! (II. iv. 55-57)
Addyman's observation, which has eluded many Shakespeareans, is that Lear conceptualizes the horror of the disenfranchisement he is soon to experience in the very terms of—indeed in the very language of the newly medicalized condition. "Some new world," she writes, "some terrible knowledge which will not accommodate existing patterns of speech and habit, is about to be brought into being, and it is experienced in its first inner stirrings as 'this mother,' as 'hysterica passio .'" [131] Why, we wonder, was hysteria, among all the various medical conditions then, perceived as capable of such drastic transformations, especially if figures as diverse as Shakespeare and Burton responded so forcefully to it? The different uses of hysteria made by Shakespeare in Lear and The Winter's Tale do not diminish his creative response—on the contrary, they heighten it. A form of knowledge for the great tragic protagonist (Lear) becomes the basis for character and destiny in the later romantic one (Leontes). Hysteria signified to Shakespeare not simply a medical malady—for him it became more than a newly discovered disease recently emancipated from its demonic bondage. The transition from demonic profile to medical malady was indeed in the thick process of transition during the Elizabethan period. As Addyman observes, "Lear's hysterica passio is a form of knowledge: it is the mode and limitation of his awakening to the world which exists beyond his will"; for Leontes it represents more than anything "his maladjustment" itself, the essence of his dis-ease. [132] It would be literal-minded, perhaps even obtuse, to in-
129 quire how Shakespeare conceived of a male hysteric in an era when the doctors had observed few. [133] Narrative, especially great imaginative literature such as Shakespeare's plays, or (conversely) popular narrative, such as pamphlets and tracts, has always provided science and medicine with some of its best ideas; narrative brilliantly leaps to hypotheses doctors would not, perhaps could not, intellectually and imaginatively dare to make. [134] The doctors saw the "mother" as feminine, but in the popular imagination it was something (however mysteriously) that could afflict men. It is unknown how Elizabethan medical authorities responded to Shakespeare's use of the term hysterica passio , and it may be that his usage in the plays was ignored. Still, the question about male hysteria in the Renaissance must be put in a medical context before it takes on significant meaning, and even more specifically must be addressed in relation to the category of hysteria raised at the beginning of this chapter. Perhaps the point about Leontes, and presumably the larger point about hysteria in the Renaissance that Addyman wishes to make, is that Leontes's hysteria signifies the amalgam of disease and confusion—indeed, a diseased confusion—in which his child, adult, and sexual self coexist; it is not a narrowly conceived and almost clinical hysteria that Shakespeare embodies through the figure of Leontes (as it might have been in Jorden's treatment), but a metaphoric and symbolic hysteria. Similarly Robert Burton enlarged the domain of melancholy and brought it to the very foreground of his agenda, making it, as Devon Hodges has suggested, the basis for an anatomy and ontology of the cosmos. [135] But if Burton's Anatomy of Melancholy demonstrates an almost uncontrollable impulse to dissect every form of knowledge as a symptom of the cultural transformation of his time, his larger signifier—melancholy—is hewn out of the stone of an even larger transformer: this category—melancholia and hysteria—reflecting the cultural shifts that to Burton virtually defy explanation. As in the plays, where hysteria—the hysterica passio —represents both the states of knowledge themselves and the psychological frames of mind of two of Shakespeare's most interesting figures, Burton uses the category hysteria to connect forms of knowledge that have been undergoing monumental conceptual shifts in his lifetime. Both responses, Burtonian and Shakespearean, demonstrate the magisterial significance of hysteria for the late Renaissance world: a meaning it could never have acquired had it not been for the medicalization of the one malady with secular and cultural overtones. [136] The question to be pondered then is why medicalization took the radical turn it did when it did , and throughout this chapter I have been suggesting that among the reasons (it was not the only reason) was the altering
130 status of women in the period from roughly 1600 to 1700 as social, economic, political, and even biological creatures. In brief, I am suggesting that doctors radically medicalize disease and become more positivistic in their approach to illness in times of unusual stress placed on one or both of the sexes. [137] This principle may seem an arbitrary correlation between disease and gender. Eventually historical sociologists will bear it out, and a great deal of research into the history of the body, the sociology of medicine, and the history of gender will be required before we can understand how the principle developed in its crucial period in early modern Europe. [138] In the discipline of anatomy, then a rapidly changing body of knowledge, as well as in medical research and empirical speculation more generally, the view of women was being revised. Throughout much of the seventeenth century, medical research promulgated the traditional view of the female reproductive apparatus as an inferior, imperfect, almost inverted equivalent of the male. [139] The notion that women were essentially and fundamentally different —radically other and strange—had not yet taken hold; they continued to be viewed as males manqué. It had long been known that female orgasm was unnecessary for conception and that menstruation occurred independent of erotic excitation, but these relationships had not yet been put into contexts that could change the old patriarchal views and create an independent biological niche for women. As Thomas Laqueur has emphasized, seventeenth-century medical theory commonly endorsed the classical view of the female reproductive system as inherently deficient, even deformed, a pathological inversion of the normative male. [140] Menarche and puberty were cosmically ordained to upset body functioning, producing physical irregularities and pain that spawned further behavioral disruptions. Pregnancy and childbirth entailed seasons of sickness, sometimes leading to postpartum insanity. Menopausal women became moody and predatory. All such disturbances were clearly caused by a single aberration—by the seventeenth century the term womb was used metaphorically as well as literally. Men had no such ordained anatomy, no such predictable vulnerability, no such biological destiny. Gender, however, was not the only factor governing the category then occupied by hysteria. Most physicians combined their learning in anatomy and physiology to religious, astrological, and astronomical beliefs in the diagnosis and treatment of these uterine syndromes. By the 1640s, a small library of medical literature conjoining these realms, natural and supernatural, had developed and was regularly producing books composed for an audience of doctors and their patients. John Sadler's The
131 Sicke Womans Private Looking-Glasse, wherein Methodically are handled all uterine affects, or diseases arising from the wombe; enabling Women to informe the Physician about the cause of their griefe is a fine specimen of the genre, and also interesting for its metaphors of hysteria and versions of linguistic representation. [141] Sadler, a licensed physician, practiced humoral medicine in Norwich and specialized in female diseases. The fifteen chapters of his book aim to explain how virtually all female health and reproduction is governed by the health of the uterus and its motions: the rising, falling, and stasis of the womb washed into health by regular discharges and frequent pregnancy. Even so, Sadler devotes a whole chapter (13) to the question "whether devils can engender Monsters [of birth]," and despite his negative conclusion the fact remains that he was willing to spend so much time answering it. Sadler nowhere invokes the word "hysteria," but his references to the "weeping of the Wombe" (chap. 4), the "suffocation of the mother" (chap. 6), and "the hystericall passions" (p. 62) make evident that hysteria constitutes, of course, his true subject matter. His approach, common in the time, is semiotic: he searches for proximate "causes" and "signs" in an attempt to provide "prognosticks" and "cures," these necessary four components providing the physician with knowledge of the real state of the patient's womb. Once in possession of this knowledge, he prescribes from a wide variety of herbal remedies considered in conjunction with "the planet's influence" on the patient, as his astrological epigraph attests. His approach emphasizes that hysterical diseases arise primarily from the "suppression" or "overflowing" of the "menses"—from unnatural discharges—and this is why he starts his book with a discussion of unhealthy menstrual discharges, the single most common cause of hysteria. "How many incurable diseases," inquired William Harvey, the famous discoverer of the circulation of the blood, "are brought about by unhealthy menstrual discharges?" [142] The question was rhetorical, replicated dozens of times by Harvey's medical brethren. Like his peers, Harvey regarded women as slaves to their biology; the idea had already been generated in the great literature of the Renaissance, especially by Shakespeare and the dramatists. Gross female appetites, the "furor of the uterus" that was by now being called furor uterinus by the doctors, [143] drove the entire sex, governing their words and deeds on earth, even necessitating a cosmic theology at whose center was an Edenic myth laying all culpability on Eve for mankind's irrevocable sin. [144] No matter what women did with their biology, in the Christian myth they were destined to sin as a consequence of it. In matters anatomic and physiologic, there was—so to speak—no free will. This specific topic the late
132 Renaissance theologians debated almost ad nauseam . [145] The church admonished its parishioners as well as serious students, as it had been cautioning for centuries, against the sins of the womb in less vivid anatomies, but secular opposition claimed that the retention of seed was equally, if also biologically, harmful. Jane Sharp, a male "quack doctor" in England who assumed a female pseudonym, advised lusty maidens to marry (and have sexual intercourse) or face the dire consequences of hysteria. [146] Harvey, the anatomist, provided the empirical secular raison d'être: without gratification, overheated wombs would spark "mental aberrations, the delirium, the melancholy, the paroxysms of frenzy, as if the affected person were under the dominion of spells," this final phase revealing how a semantic sleight of hand could perpetuate witchcraft insinuations in secular contexts. In summary, male hegemonic culture was still affirming that women, especially in their rudimentary biologic sense, were not very different from men. But they were more mysterious, as the Romantic poets, especially Wordsworth, would continue to claim: mystery—the mystery of their dreams and desire rather than of their anatomies—is what distinguished them. Whether as witches or hysterics, whether in their normal state or pathologically demented as hysterics sometimes were, their imaginations were deemed to be of another order from men's. Yet the very notion of "women as mysterious" was a male construct. Oddly, it remains a fundamental concept of twentieth-century sexual theory, as when Jacques Lacan cryptically pronounces that
it can happen that women are too soulful in love, that is to say, that they soul for the soul. What on earth could this be other than the soul for which they soul in their partner, who is none the less homo right up to the hilt, from which they cannot escape? This can only bring them to the ultimate point . . . (ultimate not used gratuitously here) of hysteria, as it is called in Greek, or of acting the man, as I call it.
Historically speaking, not until the post-Cartesian world of the Enlightenment, and even later, did the notion of a resolute female difference mandating respect for its inalterability take a firm hold. Harvey, forever the Aristotelian zoologist, explicitly drew the parallel between bitches in heat and hysterical women. In these pronouncements picturing the insatiable, ferocious, animal-like womb, he was closer to Plato and Euripides than he realized. A leader among those decrying the retention of seed, he warned that women who "continue too long unwedded, are seized with serious symptoms—hysterics, furor uterinus,
133 &c. or fall into a cachectic state, and distemperatures of various kinds." [147] For "all animals, indeed, grow savage when in heat, and unless they are suffered to enjoy one another, become changed in disposition." Thus hysterical women direly needed medical attention, for "to such a height does the malady reach in some, that they are believed to be poisoned, or moonstruck, or possessed by a devil." What, then, was to be done? Harvey advised prophylactic measures, above all "the influence of good nurture," with its power to "tranquilize the inordinate passions of the mind." [148] But if this view represented a continuation and further medicalization of the effects of Jorden's "passions of the mind," it also embedded a theory of sex whose double standard is apparent from our perspective. Harvey's advising of prophylactic repression was, of course, restricted to women. In his own mind there was no contradiction because the raging womb—the furor uterinus —by definition reflected a female state of affairs. How else could it be? He did not see, nor did his medical brethren suspect, that men, like "all animals" also "grow savage when in heat." Or if he did see, men were exempt from the need for repression by virtue of a more protective anatomic apparatus that had been ordained, it seemed, by Nature. Here then was gender formation at the hands of the scientific elite of the day—the Harveys and his like—in tacit league to invoke biology to engrave the theory. [149] The sexual repression of males and its deleterious consequences would not be understood until the nineteenth century, as we shall see in chapters 3 and 4, by Roy Porter and Elaine Showalter. Eventually it became evident, as they demonstrate, that repression itself was counterproductive, rendering the already hysterical only more hysterical. Nevertheless, seventeenth-century formulations, by construing hysteria according to the Greek model as primarily a gynecological disorder, activated the disease concept emplotted within a discourse of gender stigmatization. This is why hysteria the category and hysteria the medical discourse lie so proximate to the discourses of gender in this period of early modern history. Women were on trial, and male doctors sat on the right hand of the already male judges. This might seem a clear invitation for the historian of hysteria to chuck medical theory altogether and instead invoke social history. After all, sickness did not always excuse the hysterical: in Shakespeare's and Harvey's time, hysteria was suspected to be the stigmata of vice, the wages of intemperance, even though no one put forth a lucid or persuasive theory explaining how this could be so. Two centuries later—in the mid-eighteenth and early nineteenth centuries—thinkers as diverse
134 as Adam Smith and Samuel Johnson, Jane Austen and Harriet Martineau, reported that the sick are commonly judged to be narcissistic egoists, extravagantly demanding of other people's time, patience, and resources. [150] And who can forget the gloomy fate of the self-indulgent Emma Bovary, repaid in both life and death for her mortal sins? How then did hysteric sickness become the just reward of a defective personal morality and deformed female sexual apparatus? And what were the social or cultural determinants of this other conversion syndrome? As men were largely exempt from the anatomic stigmata, their own morality was not held accountable. If the hysterical female became somatically ill through lack of self-control or personal discipline, it had to be explained why control and discipline were intrinsically different from that expected of the male. In other words, why was the raging erotic appetite of women different from its male counterpart?[151] These questions were not answered in the seventeenth century—in many cases, not even raised. Furthermore, if we set the chronological dials to approximately 1600 or 1650, we observe little, if any, discussion of the social components. If sexual intercourse was the adjudged best remedy for hysteria, and marriage the guarantor for intercourse, is it not significant that in this period marriageable women greatly outnumbered eligible men?[152] If marriage was closed to a certain segment of the female population, can it be that women concocted hysterical symptoms as an alibi to enhance their prospects for marriage? There were, it would seem, few better ways to ward off the often fatal "womb disease" than the acquisition of a marriage partner. Also, in that time (male) physicians were increasingly prescribing intercourse through marriage as a prescription to avoid hysteria. [153] Such prescription was no doubt abetted by the very slow and incremental secularization of countries like England and other northern Protestant lands (the secularization was slower in the Catholic countries). But—we must ask—did the doctors perhaps have another agenda in recommending intercourse as the best remedy? And can hysteria have been a successful method for the otherwise erotically lost woman, so to speak, to mediate her anxiety and internal guilt? These are modern concepts, to be sure, but not without universal application, even in the period of early modern Europe. Finally, we must examine the roles played by class. These cannot be omitted either, for as early as the time of Boccaccio and Rabelais leisured ladies are said to be the most prone to erotic melancholy and hysteria; even if there is as yet no theory of class in relation to these illnesses, the idle and rich, the affluent and bored, remain the best candidates for affliction.
135
VIII This gender asymmetry differentiated males entirely. They suffered crises and anxieties too, as both the medical and imaginative literature (plays, poetry) of the day demonstrate, but much less so in the romantic and erotic sphere. As the seventeenth century unfolded they were increasingly conceptualized and represented as public creatures: open, straightforward, rational, communicative, educated; working and functioning in public, in the broad light of day where their best virtues could be seen; and, as we have already suggested, mediating their romantic disappointments—which many obviously had—in the anger said to be almost preternatural to the male condition from time immemorial. [154] The imaginative literature of the seventeenth century—especially its plays and poetry—make it apparent that the gender gulf widened as the century progressed. Perhaps this is why marriage itself was transformed from a realistic, almost literalist, view to the more idealized one found in the Miltonic theogony. Difference of every kind was introduced into the speculative discourse of gender, buttressed often by medical and empirical observation, but also by religious and moral observations that discriminated among the kinds of friendship suitable to each sex. In Milton's epic, the sexes are already so far apart, so anatomically and biologically differentiated, that idealized female mystique and well-grounded male rationality become the twin pillars on which the great poet can construct his Christian myth. [155] As the gender differences widened, the sexes found themselves increasingly categorized into stereotypes irreducibly female or male. No one cause can be assigned to these new arrangements, but their effects are miraculously captured in Jacobean and Restoration drama, especially in the roles of the rake, fop, madman, cuckold, unfaithful husband, as well as—on the other side—the virgin, widow, coquette, dreamer, foolish old duchess. Within these groupings and categorizations, appropriate diseases attached to each character type, as virgins and widows frequently found themselves cast as hysterics while clerics and students were depicted as melancholics. [156] There was no deviation. When generalizing in this fashion, over large periods of time (half centuries rather than decades), it is tempting to grasp for the obvious trend without differentiating the subtleties. Nevertheless, if one compares the archetypal conceptions of women and men from roughly 1600 to 1700, large, even monumental, differences abound. [157] If the rake is taken as a representative example in 1600 and then 1700, his transformed social identity makes the point, especially
136 within the contexts of the developing libertinism predicated on gender and sexuality. [158] In the world of Ben Jonson and John Donne, for example, he is a marginal figure in the panoply of social types: libertine, wanton, promiscuous, pictured as ravingly heterosexual; by the time he reaches his maturity in the English Restoration, especially on the stage, he displays a newly acquired bisexual identity and stands in extreme contrast to those who promote the ideals of romantic marriage and the newly domesticated family. [159] As Randolph Trumbach has written, "somewhere in this transition from one sexual system to another—from a system of two genders of male and female, to a system of three genders of man, woman, and sodomite—was . . . the growth of equality between men and women that was part of the modern European culture that was emerging in northwestern Europe around 1700 in all the structures of life." [160] This equality probably signaled a transition from one anthropological sexual system to another; it did not diminish the gender differentiation on which so many theories of hysteria were then built. Besides, the genuine underlying reasons for gender differentiation were as patently social and political as they were biological and anatomic. Political turmoil and eventual restoration of the rightful monarch, at least in England, resulted in a new sense of the nation, and with this fervid nationalism came new commerce, new professions, new military might, new wealth, and most apparent to the man or woman in the street, new urban sprawl. When Charles II returned from France in 1660, the greater London area had only about three hundred thousand people; by 1700, it had swelled to a city of six hundred seventy-five thousand, and by 1800, almost a million. With this growth a new set of social and professional relations developed and caused greater gender stress. Prostitution, female and male, arose as a profession for the first time in England, as did new and sometimes dangerous sexual liaisons between persons of different and same sexes. [161] Crime, violence, squalor, and suffering caused by poverty all reached new levels, as the Newtons and Lockes at the close of the seventeenth century were creating their intellectual revolution. Socially speaking, the world of 1700 was a vastly different place from the England of the Elizabethans just a hundred years earlier, and nowhere was the difference more palpable than in the relation of the sexes. [162] Under the strain of the new stress, hysteria became for the first time in Western civilization—a male disease. Not surprisingly, it was a consequential moment for the history of both hysteria and gender. From this Restoration world two more radical breakthroughs in the theory of
137 hysteria will emerge, both by Sydenham: the first, that hysteria can "imitate any disease," and the second, the notion that it is "the commonest of all diseases." [163] The question we must pursue is why the same generation—not merely the same physician—gives rise to both ideas, and we go a long way toward finding the answer if we isolate the new social roles of males in the Restoration. In both the Elizabethan and Restoration imagination, hysteria and melancholy were intrinsically linked. Throughout the seventeenth century they increasingly overlapped, especially when female patients were diagnosed as afflicted with the one as well as the other. [164] The medical theory of both periods reveals an unusual coexistence extending beyond overlap and reciprocity; it often demonstrates confusion and chaos centered on the issues of gender (is hysteria a female malady and melancholy a male ?) and sex (does uterine anatomy predispose women to hysteria while male grief afflicts the intercostal cavity, causing melancholy and hypochondria?). [165] By the later period (the Restoration) men are being portrayed in a way altogether different than three generations earlier. The Restoration stage presented, of course, a theater experience very different from its Tudor-Stuart antecedent. More limited to the upper crust in its audience, it also controlled their responses more, and in this sense it can be compared with Richard Foreman's contemporary "Ontological-Hysteric Theatre," which attempts to exploit the hysterical syndrome by dramatizing naturalistic triangles of persons enmeshed in alienating situations. And the Restoration stage presented a more limited repertoire of characters—especially male rakes, fops, wits, wit-would-be's, as well as squires, gentlemen, statesmen, soldiers—often consumed in erotic adventures while drawn to the very brink of the old Burtonian melancholy by unrelenting male competition. At the same time this national stage remained coherent in its class structure and a faithful index of the collective erotic fantasy of the age, holding up the male victims of a predatory female eros forever in disguise. Why didn't the medical doctors recognize that in this dramatic representation lay one of the secrets of hysteria?—that it is as much a male as female condition, and therefore in no small degree socially rather than biologically constituted, as by now (i.e., after 1660) it was widely accepted that men did not have the defective female anatomic (i.e., reproductive) apparatus that had been the nemesis of women for centuries. This is the quintessence of the matter and gives us pause in the twentieth century as we wonder why this gender difference had not always been obvious. Not until the 1680s did these ideas and ideologies coalesce in the written discourses of the "En-
138 glish Hippocrates"—so-called for his genius in clinical observation and faithful recording of what he observed in his patients—Dr. Thomas Sydenham (1624-1689).
IX Although well educated and possessing a first-class scientific mind, Sydenham seems an unlikely candidate for the imaginative leaps attributed to him. The son of landed gentry in Dorset in the West Country, he had been educated at Oxford, where he became acquainted with many of the prominent early members of the Royal Society. But the English Civil War soon drove him from Oxford's colleges to the battlefield, where he gained—in the words of his biographer—"his first introduction to manhood." [166] As a young soldier he acquired some of the practical attitudes that would benefit him as a mature doctor. Later, in the 1670s, he built an urban medical practice in England second only to that of Thomas Willis, the famous "nerve doctor," in the prestige and political eminence of its patients. It is important that Sydenham's practice was located in London and that most of his patients were what we would call city dwellers, for in that era before the dawn of psychiatry and psychotherapy, the illustrious urban physician, such as Sydenham, could expect half the complaints of his patients to be nervous (their term) or psychological (our term). [167] Because Sydenham had suffered from the gout since his twenties, his own poor health required him to use his medical knowledge in the most practical way. [168] It wasn't sufficient to be speculative and theoretical about medicine and its therapies when the doctor himself was a patient. Professionally, Sydenham's practice dealt with the diagnosis and treatment of regular, individual patients of stature, wealth, and fashion. He did not seek out the rich—they came to him. [169] His compassion for the ill was such that he may have been the most sought-after physician in the realm. In brief, medicine was his life. When the brilliant young John Locke came to London with his new medical degree from Oxford, it was in Sydenham's clinic that he most hoped to begin his practice, and he did. [170] Sydenham's reputation as an effective medical therapist had reached such a pinnacle by the 1680s that only the wealthy and powerful could afford his services, although he regularly ministered to the poor as well. In such patient-doctor encounters, demonological accusations were never taken seriously (these being more attractive to the lower classes than to his suave patients), thereby leaving the field open for new explorations of such mysterious afflictions as hysteria.
139 Sydenham, no medical historian or avid reader of medical classics, worked principally by observation. He believed that experimentation was successful only when several physicians made an identical diagnosis; otherwise, he concluded, the experiment was not even scientific. So much did he derive from his reading in Bacon, his medical education at Oxford, and his own intuition. By the time he gathered his thoughts about hysteria in the early 1680s he had read much Bacon (who did not pronounce on hysteria)—Sydenham's idol along with Cervantes—and had independently confirmed the earlier observations of Charles Lepois (the Italian physician also known as Carlo Piso, 1563-1633) that hysteria was not entirely an anatomic condition and, as a result, that males were just as susceptible as females. [171] Lepois had rebelled against the earlier theorists of hysteria, and his comments demonstrated to what degree he disagreed with the medical establishment:
We believe we are correct in concluding that all the hysterical symptoms . . . have been attributed to the uterus, the stomach and other internal organs for the wrong reason. All [these symptoms] come from the head. It is this part which is affected not by sympathy but idiopathically and produces motions which make themselves felt throughout the entire body.[172]
"The hysterical symptoms are almost all common to both men and women," Lepois wrote in the 1620s. [173] But if Lepois looked to the brain, in the head, Sydenham felt no such constraint to search anatomically at all. Instead, he seemed to have been partially liberated from the pressure to specify a unique somatic seat for the disease. He wrote little and measured his words. [174] What he wrote he penned laconically and empirically, without cynicism or malice toward his patients, addressing himself only to what he believed truly counted: clinical reality. Veith has summarized the biographical and medical circumstances under which Sydenham wrote the Epistolary Dissertation . No reason exists to recount them here, for there is little to add, except to observe Sydenham's reason for accepting Dr. William Cole's invitation to set down on paper his thoughts "concerning the so-called hysterical diseases." [175] Cole, a noted physician, had a large practice of his own in which he treated his own hysterical patients. [176] Considering Sydenham one of the greatest living physicians, he asked the venerated doctor why hysteria had proved so elusive. Sydenham's answer in the Epistolary Dissertation was brief; coming from Sydenham it must have astonished many of his medical brethren. Whether through compassion or insight, he admitted how difficult hysteria was to cure. He empathetically reflected
140 that the pain suffered by hysterical patients was more severe than that in patients with other illnesses. He was the first in the medical establishment (after Lepois, mentioned above) to break from the uterine etiology; the first to degenderize hysteria by removing its erotic stigma altogether; the first also to claim that no single organ was responsible but a combination of "mental emotions" and "bodily derangements" working through the nerves and the then all-important animal spirits. In this last matter he differed radically from Lepois, who had thought the brain the somatic seat of hysteria. [177] In brief then, Sydenham arrived at radical conclusions: 1. He claimed that hysteria afflicted both men and women. 2. He considered hysteria the most common of all diseases. 3. He viewed hysteria as a function of civilization, that is, the richer and more civilized and influential the patient, the more likely he or she was to be afflicted. A few years earlier, Willis had also concluded independently of Lepois that hysteria might be applicable to men, given its lodging—according to Willis—in the nervous stock, spanning the brain and the spinal cord. [178] He derived this attitude from his theory of sympathy, which led him to reject inherited Hippocratic versions of hysteria. Willis's main argument was with the notion of a "wandering womb" as anatomically "suffocating" the rest of the body as it supposedly rampaged and choked other organs and deprived them of their rightful space. He also held objections to this view based on the normal and pathological dry-moist conditions in the body. Hysteria was an important concern to Willis from the beginning of his medical career. He challenged Nathaniel Highmore's etiology from "bad blood" in a huge treatise written in Latin and entitled Affectionum quae dicuntur & hypochondriacae pathologia . . . (1672), all as part of a larger campaign to give the brain a much greater role in the genesis of illness and to convert many conditions into diseases of the nervous system. The specific route for our condition, he believed, was that the uterus "radiated" (his word) hysteria through an infinity of neural pathways extending into every organ and tissue of the human corpus. Willis applied his notions of corporal sympathy to hysteria and then extended this route of nervous transmission to other female conditions, including chronic "head ache" (of the intense variety suffered by his contemporary, the brilliant and rich Lady Conway), coma, somnolency, epilepsy, vertigo, apoplexy, and generalized paroxysm (i.e., numbness), among many others. These and other conditions were owing, Willis thought, to nervous disorders he often termed "paralysis of
141 the nerves." [179] But why omit men, Willis asked, unless the anatomy and physiology of the genders differ? However, Willis chose not to investigate the possibility, concentrating instead on his medical practice and treating the large number of female hysterics in his waiting rooms with a wide repertoire of drugs. The first of the great "nerve doctors" who flourished during the pan-European Enlightenment, Willis anticipated our current medical practice of prescribing drug-based therapies. Indeed, he would be at home today in our neuropsychiatric institutes where pharmacology reigns supreme and patients are drugged for almost every form of depression, anxiety, and pain. However, Sydenham gazed more deeply into hysteria than Willis: if Willis discovered hysteria through theory, Sydenham came to it from practice. Like his predecessor, Sydenham intuitively demystified hysteria by rendering it an authentic medical affliction, neither diabolical nor fanciful but rational, empirical, mechanical, even mathematical, and, most crucially, calling it "an affliction of the mind" or, in our parlance, a psychological malady. [180] The advancement in his thinking was part of a larger Restoration anatomic movement that had demystified the reproductive organs of the female body. [181] Sydenham's psychologizing of hysteria was crucial. Yet he probed further than Willis: he stressed hysteria's imitative function—an altogether new idea—and noticed its protean potential to convert the original psychological distress into somatic reality. As Foucault intimates in his own work on hysteria in chapter 5 of Madness and Civilization , Sydenham was also more compassionate than Willis and penetrated further into the wasted lives of his female patients. Whether women merely elicited from Sydenham more compassion than men is unknown, and nothing in his writing offers a clue, but he was less suspicious than most of his medical colleagues that women's hysterical complaints were faked. By virtue of the silences in his Dissertation —revealing silences given his already Spartan style and avoidance of rhetoric—he apparently ruled out the possibility that these physical symptoms originated in the patient's attempt to deceive his or her physician, or, furthermore, that hysteria was an imaginary illness. In his view pain itself was a felt emotion, as real as fear, love, grief, and hate; he refused to contemplate the possibility that a woman presenting with demonstrable somatic pain was imagining or fabricating her anger or fear. [182] In matters of gender application, Sydenham claimed that the radical mood swings of women—spasms, swoonings, epilepsies, convulsions, sudden fits—were also known among men, especially, as he wrote, "among such male subjects as lead a sedentary or studious life, and grow pale over their books and papers." [183] Caprice, in both women and men,
142 was the norm: violent laughter suddenly altered to profuse weeping, each succeeding the other in fits and starts. Nothing in the behavior of either gender, Sydenham thought, was grounded in reason, nor could actions be explained. Emotional instability was the hysteric's hallmark. But who were these "studious" types? Certainly not the farmers or rustics of eighteenth-century England or France, but the upper and leisured classes, many of whom had attached themselves to colleges, churches, and government posts. Implicit rather than explicit in Sydenham's male hysteria was a built-in class notion. The fact that "women are more subject than men," as Sydenham comments, has nothing to do with general anatomical differences or with female reproductive anatomy. Sydenham believed rather that the proclivity was an expression of the whole person , arising from a convergence of the mind and nerves mediated through the "animal spirits." These were subtle distinctions, especially the specific locations of anatomic difference. If hysteria was more prevalent and severe among women than men, it was because their anatomic nervous constitutions were weaker. These were important steps and linkages, especially the new significance attached to the mysterious animal spirits, [184] and the relatively new idea that the bodily strength of the nervous constitution was gender bound and gender determined. [185] By 1670 or 1680, not enough research on the nerves had been performed to justify such conclusions; what had been learned was speculative and theoretical; what is most interesting about Sydenham's position was that while he took a giant leap in the psychologizing of hysteria, he also laid out an agenda for "the weak and nervous feminine constitution" that would play a magisterial role in European hysteria for more than two centuries. The latter theory is, ideologically at least, a more controversial accomplishment and must be addressed now. [186] This analytic interpretation of Sydenham's three-part contribution is not meant to diminish it in any way. Surely Veith is right to praise him as "the great clinician" of hysteria and hail him for psychologizing it. Yet Veith has analyzed hysteria narrowly, considered apart from its philosophical, social, and ideological contexts—an opposite approach to that of Quentin Skinner (quoted in the epigraph to this chapter); Sydenham himself, narrowing his focus to the weak and nervous feminine constitution, further genderized the perplexing malady, as Freud would later do in fin-de-siècle Vienna. Even so, the term nervous constitution was no rhetorical flourish or linguistic elision for Sydenham, no metaphor or analogy to describe something sensed but improperly understood. To Sydenham and his colleagues it denoted the quintessence of the body's mechanical operations: the amalgam of its superlative, integrative net-
143 work. [187] It was metaphoric, of course, to the degree that all language is, but in terms of representation the description was believed to be identical with the body's most essential anatomical network. The nervous system was, in short, the body's greatest miracle, without which neither sensation nor cognition could exist. Therefore, it is inappropriate to use the approaches of literary criticism to assume the concept represented merely a metonymy or metaphor for Willis, Sydenham, or the other anatomists and physicians in the aftermath of Descartes who began to make the nerves the basis of the new medical science. [188] Sydenham believed that "of all chronic diseases hysteria—unless I err is the commonest." [189] By common he meant not simply prevalent then and in the past and presumably in Western and non-Western cultures, but constantly on the increase, and spreading , especially among the rich and the influential. [190] Although Sydenham had treated cases of poor women, beggars, and vagrants who presented hysterical symptoms, he considered them exceptions. The "common" cases to which he refers existed among the leisured and idle: He wrote, "There is rarely one who is wholly free from them [hysterical complaints]—and females, it must be remembered, form one half of the adults of the world." [191] He does not elaborate on this remark. Although he has much to say in the Dissertation about the proximate and direct causes, as well as the pathogenesis of hysteria, he does not explore one of his most brilliant insights about the social pervasiveness of hysteria. He sees hysteria as "the most common of all diseases" because afflictions of the mind now (i.e., in the seventeenth century) have assumed an importance they did not have previously. To generalize the matter to a principle: as life for the leisured and influential becomes more complex, society's maladies also alter. A hundred years ago, according to Sydenham's reasoning, hysteria may have been less prevalent, but by the end of the seventeenth century, in the complex urban milieu previously described, hysteria is on the rise and will continue to increase so long as the social milieu (its economic conditions, political institutions, class arrangements, etc.) grows increasingly complex. The observation entails no philosophy of history or philosophy of medicine, to be sure, but does demonstrate a profound insight into the relation of culture and disease. [192] Sydenham saw all this before the nineteenth-century growth of hysteria; indeed, he claims to have witnessed an explosion—an epidemic—during the English Restoration. Prophetic of things to come, he intuited that hysteria had persisted throughout the ages among both genders, although it had gone largely undiagnosed; within this context, he glimpsed the havoc wreaked on human lives by rapid socioeconomic
144 change and the new lack of personal repression. The libertinism and hedonism of the Restoration were unparalleled in previous generations. If Sydenham could somehow have been reborn into Freud's Vienna, he would neither have denied nor been amazed by hysteria's new prominence. He who had recognized that hysteria "is the commonest of all diseases" would not have been surprised by its explosion under the strain of even further gender arrangements in a nineteenth-century world in which interconnecting, almost organic, complexity created new stresses; where male individualism and selfhood were being threatened as they had not been before; and where women demanded rights (especially the vote) more vigorously than ever before. If the female nervous constitution was perceived to be weaker than the male in the English Restoration, it was deemed to be even weaker around 1900. [193] This last matter—the historical development of the so-called weak feminine constitution—forms an integral part of the story of hysteria in the aftermath of Sydenham. Nothing in its nineteenth-century formulations can be understood without glimpsing how the genders became further differentiated according to this nervous system. But Sydenham also detected something even more extraordinary about hysteria: its protean ability to transform itself and its symptoms. He wrote in 1681: "The frequency of hysteria is no less remarkable than the multiformity of the shapes which it puts on. Few of the maladies of miserable mortality are not imitated by it." [194] It is an extraordinary insight. This suspected ability "to imitate" is what rendered hysteria, Sydenham thought, unique among maladies . No one had detected this remarkable and elusive capability before. It is as if Sydenham were asking, What is hysteria if it possesses this power of transformation? It is. not surprising that "whatever part of the body it attacks, it will create the proper symptom of that part. Hence, without skill and sagacity the physician will be deceived; so as to refer the symptoms to some essential disease of the part in question, and not to the effects of hysteria." [195] Hysteria in Sydenham's construal was thus a singular malady. As in the recent profiles of such conditions as cancer or AIDS, the natural history of hysteria was such that it always brought with it another "history" personal to each patient:
Hence, as often as females consult me concerning such, or such bodily ailments as are difficult to be determined by the usual role for diagnosis, I never fail to carefully inquire whether they are not worse sufferers when trouble, lowspirits, or any mental perturbation takes hold of them. If so, I put down the symptoms for hysteria.[196]
145 Our contemporary diagnostic practices may not differ so drastically as we think. Yet Sydenham's hysteria was a sickness born of emotional agitation and physical enfeeblement, one arising, for example, when "mental emotions" were superadded to "bodily derangements," such as "long fasting and over-free evacuations (whether from bleeding, purging, or emetics) which have been too much for the system to bear up against." And—more germane to protean transformation—its symptoms had been so extraordinarily protean because, rather as with volcanic eruptions, the disorder broke out in whichever bodily system was currently weakest. [197] Long before Freud then, Sydenham was the first thinker to consider hysteria a disease of civilization , unlike most other maladies. Construing hysteria as "a farrago of disorderly and irregular phenomena," he saw the unreliability of much previous medical theory about the condition and commented: "If we except those who lead a hard and hardy life, then no persons are exempt from its tentacles." For him, hysteria was not a single disease but a broad range of medical conditions: a hodgepodge—a "farrago"—of changing symptoms, the premier emblem of the class of diseases, or conditions, that defied predictability: anomalous, sui generis , exempted from the regularity of all other diseases.
X The succession of medical theory in the Restoration and eighteenth century was therefore relatively clear. In the progression from Willis and Sydenham to Cheyne and Bernard Mandeville—the satirist of The Fable of the Bees —and their successors later in the eighteenth century, it was Sydenham who took the largest strides. Willis made free use of the hysteria diagnosis in managing sick women, saw hysteria as a somatic disturbance, treated patients with drug-based therapeutics, and considered the probability that men could be afflicted too. Inasmuch as women of all ages and ranks could suffer from it, he prudently dismissed the notion of Dr. Nathaniel Highmore, his contemporary, that hysteria was due to bad blood. [198] He doubted that it was owing to any specific uterine pathology and identified the central nervous system, spanning the brain and the spinal cord, as the true site. Being "chiefly and primarily convulsive," he argued, "hysteria flared on the brain, and the nervous stock being affected." [199] The animal spirits were specially vulnerable: "The Passions commonly called Hysterical . . . arise most often [when] . . . the animal spirits, possessing the beginning of the Nerves within the head,
146 are infected with some Taint." So he, like Sydenham, concluded that hysteria could not, technically speaking, be solely a female complaint; he offered the weaker nervous constitution as the reason why women were worse afflicted. [200] The obvious conclusion, although both Willis and Sydenham were too cautious to proffer it, was that men with clear symptoms of hysteria were effeminate. [201] These schematizations shifted the ground to the nervous system as the key through which to understand and interpret hysteria as a category as well as human illness, and the paradigmatic shift is important for Enlightenment medicine. [202] But if hysteria, as both Sydenham and Willis claimed, was the Proteus of maladies—the elusive medical condition par excellence—then we should expect the medical theory of the period to view the nervous system as the key to practically all illness, not merely hysteria. This it did. The best theory of the day did not, naturally, endow the nerves with the key to every disease, but once the mechanical philosophy had completed its work and the paradigmatic shift was absorbed (roughly by 1700), there were few if any diseases without nervous implications. Eventually this monolithic attribution would be seen for the foreshadowing of modern nervousness that it is. At the time, it was viewed as the only respectable medical course possible. Dealing with affluent clienteles, the highly influential Italian physician Georgio Baglivi and satirist Bernard Mandeville carved out comparable concepts of hysteria to encompass the protean ailments of the polite, whose sensibilities to pain were as extensive as their vocabularies, and who may have been adroit at manipulating the protective potential of sickness. Mandeville, a brilliant writer of prose, was sensitive to the languages of hysteria, especially their jumbled vocabularies and dense metaphors. He had commented profusely on the metaphoric kingdoms of "the animal spirits"—commenting pejoratively most of the time and demonstrating how little he believed that medical writers had followed the pious credos of the Royal Society espousing nullius in verba , loosely "nothing in the word." In his dialogic Treatise of the Hypochondriack and Hysterick Passions , Mandeville makes a character proclaim: "You Gentlemen of Learning make use of very comprehensive Expressions; the Word Hysterick must be of a prodigious Latitude, to signify so many different Evils," suggesting that a type of "madness" would arise from nomenclature itself, a form of illness every bit as real as the genuine "hysteric's affliction." Drawing upon his extensive clinical experience, Baglivi demonstrated how patients commonly presented symptom clusters resistant to rigid disease categories, though responsive to the personal tact and guile of
147 the physician. [203] Mandeville, for his part a profound social commentator as well as a sought-after medical practitioner, made much of the fashionable life-style pressures disposing women to hysteria while their husbands sank into hypochondriasis. [204] Was there a determinant anatomico-physiological etiology for the disorder? Mandeville, like Sydenham, deflected the question, concentrating instead upon those behavioral facets—languor, low spirits, mood swings, depression, anxiety—integral to the presentation of the self in everyday sickness. Mandeville's substantial contribution to the theory of hysteria was revisionary more than anything else. He ridiculed the elaborate speculative models of mechanico-corporeal machinery floated by Willis, especially the idea that erratic mood shifts were literally due to "explosions" in the animal spirits, and derogated the highly analogical language Willis used to capture the iatromathematical motion of these nervous eruptions. Mandeville was less troubled by Willis's theory of sympathy than with his version of idiopathy : the idea that the "explosion" could convey its neuroanatomic effects throughout the body by sympathy. Idiopathy and "detonation" were Mandeville's unrelenting gripe, especially the unpredictable onset of the "detonations," not a theory of medical sympathy that had historically antedated Willis nor neurophysiological disagreement about the manner of conveyance through the nervous pathways. Furthermore, the metaphoric dangers of "detonation in the human body" struck the satiric Mandeville as comic, even hilarious. Anatomic detonations, nervous explosions, sudden eruptions: what reason did nature have for infusing the human microcosm called "the body" with these sudden "detonations," especially if they could "explode" at any moment and throw the organism into a paroxysm of hysterical illness?[205] Subsequent theorists of hysteria took up Mandeville's caveat, favoring the sympathetic transmission over the idiopathic. But by now—the eighteenth century—the neural transmission of hysteria had almost completely replaced the "bloody" and uterine, "explosions" or not. The old dualistic categories of spirit and body, rational and physical dimensions, were replaced by a more or less integral "nervous system" (however poorly defined and ill understood) transmitting all manner of "nervous disorders," of which hysteria was indubitably the supreme. As the discourse on hysteria made its way through the world of the Enlightenment, at least three of its most cherished beliefs were quashed. Set the dials roughly to the first quarter of the eighteenth century and hysteria is now a rampantly spreading malady that clearly afflicts both genders, women primarily because of their weaker nervous systems , and while stress and daily routine are crucial in its genesis, nothing is more
148 important than the state of the nerves and the animal spirits that govern them. When Baglivi wrote in The Practice of Physick, reduc'd to the ancient Way of Observations, containing a just Parallel between the Wisdom of the Ancients and the Hypothesis's of Modern Physicians (1704) that "Women are more subject than Men to Diseases arising from the Passions of the Mind, and more violently affected with them, by Reason of the Timorousness and Weakness of their Sex," he meant weakness in the nerves . Baglivi was widely read throughout Europe, from north to south, from the avant-garde medical schools of Holland to those in Spain and Salerno. His theory of "Diseases arising from the Passions of the Mind" as diseases of gender took hold almost instantly. This eighteenth-century view represented a narrow conception of a disease that had puzzled doctors for long, even if men and women then invested in the ideologies of the animal spirits in ways now almost irretrievable. It was a narrow conception, and it demonstrates that the paradigmatic shift from a uterine to a nervous model for hysteria was the most significant shift the conception of hysteria experienced since its medicalization in the sixteenth century and until its genuine psychogenic formulation in the nineteenth.
XI I hope I have explain'd the Nature and Causes of Nervous Distempers (which have hitherto been reckon'd Witchcraft, Enchantment, Sorcery and Possession, and have been the constant Resource of Ignorance) from Principles easy, natural and intelligible, deduc'd from the best and soundest Natural Philosophy. —GEORGE CHEYNE, The English Malady
The paradigmatic shift is, of course, self-evident to the careful reader of these discourses, especially as former "hysterical" complaints now become monolithically "nervous." Sydenham died in 1689, almost at the moment that Newton's Principia (1687) was being interpreted and Locke's Essay Concerning Human Understanding (1690) printed, works providing evidence that paradigmatic shifts were then taking place in other fields as well as in medical theory. [206] Within a generation, to be hysterical was to be nervous : the two became synonymous, the latter eventually a shorthand, a metonymy, almost a code word, for the broad class of hysterical and hypochondriacal illnesses. Another feature of the theory of hysteria (not merely the fact of its existence as a medical condition) affords a clue to this transformation into nervous illnesses: the sense that nervous disease permeates society. This pervasiveness had never been a primary dimension of the older theories of hysteria. [207] For
149 generations, at least since the time of Weyer and Jorden, it had been thought that hysteria was present and could be found in segments here and there but that it was not omnipresent or pervasive in European society. Now, in the generation between the death of Sydenham and the succession of the Hanoverians (1689-1714), the pervasiveness of nervous disease became as entrenched as the mechanical revolution in science more widely. [208] Was it for that reason, perhaps, that a large number of cases began to surface in the eighteenth century in comparison to previous periods? Even more puzzling, why should diagnoses of hysteria suddenly reach such epidemic proportions? Were there the cases to support the diagnoses, or were doctors on some type of crusade to hystericize (i.e., neuralize) medical illness and encourage the perception that disease was now fundamentally nervous? The answers must be sought in the discourses themselves as well as in the views of women then and in social transformations then occurring. Today, we tend to think of the nineteenth century as the golden age of hysterical women in part because—we think—the eighteenth century refused to problematize the female sex [209] —that is, to see women in all their biologic and social complexity. Yet authoritative social history reveals the opposite: for example, Sydenham's remarkable social construction of women and their chief disease. The degree to which an epoch problematizes women varies of course; it is perfectly true that all epochs problematize their women; nevertheless, in the period of the Enlightenment it was high. Throughout the Restoration and eighteenth century, at least in the British Isles and France, even the healthy woman was still seen as a walking womb. Several dozen rebels—the Bluestockings, the Aphra Behns and Charlotte Charkes, the Lady Mary Wortley Montagus and Madame de Staël's, and other sophisticates in the leading courts and capital cities of Europe—challenged this characterization, but they and their cohorts were unable to put a significant dent in the armor of that social world. [210] For some, spleen and vapors, often used interchangeably, were still proofs of demonic possession rather than somatic ailment; this is not surprising since witches were still being tried in the early eighteenth century (until the 1730s), even if not so vigorously as they had been previously. [211] But for most, "the vapors" was the colloquial cousin of hysteria, as Dr. John Purcell, a selfprofessed "nerve doctor," insisted. [212] Dr. John Radcliffe, for whom Oxford's Radcliffe camera is named, was dismissed from Queen Anne's service after telling Her Majesty that she suffered only from the vapors, thereby implying that hers was an imaginary and doubtful malady. This was nothing Her Majesty wished to
150 hear; the Queen wanted a diagnosis indicating real illness that could be treated with acceptable therapy, not some imaginary delusion, like "the vapors," for which her character could be impugned and to which no attention would be paid. [213] We glimpse a different view in the poet Pope's treatment of Belinda when she descends into "The Cave of Spleen" in canto 4 of the famous mock-epic poem The Rape of the Lock (1714). Belinda's sudden hysterical seizure embodies the older connotation of the medical doctors, and becomes the sign of the unstable postpubescent and nubile nymph burdened with her essential uterine stigmata: [214]
Safe past the Gnome thro' this fantastic Band, A branch of healing Spleenwort in his hand. Then thus addrest the Pow'r—Hail wayward Queen Who rule the Sex from Fifty to Fifteen, Parent of Vapours and of Female Wit, Who give th' Hysteric or Poetic Fit , On various Tempers act by various ways, Make some take Physick, others scribble Plays. (lines 55-6o)[215]
The poetry succeeds brilliantly here because of a sustained ambivalence between real and imaginary delusion: "Hysteric " and "Poetic " fits: that never-never land capturing genuine dementia versus imagined, even feigned, vapors. Pope thereby enables Belinda to enjoy a status unavailable in actual life had she been the historical, precocious, upper-class Arabella Fermor suffering from medically diagnosed hysteria. [216] Unlike Belinda, real patients craved diagnoses that did not brand them as possessed or deluded by imaginary or pretended illnesses. They wanted to be told by their physicians and apothecaries that they were suffering from genuine nervous afflictions that had attacked specific parts of their nervous systems for which there existed pharmacological remedies and other tonic nostrums. [217] Alternatively, in medical theory as distinct from the diagnostic and therapeutic spheres, nothing persuaded doctors and patients alike so well as numbers and mathematics. So long as the physician could quantify the malfunction of the diseased animal spirits and apply arithmetic and even Newtonian fluxions to the motions (i.e., the contractions and expansions) of the nervous system, both diagnosis and therapy seemed possible. Specialized "nerve doctors" were well served by iatromechanical training. For the rest, quantification and numbers had proceeded so far in the mechanical imagination of the day that nothing therapeutic succeeded so well as pills and potions designed to
151 normalize the mechanical motions of the animal spirits within the nerves that had caused the hysteria in the first place. The path ahead for the theory of hysteria lay then in its iatromechanical applications, i.e., its mathematical charting. [218] The followers of Sydenham, especially Baglivi and Mandeville, and of their counterparts Archibald Pitcairne (a Scot who became an important professor of medicine in Leyden and Edinburgh) and Herman Boerhaave in Holland, [219] avowed a medical Newtonianism aspiring to establish the laws—static, dynamic, hydraulic—governing the mechanics of the organism and preferably couching their findings in these mathematical expressions. Anatomical attention to the body's solids would provide, they contended, surer foundations for medical laws than the traditional Galenic preoccupation with the humors and fluctuations of the fluids. Dr. George Cheyne in particular had nothing but scorn for talk of humors and those "fugitive fictions," the animal spirits. [220] Mechanist physicians, treading lightly in Willis's footsteps, pointed to the experimentally demonstrable role of the nervous system—a sensory skeleton variously imagined as comprising nerves, fibers and spirits, strings, pipes, or cords—in mediating between brain and body, anatomy and activity. As I have described elsewhere, Cheyne and his medical peers in Enlightenment England launched an aggressively somaticizing drive to modernize medicine in a Newtonian mode. "Physic," Cheyne advised his brethren, must aspire to the condition of physics. The possibility of diseases, especially hysteria, springing primarily from the mind was discounted—no longer, in the main, because such disorders would be deemed diabolically insinuated, but because they would thereby be rendered empirically unintelligible. For the theory of hysteria this represented an invigorating somaticizing that totally undid Sydenham's cultural unraveling. [221] The Newtonian mechanics of cause and effect meant that no reflex, no disturbance of consciousness, no sensation or motor response, was to be admitted without presuming some prior organic disturbance communicated via the senses and the nerves. "Every change of the Mind," pronounced the enthusiastic Newtonian Dr. Nicholas Robinson in 1729, "indicates a change in the Bodily Organs," [222] a view Cheyne endorsed in The English Malady by adumbrating its workings in the intimate interplay between the digestive organs and healthy nerves' tonicity:
I never saw a person labour under severe, obstinate, and strong nervous complaints, but I always found at last, the stomach, guts, liver, spleen, mesentery [i.e., thick membranes enfolding internal organs], or some of
152 the great and necessary organs or glands of the belly were obstructed, knotted, schirrous, spoiled or perhaps all these together.[223]
Cheyne subsumed hysteria—which in his fashionable medical practice covered a multitude of symptoms ranging "from Yawning and Stretching up to a mortal Fit of Apoplexy"—under the umbrella of nervous diseases, its being due to "a Relaxation and the Want of a sufficient Force and Elasticity in the Solids in general and the Nerves in particular." [224] Cheyne's "nerves" thereby endorsed the Sydenham/Willis exoneration of the womb, relocating the distemper as the neighbor of the spleen and vapors, and closely situated next to melancholy. Time elapsed, however, before the educated public caught up with Cheyne's reforms, and even someone as knowledgeable of Cheyne's theory of hysteria as the novelist Samuel Richardson, Cheyne's great friend, conflated his version of hysteria with the vapors and spleen. In Richardson's last novel, Sir Charles Grandison (1753), the willowy heroine Clementina endures the three stages of "vapours" Cheyne described in The English Malady , proceeding from fits, fainting, lethargy, or restlessness to hallucinations, loss of memory, and despondency (Cheyne recommended bleeding and blistering at this stage), with a final decline toward consumption. To cure her, Sir Charles follows Cheyne, prescribing diet and medicine, exercise, diversion, and rest, and the story is considerably affected when Clementina's parents adopt unquestioningly Dr. Robert James's further recommendation that "in Virgins arrived at Maturity, and rendered mad by Love, Marriage is the most efficacious Remedy." [225] In the perceptions and practice of early Georgian medicine, these nervous complaints constituted a block of relatively nonspecific ailments and behavioral disorders. One need merely think of the letters and diaries of the period to see what resonance spleen and vapors emitted. [226] They are even more frequently referred to in the poetry and drama of the period, where virtually no author is exempt. From the mad hack's attacks of spleen in Jonathan Swift's Tale of a Tub to Clarissa Harlowe's persistent bouts with vapors in the Richardson novel of that name, the nervous ailment exists as mundane reality as well as cliché and complex trope. [227] Gender proves no discriminating factor, as men and women alike, and in almost equal numbers, fall prey to its sudden attacks. But diagnosed inaccurately, the same symptoms could denote lunacy, insanity, dementia: the same madness Swift's hack clearly suffers from in the Rabelaisian Tale of a Tub . [228] To our way of thinking, the broad category melancholy would not seem to fit under this conception of hysteria. Yet it then did, one evidence of which is the consistent interchange of the
153 two words in even the most technical medical literature. Furthermore, the line between melancholy and madness was delicate and thus greatly feared. Melancholy, madness, hysteria, hypochondria, dementia, spleen, vapors, nerves: by 1720 or 1730 all were jumbled and confused with one another as they had never been before. Anne Finch, the Countess of Winchelsea and a poet much admired by Pope and Wordsworth, turned this confusion about the status of hysteria to her advantage in The Spleen: A Pindarique Ode by a Lady (1709). This is her most ambitious work: a phantasmagoria about life, death, and the nocturnal reverie world—all conceived and executed by pondering reality through the gaze of the splenetic poet. [229] The leading "nerve doctors"—the Mandevilles and Cheynes and their group of lesser epigoni—grounded these hysterical symptoms entirely in somatic origins: to make certain through tact and expertise that patients understood that virtually all hysterical complaints were worlds apart from gross lunacy. Thus Dr. Purcell, mentioned earlier as a fashionable nerve doctor, claimed that "the vapours"—a condition colloquially synonymous with hysteria—consisted entirely of an organic obstruction located "in the Stomach and Guts; whereof the Grumbling of the one and the Heaviness and uneasiness of the other generally preceding the Paroxysm, are no small Proofs." [230] Noting that one of Hippocrates's noblest contributions to medicine lay in recognizing that epilepsy was not a divine affliction ("the sacred disease") but entirely natural, Purcell insisted that the vapors (what the French would call the "petit mal") were akin to epilepsy (the "grand mal"); indeed that "an epilepsie, is Vapours arriv'd to a more violent degree." What had become of Sydenham's revolutionary insights—the social conditions, daily stresses, nocturnal excesses, wasting away of women in a patriarchal world, all of which he had believed were important in the genesis of hysteria? Where was the view that the new Enlightenment codes of politeness and refinement, and the encroachment of unwanted foreign customs on civilized English and French life (coffee, tea, chocolate, snuff, etc.) played a part in creating these hysterical complaints? In England and later in Western Europe they had gone underground, subservient to, or overwhelmed by, a scientific milieu bristling with vigorous Newtonianism. [231] It is not easy to imagine that a wave of Newtonian-ism diverted the nerve doctors to such a preponderant degree despite theories such as Robinson's (note 231); nevertheless, the fact is that it did. Mental illness in our time has been construed so completely within the light of socioeconomic determinants, when it is not considered a genetic or hormonal disorder requiring chemical correction, that we find
154 it hard to imagine an approach to hysteria so monolithically iatromathematical as the Newtonian one of Cheyne's world. Yet for a generation at least, extending well beyond the second quarter of the eighteenth century, personal and social stress were discounted as uninteresting to the theories of hysteria, while the limelight fell on the application of the new "mathematical medicine" to existing cases. Indeed, inquiry into the etiology of hysteria as a valid form of exploration regressed: all cases were deemed to result from deviant physiologies of the nervous system that could be understood only by Newtonian or other mechanical analyses. As the century evolved, it became clear that lunacy, insanity, and madness represented the great fears—the grand peur —of these early Georgians, not the chronic hysteria that doctors like Mandeville and Cheyne claimed they could always cure now that it was somaticized and released from its previous diabolical moorings. Lunacy was feared as the great hangman because even the best of the Newtonian doctors had no clue to its genesis and cure. [232] In cases of hysteria there was at least hope for the patient. Its onset, as the doctors assuaged their patients, had not even been mi'lady's or his lordship's fault. Madness, on the other hand, represented an unequivocal failing in the popular imagination: a fatal lapse of the soul, a disjunction of mind and body; the stigma ne plus ultra ; in the brave new world of the Enlightenment it was a final, irrevocable state, usually ending in incarceration. It was not until late in the century that a new class of humane physicians—the Batties, Monros, Chiarugis, Crichtons, Pinels—demonstrated the same humanitarian attitude to madness that the Willises, Sydenhams, and Cheynes had for hysteria and other nervous disorders. [233] Medical science thus led early Enlightenment physicians to make a great play of the organic rootings of problematic disorders. But so too did bedside diplomacy. Confronted with indeterminate ailments, Cheyne, for example, pondered the problem of negotiating diagnoses acceptable to doctor and patient alike. In his remarkable autobiography and tantalizingly ambiguous self "case history," he claimed to empathize with these victims because he himself suffered from such disorders. [234] Physicians were commonly put on the spot by "nervous cases," he noted, because such conditions were easily dismissed by the "vulgar" as marks of "peevishness," or, when ladies were afflicted, of "fantasticalness" or "coquetry." [235] But his own somaticizing categories were pure music to his patients' ears, for they craved diagnoses that rendered their hysterical disorders real . The uninformed might suppose that hysteria, the spleen, and all that class of disorders were "nothing but the effect of Fancy, and a delusive Imagination": such a charge was ill-founded,
155 Cheyne assured them, because "the consequent Sufferings are without doubt real and unfeigned." [236] Even so, finding le mot juste required tact. "Often when I have been consulted in a Case," Cheyne mused, "and found it to be what is commonly call'd Nervous, I have been in the utmost Difficulty, when desir'd to define or name the Distemper." [237] His reason was the predictable desire not to offend, "for fear of affronting them or fixing a Reproach on a Family or Person." For, "if I said it was Vapours, hysterick or Hypochondriacal Disorders, they thought I call'd them Mad or Fantastical." What precisely was the sociology and linguistics of this annotated disgust? Did the patients disown their hysteria and the similar maladies because they reflected a perverse life-style? Some moral or religious failing? Or was it that somehow centuries of uterine stigma could not be wiped away so quickly, not even by the reforms of Willis and Sydenham? Throughout his prolific medical writings, commenting on the recoil of his patients in the face of a diagnosis of nerves or spleen, even when he gave the complaints a somatic basis, Cheyne recognized the degree to which he would have to educate them. Sir Richard Blackmore, another fashionable "nerve doctor," experienced similar difficulties, to the point of admitting that his hysterical patients were often viewed as freaks suffering from "an imaginary and fantastick sickness of the Brain." [238] The freaks thus became "Objects of Derision and Contempt," and naturally were "unwilling to own a Disease that will expose them to Dishonour and Reproach." While Enlightenment doctors ignored what we would call the sociology of hysteria, they did accept the lack of gender distinctions. Black-more was as mechanical and Newtonian a physician as one could find in the early eighteenth century, certainly as "mechanical" as Robinson, his colleague, but he lost no opportunity to show that hysterical symptoms in women were identical to those in hypochondriacal men. Ridiculing uterine theories of hysteria as so much anatomical jibberish, Blackmore concluded, as Cheyne did, that "the Symptoms that disturb the Operations of the Mind and Imagination in hysterick Women"—by which he meant "Fluctuations of Judgment, and swift Turns in forming and reversing of Opinions and Resolutions, Inconstancy, Timidity, Absence of Mind, want of self-determining power, Inattention, Incogitancy, Diffidence, Suspicion, and an Aptness to take well-meant Things amiss"—"are the same with those in Hypochondriacal Men." [239] The condition, he maintained, was common to both sexes, and the many names given to it—melancholy, spleen, vapors, hysteria, nerves, among dozens of others—all amounted to the same thing: a genuine malady with so-
156 matic pathology requiring a new understanding between doctor and patient. The sensitive physician demonstrated his expertise by ridiculing theories that these nervous complaints were the result of a diseased womb, and he recommended identical therapy for hysteric male and female patients. To gain acceptance for the term hysteric and its symptoms, these physicians proposed to yoke them with more common organic illnesses, investing them with labels and copper-bottomed organic connotations, for example, by speaking of "hysterick colic" or "hysterick gout." The tendency persisted for sixty or seventy years at least. Thus one woman Cheyne treated had a "hysterick lowness," another "frequent hysterick fits"; eventually the word hysteric was so flattened and became so neutral in its connotations as to mean almost nothing at all. The physician thereby spared himself the accusation of merely trading in words—which he was consciously doing anyway in view of the number of conditions that had come under the umbrella of "nervous"—and imputations of shamming also were avoided. Robinson, already mentioned, insisted that such nervous disorders were not "imaginary Whims and Fancies, but real Affections of the Mind, arising from the real, mechanical Affections of Matter and Motion." [240] His reason was that "neither the Fancy, nor Imagination, nor even Reason itself . . . can feign . . . a Disease that has no Foundation in Nature," a position that hurls down the gauntlet to Sigmund Freud. [241] Organic agencies, such as stone, tumor, fistula, and so on, thus had to initiate the chain of reactions, no matter what the conversion process entailed: "The affected Nerves . . . must strike the Imagination with the Sense of Pain, before the Mind can conceive the Idea of Pain in that Part." Here then was the all-important role of the nerves in sensation, as well as all human pleasure and pain. Cheyne, Blackmore, Robinson, and their contemporaries did not seek to deny the contribution of consciousness to the genesis of nervous disease nor reduce mind to body (Baglivi, so influential in southern Europe, went the other way, reducing all body to mind—a mind whose passions had been shaped exclusively by the state of the nerves). But their aspirations as "scientific" doctors treating "enlightened" patients (usually the elite of the population) disposed them to insist upon the priority of physical stimuli as part of their two-pronged strategy to win the confidence of their patients and the esteem of their medical peers. They relied on their academic-medical credentials to enforce this approach as being both objective and true. Credentials were, after all, one of the main factors in determining authority, popularity, and fashion-ability. [242] The most sought-after doctors in London and Edinburgh,
157 Oxford and Cambridge, as well as at the spas and in the major cities of other countries, had been decorated, so to speak, for their academic achievements. If this approach rendered the species man—in a world increasingly explained by new theories about the sciences of man—l'homme machine , its philosophical materialism also had beneficial effects. Thus the establishment of nervous conditions as valid medical diseases helped to secure the credit of medicine itself in an era of rampant quacks and proliferating mountebanks, when doubts about its validity as a science were at an all-time high. [243] More locally, within the realm of medical theory, this state of affairs amounted to a neurological approach to hysteria, which Veith has claimed was "sterile" in a "controversial century." [244] Oddly, it was the dominance of this neurological approach to hysteria and the triumph of the nerve doctors with their patients (physicians such as Cheyne) that led Veith to any Victorian or Darwinian notions about the evolution of medicine this disastrous conclusion. Countering her judgment, we might note (without adopting approach and returned to it the primacy of neurobiology. [245] This may prove nothing in itself but at least demonstrates the or medical conditions) that late twentieth-century medicine has vindicated the neurological longevity of the neurological approach. Furthermore, the Enlightenment nerve doctors were immensely sympathetic to their patients. Even in an age, such as ours, when hysteria has become so politically and academically charged, this fact within the history of hysteria cannot be lightly dismissed. In the case histories detailed in the final section of The English Malady , Cheyne drew attention to the real woes of sufferers burdened with misery, depression, taedium vitae , ennui, hysteria, and melancholy—not least, to his own nervous misery. [246] His patients, unlike Sydenham's, shared one common thread: they uniformly came from the ranks of the rich and the famous.
XII Hysteria thus came of age in the openness of the Enlightenment, more specifically in the sunlight of the Newtonian Enlightenment. Virtually no important doctor in the first half of the eighteenth century placed the root of hysteria in the uterus, and this fact tells us as much about the patients of the epoch as its mostly male physicians. The modernization proved anatomically liberating, while also helping to discredit the theory based on the misogynistic sexual stigma of the voracious womb. [247] The new emplacement of hysteria in the world of Cheyne and his "nerve doctor" colleagues moreover skirted vulgar reductionism. Its unmistak-
158 able language of the nerves—amounting to the heart of its linguistic discourse—pointed toward the mutual interplay of consciousness and body through the brain and the (often) still perplexing animal spirits as the primary nervous medium. [248] This new linguistic footing, which had been developing since the days of Willis and Mandeville, had profound cultural and gender-based implications: cultural because society itself was growing "nervous" in ways no one had anticipated, and gender-based as a consequence of this new nervous model of mankind mandating a weaker nervous constitution for women than men. The desexualization of hysteria was, of course, one part of a movement during the Enlightenment that demystified the entire body. [249] This process included the reproductive organs and the newly privileged mind over matter, as in Hume's examples and (especially under the weight of Linnaean taxonomy) the rule of species over gender. With demystification also came the shedding of much of the shame of hysteria. Its sufferers at mid-century were now seen as the victims of an interestingly delicate nervous system buckling under the pressures of civilization, typically the thorn in the flesh of elites moving in flashy, fast-lane society. [250] This was the essence of Cheyne's message in his best-selling book, The English Malady . But the cultural reasons for this "delicate nervous constitution" were to remain hidden and elusive for some time. Its personal effects, especially for patients, were described ad infinitem; the other effects, the larger images of those living an affluent life, could be seen in the new image the emerging Georgians held of themselves. At home, in the bedroom, this might entail paralysis, fear of the dark, as well as dread of the incubus and succubus, as evidenced by sleepwalking and amnesia. [251] (If the weekly and monthly magazines can be considered reliable, amnesia was more common than we might think.) These were the standard images of the somnambulant melancholic or insomniac hysteric in the caricatures of the time, as the accompanying plate demonstrates. More locally still, within the context of a now desexualized female hysteria, the suggestion was that coquetry verged on hysteria. [252] To the vulgar, as Pope had suggested in The Rape of the Lock , hysteria might signify nothing more than coquetry itself. But these examples, medical and literary, signified something more deeply ingrained in the world of the Georgians than has been thought: namely, the nervous self-fashioning of Augustan society. Stephen Greenblatt and others among the New Historicists have written about such self-fashioning in the Renaissance. [253] Yet the latter period of the Enlightenment is even more revealing of the great personal ten-
159
"Madwoman in Terror," ca. 1775, Mezzotint by W. Dickinson, after a painting by Robert Edge Pine. Engraving in the Wellcome Institute in London. The portrait illuminates the early female iconography of hysteria, in this instance a mad young woman of perhaps twenty or so whose wild hair is strung with straw, and whose eyeballs flash with terror and fear. A bandana is wrapped around her head; in fury she has torn the garment from her breast, which now lies bare. A feathery or animal garment clings loosely around her, and she is chained and roped, evidence that she poses a threat to others and is dangerous to herself. Window high up in the left corner makes clear that this is a cell for lunatics where she has been incarcerated.
160 sions it raised between the sexes in a milieu of increasing desexualization in which women continued to enjoy greater freedom and equality than they had before. The Augustan wits—the Addisons and Swifts, virtually all the Scriblerians—encouraged us to believe that logic, wit and intelligence—all part of the realm of the mind—were the sine qua nons of polite society then. But the tension between men and women revolved around more than matching wits, competing intellects, wit and wit-would-be, even in a "republic of letters" governed by an obsessive commitment to refinement and politeness, manners and etiquette. In addition, and most important, there was the unrelenting search for personal identity and self-fulfillment. This need is what the novel and drama of the period capture par excellence, and nothing reflects the mood of the epoch better than its great imaginative literature. [254] All these cults of sensibility—as I have called them elsewhere[255] —demanded rising standards of behavioral achievement and necessarily called attention to their opposites: the realms of pathology and abnormality. This is why the medicine of the day, especially its theory based on bodily signs and symptoms, the semiology and pathology of illness, cannot be dismissed as so much esoterica. [256] We have devoted two generations of study to the literary language of the Georgians; their ideas of body would well repay half that attention. The Lady Marys and Duchess of Portlands were hardly norms capable of emulation, yet in their bodily motions were codified the brilliant new urbanity of the age. Their sophisticated postures swirled round in rarefied atmospheres of courtliness and polite town society, abiding by a code of language and gesture in which the body was always required to be disciplined and drilled, coy and controlled; always mannered, as we see everywhere from the roles of dancing masters, acting teachers, tutors, governesses, and gymnasts of the age. [257] Even so, new inner sensibilities had to find expression through refined and often subtly veiled bodily codes: one's bearing around the tea table, in the salon, at the assembly and pumproom, in town and country, at home and abroad, paradoxically revealing yet concealing at the same time, in actions, gestures, and movements that spoke louder than words. [258] This was the source of tension now superimposed on the gender pressures spawned in the Restoration under the weight of urban sprawl and new sociopolitical arrangements. In England at least, the gender rearrangements of the Restoration were elevated to exponential highs in the ages of Anne and the Georges. Isn't this a principal reason why the drama from Etherege and Congreve to Gay and Goldsmith assumes its particular trajectory vis-ÿ-vis the sexes and gender arrangements?
161 Urban sprawl, new forms of consumer consumption, gender rearrangements, interpersonal tensions, crime and violence, class mobility, the transfer of money and goods into a process of unprecedented consumption: the phrases appear to describe our vexed world. This was, however, the eighteenth century, consuming itself in newly found nationalism and wealth and basking in its accompanying leisure time, especially in food and drink. [259] The lingua franca of such expression-repression-expression lay in the refined codes of nervousness: a new body language, ultraflexible, nuanced yet thoroughly poised within ambivalence. The essence of the code lay in these bodily gestures of recognition—whether blushing or weeping, fainting or swooning—which could act as sorting-out devices in times of doubt, certainly when love and marriage were involved. The comic drama from approximately 1730 onward demonstrates what heightened requirements the code placed on actors who tried to reflect it; our lack of recognition of the code itself results, in part, from the rarity with which any of these plays is now performed. Words were also tokens of recognition for the sensible and sensitive: sorting-out devices too. Under duress and at great expense, the language (of gestures and words) could be learned, but even among the rich and great, the smart and chic, it was acquired at the cost of great personal risk and self-doubt. Risk lay everywhere in the new social arrangements represented—almost mimetically—in the proliferating idioms of nervous sensibility. The sheer number of the idioms then available has prevented us from seeing deeply (and some might say darkly) into the risks involved. Upon occasion we have even denied that the idioms existed. Readers today may well wonder: What cults of nervous sensibility? And why nervous ?[260] Want of nerve , for example, betrayed a clear effeminacy, unacceptable in all classes from the highest rakes and fops to the lowest laborers. Paradoxically, want of nerves , exposed a rustic dullness, a latent tedium, a resulting boredom odious to the British for all sorts of reasons and feared among the highest ranking of both genders. Yet florid, volatile nervousness—in both men and women—betrayed excess and confusion: symptoms that could result in hysterical crisis. And hysteria, no matter what appellation it was given and no matter how culturally positive in the popular semiotics of that world, was a refuge of last resort. It was the cry of the person (usually female) unable to cope with the sharp cultural dislocations and social norms that had occurred in such a relatively short time. Within this taxonomy of disease, then, hysteria was the final limit beyond which no condition was more baffling, none capable of producing stranger somatic consequences. The semiotics of the nerves,
162 leading to understanding of hysteria, is therefore a way of knowing, and thereby decoding, the infirmity of excess, in much the same way that Foucault's hysteria is an understanding derived through comprehension of the female's inner spaces. And it was through this semiotics of the nerves that Foucault made the grandest claim of all: "It was in these diseases of the nerves and in those hysterias [of the period 1680-1780], which would soon provoke its irony, that psychiatry took its origin." [261] The quest was rather for a golden mean filtered by decorum—the same variegated decorum extolled by the age. But decorum had its snares too; it was easier to conceptualize or verbalize than to put into practice, as weepy heroine upon heroine lamented, usually to her detriment, in the fictions of the age. The snare was the retention of one's individuality within this bodily and verbal control. In practice, the act resembled treading on a tightrope, the walker forever balancing over the abyss. This was the beginning of a way of life—as Cheyne above all others in his age seems to have recognized—where the participants lived on the edge and in the fast lane. Richard Sennett, the American sociologist, has located the origins of modern individualism within this fast-paced eighteenth-century culture. [262] More precisely, we might counterargue, individualism was created out of nervous tension and ambivalence over the self: the accommodation between the hypervisible, narcissistic individual and a society that had craved it (i.e., the individualism), while at the same time demanding conformity to the civilizing process. This was the self-fashioning of the urbane Augustans, the codes on which the sexual politics of the new hysteria of the eighteenth century depended, and it would not have come about without the prior hypostases of the great nerve doctors—the Sydenhams and Willises, the Mandevilles and Cheynes—which resulted in the nervous codes that elevated sensibility to a new pinnacle. [263] Here then was a different route to the golden age of hysteria, a different dualism than the old Cartesian saw about mind and body. This Georgian self was less a divided Cartesian self—the now unisex woman or man riveted by conventional mind and body—than a creature part public, part private, often hidden behind a mask (sometimes a literal vizard) that curtailed self-expression as well as permitted it to flourish. Here, in this passionate sexual ambivalence, was the heart (one might as well claim the stomach and liver for the visceral effect it had on lives then) of the cults of nervous sensibility. It imbued Augustan and Georgian culture; eventually it made inroads in Holland, France, Italy, all Europe. And it left its mark on the best philosophers: the Voltaires and Hailers and Humes without whom an eighteenth-century "Enlight-
163 enment" is unthinkable. [264] It energized the Diderots and Sternes, the Casanovas and Rousseaus, as well as the fictional Clarissas and Evelinas, the Tristram Shandys and other noted "gentlemen"—and gentlewomen—of feeling. How then could nervous sensibility have been born without a medical agenda that demystified the body and a subsequent Newtonian revolution that concretized its best hypotheses?[265] In the intellectual domain, this nervous tension surfaced as a Sphinxian riddle of psyche-soma affinities, and spurred, in part, the literally hundreds of works on mind and body we have heard about for so long. [266] But in more familiar corners—at home and in church, in the theater and public garden, everywhere in polite society—it also appeared in subtle ways: in bodily motion, gait, affectation, gesture, even in the simple blush or tear, and in the most private thought that now could be read by another. Nervous tension was thus domesticized for the first time in modern history. Viewed from another perspective, it was also being mechanized for the first time, as manners themselves coagulated into an abstract code-language of mechanical philosophy: on the surface a loose application of Newtonian mechanics to the body's gait and gestures, but an application nevertheless. [267] The self-fashioning of nerves was thus significantly expanded: from mechanical philosophy it was medicalized, familiarized, domesticated, and eventually transformed into the métier of polite self-fashioning and even world-fashioning, in the sense that its code was eventually adopted as a universal sine qua non for those aspiring to succeed in the beau monde. The consequences for human sexuality and social intercourse were incalculable because passion and the imagination were implicated to such an extraordinary degree, as were the links between hysteria and the imagination. As soon as the imagination was aroused or disturbed, even in the most imperceptible way, somatic change was indicated. Of this sequence, the physicians had been certain from the mid-eighteenth century, if not earlier. "It appears almost incredible," Peter Shaw, His Majesty George II's Physician Extraordinary and the English champion of chemical applications in medicine, wrote in The Reflector: Representing Human Affairs, As They Are: and may be improved (1750, number 228), "what great Effects the Imagination has upon Patients." Later on the point was reiterated by William Heberden, another noted clinician in the tradition of Boerhaave whose life spanned nearly the whole of the eighteenth century and of whom Samuel Johnson said that he was "ultimus Romanorum , the last of our great physicians." Heberden was as much a product of this "nerve culture" as anyone else. After years of clinical experience he found that the indication of hysteria usually be-
164 gan "with some uneasiness of the stomach or bowels." [268] He listed the symptoms: "Hypochondriac men and hysteric women suffer accidities, wind, choking, leading to giddiness, confusion, stupidity, inattention, forgetfulness, and irresolution." The symptoms were diverse, perhaps too diverse; a powerful and wild imagination lay at their base. But when Heberden pronounced on the root cause of hysteria, he could only say that the condition was fundamentally nervous , that is, fundamentally real or nonimaginary; in his words, "for I doubt not their arising from as real a cause as any other distemper." [269] Such nervous self-fashioning lay at the base of the social cults and linguistic idioms of Enlightenment sensibility, and were as influential as any other force in generating the theory of hysteria that we see reflected in the writings of the nerve doctors and their students. [270] The process would not be reversible. The doctors did not impose their vision of society on their culture; it was life with its tensions that drew even the doctors into its orbit and caused their theories utterly to reflect this new society. Just as important, nerves in the new culture precluded moral blame, because there could be no censure in a social, almost Zeitgeist , disease. Enlightenment swoons and their subsequent numbness in both women and men came from the act of buckling under the pressures of civilization, especially for the elite who moved within the fast lane of society. The new violence and the threat of its omnipresence enhanced the panic, as John Gay and the early novelists observed. Amelia's strange disorder is described by Captain Booth in Fielding's Amelia in terms that make clear the price she has paid for living in the new fast lane. Booth knows not what to call her "disease," but eventually lands on "the hysterics," which seems as accurate to him as any other appellations. Fielding's case history is not very different from the one Jane Austen will narrate with laser precision in Sense and Sensibility ; its Marianne Dashwood, with her swoons and sighs, is another "hysteric" whose case has not yet been discussed in the detail it deserves, meticulously recounted as it is in that novel from the first onset of fits and starts to the patient's near demise and eventual recovery. In all these cases, real and imagined, panic stemmed not merely from male violence but from a new type of female as well, and society's fears were substantiated almost daily by the culprits and vagabonds apprehended and brought into the courts of law. [271] Life in the fast lane then, at least for the new urban rich, entailed high living, conspicuous consumption, reckless spending, more travel than previously (especially to the developing seaside resorts), late nights, and new gender arrangements, all combining to set off the beau monde from the other ranks of society. Neurological chaos in the body merely
165 mirrored the social disorder of the time. Though the comparison may not have struck the average aristocrat, these forms of disorder never stood apart, nor did the hysteria of its women and men. But did a delicate nervous organization predispose one to the buckling under, or did the buckling under alter the body's nervous organization? The question is hard but cannot be overlooked or swept away. The approach to the answers taken by the nerve doctors was not, as Veith has suggested, sterile; they recognized the psychogenic burdens of their patients and the role played by mind and imagination, even though the doctors grounded virtually all their diseases in nervous structures. This monolithic attribution remains the difficult aspect of their "hysteria diagnosis" for us. Even so, the doctors often failed (almost always) to see the sociological roots of numbness and its radical enmeshment in language and its representations. [272] This is a revelatory indication of the degree to which the new nervous culture of the eighteenth century had made inroads into the philosophy, psychology, and medicine of the time. In brief, Cheyne and his colleagues scientized hysteria by radically neuralizing it. They did not invalidate consciousness in human life or reduce mind to body. Theirs was rather a crusade against duplicitous disease, campaigned for in the sunny light and quasi-blind optimism of high Enlightenment science. Not even hysteria could hide from them or prove elusive. If the Enlightenment nerve doctors came back today—heyne recidivus —they could not agree with our contemporary Dr. Alan Krohn about hysteria as "the elusive neurosis." To them, hysteria was fundamentally knowable: a neurology of solids, an iatromathematics of forces, a neural web of nerves, spirits, and fibers.
XIII By the mid-eighteenth century, nerves seem to have run wild; the resulting hysteria was chronic among all those living in the fast lane and endemic, for different reasons, among the nation at large. Some women knew they had it, others did not: the inconsistency was less a defect of medical theory than the extreme fluidity of the diagnosis. For hysteria was not poured into a rigid mold by either the doctors or their patients. The diagnosis was usually made to fit the sufferer: a nonreductive expression of disorder. Linguistically speaking, hysteria profited from a new and very malleable vocabulary of the nerves as flexible and adjustable to the particular situation as the patient's symptoms themselves. In formal writing, by mid-century this vocabulary had been expressed
166 in new nervous discourses: of poets, novelists, critics, didactic writers, in narratives of all sorts. An aesthetic of "nervous style" began to emerge, endorsed by male writers, found suspect by female, which was unabashed in calling itself, after its patriarchal affinities, masculine, strong, taut—anything but feminine or epicene. And if style was then genderized to this degree, why should medicine not have been, especially the maladia summa hysteria—the genderized condition par excellence? Cheyne, above all, exploited this protean nervous idiom and procrustean vocabulary in his best-seller The English Malady , the real reason for its instant success. So too did his followers and disciples. One of these, representative of these disciples in several ways, was Dr. James Makittrick Adair. Like Cheyne and William Cullen, Adair was also a Scot who had been deeply influenced by the Scottish Enlightenment. But Adair was also a Cheyne follower who saw what benefits could accrue to his career by worshiping, so to speak, within the "Temple of the English Malady." Adair had been taught in Edinburgh by Robert Whytt, the "philosophic doctor" who related "nervous sensibility" to every aspect of modern life, and he never forgot the great medical precept of his teacher, which resounded in the lecture theaters Adair attended: "The shapes of Proteus , or the colours of the chameleon , are not more numerous and inconstant, than the variations of the hypochondriac and hysteric diseases." But it was Cheyne's thought that lay in the deepest regions of Adair's imagination throughout his professional medical career. [273] Always acknowledging his teacher's famous essay of 176465 on nervous diseases (Whytt's Observations on the nature, causes, and cure of those disorders which have been commonly called nervous, hypochondriac, or hysteric, to which are prefixed some remarks on the sympathy of the nerves ), Adair served up explanations his readers wanted to hear about hysteria. He also provided them with a natural history of nerves in the linguistic and cultural domain:
Upwards of thirty years ago, a treatise on nervous diseases was published by my quondam learned and ingenious preceptor DR. WHYTT, professor of physick, at Edinburgh. Before the publication of this book, people of fashion had not the least idea that they had nerves; but a fashionable apothecary of my acquaintance, having cast his eye over the book, and having been often puzzled by the enquiries of his patients concerning the nature and causes of their complaints, derived from thence a hint, by which he readily cut the gordian knot—"Madam, you are nervous"; the solution was quite satisfactory, the term [nervous] became quite fashionable, and spleen, vapours, and hyp, were forgotten.[274]
167 It is an extraordinary explanation, showing the continuity of eighteenth-century nervous self-fashioning. It not only casts light on the aftermath of Cheyne's career following his death in 1743 and on Whytt's much-discussed treatise of 1764 but resonates with class filiation. Adair saw how shrewd his medical brethren had been to classify as "nervous" those behavioral disorders free of determinate organic lesions: that is, vapors, spleen, hysteria, hypochondria, melancholy, and the dozens of subcategories spawned from these. Adair also recognized that naming and labeling played a large role in the hysteric's conceptualization. The Gordian knot was unraveled when words were deciphered. Likewise, in the previous generation, when Dr. Nicholas Robinson published a "Newtonian dissertation on hysteria" and wrote that every maiden had become so nervous that coining new words to describe its minute grades was necessary, he knew whereof he spoke. He himself compiled a whole vocabulary of remarkable neologisms that had been coined in his time: hypp, hyppos, hyppocons, markambles, moonpalls, strong fiacs, hockogrogles—all jocularly describing hysteria's grades of severity. Still, it was the great male poet, the dwarf of Twickenham, who used the vernacular of nerves to describe the living consequences of male hysteria. As he lay dying at fifty-five, Alexander Pope claimed to those gathered around him that he "had never been hyppish in his life." There was no need to gloss the phrase. Presumably all knew what he meant. The very sturdy and nonhysterical Lady Mary, already mentioned, may have considered the "little poet of Twickenham" to be, like his fierce enemy Lord Hervey, a member of the "third sex." But even Lady Mary would have had to admit that Pope was essentially "male." How came it to pass that Pope, whose "long Disease, my Life" had paved the way for him to become more intimate with medical literature than he would otherwise have been, assumed male hysteria to be in the normal course of affairs?[275] One can demonstrate, as I have tried, that as far back as the Elizabethan era, and probably earlier, males were assumed to be natural targets for "the mother," this despite their obviously not having the requisite anatomical apparatus. The progress of medical theory in the aftermath of Sydenham and outside the Cheyne-Adair circle also needs to be consulted if we are to understand how male hysteria shaped up in the eighteenth century. For the fact is that virtually every serious medical author who wrote about hysteria after Sydenham's death in 1689, even the skeptics among the medical fraternity, included men among their lists of those naturally afflicted: in England, for example, these authors included some of the
168 best-known doctors of the age, including Nathaniel Highmore, Richard Blackmore, Bernard Mandeville (the physician-satirist), John Purcell, and Nicholas Robinson; in Scotland, Thomas Cupples, Lawrence Fraser, William Turner, and nearly the whole of the Edinburgh medical school; in Holland, the "Eurocentric" Boerhaave and his far-flung students, including Jan Esgers, C. van de Haghen, Lucas van Stevenick, as can be gleaned from dozens of medical dissertations written on hysteria at Leiden and Utrecht; in Denmark, Johannes Tode; in Switzerland and Bohemia, a certain number; in France, Jean Astruc, Nicholas Dellehe, J. C. Dupont, Pierre Pomme, and even the so-called father of psychiatry and transformer of therapies for the suffering insane, the great Philippe Pinel; [276] in Germany, Gustavus Becker, C. G. Burghart, Georg Clasius, C. G. Gross, J. F. Isenflamm, Johann Christoph Stock; in Italy, A. Fracassini, P. Virard, G. V. Zeviani. These names suggest little if anything now, but in their time these figures constituted something of an international gallery of medical stars. [277] The treatment of males among the hysterically afflicted, and especially males of the upper classes, was a veritable industry in the eighteenth century. Whether the doctors were persuaded that males were clinically afflicted in the same way as women (sans "the mother" and the rest of the female reproductive apparatus) we may never know, and Mark Micale's biographical researches do not extend far enough back to offer a clue. [278] Yet the medical literature from Sydenham forward speaks for itself and is unequivocal on the matter. Moreover, there seems to have been no major opponent to Sydenham's view about male hysteria to challenge his theory in the long course of the eighteenth century, neither in England nor elsewhere. Once the notion of male hysteria took root as a clinically observed phenomenon, which it had not done a hundred years earlier, its existence appears to have been guaranteed. The huge annals of eighteenth-century medical literature corroborate this position, and examples citing Sydenham as their fount are replete in the record. It is more difficult, however, to discover examples roughly contemporary with Sydenham, perhaps suggesting to what degree the notion of male hysteria had been absorbed into the medical imagination. [279] For example, consider the curious but still far from clear relationship between Thomas Guidott and John Maplet. Both were English physicians practicing in the Restoration and early eighteenth century in and around Bath. Guidott owed his entire Bath practice to Maplet, who helped him acquire it. After Guidott lost his practice in Bath through imprudence, libel, and squandering, he moved to London, remained loyal to his former patron, and continued to diagnose and treat his
169 (Maplet's) ailments until the end of his life. [280] This would seem to be a case of professional patronage larded over with friendship, but it also had its profound medical side useful in these explorations of male hysteria. What survives are Guidott's accounts (not Maplet's), and considering Guidott's colorful character, his record may not be entirely reliable or complete. But it does provide enough information to comprehend what it was about Maplet's "male hysteria" that so attracted and excited Guidott, who wrote many years after Maplet's death:
[He] was of a tender, brittle Constitution, inclining to Feminine, clear Skin'd, and of a very fair Complexion, and though very temperate. . . yet inclinable to Hysterical Distempers, chiefly Gouts and Catarrhs, which would oftentimes confuse his Body, but not his Mind [mind and body construed as separate entities], which was then more at Liberty to expatiate, and give some Invitation to his Poetick Genius . . . to descant on the Tormentor, and transmit his Sorrow into a Scene of Mirth.[281]
Multiple aspects of this analysis give us pause: Guidott's strange linking of hysteria to gout and catarrh and in other writings his subclassification of "hysterical gout"; his post-Cartesian version of the mind/body split; the assumption that creativity and hysteria ("Poetick Genius" and "the Tormentor") are cousins; above all, the presumption that in educated and intelligent males like Maplet "hysterical mania" is merely the outward sign (again a semiotics of the malady) of an almost "Feminine" nervous "Constitution." Here, in nervous anatomy and "Tender Constitution," lies the origin of temperamental sensitivity in men. Later, Guidott discusses Maplet's delicate nerves, metaphorically isolating them as "suspects" in this quasi-criminal hysterical disorder. [282] "Suspects" in both the positive and pejorative dimension: positive in that they virtually breed sensitivity and creativity; negative in their pathological predisposing toward the condition. All this is what we would expect after unraveling and decoding the complex medical theory of the time. Much less expected is Guidott's leap to friendship. He claims to be "attracted" to the nervous, brittle, delicate, tender, frail, white-skinned Maplet—not attracted sexually, certainly, nor primarily as a consequence of Maplet's professional generosity, although one would presumably be interested in the arm and leg of patronage, but attracted intellectually and humanly. Guidott's life is not sufficiently understood to hazard any guesses about his sexuality, but his case history of Maplet suggests the existence by approximately 1700 of a new Sydenhamian paradigm about male hysteria that yokes anatomy, physiology, and psychology to culture, gender formation, and society. [283]
170 What better evidence could there be of gender basis in this account? Maplet is the "tender, nervous, brittle" male who has become afflicted and requires diagnosing and treating by Guidott; he is also the soft, creative, nervous male predisposed to hysteria and friendship. Guidott's language does not yet reveal the developed jungle of nerves and fibers that will flourish in Cheyne and Richardson, and later even more metaphorically and densely in the fictions of Sterne and the Scottish doctors. But it remains one of the earliest and most interesting accounts of male hysteria in English, certainly a prototype of sorts. Guidott himself was somewhat "poetically inspired," though he is not known to have been "hysterical." He had composed poetry at Oxford and wrote poetic satire when he quarreled with the London physicians. [284] And he had matured in a world overrun with male enthusiasts of all sorts—the broad spectrum that permeates the great satires of the age, such as Swift's Tale of a Tub . Guidott's London, like that of Sydenham, his contemporary, displayed ranting enthusiasts on every corner, often said by the "doctors" to be male hysterics let loose on the Town. Though their numbers increased and decreased according to the luck of the time, decade by decade, their presence was commonly explained, as Swift had suggested in the Tale , in the language of the vapors and spleen, nerves and fibers, all their raving and madness attributable to "hysterical affections." This was a motif—the connection between religious inspiration and male hysteria—that would extend throughout the course of the eighteenth century. As newly inspired sects became more visible, so too the varieties of their male hysterics, and in almost every case where documentation survives there lingers the implication of a "hysterical affection" of one or another variety. If epilepsies and convulsions were the signs of secular distraction, they also afflicted men crazed in groups by their religious enthusiasm; Philippe Hecquet, a French physician of the ancien régime, claimed in Le naturalisme des convulsions dans les maladies de l'épidémie convulsionnaire (1733) that convulsions among the mob were anatomically experienced no differently than among individuals. [285] Charles Revillon, another French physician, supported this view in Recherches sur la cause des affections hypochrondriaques (Paris: Hérissant, 1786), explaining that sudden and unexpected catastrophic events trigger hysteria in the "mob's body" exactly as they do in the individual body. Historically there were—to browse through the century cursorily—the strolling French prophets, or Camizards, in the first two decades; the new alchemists and preachers of the mid-century; the melancholic visionary poets (the Grays, Smarts, Collinses, Cowpers), all of whom suffered some type of religious melancholy and were either incarcerated
171 in their colleges, like Gray, or in madhouses); to say nothing of the non-religious sects and the spate ranging from Hogarth's comic varieties to Dame Edith Sitwell's gallery of rogues. [286] Male hysteria coursed down through the century. Whole books could be written about it, deriving much of their information from the pages of popular reviews like the Gentleman's Magazine , one of the most widely circulated outlets of the Enlightenment, British or non-British. For example, the November issue of 1734 recounts a story embellished by the twist of cross dressing. Both the husband and wife have been "hysterically affected," she more acutely than he. More familiar than she with the medical profession, the husband persuades a friend to impersonate a physician, who treats his hysterical wife by prescribing "the simple life." The wife is duped, follows her therapy, and recovers. More common cases reveal afflicted males, prescribed to by bona fide doctors, who do not recover quickly. By 1775, Hugh Farmer, the dissenting minister who was the friend of Dr. Philip Doddridge and enemy of Joseph Priestley, persuaded his publishers that there was sufficient interest in contemporary male hysteria to resuscitate it in the oldest extant texts. Farmer did so himself in An Essay on the [male] Demoniacs of the New Testament , a work aimed to show how ancient the lineage of inspiration was. [287] Farmer, like Christopher Smart and William Cowper, had himself been afflicted with a variety of religious melancholies that left him as debilitated as many chronic male hysterics. As a dissenting minister with a parish to look after and duties to attend to, Farmer was utterly uninterested in male license and liberty and, like Smart and Cowper, had maintained a queasy fear of women, especially older, sisterly women who forever rescued him and looked after him. The mindsets of all these figures lie far from the medical theory I discussed earlier, but not so far as to escape its effects. As I continue to suggest here, culture is a large mosaic whose individual pieces do fit together if the historian can only relate them. The English lyric poets, those of the ilk of William Collins and Smart, who were diagnosed male hysterics and melancholics, glimpsed the solipsism of their condition. All they discovered was an omniscient God whose powers of insight they could worship and emulate through their own visionary capabilities. [288] More broadly though, the greater the resistance to hysteria among men (in that century there was a surfeit of resistance), the more it revealed about their male sexuality in an era growing increasingly patriarchal and fastidious about its sexual mores. All these conditions and individual cases, far-flung and disparate as they are, some more anecdotal than others, presaged the scenario for male hysterics in the nineteenth century.
172 Still, the preeminent matter of gender in cases more or less hysterical hardly vanished in the second half of the eighteenth century. Granting that both sexes could become afflicted, perhaps in equal degree, profound questions about hysteria's anatomical prefigurements lingered. This is not surprising after centuries in which the feminine gender base had been strengthened by men exorcising hysterical women in need of help. No one to my knowledge has ever attempted to compile a list of eighteenth-century cases by gender. [289] If it were tried, even on a limited basis, it would be evident that women were said to have become afflicted in far greater numbers. The trend is even reflected in the lamp of imaginative literature. One and only one clearly delineated hysterical figure, for example, appears in Fielding's mock-epic novel Tom Jones : the young Nancy Miller, steeped in love sickness. Given the care with which Fielding is known to have constructed his symmetrical work of heroic proportions, the fact is not insignificant and can be demonstrated with similar results for other writers of the epoch. In Tobias Smollett there are many more: even the male hysteric Launcelot Greaves, a modern British version of Don Quixote, whose "nerves" become damaged from his circulation in a crime-ridden, dangerous environment. Smollett was morbidly fascinated with crime in an almost sociological way. He eventually concluded that it had perpetrated the most heinous attack against the society of his day and formed the bedrock on which chronic diseases like hysteria flourished. [290] Provided that medical and nonmedical discourses are gazed at in tandem, and without undue concern for validity in evidence, it becomes apparent that for most of the eighteenth century the nerves, not gender, were the burning issue for hysteria; that is, the nerves in their variegated anatomical, physiological, vivisectional, linguistic, ideologic, and even political senses. In the first published treatise on nymphomania, M. D. T. Bienville's curious work of 1775, there is no distinction whatever in regard to gender, no sense that the irritation or excitation of the genital area specifically is the cause of his new nymphomania. [291] "Nymphomania," Bienville wrote, arises from "diseased imagination" taking root on the nervous stock, and it could afflict men as readily as women. Perhaps this occurred, in Bienville's view, because both genders had the potential for a "diseased imagination." It is an odd position to maintain, considering that his mind was formed in a world in which the close connection between sex and hysteria was taken for granted. Cases of "erotomania," a fierce and heightened form of erotic melancholy caused by love sickness, were regularly chronicled in the newspapers of the day. Erasmus Darwin, the poet and scientist, had mentioned one severe case
173 (James Hackman's shooting of Martha Ray), but others were also written up. In all of them, the nervous system had flared out of control as the result of passion. The nerves were the zone Bienville was trying to penetrate in his discourse; the healthy or unhealthy state of the nerves, as well as the anatomic condition of the genital area (morbid, tonic, flaccid, put to use or not, aroused), the determinants. Bienville, a French mechanist about whom surprisingly little is known, ultimately wanted little truck with an underlying mental malady. Turn the page, so to speak, to more literary annals, and hysteria blends in with other conditions from which its commentators barely differentiate it. Hysteria, hypochondria, melancholy—all are nervous maladies of one grade or another. Sterne's eternally melancholic Tristram may have been, in just this sense, the greatest and most self-reflective male hypochondriac of all the fictional characters of the century. He calls his confessional book "a treatise writ against the spleen," and knows, as his opening paragraph makes plain, that his animal spirits and nervous fibers have been irrevocably mutilated, rendering him a type of male hysteric. This is why he (like so many male patients in the next century) must be "taken out of himself" as it were, through his own hobbies and the hobbyhorses of others. The nervous "tracks" on which "his little gentlemen" traveled during conception have been damaged. But a visit from Tristram to the great "nerve doctors"—the Cheynes, Cullens, and Adairs—would have proved futile: he might as well have sent his manuscript, which is as good a case history of a "male hysteric" as has ever been compiled. Yet Tristram himself might have been shocked to have been tendered this diagnosis. What Sydenham and his medical followers opined about male hysteria and gender at the end of the seventeenth century took decades to filter down to the ordinary person in any sophisticated way. Popular culture was indeed permeated with notions of hysteria, as I have been suggesting throughout this chapter, but Sydenham's views required decades to filter through to other doctors, let alone the lay public. A generation after Laurence Sterne's death in 1768, Edward Jenner, the Gloucestershire doctor and medical researcher into smallpox, was astonished to find himself a member of this filtered class. "In a female," Jenner wrote, "I should call it Hysterical—but in myself I know not what to call it, but by the old sweeping term nervous." [292] The difference was extraordinarily significant for him. One of hysteria's other paradoxes was that it was alleged both to afflict males and to safeguard them against it. This was a curious double take seemingly reserved for hysteria, although traces of the incongruity are also found in the theory of gout and consumption at the time. The dou-
174 ble bind rendered men safe and vulnerable at the same time. How are these theoretical "doubles" explained? Under what framing? If run through the gamut of possibilities, it is seen that gender and patriarchy, power and marginalization alone can explain the double status of hysteria. The nerves have merely been the convenient pawns of a grander landlord. For the professional medical world of the eighteenth century was still preponderantly—as it would be in the nineteenth century and much of our own—a male-centered universe. [293] William Hogarth's male doctors, "consulting" as they often do in his prints, could not see to what degree they were monolithically set against the few females who appeared in them and were an indirect cause of the very hysterical suffering they claimed they sought to relieve. It is hardly surprising then that the theory of male hysteria between Sydenham and the Victorians revealed what it genuinely was by describing its Other, its Counter, its Double: female hysteria. Hordes of male doctors, exclusively generating medical theory, now—for the first time—institutionalized female hysteria by claiming that men could be afflicted by it but in actuality rarely were. Whether in Scotland or the West Country, in France or Germany, the results of these gender debates were more or less identical, often derived from one another. [294] The task then was to demonstrate precisely why women were more prone. But as the uterine debility hypothesis had been overthrown, the most persuasive mode was to argue from so-called incontrovertible universals: women's innate propensity to nervousness; their domestic situation in a private world conducive to hysterical excess; their insatiable sexual voracity granted from time immemorial—these as Godgiven, inevitable, unchangeable conditions. But all the while it was acknowledged that men were also prone, and proving theoretical consistency by occasionally diagnosing male hysterias and documenting them in the published literature. Today, we understand the complexity of Enlightenment hysteria only if we are willing to view its paradoxes, its double binds, within large social and cultural contexts, and only if we are capable of conceding that medical theory then was consistent and internally logical so long as doctors were not asked to be held accountable for the cultural conditions in which hysteria flourished. The state of laboratory verifiability and clinical observation of patients in a condition such as hysteria was still small compared to other maladies. A hundred years later, in Freud's Vienna, there would still be debate about the objectivity of the clinician's gaze. What counted for more than objective gaze in the world of Whytt, Cullen, and Jenner was a view of "woman" that naturally—almost preternaturally—seemed to lend itself to the hysteria diagnosis.
175
XIV It was not accidental then that treatises on madness began to appear in numbers at the historical moment that resistance set in to the monolithic theories of "the nerve doctors," especially their hysteria diagnosis. This overlap is a complex phenomenon involving theory and practice, as well as social conditions in Western European societies that were becoming more repressive of their poor classes after approximately the mid-eighteenth century. Given the degree to which nerves had earlier been held to account for everything pathological in body and mind the gamut from affections and passions to the wildest imagination—some doctors began to doubt whether this could be so. I refer, of course, to the well-known treatises by the Batties and Monros, the Perfects and Pargeters in the second half of the eighteenth century, who in varying degrees felt ambivalent about nervous diagnosis in relation to perceived lunacy and derangement; in brief, the company discussed by the late Richard Hunter and Ida Macalpine. [295] Their collective position permits us to understand how the rival theory of madness developed in relation to the hysteria diagnosis, as well as to comprehend to what degree the hysteria diagnosis had become a barometer of social conditions lorded over by notions of gender—surely a mental zone embracing more than a medical category. The spaces of confinement—madhouses public and private, the clinic, the hospital, prisons of one type or another, attics and closets—are as revealing here as the theory of madness itself. The line between so-called hysterics, female and male, and other types of lunatics was not finely drawn. Incarceration could be ordered for one type as easily as another. There were no specially ordained "hysteria hospitals" (although there were dedicated wards by late century such as the one in Edinburgh). Treatment and therapy for incarcerated hysterics were usually identical to that for other derangements. Furthermore, if the late eighteenth-century madhouse had not yet become the nineteenth-century nervous clinic, there were nevertheless structural similarities in both their methods of diagnosis and applied therapies. But there was one other difference between the diagnoses of madness and hysteria. Unlike the broad base of Enlightenment nervous conditions, madness was not then (in the age of William Battie and A. Monro) a stigma-free organic illness. It was closer to our polluted view of those afflicted with AIDS. [296] Stigma was nothing new. It had attached to diagnoses of derangement for centuries. What differentiated it now, in the medical realm of the late eighteenth century, was its new gender lines, often drawn with rank and social class as firmly in mind as any gender base. As Baglivi had pro-
176 nounced at the turn of the century: "Women are more subject than Men to Diseases arising from the Passions of the Mind." [297] He and other physicians continued to stress that madness especially afflicted "poor women." Not so hysteria, a female condition said to afflict as many of the rich as the poor and perhaps more. [298] Nor was madness gendered along the lines it would later be in the nineteenth century, in the decadent world of such subsequent "nerve doctors" as Charcot and Weir Mitchell, nor believed to imitate other diseases (Whytt's "Proteus and the chameleon"). Thus hysteria and madness drifted sharply apart in this dimension: the former deemed by medical professionals to be stigma-free, the latter tarnished by it. But in most other considerations the margins between madness and hysteria were irreparably blurred, and there was as much disagreement as agreement about which of the two diseases was more chronic and lingering. Nor was there much lucidity about, or significant differentiation of, somatic pain in relation to the two conditions. The patients' pain was often thought to be identical in both conditions, affirmed in either state to have been explicitly lodged in an organic site. So in these often contradictory conceptualizations of the late eighteenth century we are actually not far from the radical positivism of late nineteenth-century science and medicine. One other contrast between lunacy and hysteria cannot be omitted before making the central point about their difference. This is the lunacy that did not announce its pathology through the explicitly acceptable language of organic nervous obstruction but which was said to be something else: hysteria masquerading as lunacy . Hysteria could present both ways—this was one of the features of its protean ability to imitate. And it may have been one reason the proprietors of Bedlam could open its doors to the public "to view the lunatics for a penny," without considering that they were inflicting pain upon patients. This "lunacy that was something else" leads us, moreover, to interrogate the rise of madness in the clear light of the hysteria diagnosis. Fortunately, the point is not so simple as a somatic (bodily) versus psychogenic (mental) hysteria. [299] A broad gaze over the eighteenth century buttressd by a cursory bibliographical column makes the point loud and plain. When Thomas Tryon, the neo-Pythagorean guru of health and diet, commented on lunacy in his 1703 Discourse of the Causes of Madness , he was persuaded that madness was still supernaturally induced through possession of devils and spirits, and he harbored no sense of a medicalized, let alone secularized, condition or category. Only one generation later Charles Perry, a licensed physician who traveled widely in the Orient and compiled massive treatises on the Levant, published a treatise On the Causes and
177 Nature of Madness (1723) claiming that lunacy was a mechanical defect in the nervous constitution, a position echoed for years to come in other works of "mechanical medicine," as in Giovanni Battista Morgagni's Seats and Causes of Diseases . . . (English version 1769). A few years later Andrew Wilson tried to refine the classification of all these conditions, but shortly thereafter William Rowley, another English physician who specialized in "female diseases," jumbled the categories together again in A treatise on female, nervous, hysterical, hypochondriacal, bilious, convulsive disease; apoplexy & palsy with thoughts on madness & suicide, etc . [300] Rowley's classifications were weak, to say the least. Had he been a student at Edinburgh and listened to the lectures of Cullen and the other professors stressing the importance of classification in medicine, he would not have written as he did, but Rowley was a practitioner, not a theorist, and the intricacies of the female constitution and its maladies were beyond him. [301] Not a year went by, it seems, without the appearance of some medical treatise aiming to distinguish among these conditions. Over these decades writing continued about the dangers of religious melancholy leading to madness and hysteria, as in John Langhorne's Letters on Religious Retirement, Melancholy, and Enthusiasm (London, 1762) or in the real-life cases of poets such as Christopher Smart, William Cowper, and (some would later say) William Blake. Wordsworth performed something of a poetic amalgam of these traditions linking religion and hysteria, especially in the strange medical case of Susan Gale, the lonely mother whose intense passion he describes in "The Idiot Boy." Susan's "solitary imagination" lies at the base of her undiagnosed medical condition, just as the medicalized imagination did for so many hysterics examined by Wordsworth's contemporary physicians. Alan Bewell discussed the figure of Susan and "maternal passion" and claimed that the theory of hysteria plays a central role in the poetry of this great Romantic poet. "As a major figure in Wordsworth's mythology of origins," he wrote, "the lonely witch/hysteric provided him with a figural and empirical means for imagining in palpable terms the genesis of language and culture." [302] These are large claims, but substantiated, I think, by the sweeping role the theory of hysteria played in the European Enlightenment. But why, one asks, was there a need for a madness diagnosis in the first place if hysteria had been so broad and protean a category since the time of Sydenham that it could embrace most "mad" symptoms? This is the question that must be put if we are to make entry to the world of the nineteenth century, the milieu expounded in chapter 3, by Roy Porter. To restate the matter, where did hysteria and its rival, madness,
178 stand in relation to gender and the mind/body dilemma (considered separately and in tandem) if there was need for a new condition called madness in the eighteenth century? There is no simple answer to this all-important question, in itself bound to provoke debate. On one hand, it may be argued that madness was not new in the eighteenth century, and yet even a cursory glance at its discursive representations from 1600 forward shows a sudden outburst of writing in this century. More crucially on the question about gender and the mind/body split, there is no clear-cut division in the late eighteenth century, as I have been stressing, between madness and the hysteria diagnosis. On the other hand—and the adversative is as weighty—the doctors and even their patients clearly have something in mind when they point to the condition of the one or the other. And many readers today will be struck by the fact that Battie's important discussion of madness never refers to hysteria or ever uses the word. No one can read these treatises on madness—by Battie, Monro, and their cohorts—and come away believing one has read a treatise on hysteria. At the same time, and equally paradoxically, the patients' symptoms often presented identically and were described in the same language for both conditions. These are the inconsistencies that must be faced if we are to move into the world of nineteenth-century "nervousness." When the artist Joseph Farington recorded that his friend, Hone, had "been in a very nervous Hysterical state, the effect of anxiety of mind," [303] did he mean hysteria or madness? Across the channel, when French physician Pierre Pomme, who interested himself in few diseases more than nervous ones, published his treatise on "Hysterical Affections in Both Sexes," [304] did he mean hysteria or insanity or both? Pomme's boundaries are not drawn. Likewise for other medical writers of varying ranks and abilities. William Falconer's work on hysteria and madness was geared to strengthen the psychogenic bases of derangement by showing how fierce is "the Influence of the Passions upon Disorders of the Body." [305] So too John Haygarth's treatise Of the Imagination, as a Cause and as a Cure of Disorders of the Body , written only a few years later. [306] But at the same time Benjamin Faulkner, who owned and operated a private madhouse in Little Chelsea in London, complained that both hysteria and madness had "given birth to endless conjecture and perpetual error." [307] He was doubtless right, and John Haslam, for two decades an official at Bethlehem, who wrote from long experience in the prison-houses of madness, found himself writing treatises on insanity without invoking hysteria. [308] Paradoxically, it is as if the two conditions were
179 identical, yet oceans apart. The lists could be extended many times. Yet the matter is not lists but definition, categories, classification, and—from the patient's point of view—appropriate therapies for each condition. What then was madness if it was taxonomically bred in the heyday of the hysteria diagnosis? From what need was it sprung? And what had the thousand-year-old hysteria ultimately become if it required the birth of a new malady—madness—to assuage its philosophical and practical defects? Foucault provided no answers in his classic works on madness, and the fault may not be his. Or is it that the late eighteenth-century doctors generating this welter of theory really believed they had discovered some intrinsic difference now lost to time? Can the crux be the massive amount— perhaps too massive—f extant evidence? Anyone can study these early treatises on madness—from Battie to Haslam; in France, from Pomme to Pinel—and explicate them page by page. It is more difficult to pronounce authoritatively on the silences of these discourses, such as the categorical lacuna discovered when William Battie's paradigmatic Treatise on Madness defines madness by refraining from glancing at the concept of hysteria. I am therefore suggesting that we need to study these works, both on hysteria and madness, for their silences as well as their revelations. In conclusion, there is plenty of evidence to suggest that the Enlightenment nerve doctors conceptualized hysteria as light years away from lunacy, the latter normally conceptualized as a "diseased passion of the mind" often occurring without pathological nervous involvement and without a lingering and chronic madness. Lunacy, madness, insanity: the three are interchangeable terms in their conceptualization—but not so hysteria . Here then is the categorical imperative once again. [309] For them, hysteria was not a malingering malefactor, but a curable condition of the body's nervous apparatus thrown into convulsion. Hysteria was thus not essentially the inflammation of the reproductive organs unduly excited, as it would again be in the nineteenth century with its retaliative clitoridectomies and antimasturbation techniques, but the nerves laboring under some extraordinary local distress, lesion, or fever. Still, approximately by the turn of the nineteenth century hysteria was thought to be the more baffling of the two diseases—hysteria and madness—if also the less chronic condition, and now apparently losing ground to a more treatable "insanity." As Whytt had emphasized in Edinburgh a generation earlier with characteristic humility and wisdom, the body's nervous organization, following the laws of sympathy and sensibility, regulates all mind/body traffic. Even so, Whytt had to claim
180 (following Sydenham who had seen so profoundly into the mysteries of hysteria) that hysteria is entirely unpredictable whereas insanity was not. [310] But the discourses on madness, committed as they were to medical materialism, also built mystery into the essence of secularized modern man. [311] Down through the eighteenth century the Enlightenment nerve doctors had constructed their theoretical edifices on the dualistic model they inherited from a post-Cartesian legacy; as well, they wrote in an intellectual milieu desperate to construct an infallible "science of man"—one as predictable for his or her frail states as strong states. Nevertheless, in generating their versions of hysteria, and then later of madness, they carved out space for man's mystery, enigma, anomaly. The endeavor demonstrated a philosophical tolerance that would serve the nineteenth century well. It also helped to legitimate anomalous, irrational, and enigmatic creatures of both genders as the victims of a medical condition still requiring medical research and authentic classification. By the turn of the nineteenth century the male nerve doctors had palpably defeminized and dehumanized their female lunatics, often recording their case histories as if these mad patients were "unisex": conflating female and male discourse into a new version. Pinel, for all his well-deserved reforms in Paris, was the odd man out. "Ur-Enlightenment" and humanitarian figure that he was, he also displayed the most unusual versions of compassion and sympathy for his patients. But even Pinel could not resolve the definitional disputes on the boundaries of the two conditions, hysteria and madness, nor did he try. [312] In the flow of theory, female lunacy was said to imitate male, a position as old as genesis itself, and just as female voices were recorded in the terms and tropes of the male, no different from the protean imitations hysteria had performed. As hysteria had imitated virtually every other disease, according to Sydenham and Whytt, now, at the end of the eighteenth century, the case histories of women's derangement resembled those of men. It was an odd form of representation, no less baffling than all philosophical mimesis. [313] But women not only lost their sexual identity, they even lost the voice—the expressive voice —presiding over their collective discourse. The reason and control of the "mad doctors" burned feminine unreason out of the medical annals of the late eighteenth century, so much did the doctors fear it. Instead, they replaced it with a logic and language of their own: a male grammar and syntax that prevailed up to the time of Josef Breuer and Freud. Our contemporary American feminists have enlightened us here—as Mary Jacobus and Juliet Mitchell
181 have so convincingly written—when cautioning that "women's writing can never be anything other than hysterical." [314] We can almost reconstruct the position from the social vantage of the last two centuries by gleaning how inevitable it was that women would eventually retrieve the pathetic voices they had lost. No wonder that in our own time hysteria's "his-story" (history) has been transformed into "her-story": the retrieval of a grammar and syntax long suppressed as much as any set of diagnoses and therapies. To return to the world of Enlightenment hysteria as it approached the turn of the century, not until William Cullen, near century's end, did the womb reappear, and then just momentarily, only to be discredited once again. Cullen's bizarre implication of the womb clung firmly to a somatic etiology, and in this sense it may be said to have had a temporary retarding effect. He not only invoked the hysterical womb but linked it to nervous conditions and the class he called "neuroses," claiming in First Lines of the Practice of Physic (1777), as had Sydenham and others before him, that hysteria was the most "protean of all diseases." "The many and various symptoms," he wrote, "which have been supposed to belong to a disease under this appellation, render it extremely difficult to give a general character or definition of it." But Cullen's explanation retains some of the mystery of hysteria in ways that had been lost on his less enlightened colleagues in Edinburgh and elsewhere. He gazed deeply into women; he understood their anatomies as well as neuroses (a word he virtually coined and made his own). [315] He somehow gathered that the constant redefinition of hysteria's cause from the Renaissance to his own time was ultimately consistent with the socioeconomic developments he witnessed around him: in rank, class, and economic means. His version of hysteria was as sociological as Sydenham's, and it captured the age-old counterpoint of endorsing and rejecting the womb etiology that had been in vogue from the time of Hippocrates. Au fond there is something unique to women and implicitly powerful, if destructively so, in the idea of the raging womb compared to the much tamer and vaguer notion that women have "inherently weak" nervous systems merely because of inferior "inner spaces." [316] But even at that time, in the 1770s and 1780s, Cullen's strong paradigm about hysteria and neurosis took shape within the contexts of a developing rival theory of madness. Another chapter would be necessary to chart with clarity and precision its overlaps with hysteria. Yet rank and class never lurked very far behind these considerations of the role of gender in hysteria and madness. Now, in a European world that would soon be plunged into the night of chaos and political anarchy, both medicine and culture
182 conspired to rob the middle nouveau riche of its newest and most fashionable garb: nervous affliction. If the poor could be hysterical, as they were in Edinburgh, what was left for the "mad rich in London and Paris"? The pattern appeared to be global and local at once—as paradoxical in this sense as the gender-bound nature of the actual hysteria. Throughout Europe, nerves signified one thing preeminently: rank and class. What differed from place to place, locale to locale, were the forms of social control and patriarchal expression of the nerves. To these disparities, the medicine of the time was almost entirely oblivious and insensitive, and nothing proved it more than the prolific treatises on hysteria and madness. Meanwhile, the doctors churned out their vast collective annals of hysteria diagnoses, one of the largest in the medico-historical literature.
XV In conclusion, I have been suggesting that the history of hysteria is essentially a social history. Even in the periods privileged here—the Renaissance and the Enlightenment—class structures were clearly falling apart in England by the 1760s (one thinks of the Middlesex riots, which were little more than the mass hysteria of the mob). Under this new class stress, gender and sex were further constrained, and slowly, very gradually, the onset of what would become, when full-grown and full-blown, Victorian prudery set in. [317] But mass hysteria also needs to be considered within its sociopolitical contexts. For example, a case can be made that the onania crusades—the antimasturbation campaigns—of the eighteenth century manifested themselves in social forms that amounted to mass hysteria. The drive to blot out all masturbation as the road to insanity was in part a grass-roots movement; it was also abundantly discussed in the popular writings of Samuel Auguste Tissot, the prolific Swiss doctor who made "anti-masturbation" the centerpiece of his voluminous works, a chapter in social history that has now been retrieved by Roy Porter. The remarkable aspect of this sweeping manifestation of mass hysteria is the degree to which everyone then was persuaded of the evils of masturbation: hardly a voice in the long eighteenth century dared to cry out in favor of masturbation. A phenomenon merely "in the air" of a former culture (the Renaissance or the Enlightenment) may be difficult to retrieve, but it is not so when thousands of words have been expended on it, as was the case regarding onania. Regency and Victorian repression of sexuality, and other nineteenth-century versions on the Continent,
183 are unthinkable without the social upheaval created by the antimasturbation crusades extending over many decades in the eighteenth century. The process created a new bourgeois repression of sexuality in late eighteenth-century England, and property, the law, consumer consumption, and finances all combined to make woman's lot worse than it had been in the Renaissance—not worse in any absolute sense but worse in relation to desire and expectation. But the role of shame and shaming in hysteria must also be considered. Those extraordinary nerve doctors from Willis to Cheyne, Whytt to Cullen, who found a clear organic substrate, safeguarded their patients against the charges that brought shame: the notion that they were poorhouse malingerers who had feigned these symptoms to improve their sad economic condition. By contrast, early eighteenth-century nerve doctors tended to indict cultural volatility as the culprit in hysteria and hypochondriasis. Luminous literati and salon sophisticates were victims of vertiginous life-styles said to enervate the nerves and sap their tonic strength. These nerves had not been originally defective at birth; they became so through high living under the new urban and suburban stress. By the late eighteenth century the poor had filtered up, and now they too were being victimized in this new recension of the disease. The effect of economic shoring, of aping the rich without the resources to do so, clearly had its nervous consequences. Long before Robert Carter wrote about workhouse hysterics from a psychogenic point of view that cast them in a bad light, [318] others in late eighteenth century had developed a similar angle of explanation. In Scotland the hinge was social rank, as the poorer the woman, the more hysterical—and pathetic—her case was adjudged to be. Ironically, what Cullen and his cohorts saw in Scotland and England, Mesmer did not see in France. Veith credited Mesmer as a hero within the history of hysteria for reasons that misinterpret his works and inflate his hypnotism. She hails Mesmer as of towering importance to the cracking of the hysteria code, on the grounds that his demonstration of the capacity of hypnosis to control the body through tapping unconscious mental networks ultimately bore fruit in psychogenic theories of Char-cot's France and Freud's Vienna. [319] Yet Mesmer never contended that the origins of his patient's hysterias were psychological, nor did he tout his own capacity to work cures through mental suggestion. He is not the harbinger of an internal millennium of the psyche, but of a poised nervous system vulnerable at every turn. Pace Veith, but this is as flawed an interpretation of Mesmer as is the notion that his contemporary, Emanuel Swedenborg, the ardent post-Newtonian mystic, was more mystic than scientist, which no reading
184 of his works can substantiate. Mesmer was as staunch in his Newtonian-ism as the British iatromechanists, forever maintaining that animal magnetism was a physically grounded, etherial fluid coursing through the cosmos, possessed of the capacity, when properly funneled through the afflicted, to relieve illness-causing obstructions. [320] When Louis XVI's investigating commission denied the reality of such a material substance, concluding that Mesmer actually performed his cures by the use of raw "imagination," such undercutting of his claims to a material substratum punctured his credentials and ruined his aspirations. Hysteria in the French Revolution is, of course, an immensely difficult subject because it blends so cunningly into other radically misogynistic behaviors, including the cataloging of egregious acts committed by women from the beginning of French history. It may be that such extreme antifeminism was itself a display of the mass hysteria on which I have commented at different points in this chapter, and that as the 1790s evolved, retrogression rather than progress occurred in this patriarchal society. [321] Even so, the long-term student of hysteria before, and beyond, Freud wants, of course, to compare this Mesmerian agenda with Freud's. A century later, it was the failure of hypnotism that initiated Freud's passage from an organic to a psychogenic etiology of hysteria. But there is no evidence that Mesmer, any more than Swedenborg, regarded his theories of nervous disorders and their therapies as grounded in anything other than Newtonian matter theory. So too the notorious Marquis de Sade, although under rather different ideological conditions and in different genres. The Sade whose women are told by their hedonistic instructors that "they are their anatomy"; the Sade whose first principle and holy gospel is not a latter-day Cartesian mind/body relation but a physics of pleasure and pain; [322] this Sade also possesses a notion of hysteria that is much more organic than psychogenic. The powerful idiom of the nerves receded very slowly in the nineteenth century, as did the organic basis of disease. This is one reason that, in England, Regency and even Victorian treatises on hysteria often resemble, or seem to be variations on the theme of, Enlightenment hysteria: an old malady with a familiar ring. The nineteenth-century neurasthenic patient—as Roy Porter and Elaine Showalter demonstrate in chapters 3 and 4—remains forever on the verge of nervous collapse, weakened by nervous debility, with atonic nerves, spirits, and fibers that require strengthening above all. Restore the eighteenth-century capitalizations and syntax, and one has not moved very far from the world of Mandeville and Monro, Cheyne and Cullen, Willis and Whytt. This
185 will not change until the psychogenic theory and etiology of hysteria overtake the organic in the late nineteenth century. And even then, the riddle of "the elusive disease" will continue to be, as it has been in our century, hysteria's inescapable organic resonances. It is not my place in this chapter to poach in the groves of Charcot. But viewing Charcot in reverse anachronism—for example, from the perspectives of Sydenham and Mesmer—helps to expound what will be at high stake in the world of hysteria anatomized by Roy Porter and Elaine Showalter. Like Sydenham and Mesmer—even Swedenborg and Blake, to select more extreme examples—Charcot has been more misunderstood than understood in relation to hysteria. A spiritual brother of Sydenham, Charcot wanted hysteria to be the most universal of all diseases—but with this difference. Sydenham had observed it to be the most universal and protean, independent of his own ideological gain, but he had not wished it so; Charcot willed it because it legitimated his own scientificity, and no sense is made of his theory of hysteria without viewing it within the visual perspectives of the age and the broad contexts of his own life, as his biographers and best students have now shown. [323] The leap between Sydenham and Charcot is also maximal in other ways. The positivists among Charcot's circle rejected the old Aristotelian view of pain as an emotion. Current medical knowledge, since the late eighteenth century, had identified pain with organic lesions in, and constrictions of, the nervous system. Women who complained of chronic pain that could not be located in the nervous system ran the risk of finding themselves classified as hypochondriacs suffering from imaginary illnesses. What had presented itself to the Greeks as a fiery animal, an overheated, labile, voracious, and raging uterus, was now, in Charcot's world, diagnosed as a sexually diseased and morally debauched female imagination. The progress of the hysteria diagnosis from 1750 to 1850 had now been completed, and novelist Samuel Richardson's lighthearted precept about "every woman being a rake at heart"—put forward by Mrs. Sinclair's female debauches in Clarissa Harlowe —had come round full circle in Charcot: from the Greeks to the Victorians. Woman's generative organs had given her this capability, in the ancient world as well as the Victorian. Nowhere would this diseased female imagination—perceived to be cunning and artful as well as deceitful—present itself more grotesquely than in the hysterical females seen by Briquet, photographed by Charcot, and fictively imagined by novelists such as Dickens in Little Dorrit in the figure of Flora, the diminutive child-wife forever in a hysterical swoon. [324] Perhaps this is why—but in part only—the early nineteenth-century
186 novel is so heavily permeated with tyrannical husbands and child-wives on the verge of madness, only to be locked up in dingy attics by their husbands where they hallucinate, like Charlotte Perkins Gilman, imprisoned by her doctors and her yellow wallpaper. All point to a conception of hysteria whose most revelatory dimensions remain its basis in gender and social class power and control. The complex story of the medical, scientific, ideological, political, and patriarchal way the nineteenth century crafted hysteria before Freud as an exclusive province of upper-class male physicians remains to be told.
223
PART II— THEMATIC
225
Three— The Body and the Mind, The Doctor and the Patient: Negotiating Hysteria Roy Porter
Diseases A central aim of medical history must surely be to chart the history of disease, for without that, we will never fully gain a sense of people's health, sufferings, morbidity profiles, life expectations, and expectations out of life. [1] Some historians go so far as to claim that pathogens have perhaps been the most potent agents of sociopolitical change at large. [2] And without proper understanding of microbes and toxins, it has been contended, the history of hysteria will be misread. For according to Mary Matossian, what contemporaries and scholars alike have identified as eruptions of mass hysteria—the late medieval witch craze, religious revivals, la grande peur —ought properly to be read as the symptoms of ergotism. [3] Yet, as is shown by scholarly scepticism toward such claims, identifying past diseases presents daunting challenges. With all our semiotic skills and modern clinical expertise, are we able to decode the medical texts, eyewitness accounts, and mortality records of bygone centuries and alien cultures, and trace the natural histories of diseases?[4] Was the "ague" of early modern England truly malaria, or "quinsey" a streptococcal infection? On the basis of Thucydides' description of the so-called "great plague" of Athens, scholars have come up with dozens of disease labels (though such is the debris of discarded identifications, that only fools should rush in). [5] The hazards of retrospective diagnosis teach a salutary scepticism. After all, as epidemiologists know, microorganisms themselves mutate, following unpredictable evolutionary biogeographies. Perhaps the Athe-
226 nian plague, or the decimating "great sweat" of early-Tudor England, that mysterious disorder, were due to pathogens that came and went. And, in any case, our forebears may have reacted to this or that infection in ways foreign to modern symptomatologies—to the despair of the historical epidemiologist but the delight of the shameless relativist. The former expects disease to obey laws, regularly producing predictable effects; the latter may, by contrast, luxuriate in the heterogeneity of subjective experiences of affliction. [6] Medical historians must soldier on, using what evidence they can: skeletal remains, artifacts (paintings, photographs), and written testimony, though words may be false friends: what early moderns called "cholera" was certainly not the "Asiatic" cholera that swept Europe and North America in the nineteenth century, although its identity still baffles inquiry. [7] So what of hysteria? Are historians to think of hysteria as a true disease, whose rise and fall can, in principle, be plotted down the centuries, so long as we exercise vigilance against anachronistic translation of archaic concepts? Or is it a veritable joker in the taxonomic pack, a promiscuous diagnostic fly-by-night, never faithfully wedded to an authentic malady—or worse, a wholly spurious entity, a fancy-free disease name, like Prester John, independent of any corresponding disease-thing, a cover-up for medical ignorance? Or, worse still, may hysteria truly have been the doctors' Waterloo: a real disorder, but, as Alan Krohn hints, one so "elusive" as to have slipped our nosological nets?[8] For reasons clear to every reader of this book, "hysteria" inevitably induces doubts. Yet why shouldn't a history of hysteria be written? Not one expecting (in the manner of Professor Matossian) to unearth a microtoxin as vera causa , nor even one tracing progress from medical confusion to medical clarification. But a history of hysteria experiences, that is, of people labeled as hysterical, or identifying themselves as suffering from the condition, and embodying it in their behavior; one taking into account all the intricate negotiations, denials, and contestations bound to mediate such multifarious sickness presentations. [9] Such a history could be written while judgment is suspended about hysteria's ontology. Scholars, after all, habitually trace the incidence of various fevers—low, spotted, and remitting—while remaining in the dark as to their etiology; "war fever" or "gold fever" are also discussed without obligation to specify the root cause of these drives. The embossing of hysteria—perhaps unlike spotted fever—with cultural meanings does not discredit such a project, but makes it all the more inviting. We should expect not a single, unbroken narrative but scatters of occurrences: histories of hysterias, in fact. Yet the chronological epicenter
227 is bound to be the nineteenth century. As Helen King has shown in chapter 1, antiquity and medieval Europe had no need of the hysteria concept. [10] And—so runs G. S. Rousseau's discussion in the previous chapter—though from Renaissance to Enlightenment physicians developed the hysteria diagnosis, it remained largely subordinate to discourses about melancholy and the nerves. It was during the nineteenth century that hysteria moved center-stage. It became the explicit theme of scores of medical texts. [11] Its investigation and treatment made the fame and fortunes of towering medical figures—Charcot, Breuer, Janet, and Freud. Hysteria came to be seen as the open sesame to impenetrable riddles of existence: religious ecstasy, sexual deviation, and, above all, that mystery of mysteries, woman. Moreover, people began to suffer from hysteria, or (what amounts to the same thing) to be said to suffer from hysteria, in substantial numbers. In novels [12] and newspapers, police reports and social surveys, the predicaments of mass society, crowd behavior, street life, and social pathology were endlessly anatomized in the idiom of hysteria. [13] And—often in compound forms, such as hystero-epilepsy—hysteria became traded as a common currency between the sick, their families, their medical attendants, and the culture at large: witness the repeated illness episodes undergone in the 1830s by Ada Lovelace, Byron's daughter (needless to say, the word carried deeply divergent nuances for Ada, her mother, her husband, and her flock of medical attendants). [14] Hysteria's clientele broadened. One senses that, in the eighteenth century, the term still circulated in rather confined, indeed, refined, circles. That changed. As may be seen from Charcot's practice, hysteria became, at least by the belle epoque , established as a disorder of males as well as females, [15] of sensitive and silly alike: perhaps none was wholly immune. In his discussion in chapter 5, Sander Gilman documents the extension of "hysterical" to certain ethnic types, notably Semites. [16] Furthermore, as Edward Shorter has emphasized, a multitude of nineteenth-century records—police, hospital, and Poor Law—testify that the terminology of hysteria shed most of its class exclusiveness. Shop girls, seamstresses, servants, street walkers, engine drivers, navvies, wives, mothers, and husbands too, were now eligible for depiction as hysterical alongside their betters, and not merely (as in Restoration comedy) as mimicry à la mode. [17] The coming of mass society evidently democratized the disorder. Institutional evidence attests this. In the mid-nineteenth century, Robert Carter alluded to hysteria epidemics in workhouses as though such outbreaks were common. [18] Victorian asylum records show patients
228 sectioned with hysteria written into their diagnosis or figuring in their case notes. [19] Establishments—hydros, spas, retreats, sanatoria, nursing homes—started catering to private patients suffering from hysteriform conditions. [20] Shorter has explored the procedures that filtered invalids of a certain class or income into superior institutions (with greater freedom and privileges), under choicer diagnostic verbiage. Considerable linguistic tact was requisite. Too psychiatric a diagnosis could suggest psychosis, or downright lunacy, with connotations unacceptable for the family. An overly physicalist term might come too near the bone by suggesting a tubercular condition or syphilis and its sequelae. Dexterity with diagnostic euphemisms was at a premium: this became the age of "neurasthenia." [21] Finally, and to us, most famously, there was the string of clients climbing the stairs at Berggasse 19. If some were "hysterics" largely by virtue of being so designated by others, Freud's patients, it seems, mainly volunteered. Freud strenuously contested his patients' "denials," but none of them, not even Dora, seems to have denied that he or she was hysterical. [22] One could thus trace the hysteria wave (or one might say craze, epidemic, or simply spread). Its cresting at that time seems perfectly amenable to explanation, without need to resort to crass reduction-ism (vulgar labeling or social control theory, or the medical dominance model). Cultures, groups, and individuals respond in different ways to life's pains and pressures; idioms of suffering and sickness can be more or less expressive; direct or indirect; emotional, verbal, or physical; articulated through inner feelings or outward gesture. Varied repertoires clearly register the tensions, prohibitions, and opportunities afforded by the culture (or subculture) at large, reacting to expectations of approval and disapproval, legitimation and shame, to prospects of primary penalty and secondary gain. [23] Some societies legitimize psychological presentations of suffering, while others sanction somatic expression. Affluent New Yorkers are today allowed, even expected, to act out trauma psychologically. Mao's China, by contrast, apparently condemned such performances as lapses into inadmissible subjectivism and political deviancy. Hence "feeling bad" in the Republic had to be couched in terms of a physical debility or malfunction that escaped censure and solicited sympathy and relief. [24] In this respect, the sickness culture of nineteenth-century Europe and North America seems to have borne some resemblance to modern China. In a fiercely competitive economic world, high performance was expected, with few safety nets for failures. There were intense pressures
229 toward inculcating self-control, self-discipline, and outward conformity (bourgeois respectability). Personal responsibility, probity, and piety were, furthermore, internalized through strict moral training, imparted via hallowed socialization agencies like the family, neighborhood, school, and chapel. Guilt, shame, and disapproval were always nigh. In such stringent force fields, feelings of distress or resentment, anxiety or anger, were inevitable but difficult to manage; they were commonly "repressed" or rerouted into one of the rare forms of expression that were legitimate: the presentation of physical illness. Being sick afforded respite and release to those who needed temporarily or permanently to opt out. [25] And the system was skewed so that some took the strain more than others. Women were disproportionately burdened, being more isolated and incurring intenser expectations of moral and sexual rectitude; ladies often had time for reflection without outlets for their talents. [26] Such concatenations of circumstances—high pressures, few safety valves—seem almost tailor-made for hysteria, viewed (as, of course, many nineteenth-century physicians themselves viewed it) as a disorder whereby nonspecific distress was given somatic contours. Symptom choice involves complex learning and imitative processes. Picking up hysteria was aided by the fact that nineteenth-century public life put on view an abundance of physical peculiarities: gait disorders, paralyses, limps, palsies, and other comparable handicaps. Such conditions were the effects of birth defects and inherited diseases, of syphilis, lead and mercurial poisons at the workplace, of overdosing with unsafe drugs, industrial accidents, and high levels of alcoholism with consequent delirium tremens . The visibility of real biomedical neurological disorders enticed and authenticated those seeking a sickness stylistics for expressing inner pains. Shorter has further argued, as have many feminist scholars, that a certain rhyme and reason may be discerned in the symptom selection. [27] The gastric disorders men widely "adopted" were compatible with continuing an active life, and hence with a certain model of masculinity. Being a hysterical woman, by contrast, meant exhibiting a battery of incapacitating symptoms emblematic of helplessness, enfeeblement, and (with lower limb paralyses) immobilization, acting out thereby, through sickness pantomime, the sufferer's actual social condition. Hysteria was thus mock escape by self-mutilation (a male analogue finally emerged in the First World War with shell shock). We need detailed a history "from below" of rank-and-file nineteenth-century hysterics, and not just of such "immortals" as Blanche Wittmann, Léonie B., and Anna O. It would enhance our grasp of the elec-
230 tive affinities between disease and culture, confirming the adage that every society gets the disorders it deserves. Alongside epidemiology, medical history needs to study the history of illness, that is, of sufferers' conditions, regardless of science's judgment upon their authenticity. Aside from metaphysical questions (is hysteria a real disease?), it is clear that our great grandparents suffered from hysteria, no less than Elizabethans underwent the "sweat" or we succumb to "depression," "stress," or low-back pain; it is the job of historians to explain how and why. [28] This grass-roots history of hysterics, this social history of symptoms, should be high on the agenda. But it is not what the remainder of this chapter tackles. Instead, I shall explore the medical profession's attempts to resolve the hysteria mystery, a disorder enigmatic because it hovered elusively between the organic and the psychological, or (transvaluating that ambivalence) because it muddled the medical and the moral, or (put yet another way) because it was ever discrediting its own credentials (were sufferers sick or shamming?). In this, I have in mind several larger goals. I want to explore the opportunities hysteria offered, and the puzzles it posed, for the medical profession: was it to be their finest hour or their Waterloo? I shall probe how differential readings of hysteria suited diverse sectors of a profession increasingly specialized and divided. Not least, I wish to gauge hysteria's symbolic replay (parody even) of the interactions between doctors and patients, suggesting how, in psychoanalysis, it launched a wildly new and deeply aberrant script of doctor-patient interplay.
Hysteria/Mysteria Nineteenth-century doctors habitually represented hysteria as a challenge, a tough nut to crack. Chameleonlike in its manifestations, and often aggravated by their ministrations, it did not fight by the Queens-bury Rules. Medicine's flounderings suggest that hysteria proved something "other," the one that got away. Consensus never crystallized as to its nature and cause. In recent years, it has waltzed in and out of the Diagnostic and Statistical Manual , the English-speaking world's authoritative psychiatric handbook. Disgruntled doctors have often proposed conceptual slum clearance and a fresh terminological start: Josef Babinski wanted to rename it "psychasthenia" or "pithiatism," Janet suggested "psychasthenia," and certain contemporary physicians prefer "Briquet's syndrome," [29] all in the, surely vain, hope that old confusions were but word deep. As the shrewd reassessments of Alec Roy, Harold Merskey, Alan
231 Krohn, and others have made clear, medicine today remains deeply divided as to whether hysteria is a skeleton in the cupboard or a ghost in the machine; a phantom like "the spleen," or a bona fide disorder. And if authentic, is it organic or mental? A disease that has largely died out or been cured, or one camouflaging itself in colors ever new?[30] Such battles long since spilled over time's border into the terrain of history. A cast of heroes and villains from the past has been recruited to play key roles. Indeed, as Helen King established earlier in this volume, when Renaissance doctors first needed to develop the hysteria concept, high priority was given to manufacturing a pedigree going all the way back to Hippocrates. [31] Physicians have also turned to the past to exercise their skills in retrospective diagnosis: preferred readings of hysteria will, it is assumed, be vindicated if they lead to the identification of former outbreaks. After all (so argued nineteenth-century bio-medics), what is medical science if not an engine for discovering nature's universal laws, operating uniformly through time and space, in the past, present, and future? Thus Charcot declared in ringing tones that "L'Hystérie a toujours existé, en tous lieux et en tous temps." [32] In Les Demoniaques dans l'art (1887), jointly written with his colleague Antoine Richer, he contended that what benighted ages had mistaken for mystics and demoniacs were archetypically hysterics. By thus exposing the hysteria so long hidden from history, Charcot strengthened his claim to be, in the there-and-then as well as the here-and-now, the all-conquering "Napoleon of the neuroses." Further medical demystification of religious enthusiasm by D.M. Bourneville and other intimates of the charcoterie helped mobilize the radical, anticlerical medical politics of the Third Republic. [33] Psychiatrists such as Gregory Zilboorg subsequently developed these retrospective diagnoses of early modern demoniacs as sick people possessed, not by the devil, but by disease, as people fit, not for the flames, but for the couch. In propagating such views, analysts from Freud to present psychohistorians have presented themselves as pioneers of therapeutic methods and historical readings both enlightened and scientific. [34]
Historiography And historians of hysteria have characteristically followed in their footsteps: it was no accident that the first substantial chronicles of hysteria were written by Charcotian protégés. [35] Such works have assumed that the annals of medical history, down the centuries and across the cul-
232 tures, point to outcrops of a disorder now identifiable as hysteria, and that the medical mission of understanding, classifying, and treating it can be recounted as a progression from superstition to science, ignorance to expertise, prejudice to psychoanalysis. The standard English-language history, Ilza Veith's Hysteria: The History of a Disease (1965), is wholly cast within this mold. [36] As her title indicates, Veith's premise is that hysteria is an objective disease, the same the whole world over. It had been known to doctors—East and West—at least from 1800 B.C ., Veith contended, though it was the Greeks who had given it its name. Medieval Christendom's gestalt switch, treating psychosomatic symptoms as the stigmata of Satan, had entailed a gigantic regression. [37] Fortunately, far-sighted Renaissance physicians such as Johannes Weyer had recaptured hysteria from the theologians, seeing it as a disease, not a sin. Even so, true understanding (and treatment) continued to be hamstrung by a fallacious medical materialism misconstruing hysteria as organic—standardly, an abnormality of the womb, or, in later centuries, of the nervous system and brain stem. Veith particularly deplored the "increasingly sterile and repetitive neurological basis that had emanated from Great Britain for nearly two hundred years," sparked, above all, by George Cheyne's "nervous" theory, whose "affectation and absurdities are such that it scarcely merits elaborate discussion"—even the Scottish iatromechanist's "references to his own distress," Veith uncharitably grumbled, "seem inconsequential." [38] Not least, she argued, somatic hypotheses had been marred by misogyny. Overall, such ideas were precisely the obstacles that, in Freud's view, had "so long stood in the way of [hysteria] being recognized as a psychical disorder." [39] Fortunately, according to Veith, a counterinterpretation had emerged, albeit by fits and starts. Brave spirits such as Paracelsus, Edward Jorden, Thomas Sydenham, Franz Anton Mesmer, Philippe Pinel, Ernst von Feuchtersleben, and Robert Carter began to develop "an amazing amount of anticipation" of the insight—finally triumphant with Freud—that hysteria was psychogenic, the monster child of emotional trauma aggravated by bourgeois sexual repression, especially of females. [40] Thanks principally to Freud, this libidinal straitjacket had finally been flung off, leading to the disorder's demise in the present century: Veith's narration concluded with Freud. It says something for the vitality of medical history that, twenty-five years later, Veith's recension appears hopelessly outdated. For one thing, hers was heroes-and-villains history, being particularly free with bouquets for those who "anticipated" Freud's psychosexual theory. Among these,
233 the mid-Victorian practitioner Robert Carter received her most fulsome floral tributes, for having effected "a greater stride forward" than "all the advances made since the beginning of its history." [41] This rosy interpretation of Carter grates, however, upon a modern generation primed on antipsychiatry and feminism. After all, it was precisely his judgment that hysteria was psychogenic that enabled Carter to indict hysterical women as not sick but swindlers, sunk in "moral obliquity," cynically exploiting the sick role to manipulate their families and getting perverse sexual kicks out of the repeated vaginal examinations they demanded. Carter, however, saw through their tricks and advocated subjecting them to ordeal by psychiatric exposure. [42] With Dora's case in mind, we might wryly agree with Veith that Carter did indeed "anticipate" Freud, but such a compliment would, of course, be backhanded, underlining that Freud too could be a misogynistic victim blamer and therapeutic bully. Faced with the deviousness of hysterics, Freud confided to Wilhelm Fliess his sympathy for the "harsh therapy of the witches' judges." [43] More generally, Veith's "history of a disease"—indeed, of a "mental disease" [44] —conceived as a joust between benighted (somatic) theorists, who "retarded" comprehension, and their forward-looking psychological rivals, suffers from the stock shortcomings of wise-after-the-event Whiggism. [45] Past theorists are graded by the yardstick of Freud, whose theory is taken as the last word. With hindsight derived from the psychodynamic revolution, Veith organizes her history of hysteria around an essential tension between (wrong) somatogenic and (valid) psychogenic claims. A radically different reading is offered by Thomas Szasz. For Szasz, hysteria is not a real disease, whose nature has been progressively cracked, but a myth forged by psychiatry for its own greater glory. Freud did not discover its secret; he manufactured its mythology. [46] Drawing upon varied intellectual traditions—logical positivism, Talcot Parsons's theory of the sick role, ethnomethodology, and the sociology of medical dominance—Szasz has made prominent, in his The Myth of Mental Illness , [47] psychoanalysis's "conversion" of hysteria into a primary psychogenic "mental illness" marked by somatic conversion, the translation, as William R. D. Fairbairn put it, of a "personal problem" into a "bodily state." [48] "I was inclined," reflected Freud, "to look for a psychical origin for all symptoms in cases of hysteria." [49] Exposing this as a strategy integral to a self-serving "manufacture of madness," Szasz counters with a corrosive philosophical critique. By thus privileging the psyche, Freud was in effect breathing new life into the
234 obsolete Cartesian dualism, resurrecting the old ghost in the machine, or rather, in the guise of the Unconscious, inventing the ghost in a ghost. [50] For Szasz, on the other hand, the expectation of finding the etiology of hysteria in body or mind, above all in some mental underworld, must be a lost cause, a dead end, a linguistic error, and an exercise in bad faith. For the "unconscious" is not a place or an organ but, at most, a metaphor; Freud stands arraigned of rather naively pictorializing the psyche in hydraulic and electrical terms, of reifying the fictive substance behind the substantive. [51] Properly speaking, contends Szasz, hysteria is not a disease with origins to be excavated, but a behavior with meanings to be decoded. Social existence is a rule-governed game-playing ritual. The hysteric bends the rules and exploits their loopholes. Not illness but idiom (gestural more than verbal), hysteria pertains not to a Cartesian ontology but to a semiotics, being communication by complaints . Since the hysteric is engaged in social performances that follow certain expectations so as to defy others, the pertinent questions are not about the origins, but the conventions, of hysteria. [52] Sidestepping mind/body dualisms, Szasz thus recasts hysteria as social performance, presenting problems of conduct, communication, and context. Freud believed mind/body dichotomies were real, though typically mystified, and attempted to crack them. Szasz dismisses these as questions mal posées , deriv ng ( ke Freud s "d scovery" of the unconsc ous) from ngu st c re f cat on or bad fa th, and he a ms to reformu ate them. If d osyncrat c, Szasz s ana ys s s a so a ch d of ts t me. Modern ngu st c ph osophy, behav or sm, and poststructura sm a deprec ate the et o og ca quest: or g ns, authors, and ntent ons are d scounted, systems, convent ons, and mean ngs forefronted. Szasz does not, of course, expect that h s parad gm-sw tch w mag ca y sw tch off a the uncontro ab e sobb ng, f ts, tantrums, and para yses. But t offers a ternat ve read ngs of such acts, wh e underm n ng expectat ons that track ng hyster a w ead to the source of the N e, that s, the so ut on of the r dd e of m nd and body. [53] Szasz s reso ut on of hyster a s brac ng, but t s ach eved at the cost of reduc ng ts past to pantom me: h s adopt on of the anguage of game-p ay ng turns everyone, sufferers and med cs a ke, nto man pu at ve ego sts. I ness s ust a counter n a contest. So why embrace th s d sm ss ve, be tt ng v ew? It s because Szasz s at bottom an o d-schoo med ca mater a st: d sease s rea y d sease on y f t s organ c. [54] Were hyster a—were any so-ca ed menta ness—somat ca y based, t wou d have a rea h story (aff ct ng peop e, be ng nvest gated by phys c ans). Lack ng organ c "papers," ts past, rather ke those of transubstant at on
235 or of perpetua -mot on eng nes, s a b ot, a d sgrace, a f ct on, a ta e of knaves and foo s worthy of some ph osophe s pen. Thus, for equa but oppos te reasons, Ve th and Szasz both short-c rcu t hyster a s h story. Ve th (odd y ke Charcot) fee s ob ged to trace t from the pharoahs to Freud; Szasz th nks the h story of hyster a beg ns w th Freud s psychodynam c emp re bu d ng. Be ev ng hyster a psychogen c, Ve th recounts her "h story of a d sease" as the road to Freud. Be ev ng d sease must be somat c, Szasz pa nts hyster a s h story as the pageant of a dream. Both approaches tr v a ze the ntr cate texture of hyster a down the ages, the true understand ng of wh ch must respect, not exp a n away, the en gmas of mu t faceted, evanescent pa n n a cu ture w th n wh ch m nd/body re at ons have been supercharged and dev sh y prob emat c. Yet Ve th s and Szasz s po ar zed read ngs are, n the r own way, h gh y exemp ary, for they both h gh ght m nd/body d sputes n hyster a s et o ogy. Down the centur es, phys c ans ong amented how hyster a rema ned sph nx ke, because m nd/body re at ons themse ves proved a conundrum. Ve th s des re to d v de her protagon sts nto ("retard ng") mater a st and ("progress ve") psycho og ca camps s, however, m sgu ded, for t freezes the rhetor c of the Freud an era and anachron st ca y backpro ects t. Yet Szasz s myth c h story, subserv ng h s own debunk ng and berat ng po em c, a so cuts corners, above a by seem ng y deny ng any s gn f cant deve opments before Freud. Many recent h stor ans, espec a y Mark M ca e, [55] have, by contrast, ns sted on the enormous ntr cacy and ndeterm nacy of the story of hyster a. Above a , as w be exp ored be ow, t wou d be s mp st c to mp y that ear y theor es were exc us ve y e ther somatogen c or psychogen c; most common y they were attempts to d ssect and p ot the puzz ng entente between the pass ons of the m nd and the const tut on of the body. Our story s thus not a matter of e ther/or but of both/and. And t s, above a , a h story n wh ch the very not ons of m nd and body, and the boundar es and br dges between them, were constant y be ng cha enged and reconst tuted. Hence th s chapter w focus on med ca theor z ngs of m nd/body patho og es. It w thus engage the metaphys cs of hyster a, exam n ng the theoret ca underp nn ngs that made poss b e a success on of puzz es, prob ems, and so ut ons. The story of hyster a (I w argue) makes scant sense f restr cted to nterna , techn ca sk rm sh ngs over nerves and neurons, pass ons and pathogens. Far more was at stake, not east because, as Szasz has ns sted, hyster a became an exemp ary d sease, the d sorder that s ng e-handed y aunched psychoana ys s. Sma wonder th s w der h story s requ s te, for the b omed ca doc-
236 tr nes of body and bra n, psyche and soma, have never been neutra post-mortem f nd ngs, hermet ca y sea ed from the symbo c mean ngs accret ng around s ckness n da y exper ence, mean ngs of utmost s gn f cance for doctr nes of human nature, gender re at ons, mora autonomy, ega respons b ty, and the d gn ty of man. [56] Med c ne s author ty, ts pr zed sc ent f c ty, may have rested upon ts vaunted monopo y of expert se over the human organ sm, but ts pub c appea has equa y hung upon ts ab ty to attune ts terms and tones to the popu ar ear. The h stor an of hyster a must, n short, bear n m nd the w der determ nants: chang ng deas of man, mora ty and cu ture, and the po t cs of med c ne n soc ety.
Mind and Body: Medical Materialism and Hegemonic Idealism I w sh to exp ore a further d chotomy—Charcot s h stor ca metaphys cs uxtaposed aga nst Freud s—to show ts exemp ary status for understand ng the m nd/body po t cs of hyster a. To secure the r credent a s, many n neteenth-century med cs proc a med a powerfu metah story: Auguste Comte s scheme of the r se of thought, from the theo og ca , v a the metaphys ca , up to the sc ent f c p ane. [57] As embraced by pos t v sts, par exce ence those n Charcot s c rc e, such a progress ve schema mp ed that s ckness had, at the dawn of c v zat on, been m sattr buted to otherwor d y agenc es (sp r t possess on, necromancy, etc.), subsequent y be ng myst f ed nto formu a c verb age (humors, an ma sp r ts, comp ex ons) d ssemb ng as exp anat ons. Grow ng out of such mumbo umbo, phys c ans had f na y earned to ground the r art n the nuts-and-bo ts rea -wor d of anatomy, phys o ogy, and neuro ogy. [58] Through abandon ng myths for measurement, words for th ngs, metaphys cs for metabo sm, med c ne had at ong ast grasped the aws of nature, wh ch wou d prove the pre ude to effect ve therapeut cs. Accord ng to Charcot (as w further be exp ored be ow), hyster a wou d be so ved by pursu ng the sc ence of the body. Freud, however, though Charcot s somet me student, cuts across the gra n of th s exp anatory strategy— ndeed, presents a case of ontogeny revers ng phy ogeny. The young Freud had been nducted nto the German c schoo of neurophys o ogy, whose creed (para e ng the pos t v st) espoused the tr p e a ance of sc ent f c method, med ca mater a sm, and nte ectua progress: exp anat ons of the v ng had to be somat ca y grounded or they weren t sc ence. Though n t a y endors ng th s neuro og ca d om, Freud, n h s own theor z ngs of neuroses and hyster a,
237 eventua y adopted a thoroughgo ng psychodynam c stance, eventua y formu at ng a battery of menta st neo og sms—the unconsc ous, ego, d, super ego, death w sh, and so on—wh ch og ca pos t v sts have ever s nce der ded as throwbacks to Comte s "metaphys ca " stage. [59] In tandem, Freud s therapeut cs moved from drugs (e.g., coca ne), through hands-on, pressure-po nt hypnos s, to the pure y psych ca (free speech assoc at ons). [60] Freud, some wou d say, was a k nd of menta rec d v st. In thus pr v eg ng the m nd as pr mum mob e , Freud cha enged b omed c ne s bottom ne—and regarded h mse f as v ct m zed for h s pa ns, wh e energet ca y m k ng h s se f- mage as a persecuted heret c. [61] Yet, by so do ng, he has won a stand ng ovat on from twent eth-century h gh cu ture, pred sposed to be eve that exp anat ons of human behav or pred cated upon the work ngs of the m nd , however dark and dev ous, must be more profound, humane, ns ghtfu , true, and t t at ng even, than any formu ated n b ochem ca or genet c categor es. [62] As we have seen, Ve th herse f assumed that once Freud f na y d scovered hyster a to be psychogen c , the curta n cou d be brought down to rapturous app ause. Psychoana ys s s "d scovery of the unconsc ous," [63] un ock ng the secrets of human des res, both norma and patho og ca , rema ns one of the foundat on myths of modern ty. In address ng the r va parad gms of f n de s èc e hyster a, we thus f nd a cross f re—the one sc ent f c, rat fy ng pos t v st aws of the organ sm; the other conv nced that mean ngfu exp anat ons of act on must der ve from an onto ogy of the psyche. Th s s an nstruct ve d chotomy (b o og sm/menta sm), reproduc ng n a nutshe two c ash ng conf gurat ons of Western thought. On the one hand, psychoana ys s s menta sm s underp nned by the pervas ve and prest g ous Idea sm, ph osoph zed by P aton sm and the Cartes an cog to , ong underwr tten by Chr st an theo ogy, and, n secu ar garb, st the nforma metaphys ca foundat ons of the human t es n C. P. Snow s "two cu tures" d chotomy. Such h erarch ca , dua st c mode s programmat ca y set m nd over matter, th nk ng over be ng, nurture over nature, head over hand, as h gher over ower, the menta be ng onto og ca y super or to the corporea . Macrocosm ca y, brute matter was subord nate to the D v ne M nd or Idea, act ng through mmater a agenc es; kew se, m crocosm ca y, the ach evement of mens sana n corpore sano requ red that m nd, w , or sp r t must command base f esh— and, as Theodor Adorno, Norbert E as, Foucau t, and others have argued, the c v z ng process, that ce ebrated march of m nd demanded by cap ta sm, ong enta ed the ntens f cat on of bodyd sc p n ng techn ques. [64] W th n th s v ew, s ckness s regarded ( ke cr me, v ce, or s n)
238 as the aftermath of reason os ng contro , e ther because the metabo sm tse f has been h gh acked (for nstance, n the de r um of fever), or when c v war erupts w th n the m nd tse f, ead ng to the "m nd forg d manac es" of menta ness. [65] Freud torpedoed theo ogy, wrest ed w th ph osophy, but oved sc ence. H s v ews of the dr ves and the unconsc ous natura y cou d not countenance the Chr st an-P aton c d v ne-r ght monarchy of Pure Reason: t s, after a , the m ss on of psychoana ys s to debunk such us ons (pur ty ndeed!) as pro ect ons, sub mat ons, and myst f cat ons. [66] Nor cou d he accept at face va ue the doctr na re d st nct ons between freedom and necess ty, v rtue and appet te, ove and b do, and so on postu ated by ph osoph ca Idea sm. These— ke so many other va ues—were not eterna ver t es, g fts from the gods, but prob emat c, sub mated, even morb d, constructs ("defences"). Neverthe ess, the thrust of Freud an psychodynam cs—h s po nt of departure from W he m Brücke, Charcot, and F ess, and then from some of h s own ep gon such as W he m Re ch— ay n deny ng the suff c ency of b o ogy or hered ty to exp a n comp ex t es of behav or, hea thy or morb d. In the case of comp exes, the body becomes the batt eground for strugg es masterm nded e sewhere. [67] Freud was deep y torn. C n ca exper ence ed to h s g v ng sovere gnty to the psyche. Yet here n ay a profound rony, for he was a so, as Peter Gay has apt y emphas zed, a ch d of the o d En ghtenment tch to smash Idea sm, unve ng t as the secret agent of fa se consc ousness, repress on, and pr estcraft. [68] He was, moreover, he r, by tra n ng and temper, to the crusad ng med ca mater a sm and b ophys cs of h s youthfu heroes—Hermann He mho tz, Theodor Meynert, and h s mentor, Brücke, not to ment on Charcot h mse f. For such um nar es, as for the Freud of the abandoned 1895 Pro ect, do ng sc ence meant trans at ng behav or nto b o ogy, consc ousness nto neuro ogy, random exper ence nto ob ect ve aws. And n pursu ng such pos t v st approaches, n neteenth-century b osc ent sts were, as La n Entra go has stressed, further endors ng the d spos t on, from the Greeks onward, n what was s gn f cant y t t ed "phys ck," to enshr ne the body as the u t mate "rea ty pr nc p e." [69] The body prov des suff c ent exp anat on of ts own behav or. D seases are n and of the organ sm. They are caused by some f u d mba ance, phys ca es on, nterna d s ocat on, "seed" (or fore gn body), excess, def c ency, or b ockage; mater a therapeut cs—drugs and surgery—w re eve or cure. Abandon such home truths, such profess ona art c es of fa th, and the autonomy and ur sd ct on of b omed ca sc ence and c n ca pract ce me t ke May m st. Once t were adm tted that
239 s ckness cou d not be suff c ent y exp a ned n and through the body—un ess t cou d be sa d, at some eve , " n the beg nn ng, was the body"—med c ne wou d forfe t ts t t e as a master d sc p ne, grounded upon pr zed c n cosc ent f c expert se. Un ess s ckness s trans atab e nto the ngo of es ons and aws, why shou d not anyone—pr ests, ph osophers, char atans, sufferers—treat t as we as a doctor? Here n es the exp anat on of why sc ent f c med c ne comm tted tse f, from the Rena ssance, to evermore m nute anatom ca and phys o og ca nvest gat ons, even though the therapeut c payoffs ong rema ned unconv nc ng. Yet th s strategy for rat fy ng profess ona credent a s through a sc ence of the body natura y ran the r sk of counterproduct v ty. For, n a cu ture-at- arge n wh ch Idea sm was hegemon c, med c ne thereby exposed tse f to the charge that ts ncomparab e organ c expert se was purchased at the pr ce of h gher d gn ty: a ab ty perfect y summed up n Co er dge s damnat on of the doctors for the r debas ng somat sm: "They are sha ow an ma s," udged the ardent P aton st, "hav ng a ways emp oyed the r m nds about Body and Gut, they mag ne that n the who e system of th ngs there s noth ng but Gut and Body." [70] The program w de y, f tac t y, adopted by med c ne s nce the sc ent f c revo ut on of ocat ng d sease exp anat ons w th n the body seemed unexcept onab e when address ng consp cuous cond t ons—tumors or dropsy, for nstance— nvo v ng phys ca abnorma t es. It has proved more prob emat c, however, where pa n f ares seem ng y ndependent y of man fest externa es ons: even today med c ne s embarrassed when faced w th common comp a nts such as nervous exhaust on, stress, or add ct on. And med c ne s c a ms encounter spec a stra n n cases where d sturbances are sporad c and seem ng y rrat ona . It s n these border and areas, the f e ds of so-ca ed funct ona and nervous d sorders where s ckness exper ence wants secure somat c anchorage, that med ca cred t s east conv nc ng. If suffer ng acks es ons and oca zat ons, why shou d t be med c ne s prov nce at a ? After a , ead ng cr t cs from w th n the profess on, notab y Thomas Szasz, have nvoked med c ne s cher shed cr ter a ( og ca pos t v sm and methodo og ca mater a sm) to contend that, s nce phys ck s k ngdom s the body, and med c ne s thus def n t ona y organ c (e se t s a ch mera), the very dea of pr mary menta ness shou d be struck off the reg ster as a category error, a m s ead ng metaphor—or, worse, a p ous fraud, smack ng of profess ona bad fa th. [71] Med c ne has ur sd ct on over the somat c, but who author zed ts wr t to run one step beyond? As G. S. Rousseau s essay has shown, phys c ans ong ago ho sted the r f ag over hyster a; but the terra ncogn ta has ever proved remarkab y res stant to assured co on zat on. Thus ours has been a c v zat on n wh ch, n an deo og ca shadow
240 p ay of the soc opo t ca order, hegemon c Idea sm has trad t ona y enthroned m nd over what theo ogy den grated as the "f esh," forever too, too so d and su ed. [72] At the same t me, med c ne, by embrac ng (proto)-pos t v st not ons of sc ence and profess ona terr tor a mperat ves, has espoused a prax s afford ng t contro over the organ c. Superf c a y t m ght seem that these two dr ves —enshr n ng sp r t, yet mak ng matter the foundat on stone of sc ence—are rad ca y ncommensurab e. Yet doctors ve n the wor d and med c ne needs to be cred t-worthy; or, n other words, accommodat ons have ever been reached, or ensure that cu tura dea sm and med ca mater a sm work n broad harmony, rather than on a co s on course. [73] Med c ne, ph osophy, and theo ogy deve oped thought-packages des gned to demarcate the doma ns and spec fy the pathways of m nd and matter. Thus, so ran ong-stand ng prescr pt ons, the ru es of hea th requ red that m nd must be n the sadd e, enact ng the precepts of ph osophers and preachers. Whenever the re gn of reason s cha enged, when brute f esh mut n es, the resu tant state s s ckness, and then the mentor makes way for the doctor. In any case, and g v ng the e to Co er dge s s ur, phys c ans themse ves, t me out of m nd, have prescr bed. bera doses of w power as the rec pe for "who e person" we -be ng: be hea thy-m nded, th nk pos t ve, exerc se se f-contro . As M chae C ark has br ant y shown, ate V ctor an doctors character zed the sound, respons b e person as one who tempered the w and d sc p ned the body, channe ng the energ es, ke a true Ar stote an, nto hea thy pub c act v ty. By contrast, the hypochondr ac or degenerate was trapped n morb d ntrospect on, pr soner, n Henry Mauds ey s graph c phrase, of the "tyranny of organ zat on." [74] So cu tura Idea sm and med ca mater a sm, though perhaps wor ds apart, have rare y been daggers drawn. Each ass gned ro es to the other w th n ts own p ay. Even med ca mater a sts such as Ju en de La Mettr e recogn zed that, taken to extremes, to reduce man to noth ng but homme mach ne wou d be se f-d sconf rm ng, wh e no ess an dea st than B shop George Berke ey d d not hes tate to tout tar-water as a panacea. [75] Thus cu tura P aton sm and med ca mater a sm are best regarded as uncomfortab e matr mon a partners, who have engaged n part a cooperat on to frame mages of the const tut on of man, the dance of soma and psyche, the tr ang e of san ty, sa ubr ty, and s ckness, and, not east, of the po t cs of the mora /phys ca nterface. [76]
For doctors have to operate n the pub c doma n, ost ng w th r va s n expert se and author ty, and the r serv ces u t mate y have to p ease pay ng pat ents. So med c ne cannot afford to bury tse f n spra ns and pa ns but must engage w th w der ssues—re g ous, eth ca , soc a , and
241 cu tura . The pub c wants from doctors exp anat ons no ess than med cat ons; soc ety ooks to the profess on for exhortat on and excuses. Med c ne s ca ed upon to supp y stor es about the nature of man and the order of th ngs. Moreover, because med c ne has never en oyed monopo y—nor has t been mono th c; t has been d v ded w th n tse f— t has deve oped mu t p e strateg es for secur ng ts p ace n the sun. It wou d, n f ne, be myop c to treat med c ne as a m ted techn ca enterpr se. Th s s espec a y so when we are faced w th nterpret ng the pecu ar t es of hyster a, a d sorder that, as nd cated, dramat ca y rose and fe between the Rena ssance and the F rst Wor d War, a tra ectory ndub tab y nked to arger cu tura determ nants affect ng pat ents and pract t oners a ke. Hyster a presented doctors w th a tease, a tr a , and a break. The hyster a d agnos s, cr t cs gr ped, was the most egreg ous med ca hocus-pocus, attached to symptom c usters phys c ans cou d not mpute to some more regu ar cause. The symptoms were heterogeneous, b zarre, and unpred ctab e: pa ns n the gen ta s and abdomen, shoot ng top to toe, or r s ng nto the thorax and produc ng constr ct ons around the throat (g obus hyster cus ); breath ng rregu ar t es; tw tch ngs, t cs, and spasms; mount ng anx ety and emot ona outbursts, breath essness, and f oods of tears; more acute se zures, para yses, convu s ons, hem p ag as, or cata epsy—any or a of wh ch m ght r ng the changes n d zzy ng success on and often w th no obv ous organ c source. Faced w th such symptoms, what was to be done? The mystery cond t on (spake the cyn cs) was wrapped up as "hyster a." Such, accord ng to the m d-seventeenth-century neuro og st Thomas W s, was the phys c ans f g eaf worn to h de the r cogn t ve shame:
W hen a any me a s ckness happens n a Woman s Body o an unusua manner or more occu or g na so ha wh ch o en mes s on y he sub er uge o gnorance 77
s causes e h d and a Cura ory nd ca on s a oge her uncer a n
we dec are
o be some h ng hys er ca
Ev dent y, th ngs d d not mprove. A fu century ater, W am Buchan st fe t ob ged to dub hyster a the "reproach of med c ne," s nce the "phys c an . . . s at a oss to account for the symptom." [78] Was hyster a then ust a w -o -the-w sp, a fabu ous beast or phantom? Or was t an authent c ma ady, whose essence ay n hav ng no essence, be ng prod g ous y protean, the masquerad ng ma ady, m m ck ng a others?[79] And f hyster a were such a desperado, was t tru y not a d sease at a , but some k nd of Frankenste n s monster, a bra n-ch d of the med ca mag nat on f na y turned upon ts own creators?
242 In the ght of these grander ssues—the prob ems of med c ne s cont nued attempt to conf rm ts p ace w th n the w der cu ture, the m nd/body amb va ence of hyster a, the brev ty of hyster a s heyday, and the construa of hyster a as an anoma ous monster d sease— t can hard y be um nat ng to wr te, as d d Ve th, about the "h story of a d sease" n the same manner that one m ght sens b y survey sma pox and ts med ca erad cat on. It wou d be doub y m s ead ng to mp y that med ca advances success ve y a d bare the true ro es p ayed n the et o ogy of hyster a by m nd and body; for, as ust suggested, m nd and body are not themse ves cast- ron categor es, but best seen as representat ons negot ated between cu ture, med c ne, and soc ety. [80] Hence, n the rema nder of th s chapter, I sha exp ore some d fferent mean ngs success ve y assumed by hyster a, n a wor d n wh ch med c ne was batt ng to extend ts sway. My account w emphas ze the n t at ves of med c ne. Not because I be eve that doctors had un que spec a ns ght nto the cond t on, [81] or, contrar w se, that hyster a was cyn ca y manufactured by a ma gn med ca maf a. I do so, rather, be ev ng that, ke nv s b e nk when heat s app ed, hyster a was a cond t on ch ef y rendered v s b e by the med ca presence. W thout the ca ng of med ca w tnesses to w tch tr a s, ear y modern phys c ans wou d rare y have pronounced upon these b zarre behav ors. W thout the e sured sufferer whose purse spe ed good t mes for pr vate pract ce, En ghtenment phys c ans wou d not have had a ta e to te of nervousness. W thout conf nement n the Sa pêtr ère hosp ta n the prox m ty of ep ept cs, and, above a , w thout the e ectr c atmosphere of Charcot s c n c, B anche W ttmann and other stars of hyster a wou d have wasted the r swoon ngs on the desert a r. [82] Robert Carter, who was cyn ca about those "actresses," ref ected that nature knew no such be ng as a so tary hyster c: hyster a was a pub c comp a nt presuppos ng an aud ence—mass hyster a def n t ona y so. [83] Was hyster a, then, pure y atrogen c, or, at east, as E ot S ater wou d put t, "a d sorder of the doctor-pat ent re at onsh p"?[84] Maybe, though t wou d be more ud c ous to say that the n neteenth century was hyster a s go den age prec se y because t was then that the mora presence of the doctor became normat ve as never before n regu at ng nt mate ves.
Continuities: Toward Nineteenth-Century Nervousness As Rousseau showed n the prev ous chapter, En ghtenment sens b t es were confronted w th act ons and suffer ngs not eas y compat b e w th
243 vaunted parad gms of conduct or c ass f cat ons of d sease. The appearance of such a enat on and rrat ona ty has common y been b amed, by modern countercu tura cr t cs, upon the dua st c doctr ne of man proc a med by the new ph osophy, above a the Cartes an severed head and d v ded se f, der ved from the abso ute ru e of the cog to n the age of reason. [85] It s poss b e to take a v ew more sympathet c to e ghteenth-century structures of fee ng. The new ava ab ty of a p ura ty of mode s of v ng (Chr st an, c v c human st, nd v dua st, sc ent f c, and so forth) perhaps afforded we come psycho og ca Lebensraum to those—for nstance, members of the new y emergent nte gents a—who d d not f t eas y nto r g d prescr pt ons. Dua st c mode s and mu t p e prototypes a owed a certa n ndeterm nacy, or psycho og ca e ne sa s quo , to be bu t nto the makeup of modern man, a ow ng the accommodat on of eccentr c ty and d fference. [86] Such marg ns of to erance were sore y needed. For, as the En ghtenment era re axed re g ous requ rements, t was a so app y ng ntenser persona stra ns. Its exhaust ng comm tment to the fe of nte gence, ts demand for po teness, and ts re ent ess pressures for se f-awareness and-rea zat on, spe ed more stressfu standards of behav or, and hence h gh ghted the r obverse: abnorma ty. In the raref ed atmospheres of soph st cated court ness and br ant urban ty, the body was requ red to be d sc p ned and dr ed, yet a so d sp ayed. Inner sens b t es had to f nd express on at the tea tab e or n the sa on through ref ned, subt e, and often ve ed codes of et quette, revea ng but concea ng through act ons compe ed to speak ouder than words. The ngua franca for negot at ng such repress on-express on tens ons ay n nervousness, a body anguage u tra f ex b e, nuanced, and amb va ent, yet br tt e and f tfu . For fe ved through the d oms of nervous sens b ty carr ed h gh r sks. Want of nerve betrayed effem nacy; want of nerves , by contrast, exposed p ebe an du ness; yet vo at e exc tab ty cou d be too much of a good th ng, a apse of tact, cu m nat ng n hyster ca cr ses. A go den mean—po sed decorum sp ced w th d osyncrat c d fference—was the goa . Ach evement of th s hazardous ro e ad ustment, th s accommodat on between the hyperv s b e narc ss st c nd v dua and a soc ety demand ng Chesterf e d an conform sm, was perhaps fac tated by prec se y that d v ded Cartes an se f so often berated by modern cr t cs. Such a dua sm—the man-beh nd-the-mask p ay ng out the onto ogy, of the ghost n the mach ne—a owed a certa n d stance, a d sown ng, a usab e tens on between se f and body. D derot, Sterne, Casanova, and Rousseau a demonstrated, through the r ves and wr t ngs, the r ch potent a for
244 dramat c se f-express on afforded to the "new person" by the nove po ysem c d oms of mpu se, fee ng, mag nat on, nerves, and, u t mate y, hyster a. [87] En ghtenment th nkers professed baff ement at the Sph nx an r dd es of psyche/soma aff n t es. "The act on of the m nd on the body, and of the body on the m nd," noted a ead ng author ty on madness, "after a that has been wr tten, s as tt e understood, as t s un versa y fe t." [88] Th s onto og ca equ vocat on, th s suspens on of udgment, sure y enhanced that respect w th wh ch the post-Sydenham hyster c was treated n a pr vate pract ce m eu n wh ch, as N cho as Jewson has stressed, some rough-and-ready par ty governed pat ent/pract t oner re at onsh ps. [89] Thus, that great c n c an, W am Heberden, a man utter y au fa t w th the symptoms, saw hyster a as a cond t on a too read y provoked by the "s ghtest affect on of the sense or fancy, beg nn ng w th some uneas ness of the stomach or bowe s." "Hypochondr ac men and hyster c women" suffered ac d t es, w nd, and chok ng, ead ng to "g dd ness, confus on, stup d ty, nattent on, forgetfu ness, and rreso ut on," a proof that the "an ma funct ons are no onger under proper command." [90] But, a man of h s t me, he was oath to dogmat ze as to the root cause. For,
our grea gnorance o he connex on and sympa h es o body and m nd and a so o he an ma powers wh ch are exer ed n a manner no o be exp a ned by he common aws o nan ma e ma er makes a grea d h s ory o a d s empers and par cu ar y o h s For hypochondr ac and hys er c comp a n s seem o be ong who y o hese unknown par s o he human compos on 91
cu y n he
L ke most contemporary c n c ans, Heberden was prepared to ve w th the mystery v s tor. "I wou d by no means be understood, by any th ng wh ch I have sa d, to represent the suffer ngs of hypochondr ac and hyster c pat ents as mag nary; for I doubt not the r ar s ng from as rea a cause as any other d stemper." [92] In other words, the h stor ca soc o ogy of En ghtenment hyster a s def ned by the c n ca encounter between the sens t ve pat ent and the sympathet c phys c an. The amb ence was e t st, and t was, n pr nc p e at east, un sex. R d cu ng uter ne theor es of hyster a as anatom ca moonsh ne, R chard B ackmore had conc uded that "the Symptoms that d sturb the Operat ons of the M nd and Imag nat on n Hyster ck Women"—and by these symptoms he meant "F uctuat ons of Judgment, and sw ft Turns n form ng and revers ng of Op n ons and Reso ut ons, Inconstancy, T m d ty, Absence of M nd, want of se f-determ n ng
245 power, Inattent on, Incog tancy, D ff dence, Susp c on, and an Aptness to take we -meant Th ngs am ss"—these, he ns sted, "are the same w th those n Hypochondr aca Men." [93] How cou d an age na ng ts co ors to the mast of un versa reason, a cu ture whose mora vocabu ary turned upon sense and sens b ty, def ne hyster a as the ma a se of the mucous membrane? Th s c n ca rapport forged n the century after Sydenham between fash onab e doctor and h s moneyed pat ents d d not cease n 1800: far from t. N neteenth-century med c ne presents a Fr th an panorama of we -to-do, t me-to-k , tw tchy types of both sexes be ng d agnosed as hyster ca , or perhaps by one of ts ncreas ng y used euphem st c a ases, such as "neurasthen c," [94] and be ng treated, by genera pract t oners and spec a st nerve doctors a ke, w th a cornucop a of drugs and ton cs, mora and behav ora support, ndu gence, rest, reg men, and what-you-w — n ways that sure y wou d have won the mpr matur of Samue T ssot, Theodore Tronch n, or Heberden. [95] Such cont nu ty may show that V ctor an med c ne fa ed n ts quest for the prom sed spec f c for hyster a. But t wou d be more to the po nt to emphas ze that, from G org o Bag v to George Beard, the canny c n c an knew that the hyster c s pr me needs were for attent on, escape, protect on, rest, recuperat on, re nforcement—phys ca , mora , and menta a ke. The east p aus b e nd ctment aga nst e ther Mandev e or We r M tche s that they tr ed to force hyster a onto some Procrustean bed. For them, the protean anguage of nerves perm tted the sufferer to bespeak h s or her own hyster a d agnos s as a nonst gmat z ng c oak of d sorder. It was M tche who was wont to speak of "myster a." [96] In the n neteenth century, the rest home, c n c, and sanator um supp emented the spa-resort to prov de new recuperat ve s tes for the fam ar nervous comp a nts of the r ch. The r therapeut c rat ona e, however, was o d w ne n new bott es. Nerve doctors cont nued to emphas ze the force f e d of the phys ca , emot ona , and nte ectua n prec p tat ng hyster a (or, ater, neuropathy, neurasthen a, etc.); they def ned hyster a, forma y at east, as gender nonspec f c, ndependent of gyneco og ca et o ogy. There was fe st n the o d En ghtenment d om of the nerves. Above a , by cush on ng neurasthen c pat ents w th n a somat z ng d agnost cs of nervous co apse, nervous deb ty, gastr c weakness, dyspeps a, aton c ty, sp na nf ammat on, m gra ne, and so forth, fash onab e doctors cou d foresta susp c ons that the r respectab e pat ents were e ther ha f mad or ma nger ng soc opaths. [97] Not east, "nerves" prec uded mora b ame, by h nt ng at a patho ogy not even pr mar y persona , but soc a , a Ze tge st d sease. E ghteenth-
246 century nerve doctors tended to nd ct cu tura vo at ty: sa on soph st cates were v ct ms of exqu s te y vert g nous fe-sty es that sapped the nerves. By contrast, n ater recens ons of the d seases of c v zat on, H gh V ctor an therap sts on both s des of the At ant c po nted accus ng f ngers at the p t ess compet t on of market soc ety. As Franc s Gos ng has shown, George Beard and We r M tche argued that career stra ns n the bus ness rat race dev ta zed young ach evers; bra n-fagged by stress and tens on n the cockp t of commerce, they ended up nervous wrecks, the r psycho og ca cap ta overtaxed. Cerebra c rcu ts suffered over oad, menta mach nery b ew fuses, batter es ran down, bra ns were bankrupted: such metaphors, borrowed from phys cs and eng neer ng, were rem nders that d sorders were phys ca , offer ng conv nc ng exp anat ons why go-gett ng a -Amer can Ya e graduates ke C fford Beers shou d suffer nervous breakdowns no ess than the r de cate and devoted s sters. [98] Such decorous somat z ng a so perm tted phys c ans to exh b t dazz ng therapeut c mach ner es, targeted at bod y recuperat on: baths and douches, pass ve "exerc se," massage, custombu t d ets programmed to make we ght, fat, and b ood; reg mes of wa k ng, games, and gym; occupat ona therapy, water treatments, e ectr ca st mu , re axat on, rout ne, and so forth. Th s parapherna a of remed a techno og es obv ous y spe ed good bus ness for res dent a c n ca d rectors. Strateg ca y, such rout nes were sa d to benef t pat ents by def ect ng them from morb d se fawareness, tra n ng attent on more benef c a y e sewhere. For n neteenth-century phys c ans began to vo ce fears of morb d ntrospect on, that hyster ca sp ra ar s ng from pat ents dwe ng upon the r d sorders. [99] Precepts for hea thy v ng w de y canvassed—by sages such as John Stuart M and Thomas Car y e no ess than med ca gurus—dep ored ego st c preoccupat on as the road to ru n, to su c de even, and adv sed consc ousnessob terat ng, outgo ng act v ty. [100] For the hyster c was typ ca y regarded as the narc ss st or ntrovert. From her Freud an v ewpo nt, Ve th has b amed We r M tche for not encourag ng h s rest-cure conva escents to ta k the r psychosexua prob ems through, mp y ng that th s s ence may have been due to prudery. One suspects, n truth, the doctor s ret cence ref ects ne ther pur tan sm nor sha owness, but savvy: a conv ct on that some matters were better eft atent, est they nf ame morb d tendenc es. [101] "On y when bod y funct ons are deranged," warned the m d-V ctor an Br t sh phys c an Bevan Lew s, do "we become . . . consc ous of the ex stence of our organs." [102] In h s caut on about consc ousness, Lew s was of a m nd w th the eaders of Br t sh pract ce—Char es Merc er,
247 Dav d Skae, Henry Mauds ey, and Thomas C ouston—who saw hyster a as the pena ty for excess ve ntrospect on, espec a y when accompan ed by a- or ant -soc a d spos t ons and, worse st , by auto-erot sm. [103] It was, consequent a y, dangerous to d scuss such d spos t ons free y w th pat ents, est th s encourage further morb d ego sm and attent on-seek ng, and a the attendant tra n of se f-absorpt on, daydream ng, rever e, and so tary and sedentary hab ts. Prompted to dwe upon herse f, Mauds ey feared, the hyster c wou d most ke y s nk nto so ps st c mora nsan ty or mbec ty; [104] for, as the pat ent progress ve y abandoned her power of w —"a character st c symptom of hyster a n a ts protean forms"—she wou d fa nto "mora pervers on," os ng
more and more o her energy and se -con ro becom ng capr c ous y anc u abou her hea h mag n ng or e gn ng s range d seases and keep ng up he de us on or he mpos ure w h a per nac y ha m gh seem ncred b e ge ng more and more mpa en o he adv ce and n er erence o o hers and nd eren o he n eres s and du es o her pos on 105
For the r own sakes, therefore, pat ents must be taken "out of themse ves"—through therapeut c hobb es, exerc se, and soc ab ty. Thus S r W am Bradshaw, the soc ety phys c an n V rg n a Woo f s Mrs. Da oway , notor ous y nstructs the she -shocked war v ct m Sept mus Sm th to pu h mse f together and cu t vate a sense of proport on. Through the car cature of th s pompous ass, Woo f expressed her contempt for such London phys c ans as S r George Savage and Maur ce Cra g, who treated her own nervous co apses w th the mora anodyne of the rest cure. Yet Woo f herse f was no ess scath ng, n a terr b y Eng sh way, about the as n n t es of sex-on-the-bra n German c psych atr sts. There s no s gn that she favored hav ng Freud an "m nd doctors" open Freud- an w ndows onto her psyche. [106] In short, powerfu currents through the n neteenth century and beyond cont nued to c ass hyster a as a d sease of nervous organ zat on. Doctors f xed upon phys ca symptoms, and treated them w th phys ca means, steer ng c ear of too much sk rm sh ng w th, or st rr ng up, the m nd. If b nkered and comp acent, such approaches were not necessar y obtuse. The contrast ng protoco s of Charcot s Tuesday C n c [107] and the Freud an couch arguab y hyster zed hyster a, as one m ght douse a f re w th gaso ne. Yet f cont nu t es w th the En ghtenment may be seen, there are gear sh fts too; above a , perhaps, a certa n wan ng of med ca sympathy for the nervous hyster c n the generat ons after 1800, thanks to a sterner Evange ca pr z ng of se f-re ance. [108] If the En ghtenment ndu ged a certa n fasc nat on for d osyncracy, V ctor an
248 mores took the r stand aga nst the ego st c soc opath. To these soc opaths we turn.
Change: Women, Body, and Scientific Medicine Concentrat ng on cont nu t es w th the past r sks skew ng n neteenth-century out ooks on hyster a. It was, a agree, hyster a s be e epoque , thanks above a to the start ng emergence and convergence of mutua y re nforc ng cond t ons: a profound accentuat on of the "woman quest on," coterm nous w th an ev dent y not unre ated expans on n organ zed med c ne. As E a ne Showa ter fu y exp ores n chapter 4, the quest on of fem n ne nature became a burn ng ssue. Romant c sm rang the changes on the paradoxes: w fe and whore, femme frag e and femme fata e , weak but wanton—woman, t seemed, was an appa ng y rres st b e cockta of nnocence and morb d sexua ty. [109] Bram D kstra, among others, has traced the sensat ona zat on of that mytho ogy toward the turn of the century. [110] In the shadow of such stereotypes, women exper enced profound conf cts over r va dea s and expectat ons. [111] To hook a husband, a woman had to be ch d ke and dependent, yet a so a tower of strength as the househo d manager of that great mora eng ne, the fam y, and robust enough to surv ve nnumerab e pregnanc es. W ves had to be pure, yet p eas ng, or r sk be ng supp anted by the "other woman." Hence they had to deve op the r ta ents, yet nte ectua asp rat ons were censured as unnatura , mper ng the r man fest b o og ca dest ny as w ng wombs. And f, stupef ed by such pressures, paradoxes, and proh b t ons, women showed s gns of bew derment or br d ng, what d d th s prove but that they were spo ed, d ff cu t, and capr c ous, further proof of the necess ty for ma e and med ca contro ? When proto-fem n st protest mounted, t gave further ev dence to those who saw hyster a as the root of a fema e act v sm. H story, anatomy, dest ny, evo ut on—a were conscr pted to c amp women n the r p ace. [112] And so, of course, as f ne fem n st scho arsh p has shown, was med c ne. [113] Yet the med ca profess on tse f was n the to s of traumat c transformat on. Space m ts here prec ude any adequate exp orat on of the upheava s n the nterna organ zat on and pub c facade of med c ne dur ng the n neteenth century, but a few deve opments must be ment oned, p ay ng as they d d key parts n reshap ng hyster a. Am d the throng of profess ona groups compet ng for recogn t on and rewards, med c ne contr buted no s y to the c angor, frant ca y assert ng ts own un que vocat on. Doctors sought f ghter profess ona orga-
249 n zat on and pub c pr v eges. Teach ng and research assumed greater nst tut ona zat on n un vers ty and aboratory. And, thanks to such deve opments, med ca d scourse became ncreas ng y d rected to profess ona peers. W th new adders of advancement, and the expans on of research schoo s and sc ent f c c rc es, profess ona espr t de corps grew commensurab y, enta ng a certa n d sp acement of the pat ent, who was ncreas ng y downgraded to an ob ect of "the med ca gaze." A such changes had, as we sha see, profound mp cat ons for the hyster c. [114] Overpopu ated, nsecure, but amb t ous, med c ne fractured nto a pro ferat on of subd sc p nes, w th new spec a t es mu t p y ng and vy ng for funds and fame. As Orne a Moscucc has demonstrated, obstetr cs and gyneco ogy p oneered dent t es of the r own, stak ng out the new terra n of women s med c ne. Neuro ogy took shape as a spec a ty; Russe Mau tz has traced the r se of patho ogy. Pub c hea th came of age, and a ances between the soc a sc ences and the emergent spec a t es of organ c chem stry and bacter o ogy he ped to forge modern ep dem o ogy. Psych atry b ossomed, co on z ng ts own ocat ons, above a , the asy um and the un vers ty po yc n c. [115] And a such he ghtened d v s on of abor ed to d fferent schoo s, nat ona groups, and subspec a sms vaunt ng the r own cogn t ve c a ms: n some cases, bas c sc ence, n others, c n ca exper ence or aboratory exper mentat on, keyed to the m croscope. L. S. Jacyna has stressed the espousa by profess ona med cs of deo og es of sc ent f c natura sm, centered on the aws of fe. [116]
N neteenth-century med c ne reor ented tse f beyond the s ckbed nto the c n c: the vast, nvest gat ve teach ng hosp ta , equ pped w th advanced patho-anatom ca fac t es and a neverfa ng supp y of exper menta sub ects. At the same t me, w th the emergence of the ndustr a state, med c ne a so found tse f en oy ng greater nteract on w th soc opo t ca nst tut ons. Exam n ng vast d sease popu at ons n the r new pub c capac ty, phys c ans had to confront fresh quest ons: atency, d spos t on, contag on, d athes s, const tut on, and nher tance. [117] In short, sc ent f c med c ne f exed ts musc es and spread ts w ngs. It was courted by the pub c; t craved off c a author zat on. Hence, doctors made bo d to become sc ent f c po cymakers for the new age. The quest ons they addressed—matters of hyg ene, eff c ency, san ty, race, sexua ty, mora ty, cr m na ab ty, and so forth—were nev tab y mora y charged; many phys c ans c a med med c ne as the very cornerstone of pub c mora s. And so phys c ans shou dered an ever greater regu atory ro e, act ng as brokers and ad ud cators for state, ud c ary, and the fam y. Turn ng techn ca expert se nto soc a and mora d rect ves,
250 med c ne spoke out upon soc a order and soc a patho ogy, progress, and degenerat on. As w now be seen, new med ca spec a t es c a med ur sd ct on over hyster a, and made t y e d mora messages to s ake, or stoke, V ctor an anx et es. [118]
Problem Women: Gynecology and Hysteria As Thomas Laqueur has contended, research n the ate e ghteenth and ear y n neteenth centur es nto human sexua ty d d not reso ve the mystery of woman, but deepened t. The more that was d scovered, however tentat ve y and tard y, about menstruat on and concept on, the more med ca sc ence conf rmed the truth that hegemon c ma e cu ture was ndependent y aff rm ng: women were d fferent . [119] Trad t ona Greek-der ved b omed ca teach ngs had represented the fema e reproduct ve apparatus as an nfer or, mperfect nvers on of the ma e. But dur ng the e ghteenth century and beyond, med c ne and cu ture were abandon ng that v ew and comb n ng to reconstruct women as rad ca y other . [120] And not mere y other, but b zarre. It had become acknow edged that, contrad ct ng med ca teach ngs go ng back to H ppocrates, fema e orgasm was unnecessary for concept on. Invest gat ons nto ovu at on a so appeared to show that menstruat on n women, un ke other mamma s, occurred ndependent y of b d na exc tat on. In short, the re at onsh p between erot c st mu us on the one hand, and concept on on the other, became utter y (and un que y) prob emat c. Fema e sexua ty thus seemed, from the v ewpo nt of research nto generat on, a mystery, apparent y b o og ca y superf uous, and perhaps even patho og ca . [121] Pont f cat ng upon the r dd es of fema e sexua ty became the stock- n-trade of emergent gyneco ogy. E bow ng as de " gnorant m dw ves" and the much-mocked accoucheurs , spec a st surgeon-gyneco og sts made the r b d to pass themse ves off as more than mere operators: be ng rather experts, qua f ed to ho d forth on the overpower ng ro e of reproduct on n determ n ng fema e fe patterns, n a set of sc ent f c d scourses n wh ch womb became a synecdoche for woman. [122] N neteenth-century med c ne, c a med Foucau t, forged a new hyster zat on of women s bod es. Th s was prec se y the ach evement of gyneco ogy, arge y backed by the equa y un or d sc p nes of sexo ogy and psycho og ca med c ne, aga nst the backdrop, ust sketched, of the estab shment of spec a zed, sc ent f c med c ne. [123] In a context of patr archa va ues u tra-susp c ous of fema e sexua ty, [124] gyneco og sts set about des gnat ng the phys o ogy and patho ogy
251 of th s perp ex ng be ng. Once the chasm between arousa and concept on had been estab shed, fema e b do—so vo at e, capr c ous, even rampag ng—was revea ed as nherent y dysfunct ona , dangerous even. So why the pecu ar sens t v t es of c tor s and vag na, a too suscept b e to phys o og ca and emot ona d sturbance? Was not even the uterus tse f troub esome beyond the demands of ch dbear ng? Were not women ens aved by the r generat ve organs? And f so, what was to be done? Confronted w th streams of fema e pat ents—many tortured w th nterna pa n, others de ected, st others "de nquent"—these were the prob ems upon wh ch the grow ng corps of women s d sease spec a sts bu t the r p atform. The answers offered by emergent gyneco ogy portrayed women s hea th as desperate y womb-dependent. S nce the very ra son d être of the fema e ay n procreat on, [125] proper y d rected thereto, erot c arousa had a certa n va ue, w th n the wa ed garden of matr mony. Yet what of the r sk of arousa among ado escent g r s, sp nsters, and w dows? Abst nence was soc a y expected, yet cont nence had ts quandar es, ead ng to ch oros s, wast ng cond t ons, and emot ona waywardness. [126] Frustrat on fue ed fantas es and cou d ead to masturbat on, an act v ty mper ng hea th —phys ca , mora , and menta . [127] In short, the fema e reproduct ve system was so precar ous y po sed that a most any rregu ar ty, whether exc tat on or repress on, was sure to provoke hyster form d sorders. Hyster a had ever been regarded as the charade of d sease. [128] Now doctors feared t as eros n d sgu se. Its swoon ngs, erks, convu s ons, and pant ng b atant y s mu ated sexua ty, afford ng surrogate out ets and re ef, wh e the sufferer escaped the st gma of ubr c ty. Not east, n the throes of a f t, the hyster c was bound to be touched, pampered, and sub ected to med ca exam nat on and treatment, a of wh ch n neteenth-century doctors regarded as erot ca y grat fy ng. [129] Gyneco ogy and psychophys o ogy thus o ned forces to make fema e sexua ty prob emat c, h gh ght ng the ro e of the sexua organs n provok ng hyster ca cond t ons w de y be eved to prec p tate mora nsan ty. "Convu s ons . . . n ear y fe," udged the top ate V ctor an psych atr st, Henry Mauds ey, were nd ces of the " nsane temperament," even n sub ects not yet actua y nsane. [130] Such precoc ous, d sp aced erot c sm cou d tr gger ong-term d sturbances. Ear y n the century, psych atr sts had p npo nted the nks between menstrua abnorma t es and hyster a. John Has am, apothecary at Beth em Hosp ta , observed that n "fema es who become nsane, the d sease s often connected w th the pecu ar t es of the r sex." [131] In a s m ar
252 ve n, the nf uent a psych atr c spokesman, George Man Burrows, drew attent on to "var ous sangu ferous d scharges, whether per od ca , occas ona , or acc denta ," a of wh ch "great y nf uence the funct ons of the m nd." [132] Here n, argued Burrows, ay the key to fema e troub es, for "every body of the east exper ence must be sens b e of the nf uence of menstruat on on the operat ons of the m nd"— t was, he udged, no ess than the "mora and phys ca barometer of the fema e const tut on." [133] Burrows tendered a phys o og ca exp anat on based upon "the due equ br um of the vascu ar and nervous systems":
he ba ance be d s urbed so kew se w be he u er ne ac on and per od ca d scharge hough does no o ow ha he m nd a ways sympa h ses w h s rregu ar es so as o d s urb he cerebra unc ons Ye he unc ons o he bra n are so n ma e y connec ed w h he u er ne sys em ha he n errup on o any one process wh ch he a er has o per orm n he human economy may mp ca e he ormer 134
R peness for ch dbear ng was the mark of the hea thy woman. Hence, Burrows emphas zed, were menstruat on nterrupted, "the seeds of var ous d sorders are sown; and espec a y where any pred spos t on obta ns, the hazard of nsan ty s mm nent." [135] Equa y, he udged, oca gen ta and uter ne rr tat ons wou d generate "those phantas es ca ed ong ngs, wh ch are dec ded pervers ons or aberrat ons of the udgment, though perhaps the s mp est mod f cat ons of nte ectua derangement." [136] What was the exp anat on?
These anoma ous ee ngs have been re erred o u er ne rr a on rom mere grav a on and so hey may be bu hey rs nduce a grea er de erm na on o b ood o he u erus and s con en s and hen o he bra n hrough he rec proca connex on and ac on ex s ng be ween he wo organs 137
It was two-way traff c. Amenorrhea was somet mes "a cause of nsan ty," [138] but, rec proca y, "cerebra d sturbance" cou d tse f cause "menstrua obstruct on," [139] further exacerbat ng menta d sorder, for "terror, the sudden app cat on of co d, etc., have occas oned the nstant cessat on of the menses, upon wh ch severe cerebra affect ons, or nstant nsan ty, has supervened." [140]
In ne w th the t mes, Burrows a so b amed menopause for severe fema e d sturbance. Once aga n, he emphas zed, the pr mary change was phys o og ca :
The who e economy o he cons u on a ha epoch aga n undergoes a revo u on
There s ne her so much v a nor men a energy o res s
253
he e ec s o he var ous adverse c rcums ances wh ch
141
s he o o mos o mee w h n he n erva be ween puber y and he cr ca per od
Yet, n the op n on of the ess-than-ga ant Burrows, soc opsycho og ca forces were a so at work:
The age o p eas ng n a ema es s hen pas hough n many he des re o p ease s no he ess ve y The ex er or a one oses s a rac ons bu van y preserves s pre ens ons s now espec a y ha ea ousy exer s s emp re and becomes very o en a cause o de r um Many oo a h s epoch mb be very en hus as c re g ous no ons bu more have recourse o he s mu us o s rong cord a s o a ay he uneasy and nervous sensa ons pecu ar o h s me o e and hus produce a degree o exc a on equa y dangerous o he equan m y o he mora ee ngs and men a acu es 142
Doub e eopardy surrounded the menopausa cr s s. Overa , Burrows udged hyster a ntr ns c to the fema e sexua const tut on: "Nervous suscept b e women between puberty and th rty years of age, and c ear y the s ng e more so than the marr ed, are most frequent y v s ted by hyster a." [143] Its root, he emphas zed, was organ c: "Such const tut ons have a ways a greater apt tude to strong menta emot ons, wh ch, on repet t on, w super nduce menta derangement, or perhaps ep epsy." [144] Un ke En ghtenment phys c ans, though pref gur ng ater V ctor an op n on, Burrows feared hyster a, because t was a ways ab e to f are nto a dangerous, even ncurab e, cond t on. "De r um s a common symptom of hyster a," he warned, "and th s symptom s pro onged some-t mes beyond the remova of the spasm of paroxysm." [145] Thus, n the event of a repet t on of hyster ca f ts, "the bra n at ength reta ned the morb d act on, and nsan ty s deve oped." Indeed, because "hyster a s of that c ass of ma ad es wh ch, wherever t s man fested, betrays a man aca d athes s," t fo owed that "hab tua hyster a c ear y approx mates to nsan ty." [146] Th s prognos s (uter ne d sturbances ead to hyster ca cond t ons that prec p tate nsan ty proper) became standard to n neteenth-century med c ne. "The reproduct ve organs . . . when undu y, unseasonab y, or exorb tant y exc ted," argued A fred Beaumont Maddock, are not on y "necessar y sub ect to the usua advent of those phys ca d seases wh ch are the nher tance of fra human ty, but are a so c ose y nterwoven w th errat c and d sordered nte ectua , as we as mora , man festat ons." [147] Such fema e d sorders were, Maddock udged, the d rect resu t of "the pecu ar dest ny that [woman] s ntended by nature to fu f , as
254 the future mother of the human race." [148] Others concurred. "Menta derangement frequent y occurs n young fema es from Amenorrhoea," argued John M ar, "espec a y n those who have any strong hered tary pred spos t on to nsan ty." [149] Th s "Hyster c s Progress," arc ng a most tera y from womb to tomb, was evoked most v v d y by that g oomy g ant of ate V ctor an psych atry, Henry Mauds ey. Mauds ey traced the s ppery s ope from hyster a to "hyster ca nsan ty," a "spec a var ety" of the comp a nt connot ng
an a ack o acu e man aca exc emen w h grea res essness rap d and d sconnec ed bu no en re y ncoheren conversa on some mes end ng o he ero c or obscene ev den y w hou abo on o consc ousness and a so augh ng s ng ng or rhym ng and perverseness o conduc wh ch s s more or ess coheren and seem ng y w u 150
Such d sturbances "may occur n connect on w th, or nstead of, the usua hyster ca convu s ons," a though, Mauds ey warned, "the ord nary hyster ca symptoms may pass by degrees nto chron c nsan ty." [151] Gyneco og ca and psych atr c causes were v rtua y nseparab e: "Outbursts of temper become a most outbreaks of man a, part cu ar y at the menstrua per ods. An erot c t nge may be observab e n her manner of behav our; and occas ona y there are quas -ecstat c or cata ept c states." [152] Such cond t ons, emphas zed the h gh y mater a st Mauds ey, were "the effect of some cond t on of the reproduct ve organs on the bra n." The r cerebra f bers warped, sufferers wou d not hes tate to exp o t the r se f-dramat z ng potent a , Mauds ey admon shed, po nt ng to the "extreme mora pervers on shown by such hyster ca young women of a nervous temperament as mag ne that the r mbs are para ysed and e n bed or on a couch day after day." [153] There was, however, a mora st ng n the ta of Mauds ey s mater a sm. L ke most of h s c oth, he udged that the opt mum treatment for young ad es n th s "extreme y perverted mora state" was mora , requ r ng that "the pat ent be removed n t me from the anx ous but hurtfu sympath es and attent ons of her fam y, and p aced under good mora contro ." If, nstead, " t be a owed to go on unchecked, t w end n dement a, and t s espec a y apt to do so when there s a marked hered tary pred spos t on." [154] Not surpr s ng y, Mauds ey nked hyster ca nsan ty to nymphoman a, both fo ow ng from "the rr tat on of the ovar es or uterus." [155] Such anx ety-mak ng, m sogyn st c v ews—s ng ng out women and b am ng the uterus—were no pecu ar ty of the Eng sh. The em nent German psych atr st W he m Gr es nger dent f ed hyster a as symptomat c of oca d sorders of the uterus, ovar es, and vag na. [156] L ke h s
255 Eng sh counterparts, Gr es nger espoused a doctr na re med ca mater a sm n wh ch b o-rea ty was def n t ona y somat c, and phenomena apparent y w thout bod y corre ates were to be presumed mag nary. Fema e hyster a, he d sc osed n h s Menta Patho ogy and Therapeut cs (1845), was thus e ther the product of gen ta d sease or a work of art. Authent c hyster a was somat c, nvo v ng the "morb d act on of . . . the bra n," [157] genera y provoked by vag na y seated erot c st mu us, tse f n turn sparked by menstrua pa n and rregu ar t es, constr ct ons and stoppages, and exacerbated by hab tua masturbat on. But hyster a was often faked—a character st c fo b e of a sex whose ent re demeanor was pockmarked by d shonesty, dece tfu ness, and emot ona waywardness. Gr es nger s "revers on to a somat c exp anat on for hyster ca d sturbances," udged Ve th, "must be ooked upon as a regress on from the psych atr c concepts of P ne and Feuchters eben," above a because he had a "b nd spot" for women s sexua frustrat on. [158] Thus the new sc ences of gyneco ogy and psycho og ca med c ne prov ded tw n p ars support ng the rehab tat on of uter ne theor es of hyster a that became so prom nent throughout the n neteenth century. These ed n turn, w th grow ng frequency, as Jeffrey Masson has amp y documented, to surg ca ntervent ons, nc ud ng the pract ce of hysterectomy and ovar ectomy and the occas ona resort to c tor dectomy or cauter zat on by f gures such as Baker Brown and A fred Hegar, touted as rad ca so ut ons to menta d sorders no ess than to oca nfect ons. It was not unknown, Orne a Moscucc has shown, for Eng sh surgeons to recommend gen ta operat ons for prevent ve psych atr c purposes. [159] Aga nst the backdrop of the "woman prob em," aggress ve med ca zat on thus re nstated, n new gu se, the uter ne patho ogy theory, both regender ng and re-erot c z ng the cond t on.
Neurology and Hysteria En ghtenment sc ent f c med c ne c assed as "nervous" those protean behav ora d sorders, f oat ng free of determ nate es ons, wh ch t termed the vapors and sp een, hyster a, hypochondr a, and me ancho y. Ass m at ng hyster a by th s verba s e ght of hand to one of the ma or organ c systems proved strateg ca y adro t, a ow ng the ncorporat on of the anoma ous w th n prest g ous, systemat z ng, and bod y anchored d sease schemata. Neuro og ca mode s proved equa y fru tfu n the n neteenth century, n context of the spec a d agnost c and bureaucrat c needs of the pub c hosp ta and the mammoth menta asy um. [160] Inst tut ona med -
256 c ne had the burden of process ng—and the benef t of study ng—an nf n te y w der range of morb d cond t ons than ever before encountered c ose up and en masse: chron c, progress ve, and degenerat ve d sorders, above a . Hosp ta med c ne, on the Par s mode , took advantage of the un que ava ab ty of poor pat ents for observat on, exper ment, and postmortem nvest gat on. D agnost c acumen, therapeut c n h sm, and patho-anatom ca expert se comb ned to ay bare a host of degenerat ve d sorders. [161] The asy um kew se prov ded unpara e ed opportun t es for ongterm surve ance (and subsequent autopsy) of ep epsy, dement a, genera pares s, speech and ga t defects; of what wou d eventua y be dent f ed as mu t p e sc eros s; of Park nson s d sease, Hunt ngdon s chorea, cerebra pa sy, and a host of other h therto tt e-tracked sensor motor d sturbances. Such cond t ons, many feared, were spread ng; they certa n y aff cted a hard core of pat ents n n neteenth-century pub c nst tut ons, workhouses, and nf rmar es, and the "back wards" and chron c and ncurab e w ngs of Europe s and North Amer ca s mush-room ng unat c asy ums. Though typ ca y defy ng not ust cure but even anatom ca oca zat on, such cond t ons at east squared w th a popu ar and p aus b e comprehens ve s ckness scenar o, whose parameters were nature and h story: degenerat on. [162] D sorders otherw se baff ng to sc ence were ncreas ng y norma zed by be ng termed const tut ona , hered tary, and degenerat ve. In the absence of tang b e es ons, even postmortem, the nd v dua s ped gree, the fam y h story, became, as t were, a d sp ay of es ons dredged up from the past: the generat ona deter orat on, for nstance, from a coho c great grandparents, through a nymphoman aca prost tute of a grandmother, to a hyster ca mother, and f na y perhaps to an ep ept c ch d. Such genea og ca dec ens ons apparent y a d the d sease aff n t es bare. It s aga nst th s w der degenerat on st backdrop, and n context of the dr ve to trans ate ntractab e d sorders nto neuro ogy through dep oy ng the patho-anatom ca methods p oneered n the c n c, that the career of Jean-Mart n Charcot assumes such monumenta mportance n fram ng yet another parad gm of hyster a. H stor ans have r ght y drawn attent on to the great professor s exerc se of Svenga an author ty over h s fema e pat ents. [163] Yet someth ng far more comp ex was go ng on. The hyster a that Charcot stud ed—or, better perhaps, that he and h s pat ents coproduced—was a pa mpsest of a performance, many ayered w th mean ngs. It bespeaks the utter doc ty of the body, under the char smat c author ty of m nd (above a , the robot behav or of the hypnot zed). It marks def ected, ob que protest—a res stance that, ncapa-
257 b e of verba zat on, was converted nto somat c s gna s of v o ence and bur esque. [164] It may a so be read as dup c tous seduct on: were not the pat ents, or the r d seases, dup ng the sc ent st c, voyeur st c doctors, thereby ron ca y conf rm ng—had Charcot on y known!—f n de s èc e med c ne s conv ct on of the pathognomy of the fem n ne, and nsens b y rat fy ng ma e phob as about woman as the femme fata e? These are ust some of the facets of gender po t cs n Charcot an hyster a, further d ssected n chapter 4 by E a ne Showa ter. Aga nst such a background, a d fferent aspect a so deserves emphas s: Charcot s burn ng des re to make hyster a reputab e, d st ngu shed even, w th n the somat z ng enterpr se of sc ent f c med c ne. As Tr at and M ca e have emphas zed, desp te h s ocat on at the Sa pêtr ère, Charcot never was, nor asp red to be, a psych atr st or a en st n the great trad t on of P ne and Esqu ro . [165] He was an ardent neuro og st, comm tted to the techn ques of patho og ca anatomy, proud to ho d a C n ca Cha r of the Nervous System. He a med to reduce neuro og ca chaos, hyster a nc uded, to order. He was faced w th f end sh y comp ex symptom c usters. Such cond t ons as "ep epsy, hyster a, even the most nveterate cases, chorea, and many other morb d states . . . come to us ke so many Sphynx," he confessed, defy ng "the most penetrat ng anatom ca nvest gat ons." For prec se y that reason, he observed, scept cs urged that hyster a "shou d be ban shed to the category of the unknown." [166] Not so! H s amb t on, n t a y at east, was to p n down nervous phenomena to organ c es ons, and thereby to br ng regu ar system to genera para ys s, neura g as, se zures, ep ept form f ts, spast c symptoms, tabes dorsa s, and, not east, hyster a. [167] And n attempt ng th s Hercu ean abor, far from focus ng exc us ve y upon a troupe of star hyster cs, Charcot a med to show that hyster a partook of the character st cs of neuro og ca d sorders as a who e, d spersed among the commun ty at arge. He thus took pr de n h s demonstrat ons that hyster a v s ted ma es as we as fema es, parents and ch dren a ke, a ga axy of ethn c groups, and, above a , the who e soc a spectrum. [168] W th hyster a, the more t was un versa , the surer the ground ng for ts "sc ent f c ty." Address ng thus the range of ts man festat ons, Charcot s pro ect was comm tted to mass ve c n ca scrut ny of hyster ca patho ogy—motor and sensory symptoms, b zarre v sua abnorma t es, t cs, m gra ne, ep ept form se zures, somnambu sm, ha uc nat ons, word b ndness, a ex a, aphas a, mut sm, contractures, hyperaesthes as, and numerous other def c ts—dev s ng cr t ca exper ments (e.g., upon eyes ght and hear ng pecu ar t es), ref n ng compar son and measurement, and com-
258 p ng av sh and mu t generat ona pat ent h stor es. [169] The contented pos t v st cou d eave no var ab e unturned. Charcot had some measure of success n mapp ng hyster a onto the body. He was de ghted to d scover, for nstance, hysterogen c po nts, zones of hypersens t v ty wh ch, when f ngered, provoked an attack, ana ogous perhaps to the press ng of an e ectr c ght sw tch. Such a d scovery conf rmed h s conv ct on of the rea ty of " atent hyster a." [170] Yet h s ear y fa th that sc ent f c nvest gat on nto hyster a wou d systemat ca y revea demonstrab e neuro og ca substrates ncreas ng y proved a for orn—or, at east, a premature—hope. By consequence, Charcot found he needed to sat sfy h mse f w th an ep phenomena st account of the regu ar t es and aws of hyster a, der ved from ts man festat ons. Character st ca y, he couched h s pra se for h s predecessor, P erre Br quet, n ust these terms; Br quet s ach evement ay n hav ng shown that "hyster a s governed, n the same way as other morb d cond t ons, by ru e and aws, wh ch attent ve and suff c ent y numerous observat ons a ways perm t us to estab sh." [171] Bu d ng thereupon, Charcot thus c a med to have estab shed the ser es or stages of man festat ons, from pet te hystér e through hystér e ord na re up to the grande attaque d hystéro-ep ept que . In th s way c n ca observat ons perm tted the uncover ng, he c a med, of the natura h stor es of extended fam es of re ated def c ts: hem atera anesthes as, pharyngea anesthes as, grandes paroxysmes , pa p tat ons, chorea, Sa nt V tus dance, tert ary neurosyph t c nfect ons, and tempora obe ep epsy. If Sydenham had seen hyster a as the except on to the natura h story of d seases, the pos t v st Charcot, by contrast, be eved he cou d ncorporate t w th n such a taxonomy. "These d seases," he ns sted, "do not form, n patho ogy, a c ass apart, governed by other phys o og ca aws than the common ones." [172] It s th s pass on to um nate hyster a s h dden d spos t on, ts d atheses and frequenc es, that exp a ns Charcot s ast ng pass on for hypnos s and h s br ef encounter w th meta oscopy. Hypnos s served Char-cot as a k nd of tmus test. It became an art c e of fa th w th h m that the capac ty to be hypnot zed was a cruc a exper menta demonstrat on of under y ng, organ c, hyster ca patho ogy. Hypnos s was the dowser s tw g, po nt ng to the reservo r of the patho og ca ; hence h s eagerness to d scred t H ppo yte Bernhe m s v ew that hypnot c states were norma and potent a y un versa . For Charcot, hypnot zab ty was the g veaway of the patho og ca . [173] For s m ar reasons, as Anne Harr ngton has demonstrated, Char-cot s c rc e became fasc nated by V ctor Jean-Mar e Burq s meta oscop c
259 exper ments. Burq c a med that d st nct meta s, each possessed of ts own force neur que , had the power, when brought c ose to a sub ect, to mod fy behav or. Indeed, the b o-magnet st Burq even appeared to have the capac ty, through dep oy ng rods of d verse a oys, to transfer hypnot c and hyster c cond t ons from organ to organ, and from nd v dua to nd v dua , depend ng upon the r "meta c persona ty." Burq s neo-Mesmer c use of rods offered further conf rmat on to the credu ous Charcot ( n a manner echo ng Mesmer h mse f) that hyster a and ts k ndred nervous cond t ons der ved from authent c, f -understood, organ c substrates, be ng sub ect to the un versa phys ca aws govern ng the atom c structures of d fferent meta s. Man pu at on of mood by the man pu at on of meta s showed the very aws of cause and effect at work, no ess c ear y than us ng magnets to make ron f ngs dance. In draw ng upon Burq, the charcoter e (group of d sc p es of Charcot) thus further h tched ts wagon to the r s ng star of ate-n neteenth-century phys cs, w th ts prest g ous doctr nes of ethers and quas -occu t energy sources. [174] How then do we appra se Charcot s character zat on of hyster a? It was c ear y n part the product of the nterprofess ona r va r es of med cosc ent f c spec a sms d scussed ear er. In champ on ng phys o og ca methods to p ot hyster a onto the body, Charcot was p ant ng patho-anatomy s f ag on a cond t on contested by a en sts and c n c ans, gyneco og sts and obstetr c ans. Charcot never approached hyster ca pat ents from the standpo nts of psych atry or psycho ogy. H s nvest gat ve techn ques rema ned arge y nd fferent to the prob ng of the r consc ousness. [175] Why? Inst tut ona ensconcement n the " v ng patho og ca museum" of the Sa pêtr ère[176] and staunch Th rd Repub c pos t v sm conf rmed n Char-cot a concept of sc ence wh ch gave pr or ty to estab sh ng the aws of fe, grounded n the tota ty of the v ng organ sm. Hence he set consc ousness to one s de as essent a y secondary. Of course, he had no doubt that hyster a attacks were common y sparked by menta and emot ona trauma, a be t, natura y, n nd v dua s a ready endowed w th a hyster ca const tut ona d athes s. And, equa y, he had to put h s pat ents m nds to the test n cr t ca exper ments, to w nk e out ma ngerers and se f-pub c sts: h s pneumograph mach ne, for examp e, gave graph c proof that, un ke a genu ne cata ept c, a bogus cata ept c w reg ster fat gue. H nds ght revea s the deep pathos n Charcot s boast that the "prov nce of the phys c an" s "to d ss pate ch canery." [177] But overa , Charcot—un ke certa n of h s protégés such as Janet [178] —showed scant profess ona nterest n what were then be ng ca ed the
260 psycho ogy or psychodynam cs of the pat ents he used for exper menta and pedagog ca purposes. Th s was part y the resu t of c rcumstances. It s ke y, after a , that Charcot s ma n face-to-face contact w th such pat ents ay n c n ca demonstrat ons, h s ass stants and students hav ng been de egated to sub ect them to pr or persona exam nat on. Charcot was thereby probab y the unw tt ng v ct m of both doctor and pat ent comp ance, yes-peop e a n h s Napo eon c emp re. In any case, h s Tuesday C n c sub ects were but work ng-c ass Par s an g r s. Wou d a Charcot cons der t sc ent f ca y fru tfu to nterrogate such r ffraff persona y? (For the sake of h s us ons, t was perhaps ust as we that he d dn t.) One wonders whether Charcot used dent ca , that s, neuro og ca , approaches on h s pr vate pat ents: t was certa n y h s content on that, n hyster a, "everyth ng fo ows def n te ru es—a ways the same, whether the case s met w th n pr vate or hosp ta pract ce." [179] Charcot the pub c f gure, the nst tut ona man, and champ on of the d sc p ne of neuropatho ogy, was who y wedded to the pos t ve sc ent f c pursu t of hyster a as a patho ogy of the const tut on. We know a too tt e of how far the pub c Charcot a so had a doub e, one prepared to e aborate on the more psycho og ca perspect ves mp ed by h s notor ous as de, "C est tou ours a chose gén ta e "—a remark reestab sh ng prec se y that nk between hyster a and ubr c ty wh ch he hab tua y den ed. [180] Charcot p ayed the sc ent st, an ep phenomena st ns stent that hyster a was a funct on of the body. Sc ence s po nt of entry ay not n psycho ogy but n phys o og ca st gmata, re nforced by degenerat on st neuropathy ("contracture d athes s" or " atent hyster a"). "Neuropath c hered ty," he be eved, "f gures consp cuous y n the et o ogy of hyster a," [181] for "hyster a s often hered tary." [182] Hyster a, of course, had ts emot ona corre ates (attent on seek ng, coquett shness, y ng), but these were ch ef y by-products, symptomat c of more bas c psychophys o og ca defects embedded n bod es over the generat ons. [183]
Hysteria, Psychiatry, and the Clinical Encounter N neteenth-century transformat ons n med c ne and soc ety produced the r reconceptua zat ons of hyster a. Gyneco ogy and psycho og ca med c ne nteracted to represent hyster a as a woman s d sease, stemm ng from the reproduct ve system and generat ng an emot ona patho ogy. By contrast, the patho-anatom ca gaze of hosp ta med c ne mag ned a hyster a that was un sex and ndexed by mu t p e behav ora rregu ar t es that were deemed u t mate y neuro-phys o og ca . In th s
261 h gh y schemat c account, a th rd and f na n t at ve rema ns to be d scussed: the deve opment of a psycho og ca theory of hyster a. The nte ectua roots of th s approach e n unat c asy um reform around the turn of the n neteenth century. Lead ng asy um super ntendents, part cu ar y Ch arug , P ne , Johann Re , and the Tukes (W am and Samue ), repud ated trad t ona organ c noso og es and med ca therapeut cs as m sconce ved and neff cac ous, urg ng nstead techn ques of mora management and mora therapy. W th n the r theor es, nsan ty was redef ned as spr ng ng from consc ousness—the nte ect and the pass ons—thus necess tat ng treatment on psycho og ca pr nc p es, by appea s to reason, human ty, and the fee ngs (fear and esteem, p easure and pa n, etc.). Here n ay the found ng of psych atry. Be ng ch ef y concerned w th desperate asy um cases, such authors natura y had rather tt e to say about hyster a per se. But the r v s on of an authent c secu ar psychopatho ogy ater proved a source of nsp rat on and author ty. [184] Psycho og ca theor es of hyster a were deve oped by doctors act ve n bourgeo s pr vate pract ce. Th s shou d come as no surpr se. Such pract ces necess tated protracted and nt mate contact w th pat ents, women above a , who—whatever the r actua med ca h stor es—were utter y au fa t w th the power possessed by s ckness and nva d sm to secure resp te or everage w th n the po t cs of the fam y. The cu ture of sens b ty, part cu ar y among those on whose hands t me hung heav y, encouraged hypersens t v ty to ma a se. Bourgeo s sufferers were both ntrospect ve and voca n the r comp a nts, rat ona zat ons, and demands. L tt e wonder that the aff n ty between hyster ca symptoms and the outpour ngs of consc ousness m ght be thought to stare phys c ans n the face. I have argued ear er that doctors typ ca y refused th s assoc at on. The rs was a menta set wh ch, by profess ona art c e of fa th, and a most by way of ref ex, equated s ckness w th the somat c. Many chose, as suggested above, for the r pat ents peace of m nd, surrept t ous y to trans ate comp a nts nto somat c a ments (nervous stomach, and so forth), be ev ng th s recourse opt ma , for a concerned, for negot at ng tr cky cond t ons. A few, however, broke out of th s convent on, perhaps th s p ous fraud. Why th s happened n the part cu ar case s genera y mposs b e to dec pher. The consequences were, however, qu te rad ca : trans at ng hyster a nto a ma ady of the m nd drast ca y changed the ru es of the game. It typ ca y reduced hyster a from a d sease nto a dece t; excu pat on turned to nd ctment; and a darker psychopatho ogy emerged of the pretend hyster c, a most w thout except on fema e. Hys-
262 ter a as the d sease-m m ck ng d sease made way for the hyster c as the woman (or the woman s unconsc ous ) pretend ng to be . These moves appear most stark y n the wr t ngs of Robert Carter, a man pra sed by Ve th for h s "c ear ns ght nto the psychopatho ogy of hyster a" and h s "advanced" d scovery of sexua et o ogy. [185] Carter was a young genera pract t oner n the eafy London suburb of Leytonstone when he pub shed h s On the Patho ogy and Treatment of Hyster a n 1853. [186] In t, he rev ewed a ava ab e somat c theor es of the cond t on—Cu en s and P ne s v ew that t was a morb d cond t on of the uter ne nerves; Cheyne s and Ca eb Parry s nd ctment of the stomach; H ghmore s c a m that t was consequent upon ung and heart congest on; the not on, assoc ated w th Whytt, T ssot, Boerhaave, and Bo ss er de Sauvages, that t was a d sease of the nervous system; W s s theory, rev ved by Et enne Georget, that t was a morb d cond t on of the bra n; Gerard Van Sw eten s "morb d cond t on of the sp na cord," and so forth. A w thout except on he udged as ack ng authent cated foundat on; for "the d sease tse f s too sh ft ng and var ab e to depend upon any def n te change n any nd v dua organ." [187] Above a , attempts to ground hyster a n " rr tat on of the uterus and ovar a [were] . . . utter y untenab e"— ndeed, mere y c rcu ar. [188] Hyster a, n short, was not somat c at a , but psycho og ca : "The emot ona doctr ne affords an easy and comp ete so ut on of the d ff cu ty." Indeed, ts et o ogy ay spec f ca y n "the sexua fee ngs," these be ng "both more un versa and more constant y concea ed than any others." [189] What was the mechan sm of the psycho og ca theory of hyster a? Draw ng upon the wr t ngs of W. B. Carpenter, Thomas Laycock, and other Br t sh psychophys o og sts, he exp a ned that, w th n the regu ar se f-ad ust ng system of the metabo sm, strong emot ons (fear, oy, etc.) shou d proper y f nd hea thy out et n phys ca re ease such as tears, aughter, f ght, and so on. Obv ous y, centra among the emot ons were the sexua pass ons. Idea y these found natura fu f ment n erot c act v ty, u t mate y n orgasm. D scharg ng such des res rare y posed prob ems for ma es. [190] In modern c v zat on, however, the doub e standard common y den ed such re ef to women—a resu t of h gh mora expectat ons and the "hab tua restra nt" mposed upon ad es by respectab ty. Den ed the "safety va ve" [191] of such d rect, phys o og ca out ets, women were forced to bott e up the r amatory ong ngs and suffer what Carter ca ed repress on. Intense persona cr ses (e.g., a broken engagement) cou d eas y cause that dam to burst, however, whereupon nd rect tens on re ease was un ntent ona y ga ned n hyster a—expressed n outbreaks of un-
263 contro ab e sobb ng, shak ng, f ts, temper, and the ke. Such hyster a—"a d sease start ng w th a convu s ve paroxysm" [192] —Carter ca ed "pr mary"; t was, n a sense, a spontaneous compensatory mechan sm des gned to make the best of a bad s tuat on. Some sa utary tens on-d scharge was at east ach eved, and eventua y the sobb ng or tantrum wou d p ay tse f out and ca m wou d be restored. Pr mary hyster a of th s k nd d d not requ re the phys c an s serv ces. Hyster a d d not stop there, however. For unfortunate y, "the suggested or spontaneous remembrance of the emot ons" [193] attend ng the pr mary f t cou d eas y provoke further attacks, wh ch Carter dubbed "secondary hyster a." Sufferers, re at ves, and doctors a ke cou d he p foresta such secondary attacks by prov d ng appropr ate d stract ons. Such prevent on was prudent, for pat ents qu ck y hab tuated themse ves to secondary hyster a, f nd ng t prov ded them w th compensatory p easures—not east, attent on. Worse, such nd rect grat f cat ons read y deter orated nto "tert ary hyster a," wh ch Carter def ned as a cond t on "des gned y exc ted by the pat ent herse f through the nstrumenta ty of vo untary reco ect on, and w th perfect know edge of her own power to produce them." [194] In short, tert ary hyster a—Carter s pr me concern—was an ego-tr p, mob zed by the pat ent s w , for tyrann z ng others. The tert ary hyster c, n Carter s v ew, had thus sunk to appa ng depths of mora deprav ty, contr v ng to man pu ate a around her, so as to grat fy her wh ms and dom neer ng sp r t, and enab e her to bask n the "fuss and parade of ness." [195] Because th s exerc se of w was who y camouf aged n somat c express ons, t natura y compe ed sympathy (the pat ent, after a , appeared dramat ca y s ck), w thout r sk ng susp c ons of shamm ng. The greater the sympathy t won, the more tyrann ca t became. Hyster cs grew expert n the r art. Thus, to create an effect, Carter noted, "ha r w often be so fastened as to fa at the s ghtest touch," and other h str on c effects wou d test fy to the " ngenu ty of the performer. [196] Such a m nx, man pu at ng a "se f-produced d sease" n wh ch the pat ent herse f had fu "power over the paroxysm," [197] cou d be overcome on y by a batt e roya engaged by the phys c an, w ng to enter nto a war of w s. Defeat ng the "tr cks" of such a monster of "se f shness and decept v ty," possessed of a "mendac ty that verges on the sub me," [198] was not, however, an easy matter; for the symptoms of phys ca ness ( nc ud ng n the extreme case the tac t threat of fast ng unto death) were powerfu weapons to have n one s armory. Carter knew med ca means were utter y rre evant (no Mesmer c magnets for h m). Psycho og ca warfare was needed to defeat "the ends wh ch she proposes to
264 herse f for atta nment." [199] F rst, the hyster c had to be separated from her parents and fr ends and ncarcerated n the phys c an s home. Once there, under no c rcumstances shou d the doctor "m n ster to the hyster ca des re." [200] Every b d of the pat ent to use hyster ca tantrums to command attent on had to be steadfast y gnored and thus proven fut e: no not ce was to be taken of convu s ons, se f-starv ng, or acts of se f-mut at on; above a , the hyster c s crav ngs for surrogate sexua grat f cat on, espec a y through demands for vag na exam nat ons w th a specu um, had to be res sted. [201] Norma , soc ab e behav or was, by contrast, to be encouraged and rewarded. No ho ds were barred. The hyster c was m stress of dup c ty, and, n response, the phys c an wou d often f nd t necessary to "comp ete y dece ve her." [202] H s most d ff cu t task was to f nd tactfu ways of commun cat ng to the hyster c that her w es had been rumb ed and the game was up. D p omat ca y done, th s wou d afford her the opportun ty to surrender w th honor, and put herse f "comp ete y n the power of her nter ocutor," [203] whereupon she m ght make a c ean breast of th ngs, preparatory to be ng re ncorporated, as the prod ga daughter, nto norma , bourgeo s fe (that fe whose constra nts and doub e standards, Carter h mse f had n t a y acknow edged, were respons b e for hyster a n the f rst p ace). Severa aspects of Carter s account of how to tame a hyster ca shrew and br ng her to "hum at on and shame" are worth not ng. [204] For one th ng, h s psycho og ca read ng of hyster a drew heav y upon the d om and prem ses of ear y n neteenth-century psych atry; Carter exp c t y va ued "mora management" and "mora therapy." [205] He proposed turn ng h s own abode nto a hyster cs asy um, n whose goth c so at on the batt e for the m nd cou d be waged. One m ght g oss th s by not ng that as a young genera pract t oner, Carter was n no pos t on to contemp ate the abor ous nvest gat on of the aws of hyster a as undertaken by Professor Charcot at the Sa pêtr ère. Econom cs forced Carter—as to some degree Freud after h m—to be concerned w th cure rather than sc ent f c exp orat on, and to have an eye to fees. Draw ng upon contemporary asy um psych atry, Carter forged a conceptua tr ang e of e ect ve aff n t es, profound y pregnant for the future, nk ng (1) psycho og ca exp anat on w th (2) fema e nature and (3) a sexua et o ogy ("sexua emot ons are those most concerned n the product on of the d sease"). [206] In other words, n ts grave forms, hyster a was a matter of menta acts (frauds), perpetrated by women , n order to ach eve surrogate sexua grat f cat on. By contrast, however, to ear er uter ne theor es, Carter s hypothes s d d not ay b ame at the door of
265 fema e anatomy: rather what Hack Tuke ater ca ed a "para ys s of the w " was at fau t. A though Carter noted that " f the state of soc ety perm tted free express on" [207] of fema e sexua des res, hyster a m ght d sso ve away, he produced not a cr t ca soc o ogy of hyster a but a mora z ng nd ctment of se f- ndu gent women. In th s, h s d om exp c t y echoed the w tch-hunt, as when he remarked that the hyster c who made a hash of fak ng d sease thereby "betrays the c oven foot." [208] The soc a h stor es of V ctor an med c ne on the one hand, and of women on the other, eave t sure y no acc dent that the prototyp ca psychogen c theory of hyster a was m sogyn st c and v ct m b am ng. For the ra son d être of psycho og z ng hyster a was prec se y to deny ts authent c ty as a ma ady, expos ng t as fraud nvo v ng a terr b e "degree of pervers on of the mora sense." [209] In the h story of hyster a, sexua et o og es, genderedness, and v ct m b am ng have ever gone together.
Conclusion Th s chapter has been h gh y se ect ve. In concentrat ng upon the v ewpo nt of doctors, t has had tt e to say about how sufferers represented hyster a to themse ves, nor ndeed about why peop e "somat ze." [210] It has had noth ng to say about ntr gu ng subsets of hyster a—mass hyster a, the hyster ca persona ty— n wh ch m nd/body ssues a so s gn f cant y underp n the controvers es. It has ne ther exam ned the ntr cac es of Freud s formu at ons over a per od of some twenty years, nor surveyed Freud s contemporar es such as Janet and Bab nsk . [211] It wou d, however, seem that the d sso ut on of the hyster a d agnos s n the wake of Freud may be seen, n part at east, n terms of those sh fts n modern onto ogy ment oned ear er n the d scuss on of Szasz s contr but on. Mon que Dav d-Ménard, for nstance, has suggested that the Lacan an trans at on of the ocat on of the psyche from the Freud an menta underground to the doma n of anguage has n effect rendered utter y obso ete most of the m nd/body ssues so f erce y d sputed by the e ghteenth- and n neteenth-century doctors d scussed n th s chapter. Not surpr s ng y. The psychoana yt ca enterpr se, un ke the V ctor an fam y or the Wor d War I trench, un ke the nerve sanator um or the gyneco og ca operat ng tab e, s ent re y a theater of words. [212] And th s s the po nt. In the case of hyster a, d sease formu at ons, I have been argu ng, go w th c rcumstances: doctors, pat ents, phys ca m eux, nte ectua and cu tura andscapes. My concern has been to argue that hyster a cou d be fash oned as a d sorder, prec se y because the cu ture-at- arge susta ned tense and amb guous re at ons between
266 representat ons of m nd and body, wh ch were, n turn, reproduced n the h erarch ca yet nteract ve onto og es of mora ty and med c ne, and, yet aga n, ref ected by the soc o og ca nterp ay of c n ca encounters. In hyster a, as w th other d sorders, d fferent f e ds of force break n d st nct ve ways, and med c ne p ays doub e games. Somet mes ts m ss on s reduct on st, reso v ng hyster a now nto the womb, now nto mere w fu ness. In other c rcumstances, med c ne seeks to render hyster a rea , protect ng ts myster es. In hyster a, m nd and body may be seen as sub mated representat ons of doctors and pat ents.
286
Four— Hysteria, Feminism, and Gender Elaine Showalter1 Hyster a has taken many strange turn ngs n ts ong career, but one of the most surpr s ng s the modern marr age of hyster a and fem n sm, the fasc nat on among fem n st nte ectua s, terary cr t cs, and art sts w th what Mary Ke y ca s "the cont nu ng romance of hyster a." [1] Fem n st understand ng of hyster a has been nf uenced by work n sem ot cs and d scourse theory, see ng hyster a as a spec f ca y fem n ne proto anguage, commun cat ng through the body messages that cannot be verba zed. For some wr ters, hyster a has been c a med as the f rst step on the road to fem n sm, a spec f ca y fem n ne patho ogy that speaks to and aga nst patr archy. For others, the famous women hyster cs of the n neteenth century have been taken to ep tom ze a un versa fema e oppress on. As the French nove st and theor st Hé1ène C xous me odramat ca y nqu res, "What woman s not Dora?" [2] Th s ardent rec a m ng of hyster a n the name of fem n sm s a new tw st n the h story of the d sorder. Throughout ts h story, of course, hyster a has a ways been constructed as a "woman s d sease," a fem n ne d sorder, or a d sturbance of fem n n ty, but th s construct on has usua y been host e. Hyster a has been nked w th women n a number of unf atter ng ways. Its vast, sh ft ng reperto re of symptoms rem nded some doctors of the ab ty and capr c ousness they assoc ated w th fema e nature. "Mutab ty s character st c of hyster a because t s character st c of women," wrote the V ctor an phys c an Edward T t. " La donna è mob e . " [3] Doctors have tended to favor arguments from b o ogy that nk hyster a w th fema eness: "Women are prone to hyster a because of someth ng fundamenta n the r nature, someth ng nnate, f xed or
287 g ven that obv ous y requ res nteract on w th env ronmenta forces to become man fest but s st a pr mary and rremed ab e fate for the human fema e." [4] "As a genera ru e," wrote the French phys c an Auguste Fabre n 1883, "a women are hyster ca and . . . every woman carr es w th her the seeds of hyster a. Hyster a, before be ng an ness, s a temperament, and what const tutes the temperament of a woman s rud mentary hyster a." [5] The hyster ca se zure, grande hystér e , was regarded as an act ng out of fema e sexua exper ence, a "spasm of hyper-fem n n ty, m m ck ng . . . both ch db rth and the fema e orgasm." [6] In the twent eth century, these v ews about an essent a and organ c fema e b o ogy that produces hyster a have mutated nto more psycho og ca portra ts that nk hyster a w th fem n n ty — w th a range of "fem n ne" persona ty tra ts. In a psychoana yt c context, women have been seen as d sadvantaged n master ng oed pa tasks and thus d sposed to hyster ca behav ors. Thus, accord ng to the Br t sh ana yst Gregor o Kohon, "A woman at heart a ways rema ns a hyster c." [7] Pau Chodoff notes that hyster ca behav ors "may present as . . . unattract ve, no sy, emot ona d sp ays . . . or as the hyster ca (h str on c) persona ty d sorder—a DSM-III d agnost c abe , referr ng to hab tua and susta ned patterns of behav or character st c of some women." [8] The d agnos s becomes "a car cature of fem n n ty" but a so an exaggerat on of the cogn t ve and persona sty es that women are encouraged to deve op as attract ve y "fem n ne." [9] Unt recent y, stor es about hyster a were to d by men, and women were a ways the v ct ms n these stor es rather than the hero nes. In the past few decades, however, the story of hyster a has been to d by women h stor ans as we as by ma e doctors and psychoana ysts. They have argued that hyster a s caused by women s oppress ve soc a ro es rather than by the r bod es or psyches, and they have sought ts sources n cu tura myths of fem n n ty and n ma e dom nat on. What we m ght ca the "herstory" of hyster a s the contr but on of fem n st soc a h stor ans to th s pro ect, n works that concentrate on the m sogyny of ma e phys c ans and the persecut on of fema e dev ants n w tch-hunts. [10] But as Mark M ca e notes, "No ne of evo ut on w th n the h stor ography of hyster a s more comp cated than the fem n st one." [11] The fem n st romance w th hyster a began n the wake of the women s berat on movement of the ate 1960s and the French événements of May 1968, when a young generat on of fem n st nte ectua s, wr ters, and cr t cs n Europe and the Un ted States began to ook to Freud an and Lacan an psychoana ys s for a theory of fem n n ty, sexua ty, and sexua d fference. They began w th the V ennese women who were treated by
288 Freud and Breuer for hyster a, and who had n a sense g ven b rth to the psychoana yt c method, the "ta k ng cure." Fem n st nterpretat ons of hyster a n women offered a new perspect ve that decoded phys ca symptoms, psychotherapeut c exchanges, and terary texts as the presentat ons of conf ct over the mean ng of fem n n ty n a part cu ar h stor ca context. Hyster a came to f gure as what Ju et M tche ca s "the daughter s d sease," a syndrome of phys ca and ngu st c protest aga nst the soc a and symbo c aws of the Father. [12] Many Lacan an fem n st cr t cs nterpret hyster a as a women s anguage of the body, or pre-oed pa sem ot cs. St others see b sexua ty as the s gn f cance of the syndrome. Thus Jane Ga op wr tes, "Freud nks hyster a to b sexua ty; the hyster c dent f es w th members of both sexes, cannot choose one sexua dent ty. . . . If fem n sm s the ca ng nto quest on of constra n ng sexua dent t es, then the hyster c may be a protofem n st." [13] S m ar y, C a re Kahane def nes "hyster ca quest ons" as quest ons about b sexua ty and sexua dent ty: "Am I a man? Am I a woman? How s sexua dent ty assumed? How represented?" [14] But cou d hyster a a so be the son s d sease, or perhaps the d sease of the power ess and s enced? A though ma e hyster a has been documented s nce the seventeenth century, fem n st cr t cs have gnored ts c n ca man festat ons, wr t ng as though "hyster ca quest ons" about sexua dent ty are on y women s quest ons. In order to get a fu er perspect ve on the ssues of sexua d fference and dent ty n the h story of hyster a, however, we need to add the category of gender to the fem n st ana yt c reperto re. The term "gender" refers to the soc a re at ons between the sexes, and the soc a construct on of sexua ro es. It stresses the re at ona aspects of mascu n ty and fem n n ty as concepts def ned n terms of each other, and t engages w th other ana yt ca categor es of d fference and power, such as race and c ass. Rather than seek ng to repa r the h stor ca record by add ng women s exper ences and percept ons, gender theory cha enges bas c d sc p nary parad gms and quest ons the fundamenta assumpt ons of the f e d. [15] When we ook at hyster a through the ens of gender, new fem n st quest ons beg n to emerge. Instead of trac ng the h story of hyster a as a fema e d sorder, produced by m sogyny and chang ng v ews of fem n n ty, we can beg n to see the nked att tudes toward mascu n ty that nf uenced both d agnos s and the behav or of ma e phys c ans. Converse y, by app y ng fem n st methods and ns ghts to the symptoms, therap es, and texts of ma e hyster a, we can beg n to understand that ssues of gender and sexua ty are as cruc a to the h story of ma e exper ence as they have been n shap ng the h story of women.
289 In part cu ar, we need to see how hyster a n men has a ways been regarded as a shamefu , "effem nate" d sorder. In many ear y stud es the ma e hyster c was assumed to be unman y, woman sh, or homosexua , as f the fem n ne component w th n mascu n ty were tse f a symptom of d sease. John Russe Reyno ds wrote n A System of Med c ne that hyster ca men and boys were "e ther menta y or mora y of fem n ne const tut on." [16] n h s case stud es of ma e hyster a at the end of the n neteenth century, Em e Batau t observed that hyster ca men were thought to be "t m d and fearfu men. . . . Coquett sh and eccentr c, they prefer r bbons and scarves to hard manua abor." These expectat ons made t d ff cu t for doctors to accept the hyster a d agnos s n men who seemed convent ona y v r e. Wh e t m ght be poss b e to " mag ne a perfumed and pomaded femme ette suffer ng from th s b zarre ma ady," Batau t noted, "that a robust work ng man has nerves and vapours ke a woman of the wor d" stra ned credu ty. [17] The pre ud ces and stereotypes Batau t protested at the Sa pêtr ère are a ve and we n the twent eth century. "One gets the mpress on," an ana yst notes, "that a ma e hyster c s one who behaves ke a woman. " [18] W he m Re ch descr bed the ma e hyster c as character zed by "softness and over-po teness, fem n ne fac a express on and fem n ne behav or." [19] The mage of the hyster c n psych atr c terature s such that "the man who wou d most c ose y f t the descr pt on wou d be a pass ve homosexua ." [20] Thus d scuss ons of ma e hyster a, rather than transform ng the d scourse of hyster a as represent ng the worst aspects of fem n n ty, actua y re nforce the stereotype that t s the d sease of weak, pass ve, over y emot ona peop e, whether fema e or ma e. Gender constructs, moreover, are not restr cted to the med ca profess on. They a so nf ect the way we wr te the h story of med c ne and psych atry. Wh e fem n st terary cr t cs often seem narrow n the r use of h story, m t ng the r textua nterpretat ons to a t ny group of famous doctors and pat ents, h stor ans are rare y sens t ve to f gurat ve anguage and to the nscr pt ons of gender deo ogy n med ca texts. H story can show us where to ook for a more accurate and comp ete p cture of hyster a, but terary cr t c sm can show sc ent sts and h stor ans how to read the texts and gender subtexts of med c ne, psych atry, and h story tse f. For wh e soc a h stor ans of hyster a have been sens t ve to the ways that att tudes toward women shaped and d storted the work of doctors ke Robert Brudene Carter, Charcot, or Freud, they have wr tten as f they too were not nf uenced by gender constructs. Issues of sexua d fference are re evant to h stor ography as we as med c ne. Moreover, wr t ng about hyster a s d fferent for women than t s for
290 men. Because of trad t ona be efs about the potent a hyster a of a women, women scho ars are more consc ous of the need to f nd an ob ect ve, mpersona , and sc ent f c anguage and d scourse about the sub ect. How can one who s potent a y hyster ca , "at heart a ways a hyster c," transcend her nature to wr te about the d sorder? S nce fem n sm has often been nterpreted as hyster a by ma e phys c ans and soc a cr t cs, women wr t ng about hyster a n the ear y part of the twent eth century may have avo ded fem n st nterpretat ons of hyster ca phenomena. On the other hand, men wr t ng about hyster a, n ma es or fema es, can masquerade the r own emot ons as reason, or d sgu se fee ng and pre ud ce beh nd other term no og es and se fdef n t ons. In h s study L hystér que, e sexe, et e médec n , the French psych atr st Luc en Israë d scusses the "unconsc ous comp c ty between s ck men and ma e doctors to avo d the shamefu and nfamous d agnos s of hyster a." But when he ta ks about what he terms "successfu hyster cs," peop e who n the r adu t ves seemed to outgrow the r ado escent hyster a, or transformed what had been hyster ca symptoms nto soc a causes, Israe ment ons on y women, such as Mary Baker Eddy, the founder of Chr st an Sc ence, and Bertha Pappenhe m, or Anna O., who became a German fem n st eader. He sees the r ded cat on as an evo ut onary form of fem n ne hyster a tse f, an obsess ve des re to become the maître rather than subm t to h m, an act ng out of fantas es of devot on. Thus fema e act v sm becomes mere y a construct ve patho ogy, and fem n sm on y a hea th er form of hyster a. It does not occur to Israë to abe F aubert or Sartre a successfu hyster c, et a one to specu ate on the way th s scenar o m ght exp a n the career dec s ons of ma e psychoana ysts. [21] Language has p ayed a ma or ro e n the h story of hyster a; to pry apart the bond between hyster a and women, to free hyster a from ts fem n ne attr butes, and to berate fem n n ty from ts bondage to hyster a, means go ng aga nst the gra n of anguage tse f. To beg n w th, as He en K ng shows n chapter 1, hyster a has a ways been etymo og ca y nked w th women and the fem n ne because of ts name. We can argue that when Freud s V ennese co eague d sm ssed Freud s ta k on ma e hyster a because men d dn t have wombs, he was pathet ca y out of date; nonethe ess, the word tse f has become so gener ca y nked w th the fem n ne n popu ar understand ng that we need to spec fy ma e hyster a the way we spec fy women wr ters, whereas to say fema e hyster a sounds redundant. Because of th s understand ng and the st gma t has carr ed, throughout the centur es doctors have sought to f nd other names for hyste-
291 r a n men. As Israe exp a ns, "The hyster a d agnos s became for a man . . . the rea n ury, a s gn of weakness, a castrat on n a word. To say to a man you are hyster ca became under these cond t ons a form of say ng to h m You are not a man. " [22] To avo d such a confrontat on, doctors sought unconsc ous y to mask the hyster a d agnos s under other terms; n France n the n neteenth century, for examp e, t was known as "neurospasme," "tarass s," "d dyma g e," "encépha e spasmod que," or "neuropath e a gue cérébro-pneumogastr que." Furthermore, hyster a s nvar ab y represented as fem n ne through the f gures of med ca and h stor ca speech. Eve yn Fox Ke er, Ludm a Jordanova, Em y Mart n, and Cynth a Russett, among others, have begun n recent years to ana yze the gendered rhetor c and ep stemo ogy of sc ent f c nqu ry, through c ose read ng of the f gures, metaphors, and representat ons that have a ways been part of med ca d scourse. [23] Such mages are not mere y decorat ve or acc denta , they argue, but are a fundamenta part of the gendered anguage that sc ence shares w th other human d scourses. As Jordanova notes, "the b omed ca sc ences dep oy, and are themse ves, systems of representat on. If dev ces ke person f cat on and metaphor have been centra to sc ent f c th nk ng, then the not on of representat on becomes a centra ana yt ca too for h stor ans." [24] He en K ng po nts out that the h story of hyster a depends on a ser es of texts, on the way anguage was dep oyed and trans ated w th n these texts, and on the narrat ves of fema e power and power essness that were based upon them. In order to understand the ongev ty and cu tura force of these narrat ves, we need to ook at term no ogy, metaphor, and narrat ve techn ques as we as at stat st cs and theor es. In h s recent study, for examp e, Et enne Tr at d scusses the theor es of ma e hyster a that have f our shed for severa centur es. But h s mages te a d fferent story. "A psychoana yt c theory was born from hyster a," he wr tes, "but the mother d ed after the b rth." Even n deny ng the sexua et o ogy of hyster a, thus h stor ography re nscr bes t through anguage echo ng the trad t ona term no ogy for hyster a, the "suffocat on of the mother" or the "mother." [25] We cou d a so ook at the str k ng metaphor Breuer used n Stud es on Hyster a when he ca ed hyster cs "the f owers of mank nd, as ster e, no doubt, but as beaut fu as doub e f owers." [26] The mage s botan ca , sexua , and aesthet c. In cu t vated f owers, doub ng comes from the rep acement of the stamens by peta s. L ke the doub e f ower, Breuer mp es, the hyster c s the forced bud of a domest c greenhouse, the product of uxury, e sure, and cu t vat on. Her reproduct ve powers have been sacr f ced to her nte ect and mag nat on. L ke the curved f owers
292 of Art Nouveau, or the Jüngenst h , she s a so an aesthet c ob ect, stand ng n re at on to a more sober "mank nd" as fem n ne and decorat ve. F na y, the hyster c s seduct ve and attract ve, but ncapab e of matern ty or creat v ty. From Breuer s po nt of v ew, as the case stud es make c ear, the hyster c s ster ty and her ntense abnorma f ower ng go together, as f to echo V ctor an stereotypes about the ncompat b ty of uter ne and cerebra deve opment. But from the woman s po nt of v ew, ster ty may resu t from be ng n advance of one s t me and unab e to f nd a partner. The same metaphor s used by O ve Schre ner, herse f an examp e of the New Woman who overcame hyster ca d sorders to ead an mportant career as a fem n st and wr ter. Schre ner mag ned that f sex and reproduct on cou d be separated, human sexua ty, espec a y fema e sexua ty, m ght become ke the cu t vated rose, wh ch "hav ng no more need to seed turns a ts sexua organs nto peta s, and doub es, and doub es; t becomes ent re y aesthet c." [27] For Schre ner, the hyster c s thus a member of the sexua avant-garde. Ma e homosexua s too can be read, perhaps more prec se y than women, nto Breuer s metaphor of the doub e f ower. They are Schre ner s h gh y evo ved be ngs who have perforce separated sexua ty from reproduct on, and who must pour the r creat v ty nto art. In h s study of Oscar W de, for examp e, Ne Bart ett ca s W de s green carnat on the symbo c f ower of the gay man: "A homosexua , ke a hothouse f ower, dec ares h s super or ty to the mere y natura . . . . Homosexua s are ster e . . . they b ossom n the form of works of art." [28] It s not surpr s ng that the metaphors of hyster a shou d conta n doub e sexua messages about fem n n ty and mascu n ty, for throughout h story, the category of fem n ne "hyster a" has been constructed n oppos t on to a category of mascu ne nervous d sorder whose name was constant y sh ft ng. In the Rena ssance, these gendered b nary oppos t ons were set up as hyster a/me ancho y; by the seventeenth and e ghteenth centur es, they had become hyster a/hypochondr a; n the ate n neteenth century they were transformed nto hyster a/neurasthen a; dur ng Wor d War I, they changed yet aga n to hyster a/she shock; and w th n Freud an psychoana ys s, they were coded as hyster a/obsess ona neuros s. But whatever the chang ng terms, hyster a has been constructed as a per orat ve term for fem n n ty n a dua ty that re egated the more honorab e mascu ne form to another category. If we go back to med ca records from the ear y seventeenth century, we f nd a d fferent at on between hyster a, a d sorder that was be eved to have ts or g ns n d sp acement of the uterus and the accumu at on
293 of putr d humors; and me ancho y, a prest g ous d sorder of upper-c ass and nte ectua men. V eda Sku tans has po nted out that "the ep dem cs of me ancho y wh ch swept the fash onab e c rc e of London from 1580 onwards cur ous y bypassed women." [29] She sees a connect on between the m sogyn st c terature that f our shed dur ng the ate seventeenth century and the emergence of hyster a as a s gn f cant d agnost c category. By the end of the seventeenth century, me ancho y and hyster a had been o ned by new fash onab e d seases: the sp een, vapours, and hypochondr a; and these d sorders were a so d fferent ated by gender. Sp een and vapours were seen as ak n to hyster a, fema e ma ad es that came from the po sonous fumes of a d sordered womb. As Roy Porter has d scussed n chapter 3, ate seventeenth-century accounts of the neuro og ca aspects of hyster a that moved away from the uter ne theory a so advanced theor es of ma e hyster a. In these accounts phys c ans were agreed that hyster ca men were much rarer than hyster ca women, that they behaved n woman sh ways, and that the r aff ct on shou d be ca ed "hypochondr as s." Accord ng to Thomas Sydenham, for examp e, hypochondr aca symptoms were as s m ar to hyster ca symptoms "as one egg s to another" and cou d be seen n "such ma e sub ects as ead a sedentary or stud ous fe, and grow pa e over the r books and papers." [30] In the e ghteenth century, there was a gender sp t n the representat on of the body, w th the nervous system seen as fem n ne, and the muscu ature as mascu ne. [31] Doctors made a f rm gender d st nct on between forms of nervous d sorder, ass gn ng hyster a to women and hypochondr a to men. Accord ng to the French phys c an Jean-Bapt ste Louyer-V ermay, these categor es a so corresponded to a psycho ogy of sex d fferences. Turbu ent pass ons, amb t ons, and hate, wh ch were natura to men, pred sposed them towards hypochondr a, wh e n women the dom nant emot on was that of ove. [32] Concern w th the fem n z ng abe of hyster a obv ous y affected d agnos s; when Edward Jenner had hyster ca symptoms, he noted that " n a fema e I shou d ca t hyster ca —but n myse f I know not what to ca t but by the o d sweep ng term nervous." In Eng and, most V ctor an med ca men "had the dea that there was a menta d sease for each sex—hypochondr as s for the ma e and hyster a for the fema e." [33] By the n neteenth century, the sexua spec f c ty of hyster a and hypochondr as s had become a med ca dogma, so that "when hyster a s adm tted n men, t s understood neverthe ess as a fema e aff ct on." [34] Thus the V ennese doctor Ernst von Feuchters eben n 1824 argued that f women showed s gns of hypochondr as s they
294 must be "mascu ne Amazon an women," wh e hyster ca men "are for the most part effem nate men." [35] But whereas hypochondr as s had started as a d gn f ed ness that a man m ght even c a m w th some mascu ne se f-respect, dur ng the n neteenth century t too gradua y became estab shed as a form of menta d sorder that carr ed ts own st gma. In the e ghteenth century, the man of cu t vat on and nte ect who suffered from a var ety of aff ct ons was un versa y adm red, but when t became embarrass ng for men to acknow edge that they were hypochondr acs, and such peop e, ke Jane Austen s Mr. Woodhouse, became f gures of fun, a new mascu ne term was requ red to set a ongs de hyster a. In 1873, th s gap n the med ca ex con was f ed by the term neurasthen a . "Undoubted y the d sease of the ma e sub ect n the ate n neteenth century," [36] neurasthen a was f rst dent f ed n the Un ted States and nked w th the nat on s nervous modern ty. In Amer can Nervousness , George M. Beard, who named the new d sorder, def ned neurasthen a as a cond t on of nervous exhaust on, an " mpover shment of nervous force." He be eved that neurasthen a was caused by ndustr a zed urban soc et es, compet t ve bus ness and soc a env ronments, and the uxur es, demands, and excesses of fe on the fast track. In a sense then, neurasthen a was a source of pr de and a badge of nat ona d st nct on and rac a super or ty. To be stressed was "one of the card na tra ts of evo ut onary progress mark ng the ncreased supremacy of bra n force over the more retarded soc a c asses and barbarous peop es." To Beard, reports of m ss onar es, exp orers, and anthropo og sts seemed to show that pr m t ve, savage, and heathen groups were s mp er and ess sens t ve than m dd e-c ass Amer cans. [37] Bushmen and S oux Ind ans d d not become neurasthen c ke Boston bankers and New York awyers. L ke hyster a, neurasthen a encompassed a stagger ng range of symptoms, from b ush ng, neura g a, vert go, headache, and tooth decay to nsomn a, depress on, chron c fat gue, fa nt ng, and uter ne rr tab ty. But un ke hyster a, neurasthen a was an acceptab e and even a va uab e ness for men. Wh e t affected both men and women between the ages of f fteen and forty-f ve, t was most frequent "among the we -to-do and the nte ectua , and espec a y among those n the profess ons and n the h gher wa ks of bus ness fe, who are n dead y earnest n the race for p ace and power." [38] t was def n te y, n short, the neuros s of the ma e e te. Many nerve spec a sts, nc ud ng Beard h mse f, had exper enced cr ses of nervous exhaust on n the r own careers, and they were h gh y sympathet c to other m dd e-c ass ma e nte ectua s tormented by vocat ona ndec s on, overwork, sexua frustrat on, nterna zed cu tura
295 pressure to succeed, and severe y repressed emot ona needs. When Herbert Spencer v s ted the Un ted States n 1882, he was struck by the w despread hea th of Amer can men: "In every c rc e I have met men who had themse ves suffered from nervous co apses, due to stress of bus ness, or named fr ends who had cr pp ed themse ves by overwork." [39] But French and Eng sh men, doctors from these countr es were qu ck to argue, cou d be nervous too. In Par s, Charcot noted that "the young men who graduate from the Eco e Po ytechn que, who ntend to become heads of factor es and rack the r bra ns over mathemat ca ca cu at ons, often become v ct ms of these aff ct ons." [40] The ma e pat ents n Charcot s pr vate pract ce, who came from the m dd e and upper c asses, were more ke y to be ca ed "neurasthen c" than "hyster ca ." [41] The soc a construct on of neurasthen a ref ected the romance of Amer can cap ta sm and the dent f cat on of mascu n ty w th money and property. Beard s metaphors repeated y emphas zed the econom c and techno og ca contexts of Amer can nervousness. Neurasthen cs were n "nervous bankruptcy," perpetua y overdraw ng the r account, rather than "m ona res of nerve force." [42] The neurasthen c man
s a dam w h a sma reservo r beh nd ha o en runs dry or near y so hrough he orren as he s u ceway bu speed y s aga n rom many moun a n s reams a sma urnace ho d ng e ue and ha n ammab e and combus b e and w h s rong draugh caus ng qu ck exhaus on o ma er a s and mpar ng unequa ncons an warm h a ba ery w h sma ce s and e po en a orce and wh ch w h e n erna res s ance qu ck y becomes ac ua orce and so s an ncons an ba ery requ r ng requen repa r ng and re ng a dayc ock wh ch be no wound up every wen y- our hours runs u er y down evo v ng a orce some mes weak some mes s rong and an eng ne w h sma bo er-power ha s soon emp ed o s s eam an e ec r c gh a ached o a sma dynamo and eeb e s orage appara us ha o en ckers and speed y weakens when he dynamo ceases o move 43
Th s ep c metaphor v v d y suggests the specter of the mascu ne eng ne wear ng out, the dep et on of sperm ce s, the ack of e acu atory force. It ref ects ate n neteenth-century ma e sexua anx et es of mpotence caused by menta or phys ca overwork. Herbert Spencer put th s dea forward qu te stra ghtforward y n an art c e wr tten for the Westm nster Rev ew n 1852. "Intense menta app cat on," Spencer argued, " s accompan ed by a cessat on n the product on of sperm-ce s," wh e correspond ng y, "undue product on of sperm-ce s nvo ves cerebra nact v ty," beg nn ng w th headache and proceed ng to mbec ty. [44] Th s theory cut both ways. On the one hand, ack of des re for women
296 cou d be exp a ned by devot on to nte ectua tasks; on the other hand, over ndu gence n sex cou d ead to nte ectua dec ne. Thus for some ma e nte ectua s, the neurasthen a d agnos s re eved anx ety about apses from convent ona mascu ne sexua ty by c ass fy ng them under the man y head ng of overwork. Spencer h mse f was c ted by Beard as one of the wor d s most d st ngu shed neurasthen cs, "do ng or g na work on a sma reserve of cap ta force." In 1853, after a v gorous c mb ng exped t on n the A ps, Spencer had not ced odd symptoms—pa p tat ons, nsomn a, "card ac enfeeb ement," a "sensat on n the head." A though he ved another f fty years, he treated h mse f as an nva d, pamper ng h mse f w th rest and recreat on, putt ng n earp ugs when a conversat on threatened to become too exc t ng, "keep ng up the cerebra c rcu at on" by wett ng h s head w th sa twater and encas ng t n f anne and a rubber n ghtcap. Desp te what one m ght regard today as rea soc a hand caps, Spencer was seen by h s ma e fr ends as a great mar ta catch, and w th shrewd pre-Freud an ns ght nto h s prob em, they urged h m to take a w fe, recommend ng "gynoepathy" as a cure for h s s. Spencer however res sted, and as Gordon Ha ght w se y remarks, w th neurasthen a "he bought safety from the per s of marr age." [45] But the construct on of neurasthen a as mascu ne was an us on. In the Un ted States, equa numbers of ma e and fema e pat ents were reported n the med ca ourna s. [46] However, cases were d fferent ated n terms of both gender and c ass. In m dd e-c ass men, the d sorder was attr buted to overwork, sexua excess, anx ety, amb t on, sedentary hab ts, or the use of a coho , tobacco, or drugs. Beard est mated that one out of every ten neurasthen cs was a doctor. In work ng-c ass men, sexua excess, trauma, and overwork were c ted as the ma n causes of the d sease. And n a women, ch db rth and reproduct ve d sturbances came at the top of the st, w th overwork a factor for work ng-c ass women and attend ng co ege a factor for m dd e-c ass women. [47] Gos ng notes that the case h stor es of ma e pat ents are much more nterest ng, deta ed, and var ed than those of women; "because men norma y ed more var ed ves than most women, nvo v ng themse ves n career, fam y, and soc a act v t es both w th n and outs de the domest c c rc e, phys c ans made greater d st nct ons n the causes to wh ch they attr buted ma e nervousness. Phys c ans a so quest oned men n more deta about the r hab ts and persona affa rs, part a y because they were more ke y to suspect men of h dden v ce and part a y because of the de cacy of ra s ng nt mate ssues w th members of the oppos te sex." [48] In Eng and, neurasthen a qu ck y ost ts she ter ng power for men
297 and became a fema e ma ady ke hyster a. Indeed, Have ock E s est mated that there were fourteen neurasthen c women for every neurasthen c man. Exp anat ons for neurasthen a n women drew on some of the same sources as the exp anat ons about men, but w th a d fferent mora emphas s. Edward C arke n the Un ted States and Henry Mauds ey n Eng and drew on new theor es of the conservat on of energy to argue that menta and phys ca energy were f n te and compet ng. Women s energy, post-Darw n an sc ent sts be eved, was natura y ntended for reproduct ve spec a zat on. Thus women were heav y hand capped, even deve opmenta y arrested, n nte ectua compet t on w th men. Nervous d sorder wou d come when women def ed the r "nature" and sought to r va men through educat on and work, rather than to serve them and the race through matern ty. Wh e compet t on was a hea thy st mu us to ma e amb t on, t was d sastrous for women, who furthermore d d not have the out et of ath et cs to re eve the r stra ned nerves. The h gher educat on of women n un vers t es was obv ous y then a threat not on y to the r hea th but to the r reproduct ve capac t es. "What Nature spends n one d rect on, she must econom se n another d rect on," Mauds ey wrote, and thus the young woman who gave herse f over to earn ng wou d f nd her sexua and reproduct ve organs atrophy ng, her "pe v c power" d m n shed or destroyed, and her fate one of sex essness and d sease. [49] The neurasthen c G rton or Vassar g r was overwork ng her bra n and uterus nto ster ty. The standard treatment for neurasthen a was the rest cure, deve oped by the Amer can Dr. S as We r M tche (1829-1914) after h s exper ence n the C v War. F rst descr bed n 1873, the rest cure nvo ved sec us on, massage, mmob ty, and "excess ve feed ng." For s x weeks the pat ent was so ated from her fr ends and fam y, conf ned to bed, and forb dden to s t up, sew, read, wr te, or do any nte ectua work. She was expected to ga n as much as f fty pounds on a r ch d et that began w th m k and bu t up to severa substant a da y mea s. M tche was we aware that the sheer boredom and sensory depr vat on of the rest cure made t a pun shment to the pat ent: "When they are b dden to stay n bed a month, and ne ther to read, wr te, nor sew, and have one nurse—who s not a re at ve—then rest becomes for some women a rather b tter med c ne, and they are g ad enough to accept the order to r se and go about when the doctor ssues a mandate wh ch has become p easant y we come and eager y ooked for." The rest cure evo ved from M tche s work w th "ma nger ng" so d ers n the C v War, whom he had ass gned to the most d sagreeab e obs, so that after a few weeks n the atr nes they were eager to return
298 to the front. [50] But t a so depended on h s fee ngs on the d fferences between men and women and the r soc a mean ng:
For me he grave s gn cance o sexua d erence con ro s he who e ques on and say eo n words canno exc ude rom my hough o hem and he r d cu es The woman s des re o be on a eve o compe on w h man and o assume h s du es s am sure mak ng m sch e or s my be e ha no eng h o genera ons o change n her educa on and modes o ac v y w ever rea y a er her charac er s cs She s phys o og ca y o her han man am concerned w h her now as she s on y des r ng o he p her n my sma way o be n w ser and more hea h u ash on wha be eve her Maker mean her o be and o each her how no o be ha w h wh ch her phys o og ca cons ruc on and he s rong dea s o her sexua na ure hrea en her as no con ngenc es o man s career hrea en n ke measure or ke number he eeb es o he mascu ne sex 51
A determ ned opponent of h gher educat on for women, a cr t c of Vassar and Radc ffe and espec a y of "the horr b e system of coeducat on," [52] M tche , ke other V ctor an phys c ans, be eved that the fema e reproduct ve system and the bra n der ved the r nour shment from the same source, and that women shou d not try to earn too much dur ng ado escence when the menstrua funct on was be ng estab shed. "I f rm y be eve," he wrote, "that as concerns the phys ca future of women they wou d do better f the bra n were very very ght y tasked and the schoo -hours but three or four a day unt they reach the age of seventeen at east." [53] He a so adv sed mothers not to a ow the r pubescent daughters to take strenuous exerc se. The quest for know edge, he fe t, destroyed that subt e and tender fem n ne charm wh ch was the on y source of mascu ne ove: "For most men, when she se zes the app e, she drops the rose." [54] Wh e M tche was aware that hyster a n women of the m dd e and upper c asses was arge y caused by "the da y fret and wear someness of ves wh ch . . . ack those d st nct occupat ons and a ms" that susta ned the r brothers and husbands, he d d not seem to make the connect on between h s program of fema e gnorance and pass v ty, and women s ater nab ty to ead hea thy ves. [55] He preferred women pat ents who were s ent and acqu escent to those w th nqu r ng m nds. "W se women choose the r doctors and trust them," he wrote n Doctor and Pat ent . "The w sest ask the fewest quest ons. The terr b e pat ents are nervous women w th ong memor es, who quest on much where answers are d ff cu t, and who put together one s answers from t me to t me and torment themse ves and the phys c an w th the apparent ncons s-
299 tenc es they detect." [56] In h s nove Ro and B ake , M tche created such a terr b e pat ent n the f gure of Octap a Darne , a repugnant hyster c whose s ck y tentac es wound themse ves about her hap ess fam y. He preferred to use women s trust n h m n effect ng a cure: "If you can cause such hyster c women as these to be eve that you can cure them, you en st on your s de the r own troops, for as you can create symptoms, so you can a so create absence of symptoms." [57] Furthermore, the treatment assumed that the pat ent be "p ant and wea thy": one who d d not work, or at east d d not need to work. M dd e-c ass women were thus the best cand dates for the rest cure, s nce men and the poor were un ke y to be w ng to spend s x to e ght weeks n d eness. Doctors thus mod f ed the treatment for the r ma e pat ents, who m ght s mp y be adv sed to get to bed ear y and to trave f rst-c ass. As the Ch cago neuro og st Arch ba d Church observed, "We cannot put [men] to bed w th any expectat on that they w stay there. I have tr ed t repeated y and have near y a ways fa ed. Men do not take to the recumbent pos t on for any cons derab e ength of t me w th equan m ty. The fact of the r be ng n bed const tutes an aggravat on; and rr tat on s what we w sh to exc ude." [58] Women were ust as rr tated by so at on and enforced d eness as men. M tche s pat ents ndeed nc uded many of the ead ng fem n st nte ectua s, act v sts, and wr ters of the per od, nc ud ng Jane Addams, W n fred Howe s, Char otte Perk ns G man, and Ed th Wharton. For them, fem n st scho ars have argued, the rest cure seemed ke a regress on to nfancy, n wh ch the pat ent was forced back nto "womb ke dependence" on the parenta team of god ke ma e doctor and subserv ent fema e nurse, and reeducated to "make the w of the ma e her own"; [59] or a d sc p nary treatment that pun shed unconvent ona asp rat ons; or even a pseudo-pregnancy that symbo ca y put the dev ant woman back n her b o og ca p ace. Forb dden by M tche to wr te or draw, G man came c ose to a breakdown: "I wou d craw nto remote c osets and under beds—to h de from the gr nd ng pressure of that profound d stress." [60] Cast ng M tche s adv ce to the w nds, she went to work aga n, "work, n wh ch s oy and serv ce, w thout wh ch one s a pauper and a paras te." For G man, hyster a was the resu t of pass ve acqu escence to the str ctures of a patr archa soc ety, but t cou d be overcome by purposefu act v ty, n her case wr t ng. She wrote the ch ng short story "The Ye ow Wa paper" (1892), a Goth c ta e of a young mother suffer ng from a "temporary nervous depress on—a s ght hyster ca tendency," who goes mad dur ng a rest cure, as a protest aga nst M tche , but there s no ev dence that he ever read or responded to t. S m ar y,
300 Dr. Margaret C eaves ns sted on the mportance of work for women s menta hea th, and the dangers of the rest cure: "The hardest cases I have had to take care of profess ona y," she wrote, "are those who have acqu red the rest cure hab t. I have a phys c an under care now, th s t me a woman, who regrets p teous y that she was not g ven someth ng to feed her nte gence nstead of an unqua f ed rest cure." [61] But even women doctors d d not have the cu tura author ty to contest med ca dogmas. Later Freud d d have the author ty to cr t c ze M tche . In Stud es on Hyster a , n a passage that m ght be seen as a med ca acknow edgment of G man s exper ence, he adv sed comb n ng the rest cure w th ana ys s: "Th s g ves me the advantage of be ng ab e . . . to avo d the very d sturb ng ntroduct on of new psych ca mpress ons dur ng a psychotherapy, and . . . to remove the boredom of a rest-cure, n wh ch the pat ents not nfrequent y fa nto the hab t of harmfu daydream ng." [62] St , the rest cure was not rea y d scred ted unt Wor d War I, when t was d scarded as nappropr ate and even harmfu as a therapy for men. The rest cure was one form of f n-de-s èc e therapy that asserted ma e med ca dom nat on over the nervous woman. Treatments for hyster ca women n the ate n neteenth century were even more tyrann ca , and doctors found reasons not to app y them to men. In Eng and the mode for th s approach, based on estab shed not ons about the char smat c ma e phys c an and the man pu at ve s ck y woman, had been p oneered by Robert Brudene Carter and descr bed n h s book On the Patho ogy and Treatment of Hyster a (1853). On y twenty-f ve when he wrote h s book, Carter adopted the tone of a much more mature and estab shed man, a persona that was very much part of h s who e program for assert ng sexua and med ca author ty over the wayward hyster ca g r . Wh e Carter recogn zed that there were a so cases of hyster a n men, he ns sted that they were rare and anoma ous. Not on y were emot ona derangements "much more common n the fema e than the ma e," but a so women were forced by soc a pressure to concea the r fee ngs and des res, espec a y sexua ones. Moreover, the "morb d and nsat ab e . . . crav ng for sympathy" that ed to s ck behav or was "ten t mes stronger n women than n men." [63] Dur ng a season when he served as the d rector of an agr cu tura workhouse, Carter had to contend w th a number of young marr ed women who had been separated from the r husbands and ch dren. These women had no rea out et for the r fee ngs of one ness and anx ety, and some had begun to have da y f ts of cry ng and scream ng. Carter found the attacks an adm n strat ve nu sance and set out to stop
301 them. Whenever a woman had an attack, he made a arge group of the others nurse her, ns st ng that none of them cou d have any food unt a the symptoms of the attack had subs ded. Very qu ck y the "hyster ca " women became so unpopu ar w th the others that the f ts ceased to occur. Carter s att tude toward m dd e-c ass hyster cs was equa y antagon st c, but h s methods of manag ng them had to be more subt e. In h s v ew, the hyster ca g r s a c ever, pers stent, and desperate person who has entered nto a susta ned decept on, and wou d " ose caste" f exposed. Therefore she s prepared for a ong s ege aga nst the doctor who wou d make her we —that s, make her g ve up her symptoms. Wh e he thoughtfu y cons ders the eff cacy of rough treatments for hyster cs, such as unp easant med c nes, b ows, or buckets of co d water, Carter conc udes that most hyster ca g r s wou d be ab e to to erate such attacks and turn them aga nst the doctor, underm n ng h s author ty: "A young woman who s v ng at home w have too much courage and endurance to be beaten by the torture, and . . . a certa n amount of perseverance on her part w exa t her nto a martyr n the eyes of her fam y, and w enab e her to b d def ance to profess ona denunc at ons." [64] Thus he advocated remov ng the pat ent from her fam y to the doctor s home, where she cou d be under constant surve ance. The p an for treatment he out nes s bas ca y a form of b ackma , threaten ng the hyster c that f she does not reform her ways, the doctor w expose her ma nger ng and d sgrace her n the eyes of her fam y and fr ends. In fact, by the t me th s threat s pronounced, the doctor has a ready secret y to d the fam y h s d agnos s and sworn them to secrecy, so the hyster c s operat ng n the m dst of a consp racy or game n wh ch everyone s co aborat ng to tr ck her. Te ng the fam y of the p ot s necessary to effect the pat ent s separat on from them. When she s removed from a her accustomed sources of sympathy and support, the doctor can have fu power over her hab ts and treatment. Br t sh att tudes toward the understand ng and management of the hyster ca woman fo owed Carter s examp e. In genera , V ctor an doctors saw hyster a as a d sorder of fema e ado escence, caused both by the estab shment of the menses and by the deve opment of sexua fee ngs that cou d have no out et or cathars s. Ado escence was a r sky t me for g r s, many doctors observed, not on y because the reproduct ve organs had so great an nf uence on the r ent re we -be ng but a so because "the range of act v ty of women s so m ted, and the r ava ab e paths of work n fe so few . . . that they have not, ke men, v car ous out ets for fee ngs n a var ety of hea thy a ms and pursu ts." [65] Wh e men, wrote
302 Char es Merc er, had the "safety-va ve" of exerc se, women s fee ngs were bott ed up, so that n ado escence, "more or ess dec ded man festat ons of hyster a are the ru e." [66] "A k nds of . . . barr ers to the free p ay of her power are set up by ord nary soc a and eth ca customs," wrote Dr. Bryan Donk n. " Thou sha t not meets a g r at every turn." [67] F. C. Skey, who de vered a ser es of ectures on hyster a to the med ca students at St. Bartho omew s Hosp ta n 1866, not ced that h s pat ents were pr mar y ado escent g r s w th dom neer ng parents, g r s who "exh b ted more than usua force and dec s on of character." [68] Desp te the r sympathy for the p ght of V ctor an g r s, V ctor an doctors found the r hyster ca pat ents se f sh, dece tfu , and man pu at ve. Henry Mauds ey denounced the "mora pervers on" of hyster ca young women who " e n bed" a day, "when a the wh e the r on y para ys s s a para ys s of the w ." [69] Skey fo owed Carter s ead n recommend ng "fear and the threat of persona chast sement" for hyster ca women. [70] In the t t e of one Amer can med ca text, hyster a was a matter of "tr a s, tears, tr cks, and tantrums." [71] In France, work ng-c ass hyster ca women pat ents at the Sa pêtr ère were regarded w th the same host ty by such doctors as Ju es Fa ret. Fa ret denounced the women as "ver tab e actresses; they do not know a greater p easure than to dece ve . . . a those w th whom they come n touch. The hyster cs who exaggerate the r convu s ve movement . . . make an equa travesty and exaggerat on of the movements of the r sou , the r deas, and the r acts. . . . In a word, the fe of the hyster c s noth ng but one perpetua fa sehood; they affect the a rs of p ety and devot on, and et themse ves be taken for sa nts wh e at the same t me abandon ng themse ves to the most shamefu act ons; and at home, before the r husbands and ch dren, mak ng the most v o ent scenes n wh ch they emp oy the coarsest and often most obscene anguage and g ve themse ves up to the most d sorder y act ons." [72] Why d d hyster a become such a frequent phenomenon n the ate n neteenth century? Why were doctors ke Carter, M tche , Fa ret, and Skey so contemptuous of the r fema e pat ents and so d ctator a n the r treatments? A number of theor es have been advanced to exp a n the phenomenon of f n-de-s èc e hyster a. The fem n st h stor an Carro Sm th-Rosenberg g ves an answer that s sympathet c to both hyster ca women and the r ma e phys c ans. She sees fema e hyster a as stemm ng from sex-ro e conf cts that emerged n the n neteenth century. She has argued that the Amer can hyster c was typ ca y the d e m dd e-c ass woman, both "product and nd ctment of her cu ture." Reared to be weak, dependent, f rtat ous, and unassert ve, many Amer can g r s grew
303 up to be ch d-women, unab e to cope w th the pract ca and emot ona demands of adu t fe. They defended themse ves aga nst the hardsh ps and ob gat ons of adu thood "by regress ng towards the ch d sh hyper-fem n n ty of the hyster c." Faced w th rea respons b t es and prob ems, these women f ed from stress by choos ng a s ck ro e n wh ch they won cont nued sympathy and protect on from the fam y. Thus hyster a prov ded a so ut on to the fem n ne conf ct between dea zed sex ro es and quot d an rea t es: "The d scont nu ty between the ro es of courted young woman and pa n-bear ng, se f-sacr f c ng w fe and mother, the rea t es of an unhappy marr age, the one ness and chagr n of sp nsterhood, may a have made the petu ant nfant sm and narc ss st c se fassert on of the hyster c a necessary soc a a ternat ve to women who fe t unfa r y depr ved of the r prom sed soc a ro e and who had few strengths w th wh ch to adapt to a more try ng one." Ma e phys c ans ke M tche dea ng w th these women may somet mes have been harsh and nsens t ve, Sm th-Rosenberg conc udes, but they were not necessar y more m sogyn st c than other men of the r t me. The r profess on made t necessary for them to make ana yt c statements about fem n n ty, wh e the r gender demanded that they estab sh an author tat ve re at onsh p w th the r pat ents. Thus the phys c an too was a product of h s gender and cu ture, "stand ng at the unct on where the cu tura def n t ons of fem n n ty, the needs of the nd v dua fema e pat ent, and mascu n ty met." [73] If hyster ca women were v ct ms of a cu ture that d d not prepare them to meet the respons b t es of adu thood, the r doctors too were v ct ms of a sex-ro e conf ct that requ red them both to dent fy w th the fathers and husbands of the r pat ents, and to prov de answers and cures for the prob ems of the women n a way that threatened to fem n ze them. In The H story of Sexua ty , M che Foucau t suggests that hyster a was a abe bestowed on fema e sexua ty by ma e phys c ans. Rather than see ng hyster a as a so ut on to the doub e b nds and d emmas of f n-de-s èc e women, Foucau t descr bes the "hyster zat on of women s bod es" as one of the cruc a features of psych atr c and med ca power. Hyster zat on was "a three-fo d process whereby the fem n ne body was ana yzed . . . as be ng thorough y saturated w th sexua ty; whereby t was ntegrated nto the sphere of med ca pract ces, by means of a patho ogy ntr ns c to t; whereby, f na y, t was p aced n organ c commun cat on w th the soc a body . . . the fam y space . . . and the fe of ch dren; the Mother, w th her negat ve mage of nervous woman, const tuted the most v s b e form of th s hyster zat on." [74] Women s needs, ro es, conf cts, fee ngs, and vo ces have tt e to do
304 w th the scenar o of power out ned by Foucau t. Instead, women are pass ve and apparent y power ess bod es and f gures who are nscr bed by unnamed forces. "It s worth remember ng," he ns sts, "that the f rst f gure to be sexua zed was the d e woman. She nhab ted the outer edge of the wor d , n wh ch she a ways had to appear as a va ue, and of the fam y, where she was ass gned a new dest ny charged w th con uga and parenta ob gat ons. Thus there emerged the nervous woman. . . . In th s f gure the hyster zat on of woman found ts anchorage po nt." [75] Through h s use of quotat on marks, Foucau t casts ron c doubt on the rea ty of the hyster ca woman s d eness or sexua ty, but s nce h s focus s on the arge anonymous forces of psych atr c power, he does not supp y an exp anat on for the hyster c s co us on or he p essness before such abe ng. Nor, un ke Sm th-Rosenberg, does he attempt to exp a n some of the mot ves doctors m ght have had for exert ng such power over the def n t on of fema e hyster a, or the reasons why t became ep dem c n the ast decades of the century. Ne ther of these nf uent a theor es can rea y account for the var et es and causes of hyster a n the r respect ve contexts. To beg n w th, I need to emphas ze once aga n that they exc ude ma e hyster a from the r ana ys s, a though both are aware of ts ex stence. Sm th-Rosenberg comments n a footnote that ma e hyster a does not underm ne her arguments about ts re at on to fema e exper ence for four reasons. F rst, "to th s day hyster a s st be eved to be pr nc pa y a fema e d sease or behav or pattern." Second, the ma e hyster c s "d fferent"—homosexua or work ng c ass. Th rd, "one must hypothes ze that there was some degree of fema e dent f cat on among the men who assumed a hyster ca ro e." F na y, she argues, ma e hyster a had ts most typ ca form n she shock. [76] These c rcu ar arguments, wh ch Sm th-Rosenberg d d not recons der when she rev sed her or g na essay for pub cat on n the book, make t mposs b e for the "d fference" of ma e hyster a to mod fy her concept of the "hyster ca ro e." Ma e hyster a s s mp y a subset of fema e hyster a, and m m cs ts mot ves and behav ors. App y ng Sm th-Rosenberg s mode to ma e hyster cs, then, one wou d see them as ch d sh, weak, and escap st. The a ternat ve approach—ana yz ng hyster ca symptoms as a response to power essness—does not come up. Desp te h s nterest n forms of d scurs ve power, Foucau t too does not cons der hyster a from the po nt of v ew of the pat ent, a though some of h s references h nt at the d emma of young hyster cs, both ma e and fema e, caught between dom neer ng parents and dom neer ng doctors. He quotes Charcot s ns stence that hyster ca g r s and boys must be separated from the r mothers and fathers and hosp ta zed. [77] But the
305 dea that these power strugg es m ght have contr buted to the prob ems of ado escent pat ents s extraneous to Foucau t s concerns. He s nterested nstead n mapp ng the e ements by wh ch doctors took contro of the def n t on of sexua ty. Both Sm th-Rosenberg and Foucau t dent fy the bourgeo s mother as the representat ve f n-de-s èc e hyster c. But th s p cture does not correspond to the rea t es they each descr be, nor to the c n ca p cture. Sm th-Rosenberg acknow edges that hyster a crossed c ass and econom c boundar es, and that t a so affected work ng-c ass and farm women, mm grants and tenement dwe ers. In her v ew these women too had fa ed "to deve op substant a ego strengths." [78] But Amer can doctors who treated poor women n the r hosp ta s and d spensar es had a d fferent v ew. E. H. Van Deusen, who saw many hyster ca farm women at h s asy um n M ch gan, b amed the soc a so at on and nte ectua depr vat on of the r one y ves. [79] S m ar y, most of the g r s and women Fa ret and Charcot were treat ng for hyster a at the Sa pêtr ère came from poor fam es and had worked s nce ch dhood to support themse ves. They were ne ther d e nor, for the most part, mothers. In case after case, they were the v ct ms of poverty, sexua and f nanc a exp o tat on, and gnorance. The work ng-c ass men Charcot treated n h s ward, whose hyster a was usua y prec p tated by some k nd of v o ent acc dent, seem ke the brothers of the women. Foucau t s h gh y schemat c and abstract account of d scurs ve power gnores both context and agency; t ne ther exp a ns why pat ents man fested symptoms of d stress nor exp a ns why phys c ans were so eager to focus on these comp a nts n women and to see them as threats to the fam y and the state. The "hyster sat on" of women s bod es wh ch Foucau t descr bes can a so be seen from a fem n st perspect ve as "a reassert on of women s essent a y b o og ca dest ny n the face of the r ncreas ng y mob e and transgress ve soc a ro es." [80] That hyster a became a hot top c n med ca c rc es at the same t me that fem n sm, the New Woman, and a cr s s n gender were a so hot top cs n the Un ted States and Europe does not seem co nc denta . Dur ng an era when patr archa cu ture fe t tse f to be under attack by ts rebe ous daughters, one obv ous defense was to abe women campa gn ng for access to the un vers t es, the profess ons, and the vote as menta y d sturbed. Whether or not women who were abe ed "hyster ca " were assoc ated w th the women s movement, they were often seen by doctors as res stant to or cr t ca of marr age, and as strange y ndependent and assert ve. These character st cs are most v v d y present n the V ennese women d ssected by Breuer and Freud, but Eng sh phys c ans ke Skey and Bryan Donk n a so commented on
306 the nte gence and amb t on of the r hyster ca pat ents. Any woman man fest ng symptoms of hyster a aroused susp c ons of a s ent revo t aga nst her domest c, c ass, and reproduct ve ro e. Thus nervous women rece ved much more attent on than nervous men, and were abe ed as "hyster ca " or "neurasthen c" n the contexts of a h gh y charged rhetor c about the dangers of h gher educat on, women s suffrage, and fema e se f-assert on n genera . In every nat ona sett ng where fema e hyster a became a s gn f cant ssue, there were para e concerns about the ways that new opportun t es for women m ght underm ne the b rthrate, the fam y, and the hea th of the nat on. Inte ectua y compet t ve women, doctors warned, were ster e f owers doomed to br ng forth on y b ossoms of hyster a and neurasthen a. In the Un ted States, gyneco og sts warned aga nst the bra n-fag, headache, backache, sp ne-ache, and a -around sexua ncompetence that New Women wou d produce. [81] n France, the femme nouve e was b amed for the dec n ng b rthrate; new d v s ons of abor seemed to threaten the stab ty of the fam y and the state. As women made the r f rst nroads nto pub c and profess ona space, a fasc nat ng a ance of art sts, trad t ona women, and neuropsych atr sts ke Charcot un ted n a campa gn to ce ebrate matern ty and the nter or ty of Woman. [82] n Eng and the New Woman as neurot c fem n st nte ectua had become a recogn zab e type by the 1890s; "the New Woman ought to be aware that her cond t on s morb d, or at east hyster ca ," wrote one ourna st. [83] She had a so become a standard f gure n terature, whether Thomas Hardy s Sue Br dehead n Jude the Obscure (1895) or George G ss ng s A ma Ro fe n The Wh r poo (1897), whom Ian F etcher ca s "a new type of woman, the névrose , the modern hyster c." [84] Wh e hyster ca g r s were v ewed as c oset fem n sts and reprogrammed nto trad t ona ro es, fem n st act v sts were den grated as hyster cs, s ck and abnorma women who d d not represent the r sex. By the 1880s n Eng and, t had become customary for the term "hyster ca " to be nked w th fem n st protest n the newspapers and n the rhetor c of ant suffrag sts. As L sa T ckner notes n her study of the Br t sh suffrage movement, "for ha f a century and more, fem n sm and hyster a were read y mapped on to each other as forms of rregu ar ty, d sorder, and excess, and the c a m that the women s movement was made up of hyster ca fema es was one of the pr nc pa means by wh ch t was popu ar y d scred ted." [85] Women who found a pub c vo ce for the r concerns were ampooned as "the shr ek ng s sterhood," a term co ned by the ant fem n st wr ter E za Lynn L nton, who wrote n 1883 that "one of our quarre s w th the Advanced Women of our generat on s the hyster ca
307 parade they make about the r wants and the r ntent ons. . . . For every hyster ca advocate the cause oses a rat ona adherent and ga ns a d sgusted opponent." [86] Jean-Mart n Charcot s c n c at the Sa pêtr ère offered the best opportun ty to exam ne the d fferent ways that women and men were d agnosed and treated for hyster a at the turn of the century. Stud es of hyster a at the Sa pêtr ère took the r form from Charcot s char smat c sty e. So powerfu was h s nf uence n the 1880s that the Sa pêtr ère was often ca ed the "Hôp ta Charcot," and the group of d sc p es and adm rers around h m was known as the charcoter e . [87] They were strong y nf uenced by h s work on ma e hyster cs; a though the Sa pêtr ère had trad t ona y been a women s hosp ta , under Charcot s d rect on a sma men s ward was opened; ma e pat ents were a so seen at the outpat ents c n c. Charcot took pr de n h s research on ma e sub ects and regarded the study of ma e hyster a as one of the spec a t es of h s c n c and of ate n neteenth-century French med c ne. By h s death n 1893, he had pub shed s xty-one case stud es of ma e hyster cs, and he eft notes on many more. In a ecture-presentat on on hyster a n men, Charcot noted that:
n some ways h s ques on o ma e hys er a s he order o he day n France has preoccup ed phys c ans or he pas severa years Be ween 1875 and 1880 here have been ve d sser a on de enses on ma e hys er a a he Facu é de Par s and M K e n he au hor o one o hese heses done under he superv s on o M e Dr O v er was ab e o ca a og 80 cases S nce hen have appeared he mpor an pub ca ons o M Bournev e and h s s uden s o MM Debove Raymond Drey us and severa o hers and a hese works end o demons ra e among o her h ngs ha cases o ma e hys er a can be ound a r y requen y n common prac ce 88
He decr ed the popu ar be ef that "the character st c tra t of hyster a s the nstab ty and the mob ty of the symptoms." Even n women, he exp a ned, there "were hyster as of sturdy, permanent phenomena . . . wh ch somet mes res st a med ca ntervent on." Furthermore, men too were somet mes emot ona y errat c or exh b ted depress on and me ancho y. Charcot s c n c was noted for the arge number of fema e pat ents who, under hypnos s, produced spectacu ar attacks of grande hystér e or "hystero-ep epsy," a pro onged and e aborate convu s ve se zure. The attack cou d be nduced or re eved by pressure on certa n areas of the body—what Charcot ca ed hysterogen c zones—and these were espec a y to be found n the ovar an reg on. A comp ete se zure nvo ved three
308 phases: the ep epto d phase n wh ch the pat ent ost consc ousness and foamed at the mouth; the phase of "c own sm" (Charcot was a great fan of the c rcus), nvo v ng eccentr c phys ca contort ons; and the phase of "att tudes pass onne es," or sexua poses. The attack ended w th a back-bend ca ed the arc-en-cerc e . It was cruc a to Charcot s theory of hyster a that t took the same course n men and women. Thus he ns sted that there were "numerous str k ng ana og es" between ma e and fema e grande hystér e . Charcot s d sc p e Em e Batau t reported w th p easure that a hyster ca young man named Gu "presents the symptoms most character st c of grande hystér e . The attacks are a ways preceded by the phenomena of test cu ar aura; he fee s someth ng wh ch mounts from the ngu na reg on towards the esophagus; he has then a fee ng of thorac c constr ct on wh ch oppresses h m, h s temp es throb v o ent y, he has r ng ng n h s ears and hears heavy no ses ke the f re of d stant cannons. H s head sp ns, he oses consc ousness, and the attack beg ns." Because he was young and ath et c, Gu s arc-en-cerc e was a so a sp end d affa r, wh ch mpressed Batau t very m ght y, as an "acrobat c performance as beaut fu as t was var ed." [89] Batau t a so found a hysterogen c zone on Gu s body ocated around the r ght test c e. Just as t was poss b e to stop a hyster ca attack by compress ng the woman s ovar es, doctors at the Sa pêtr ère were conv nced that t shou d be poss b e to affect the course of a man s attack by putt ng pressure on the test c es. But th s procedure d d not a ways have the des red effects. The doctors found that the attacks were re eved by the compress on of the test c es. Others, however, obta ned no effect from putt ng pressure on the sem na g and, and one doctor d scovered, perhaps not to our surpr se, that squeez ng the pat ent s test c es made the convu s ons stronger. One of Charcot s most or g na contr but ons to the theory of ma e hyster a was h s ns stence that t shou d not carry the st gma of effem nacy. He emphas zed the fact that hyster a often appeared among tough manua aborers; most of the cases had occurred n the aftermath of a traumat c acc dent, e ther at work or n trave . Furthermore, he stressed the work ng-c ass status, phys ca strength, and v r e emot ons of h s ma e pat ents, and he mocked other doctors who had prob ems accept ng both the c ass and gender of pat ents who c ashed w th the r stereotypes of hyster a: "One s w ng to concede that a young, effem nate man may, after ndu g ng n excess ve behav or, suffer ng heartache, or exper enc ng deep emot ons, exh b t severa hyster ca phenomena; but that a man y art san, so d, unemot ona , a ra way eng neer, for ex-
309 amp e, m ght, fo ow ng a ra way acc dent, a co s on, a dera ng, become hyster c, the same way as a woman—th s, t appears, surpasses the mag nat on." [90] Nonethe ess, there were s gn f cant sexua d fferences n Charcot s concept of ma e hyster a. In terms of anguage, t was often ca ed "hystér e v r e" or "hystér e traumat que" to mark ts d st nct on from fema e hyster a. A though t fo owed the same course of behav or n men and women, Charcot be eved hyster a had d fferent causes that depended on gender. As Mark M ca e observes, "Women n h s wr t ngs fe due to the r vu nerab e emot ona natures and nab ty to contro the r fee ngs, wh e men got s ck from work ng, dr nk ng, and forn cat ng too much. Hyster ca women suffered from an excess of fem n ne" behav ors, hyster ca men from an excess of mascu ne behav ors." [91] Moreover, a though some of Charcot s ma e hyster cs were as co orfu and dramat c as the women, they d d not attract as much attent on from doctors, wr ters, art sts, and ourna sts. The "w d man" Lap . . . sonne, for examp e, was covered w th symbo c tattoos, such as a ve ed woman he ca ed "the n ght," and he earned h s v ng eat ng ve rabb ts n fa rs. But wh e B anche W ttmann became the "Queen of Hyster cs" perform ng at the Sa pêtr ère c n c, Lap . . . sonne s remembered on y as a case study. The actua numbers of ma e hyster cs were few; overa , ma e pat ents compr sed no more than f ve to ten percent of the who e mmense hosp ta popu at on. [92] On the other hand, dur ng the 1870s, the percentage of women pat ents at the Sa pêtr ère d agnosed as "hyster ca " rose as h gh as twenty percent. [93] In add t on to the theoret ca and stat st ca d fferences between ma e and fema e hyster a, there were d fferences n ts representat on. As Sander G man exp a ns n chapter 5 n th s book, the hyster ca c n c of Charcot was organ zed pr mar y around the v sua , the photograph c, the theatr ca , and the spectacu ar. He was famed for h s prob ng gaze that seemed to penetrate not on y to the heart of the pat ent but a so to the sou s of h s ass stants, nterns, and assoc ates. H s student and b ographer Georges Gu a n descr bed the exam nat on sess ons n wh ch the naked pat ent sat ke an art st s mode wh e Charcot s ent y stud ed every deta of the body. [94] Roger Mart n du Gard wrote about Charcot s "p erc ng, pry ng gaze" and h s "tyrann ca way of f x ng you w th h s stare." [95] Have ock E s too reca ed Charcot s "d sda nfu express on, somet mes even t seemed, a tt e sour. [96] Th s ntense y scrut n z ng ma e gaze m ng ed the mesmer z ng power of the hypnot st and the command ng eye of the art st w th the penetrat ng v s on of the sc ent st p erc ng the ve of nature. It was very much
310 assoc ated w th mascu n ty tse f. Charcot s stare was contrasted w th the downcast eyes of h s hyster ca women pat ents, and w th the "soft, poet c and anguorous" gaze of h s hyster ca ma e pat ents. [97] Through h s theatr ca ecture-demonstrat ons (Sarah Bernhardt, act ng n cross-dressed parts at the same t me, was often compared to the hyster ca queens of Charcot s amph theater[98] ), and even more through the photograph c ate er that captured mages of the hyster ca women for the vo umes of conograph es , Charcot emphas zed the v sua man festat ons of hyster a and the hyster ca body as an art ob ect. H s representat ons of gender were a ed to aesthet c convent ons about the fema e body, whether n pa nt ng, photography, or drama. Charcot not on y borrowed from art n mak ng the fema e body the focus of h s nvest gat on, but through h s photograph c ate er a so contr buted to the h stor ca emergency of a "reg me of representat on" n wh ch, accord ng to the art cr t c Gr se da Po ock, "the hyster zed body of woman. . . was made the ob ect of patho og ca scrut ny and dec phered n terms of mascu ne gaze and speech." [99] The fasc nat on w th the fema e body as art and symbo extended a so to Charcot s nf uence on h s fam y. H s w fe and daughters were art sts who worked w th h m n the fam y ate er. In 1892, Madame Charcot showed her work n the Exh b t on of the Arts of Woman n Par s, contr but ng a arge carved and decorated coffer, whose dark surfaces and fantast ca y pa nted nner pane s suggested both the structure of the m nd her husband had stud ed n hyster a—"a rat ona facade and an rrat ona nter or"—and the mage of woman promoted by the Centra Un on of the Decorat ve Arts and the Women s Comm ttee of wh ch she was a member. [100] As Debora S verman has shown, "a prom nent part of the Centra Un on program n the 1890s was the def n t on of nter or space as d st nct ve y fem n ne and the promot on of . . . woman as the queen and art st of the nter or," n response to "the cha enge of the femme nouve e or new woman, who was perce ved as threaten ng to subvert women s ro es as decorat ve ob ects and decorat ve art sts." [101] Through the performances of B anche W ttmann, the "Queen of Hyster cs," and other famous hyster cs at the Sa pêtr ère, Charcot too promoted women as art sts of the nter or, and paradox ca y returned them to the status of decorat ve ob ects. Even Charcot s contemporar es, however, were cr t ca of the ca ous way that Charcot exh b ted h s hyster ca stars and of h s exposure of the r secrets. In h s ant med ca sat re Les Mort co es (1894), Leon Daudet car catured Charcot as the voyeur st c neuro og st "Foutange," who sad st ca y nterrogates a hyster ca g r : "And so, n front of two hun-
311 dred sn gger ng persons, these wretches must d sp ay the r shame, the r own, and the r fam es ta nts, and revea the r nt mate secrets. . . . Foutange penetrates w th d abo ca sk to the depths of these stunted creatures." [102] Axe Munthe, a Swed sh doctor pract c ng n Par s at the t me, gave a v v d descr pt on of Charcot s Tuesday ectures, when "the huge amph theatre was f ed to the ast p ace w th a mu t co oured aud ence drawn from tout Par s, authors, ourna sts, ead ng actors and actresses, fash onab e dem monda nes." The hypnot zed women pat ents put on a spectacu ar show before th s crowd of cur os ty seekers. "Some of them sme t w th de ght a bott e of ammon a when to d t was rose water, others wou d eat a p ece of charcoa when presented to them as choco ate. Another wou d craw on a fours on the f oor, bark ng fur ous y when to d she was a dog, f ap her arms as f try ng to f y when turned nto a p geon, ft her sk rts w th a shr ek of terror when a g ove was thrown at her feet w th a suggest on of be ng a snake. Another wou d wa k w th a top hat n her arms rock ng t to and fro and k ss ng t tender y when she was to d t was her baby." [103] Fem n sts were nd gnant at Charcot s treatment of women, often compar ng t to the atroc t es of v v sect on. Wr t ng n the Eng sh ant v v sect on st ourna Zoö ph st , one woman condemned the "no ess d sgust ng exper ments pract ced on the unat cs and hyster ca pat ents n the Sa pêtr ère. The nurses drag these unfortunate women, notw thstand ng the r cr es and res stance, before men who make them fa nto cata epsy. They p ay on these organ sms. . . on wh ch exper ment stra ns the nervous system and aggravates the morb d cond t ons, as f t were an nstrument. . . . One of my fr ends to d me that she. . . had seen a doctor of great reputat on make one unhappy pat ent pass, w thout trans t on, from a ce est a beat tude to a cond t on of nfamous sensua ment. And th s before a company of terary men and men of the wor d." [104] In an essay n the Revue sc ent f que des femmes (1888), C. Renoz accused Charcot of a "sort of v v sect on of women under the pretense of study ng a d sease for wh ch he knows ne ther the cause nor the treatment." [105] Furthermore, the textua case stud es of the hyster ca women pat ents end themse ves to fem n st nterpretat on of oppress on and exp o tat on. August ne, who spent f ve years as a pat ent at the Sa pêtr ère, s a part cu ar y dramat c examp e. She came to the Sa pêtr ère at the age of f fteen n October 1875, suffer ng from pa ns n the stomach and convu s ve attacks dur ng the n ght wh ch somet mes eft her para yzed. A though she had not yet begun to menstruate, August ne had the appearance of a sexua y mature woman. One does not have to search far for
312 the traumat c exper ences that had prec p tated her hyster ca attacks. Beg nn ng at puberty, she had been sub ected to sexua attacks by men n the ne ghborhood, and at the age of th rteen, had been raped by her mother s over, who had threatened to s ash her w th a razor f she d d not comp y. Dur ng the se zures wh ch began mmed ate y thereafter, she mag ned that she was be ng b tten by w d dogs or surrounded by rats; somet mes she had ha uc nat ons of the rap st w th a kn fe. Treated w th ether and amy n trate, August ne spoke ncessant y about her v s ons, but wh e the doctors recorded her words, they were not nterested n the contexts of her exper ence. Instead she was repeated y photographed n revea ng hosp ta gowns demonstrat ng the var ous stages of grande hystér e . In 1879, her cond t on mproved and she was taken on as a nurse n the hosp ta . But the resp te was br ef; by Apr 1880 she was once aga n hav ng frequent attacks, to wh ch the doctors responded w th ncreas ng y severe measures: ether, ch oroform, stra t- ackets, and f na y, conf nement n a padded ce . A though she was suff c ent y mproved to attend a concert on the Sa pêtr ère grounds n June, she used the opportun ty to run away, but she was caught on the bou evard outs de. Her hea th grew worse; n add t on to the attacks, she n ured herse f n fut e efforts at freedom. The ast entry about August ne s September 9, 1880: she "escaped from the Sa pêtr ère, d sgu sed as a man." [106] One cannot he p re o c ng at August ne s escape, and her ma e d sgu se seems ke a coded statement about hyster a and gender; desp te Charcot s ns stence on the equa ty of ma e and fema e hyster a, men had an eas er t me gett ng out of the Sa pêtr ère. V ct m zed by sexua predators, she endured symbo c rapes at the hands of her doctors, who end ess y recorded her menstrua per ods, her vag na secret ons, her phys ca contort ons, and her sexua fantas es, but pa d no attent on to her sense of betraya by her mother and brother, as we as by the men who had abused her. In 1928, August ne became the p n-up g r of the French surrea sts, who reproduced her photographs to ce ebrate the f ft eth ann versary of hyster a, wh ch they ca ed "the greatest poet c d scovery of the end of the n neteenth century." For Lou s Aragon and André Breton, August ne was the "de c ous" embod ment of the sexy "young hyster cs" they so much adm red. [107] In 1982, Georges D d -Huberman made August ne the martyred hero ne of h s study of Charcot, the "masterp ece" of Charcot s hyster ca museum. [108] She s a so becom ng an exemp ary f gure for fem n sts. I wrote about her n The Fema e Ma ady n 1985; a group of fem n st scho ars, choreographers, and dancers based at Tr n-
313 ty Co ege n Connect cut have produced a performance work about her ca ed "Dr. Charcot s Hyster a Shows"; and a successfu p ay, August ne: B g Hyster a , was staged n London n 1991. [109] But we need to be caut ous about see ng Charcot as a m sogyn st. Wh e he was famous for these performances w th women, Charcot a so took a bera pos t on on women s r ghts. The Sa pêtr ère ourna Progrès Méd ca campa gned for women s adm ss on to med ca schoo , and some of Charcot s students and externs were women. The f rst French d ssertat on on hyster a by a fema e phys c an, Hé ène Go dspe ge s Contr but on à étude de hystér e chez es enfants (1888) was wr tten under Charcot s superv s on at the Sa pêtr ère. [110] Indeed, one of the ear est h stor es of hyster a was G af ra Abr cosoff s L hystér e aux XVIIe et XVIIIe s èc es (1897). Abr cosoff had been a student of Charcot s and ded cated her book to the memory of "my ustr ous master, J.-M. Charcot." As she exp a ned n her ntroduct on, "It s to h m that I owe my med ca know edge, and t s, n a sense, out of grat tude for my dear departed master that I have w shed to retrace the h stor ca var at ons of a ma ady on wh ch h s br ant persp cac ty and h s penetrat on have shed so much ght. [111] Abr cosoff s h story makes no spec a case for women, but rather stresses the ex stence of ma e cases. Throughout her book Abr cosoff drew attent on to those wr ters such as Joseph Rau n who had observed and descr bed ma e hyster a, and who had ns sted that t cou d not be an exc us ve y fema e d sorder. Her book s an examp e of one form of ear y fem n st h story of hyster a. Another effort by a woman doctor to dea w th hyster a was the book of Dr. Georgette Déga, who had stud ed at the med ca facu ty of Bordeaux. Déga attr buted hyster a to the nadequac es of women s educat on. Hyster a, she wrote, was "the v ctory of the ower centers over the h gher," and mathemat cs was the best d sc p ne for hyster ca women. [112] One can mag ne that she be eved med ca tra n ng to be even better. It s nterest ng to specu ate on the reasons why Charcot s work on ma e hyster a d d not have a ast ng effect on med ca d scourse, why h story has remembered August ne and forgotten the hyster ca men Char-cot descr bed. In the Br t sh med ca commun ty, there had a ways been res stance to the dea of ma e hyster a, wh ch had been camouf aged under other term no og es, organ c exp anat ons, and forms of den a and pro ect on. As M ca e conc udes, "Charcot s hyster zat on of the ma e body n the 1880s was sharp y at var ance w th dom nant med ca mode s of mascu n ty, and t ran counter to re gn ng V ctor an codes of man ness. It requ red from V ctor an phys c ans the app cat on of an anc ent and den gratory abe to members of the r own sex. And per-
314 haps most d sturb ng, t suggested the poss b ty of exp or ng the fem n ne component n the ma e character tse f." [113] Furthermore, Charcot s death n 1893 prec p tated a ong per od of "d smemberment" of h s work dur ng wh ch the concept of hyster a fe nto d srepute, and some c a med that he had been a char atan who coached h s hyster ca fema e pat ents n the r performances or produced the r symptoms through suggest on. [114] Men were om tted from the record. Even P erre Janet re nforced the be ef that a the hyster cs were women when he remarked n h s ectures at the Harvard Med ca Schoo n 1920 that "by a k nd of nternat ona rony, peop e were w ng to adm t, after the nnumerab e stud es made by French phys c ans, that hyster a was frequent on y among French women, wh ch aston shed nobody, on account of the r bad reputat on." [115] Iron ca y, the work of S gmund Freud, Charcot s most famous student, a so p ayed a ma or ro e n the suppress on of ma e hyster a after Charcot s death. Freud came to Par s to study at the Sa pêtr ère from October 1885 to March 1886. H s or g na p an for the research tr p was qu ck y changed, as he became overwhe med by the persona ty, access b ty, and org na ty of Charcot, who became a profess ona ro e mode as we as a mentor. The amb ance of Charcot s c n c was very d fferent from that wh ch Freud had been used to n Ber n. Charcot was spontaneous, generous, and open to cr t c sm and argument, and Freud found the democrat c atmosphere both surpr s ng and st mu at ng: "The Professor s work proceeded open y, surrounded by a the young men act ng as h s ass stants as we as by the fore gn phys c ans. He seemed, as t were, to be work ng w th us, to be th nk ng a oud and to be expect ng to have ob ect ons ra sed by h s pup s. Anyone who ventured m ght put a word n the d scuss on and no comment was eft unnot ced by the great man. The nforma ty of the preva ng terms of ntercourse, and the way n wh ch everyone was treated on a po te foot ng of equa ty—wh ch came as a surpr se to fore gn v s tors—made t easy even for the most t m d to take the ve est share n Charcot s examp es." [116] Fo ow ng Charcot s ead, Freud began by emphas z ng that hyster a cou d affect both sexes, a pos t on that was acceptab e to h s med ca co eagues. On October 15, 1886, when he read h s paper "On Ma e Hyster a" to the V enna Psych atr c Soc ety, severa of the doctors present test f ed that ma e hyster a was a ready we known. Theodor Meynert, who pub c y expressed skept c sm about Charcot s symptomato ogy, ater "confessed to Freud that he had h mse f been a c ass ca case of ma e hyster a, but had a ways managed to concea the fact." [117] In 1887-88 Freud trans ated Charcot s Leçons de Mard , wh ch conta ned most of
315 Charcot s case stud es of men. In "Hystér e," an essay he pub shed n a med ca encyc oped a n 1888, he further condemned the "pre ud ce, overcome on y n our own days, wh ch nks neuroses w th d seases of the fema e sexua apparatus." Here he a so noted the nc dence of hyster a n both boys and g r s, as we as n adu t men. A though rarer n men than n women, hyster a, Freud argued, s more d srupt ve for men, because t takes them away from the r work: "The symptoms t produces are as a ru e obst nate; the ness n men, s nce t has the greater s gn f cance of be ng an occupat ona nterrupt on, s of greater pract ca mportance." [118] In h s work on hyster a, Freud took Charcot s theor es to the r og ca extremes. Whereas Charcot had ma nta ned that ma e and fema e hyster a had d fferent causes, but s m ar effects, Freud argued that a hyster a came from traumat c or g ns. But the trauma d d not have to be a ra way acc dent or an n ury n the workp ace; t cou d be a d sturb ng sexua exper ence that had been forgotten and repressed. Furthermore, hyster a cou d be cured by hav ng the pat ent reca and re ve, or abreact, the or g nat ng trauma, whether by hypnos s or through the process of dream ana ys s and free assoc at on. The symptoms of hyster a, Freud noted, were created through a process of symbo zat on, and expressed emot ona states. A though he cont nued to acknow edge the ex stence of ma e hyster a, Freud s work on hyster a n V enna concentrated on women. In contrast to Charcot, who exam ned, measured, and observed hyster cs, but pa d no attent on to what they sa d, Freud and h s co eague Joseph Breuer were the f rst to actua y sten to hyster ca women and to heed the r comp a nts. In Stud es on Hyster a (1895), he and Breuer worked out the fundamenta techn que of psychoana ys s. Most of the r pat ents were m dd e-c ass Jew sh women who found themse ves mpr soned n trad t ona ro es as dut fu daughters. Frustrated n the r nte ectua amb t ons, expected to stay home and care for the r brothers and father unt they marr ed, these br ght and mag nat ve young women deve oped a w de range of symptoms— mps, para yses, cr pp ng headaches, and most s gn f cant y, aphon a, or oss of vo ce. By encourag ng them to ta k, to recount the r dreams, to reca repressed memor es of sexua traumas and des res, Freud and Breuer found that they cou d cure the women s symptoms. Stud es on Hyster a thus seemed to ay the groundwork for a cu tura y aware therapy that respected women s words and ves. In the case of Anna O., or Bertha Pappenhe m, the connect ons between hyster a and fem n sm seemed part cu ar y c ear because after her ana ys s w th Breuer n 1882, she went on to become a fem n st
316 act v st. She trans ated Mary Wo stonecraft s V nd cat on of the R ghts of Woman nto German, wrote a p ay ca ed Women s R ghts , and was the cofounder and d rector of the Jud scher Frauenbund, the League of Jew sh Women. In her hyster ca se zures, Anna became unab e to speak her nat ve German, and nstead spoke e ther Y dd sh, wh ch she ca ed "the woman s German," or a umb e of Eng sh, Ita an, and French. These ngu st c symptoms have been read symbo ca y by fem n st cr t cs as the repress on of women s anguage or ts mposs b ty w th n patr archa d scourse. D anne Hunter ana yzes Pappenhe m s hyster ca symptoms as a ngu st c protest aga nst the German father tongue. In Anna O. s case, "speak ng German meant ntegrat on nto a cu tura dent ty [she] w shed to re ect," the patr archy n wh ch she was an mmob zed daughter. [119] Hunter conc udes that Anna O. s hyster a was a "d scourse of fem n n ty addressed to patr archa thought," s gn fy ng both through the body and through nonverba anguage the protest that cou d not be put nto words. [120] As she began to verba ze th s protest n her conversat ons w th Breuer, and to re ve some of her dreams and ha uc nat ons, Anna s symptoms were re eved. But she was not cured unt she took comp ete contro of anguage and sub ect v ty n her own wr t ng. She rema ned for seven years after her treatment w th Breuer, v s t ng sanator ums dur ng re apses. Anna O. recovered comp ete y on y w th the pub cat on of her f rst book, In the Rummage Store , n 1890. Rather than cont nu ng her ro e as the pass ve hyster ca pat ent, through wr t ng she became one who contro ed her own cure. [121] By the turn of the century, the sympathy w th women s nte ectua and creat ve frustrat ons and the openness to the r words so marked n Stud es on Hyster a had become cod f ed n the nterests of Freud s emerg ng psychoana yt c system, a system that depended very much on dom nat on over the pat ent. We see th s ncreased r g d ty n h s famous case h story of Ida Bauer, the young V ennese g r he ca ed "Dora." Dora was brought to Freud by her father when she was e ghteen. Inte gent and amb t ous, Dora was st f ed by the requ rements of her ro e as the marr ageab e daughter of a bourgeo s fam y, when she onged to go to the un vers ty and to have a career rather than a husband. Dora was a V ennese vers on of the New Woman of the 1890s, the fem n st who seeks h gher educat on and w shes to avo d marr age. Freud never met Dora s mother, whom he regarded as a bor ng case of "housew ves neuros s." A though Dora fe t contempt for her mother s monotonous domest c fe, t was the fe for wh ch she too was dest ned as a woman. Her mother was "bent upon draw ng her nto tak ng a share n the work of the house." Dora cou d f nd no support for her nte ectua asp rat ons
317 from e ther parent. A though she had a governess who was "we -read and of advanced v ews," Dora be eved that the governess was neg ect ng her and was rea y n ove w th her father. She arranged to have the woman d sm ssed. Afterward, she strugg ed a one w th the effort to keep up her ser ous read ng, and she attended ectures spec a y g ven for women. Her o der brother, however, went off to the un vers ty, and ater became a prom nent Austr an po t c an. Moreover, Dora was treated ke a pawn or a possess on by her father and den ed the r ghts to pr vacy or persona freedom. He was hav ng an affa r w th the w fe of a fr end, Herr K., who had attempted to seduce Dora when she was on y fourteen, and she fe t that "she had been handed over to Herr K." by her father n exchange for Herr K. s comp c ty n the adu tery. Profess ng to be anx ous about her depress ve state of m nd, but rea y, Dora be eved, afra d that she wou d betray h s sexua secrets, her father then "handed her over" to Freud for psycho-therapeut c treatment. He wanted Freud to persuade Dora that her percept ons were s mp y ado escent fantas es. He h red Freud hop ng for an advocate to "br ng her to reason." [122] As Jeffrey Masson observes, Dora had good reason to be upset: "She fe t consp red aga nst. She was consp red aga nst. She fe t ed to. She was ed to. She fe t used. She was used." [123] Moreover, Freud s determ nat on to abe her as a hyster c d d not depend upon the sever ty of her symptoms. Indeed, un ke the other women treated for hyster a by Breuer and Freud, Dora s "symptoms" were few and s ght. She had a nervous cough, headaches, depress ons. Wh e he acknow edged that Dora s case was no more than "pet te hystér e," Freud be eved that the very ord nar ness of her symptoms made her an dea sub ect. S nce he was comm tted from the start to the hyster a d agnos s, Freud nterpreted a of Dora s behav ors and statements n accordance w th h s theor es about the or g ns of hyster a n ch dhood sexua trauma and repressed des res. Many of h s v ews, such as the be ef that "gastr c pa ns occur espec a y often n those who masturbate" and that masturbat on was re ated to hyster a, are now seen as V ctor an sexua superst t on. But Freud s nterpretat ons of Dora s fantas es, wh ch have as tt e bas s as h s statements about her phys ca symptoms, are st accepted n psychoana ys s. He to d her that she was rea y attracted to Herr K., n ove w th her father, and n ove w th h mse f. He gnored the appa ng c rcumstances of Dora s fam y s tuat on, and she f na y broke off the therapy. The conc us on of Dora echoes the end ngs of many V ctor an nove s about women: "Years have gone by s nce her v s t. In the meant me the
318 g r has marr ed . . . she had been rec a med once more by the rea t es of fe." In fact Dora s prob ems were not reso ved by marr age, a though Freud borrows t as a terary dev ce to s gn fy a happy reso ut on of the therapeut c p ot. In the case h stor es of ma e pat ents, however, Susan Katz po nts out, these c osed marr age p ots are s gn f cant y absent; "the forms of Freud s case h stor es ref ect h s deo og ca pos t ons toward women and men." [124] S m ar y, Tor Mo rem nds us, when Freud wr tes about L tt e Hans, he "never ceases to express h s adm rat on for the nte gence of the tt e boy," wh e Dora s nte gence s represented as a form of neurot c res stance. [125] In add t on to ts p ot and themes, Dora s case had other terary character st cs. Wh e Breuer, n the case of Anna O., commented on the broken anguage and mu t ngua nature of the hyster c s speech, Freud h mse f f rst drew attent on n the Dora case to the fragmentary and d scont nuous nature of the hyster c s narrat ve, and to the phys c an s respons b ty for reorgan z ng t nto a coherent who e. As he exp a ned, hyster cs ke Dora were unab e to te an " nte g b e, cons stent, and unbroken" story about themse ves. They repressed, d storted, and rearranged nformat on; the r vo ub ty about one per od of the r ves was sure to be fo owed "by another per od n wh ch the r commun cat ons run dry, eav ng gaps unt ed and r dd es unanswered." And th s ncapac ty to g ve an "ordered h story of the r fe" was not s mp y character st c of hyster cs, Freud c a med; t was n a sense the mean ng of hyster a. If the hyster c cou d be brought to remember what was repressed, and to produce a coherent narrat ve, she wou d be cured. Thus the therap st s task was to construct such a narrat ve for the pat ent. Freud was conf dent that no matter how e us ve and en gmat c the hyster c s story, the ana yst cou d reconstruct a og ca , sc ent f c, and comp ete narrat ve. "Once we have d scovered the concea ed mot ves," he wrote, "wh ch have often rema ned unconsc ous, and have taken them nto account, noth ng that s puzz ng or contrary to ru e rema ns n hyster ca connect ons of thought, any more than n norma ones." [126] In do ng so, moreover, he had not on y to f n the gaps n the hyster c s own story but to overcome her res stance to h s narrat ve nterpretat ons. In order for the therapy to work, the hyster c had to accept and be eve the narrat ve of the ana yst. In h s ater papers on psychoana yt c techn que, Freud descr bed the process as one of combat n wh ch "the pat ent br ngs out of the armory of the past the weapons w th wh ch he defends h mse f aga nst the progress of the treatment—weapons wh ch we must wrest from h m one by one." [127] The ana yst, Freud ns sted n "The Dynam cs of Transference," must w n "the v ctory whose ex-
319 press on s the permanent cure of the neuros s." [128] But Dora was qu te uncooperat ve n th s regard. She f at y den ed Freud s narrat ve embe shments of her story, wou d not accept h s vers on of her act v t es and fee ngs, and e ther contrad cted h m or fe nto stubborn s ence. F na y she wa ked out on Freud by refus ng to cont nue w th therapy at a . Freud v ewed th s res stance as the prob em of her transference; Dora, he argued, had pro ected onto h m her fee ngs of erot c attract on for her father and Herr K. and was pun sh ng h m w th her re ect on. If Freud s a re ab e narrator, what happened n h s exchange w th Dora was that he succeeded n penetrat ng the mystery of her hyster ca symptoms. In h s term no ogy, he un ocked her case and exposed her sexua secrets. Unab e to face the truth, Dora ran away from her therapy and rema ned s ck for the rest of her fe. Freud was a hero c p oneer who was d sappo nted n h s efforts to he p. But f Freud s an unre ab e narrator, a very d fferent p ot emerges. In th s case, Dora s a v ct m of Freud s unconsc ous erot c fee ngs about her that affected h s need to dom nate and contro her. It s s gn f cant that Dora has no vo ce n Freud s text, that we get noth ng of her d rect d a og, and that her h stor ca and Jew sh dent ty are both suppressed. Un ke Anna O., she never became a sub ect, on y the ob ect of Freud s narrat ve. H s nterpretat ons of her prob em ref ect h s own obsess ons w th masturbat on, adu tery, and homosexua ty. He never understands her story at a ; he s mp y tr es to bu y her nto accept ng h s vers on of events. H s vaunted penetrat on of her secrets s rea y a k nd of verba rape. Dora s departure s then a hero c gesture of se f-assert on and def ance. Her unhappy subsequent fe was the resu t of Freud s fa ng her and eav ng her defense ess n a soc a env ronment host e to nte ectua women. H s nterpretat on of her story s more about h mse f than about her. Contemporary ana ysts agree that for a var ety of reasons psychoana ys s cou d on y have been deve oped out of work w th hyster cs. "I th nk . . . that psychoana ys s had to start from an understand ng of hyster a," Ju et M tche wr tes. "It cou d not have deve oped. . . from one of the other neuroses or psychoses. Hyster a ed Freud to what s un versa n psych c construct on and t ed h m there n a part cu ar way—by the route of a pro onged and centra preoccupat on w th the d fference between the sexes. . . . The quest on of sexua d fference—fem n n ty and mascu n ty— was bu t nto the very structure of the ness." [129] Because hyster cs formed strong and exp c t transferences to the r doctors, they were ana yzab e and thus were an dea group from wh ch to gen-
320 erate a psychoana yt c theory. Kurt E ss er has hypothes zed that "the d scovery of psychoana ys s wou d have been great y mpeded, de ayed, or even made mposs b e f n the second ha f of the n neteenth century the preva ng neuros s had not been hyster a." [130] What s eft unsa d n these c a ms, however, s that on y fema e hyster cs offered these opportun t es. The gender of the hyster c was cruc a n ead ng Freud to the theory of sexua et o ogy of the neuroses. Had h s pat ents pr mar y been men, had he wr tten a case study of "Dor an" rather than "Dora," the h story of psychoana ys s wou d ook very d fferent. The gender d fference depends n part on Freud s re ance on cu tura myths of mascu ne and fem n ne deve opment n shap ng h s nterpretat on of hyster a. At the turn of the century, hyster a was st popu ar y and med ca y con o ned w th fema e dev ance. In France, desp te the "d smemberment" of Charcot, the hyster c was st seen n a theatr ca context as a performer: "The hyster c s an actress, a comed enne," wrote P. C. Dubo s n 1904, "but we never reproach her, for she doesn t know that she s act ng. [131] The most vehement negat ve statements assoc at ng fem n sm w th hyster a came dur ng the m tant suffrage campa gn. "One does not need to be aga nst women suffrage," the London T mes ed tor a zed n 1908, "to see that some of the more v o ent part sans of that cause are suffer ng from hyster a. We use the word not w th any sc ent f c prec s on, but because t s the name most common y g ven to a k nd of enthus asm that has degenerated nto hab tua nervous exc tement." In a notor ous art c e ca ed "On M tant Hyster a," Dr. A mwroth Wr ght traced fem n st demands to the "phys o og ca emergenc es" that constant y threatened women. Suffrag st protest, espec a y when t nvo ved work ng-c ass women, wrote the Da y Chron c e , was s mp y "hyster ca hoo gan sm." [132] The representat ons of the m tant fem n st and the hyster c were conf ated n the popu ar press, ref ect ng the v ew that nervous d sorders were v s b e and detectab e through study of the phys ognomy. As Sander G man shows n chapter 5 n th s book, the face of the hyster c had been presented as the ch ef s gn of hyster ca "d fference" through the popu ar zed mages and photographs of Charcot s ate er, and through h s stud es of re g ous trance and possess on n art as hyster ca man festat ons. Thus, the Da y M rror wrote on 25 May 1914, the "hyster ca ecstasy" of the suffragettes cou d be seen "unm stakab y n the express on of the face." [133] But w th the outbreak of war and the abrupt end of the suffrage campa gn, there were expectat ons that hyster a was dy ng out. "One doesn t dare any onger to speak of hyster a," wrote one doctor n 1914. [134] But
321 the Great War changed a th s conf dent pred ct on w th a great ep dem c of hyster a among men. There had been scattered warn ngs of hyster a among so d ers before 1914. Dur ng the Boer War, the Br t sh surgeon C. A. Morr s noted neurasthen c prob ems among the troops, wh ch he attr buted to pr vat on, exhaust on, and menta stra n. There were s m ar nstances dur ng the RussoJapanese War of 1904-1905, and n 1907, the term "war neuros s" was ntroduced at the Congrès A emand de Méd c ne Internat ona e. [135] But Wor d War I, n the words of Sándor Ferencz , offered "a ver tab e museum of hyster ca symptoms." [136] In a the European arm es, war neuros s was extens ve. In Eng and by 1916, nervous cases accounted for as much as 40 percent of the casua t es n the combat zone. By 1918 there were over twenty war hosp ta s for menta pat ents n the Un ted K ngdom. And by the end of the war, e ghty thousand cases had passed through army med ca fac t es. One-seventh of a d scharges were for nervous d sorders. "It s a wonderfu turn of fate," marve ed the Br t sh psycho og st W. H. R. R vers, "that ust as Freud s theory of the unconsc ous and the method of psycho-ana ys s founded upon t shou d be so hot y d scussed, there shou d have occurred events wh ch have produced on an enormous sca e ust those cons derat ons of para ys s and contracture, phob a and obsess on, wh ch the theory was des gned to exp a n." [137] The psych atr c theor es that deve oped around war neuros s ref ect the amb va ence of the med ca estab shment upon confront ng hyster ca behav or n f ght ng men. The f rst prob em was n nam ng the d sorder. When Dr. Char es S. Myers saw cases of amnes a, mpa red v s on, and emot ona d stress among Br t sh so d ers n France, he noted "the c ose re at on of these cases to hyster a." But ke doctors before h m, Myers d d not want to use the fem n z ng term "hyster a," and thus he argued that the symptoms cou d be traced to a phys ca n ury to the centra nervous system caused by prox m ty to an exp od ng she . He chr stened the d sorder "she -shock." Later Myers wou d concede that the ack of ev dence of any organ c re at on between exp od ng she s and neurot c symptoms made she shock "a s ngu ar y -chosen term," but ts s mp c ty, a terat on, and m tary sound made t the abe that won out over such other a ternat ves as "anx ety neuros s," "war stra n," and "so d er s heart." [138] The eff cacy of the term "she shock" ay n ts power to prov de a mascu ne-sound ng subst tute for the effem nate assoc at ons of hyster a, and to d sgu se the troub ng para e s between ma e war neuros s and the fema e nervous d sorders ep dem c before the war. French doctors were a so re uctant to dent fy war neuroses as hys-
322 ter a, part y because of the nterna strugg e over the reputat on of Char-cot. They ca ed war neurot cs pth at ques , n Bab nsk s term, or, more harsh y, s mu ateurs . M tary author t es, ndeed, regarded she shock as a form of coward ce or ma nger ng, and some sen or army off cers thought that pat ents shou d be court-mart a ed and shot. [139] One of the str k ng aspects of she shock was the c ass d fference n symptoms; "she -shocked off cers tended to suffer from chron c anx ety states wh e men n the ranks genera y suffered from acute hyster ca d sorders." [140] In the ranks, symptoms tended to be phys ca : para yses, mps, b ndness, deafness, mut sm. In off cers, symptoms tended toward the emot ona : n ghtmares, nsomn a, depress on, anx ety attacks. Sexua mpotence was w despread n a ranks. Exp anat ons for the d fferences were c ass-based. Myers exp a ned that "the force of educat on, trad t on, and examp e make for greater se f-contro n the case of the Off cer. He, moreover, s busy throughout a bombardment, ssu ng orders and sub ect to worry over h s respons b t es, whereas the men can do noth ng dur ng the she ng but watch and wa t unt the order s rece ved for an advance." [141] Some Br t sh doctors saw a one-to-one cause-and-effect re at onsh p between the hyster ca convers on symptom and the trauma that had caused t. Accord ng to Thomas Sa mon, "A so d er who bayonets an enemy n the face deve ops a hyster ca t c of h s fac a musc es; abdom na contract ons occur n men who have bayonetted enem es n the abdomen; hyster ca b ndness fo ows part cu ar y horr b e s ghts; hyster ca deafness appears n men who f nd the cr es of the wounded unbearab e, and the men detached to bur a part es deve op amnes a." [142] There were two ma or ways of treat ng she shock dur ng the war, both des gned to get men funct on ng and back to the trenches as fast as poss b e, and these treatments were d fferent ated accord ng to rank. She -shocked so d ers were treated w th the host ty and contempt that had been accorded hyster ca women before the war. As n the n neteenth century, work ngc ass men were nked w th hyster ca women as the antagon sts of doctors. "The case of a psycho-neuropath," wrote Freder ck Mott, "rea y cons sts of a menta contest, resu t ng n the v ctory of the phys c an." [143] Not on y n Eng and but n a European countr es, she -shocked ord nary so d ers were sub ected to forms of d sc p nary treatment, such as so at on, restr cted d et, pub c sham ng, and pa nfu e ectr c farad zat on, or shocks to the aff cted parts of the r bod es. The treatments known as "qu ck cure," "queen square" (for the London hosp ta where t was pract ced), "torpedo ng," "torp age," "man ère forte," "terror sm," or "Uberrümp ung" (hust ng) were n fact
323 sem -tortures des gned to make the hyster ca symptom more unp easant to ma nta n than the threat of death at the front. German phys c ans, for examp e, were d v ded between those who ooked for the organ c es ons of nervous trauma and those who be eved the symptoms man fested a w sh to escape that was ndependent of any spec f c traumat c nc dent. Wh e n the short term these methods d d terror ze pat ents nto dropp ng the r symptoms, when they were returned to the front, more d sab ng and permanent cond t ons emerged. H. Stern est mated that out of three hundred so d ers "cured" and sent to the front, ess than two percent cou d be ma nta ned. [144] After the war, a spec a Austr an comm ss on was appo nted to nvest gate the treatment of war neurot cs n the V enna Genera Hosp ta under Professor Ju us Warner-Jauregg, who be eved a she -shock cases to be ma ngerers. In h s report for the comm ss on, Freud test f ed that "there were cases of death dur ng the treatment and su c des as a resu t of t," but Warner-Jauregg was acqu tted. [145] More advanced psych atr sts adopted psychotherapeut c techn ques n the treatment of she -shocked off cers, us ng abreact ve or cathart c methods such as hypnos s, dream ana ys s, and free assoc at on. Off cers were g ven var ous k nds of rest cures s m ar to those ass gned to neurasthen cs. When men were the pat ents, however, the rest cure had to be rev sed. M tary doctors fe t that ntense act v ty was necessary for the restorat on of mascu ne se f-esteem. As H. Cr chton-M er adv sed, "Rest n bed and s mp e encouragement s not enough. . . . Progress ve da y ach evement s the on y way whereby manhood and se f-respect can be rega ned." [146] The treatment of so at on and rest, G. E ot-Sm th and T. H. Pear rem nded doctors, had been deve oped n c v an fe for "we -to-do women v ng n the ap of uxury" and cou d not be good for hardy m tary men. [147] A though the men of the f rst group of neurasthen c cases treated n Eng sh m tary hosp ta s were g ven the We r M tche rest cure, t was ater reported that these pat ents rema ned throughout the war. [148] In dea ng w th she shock, doctors seemed to have forgotten or gnored Charcot s work w th ma e hyster cs. They acked a neutra vocabu ary for d scuss ng the cases n the contexts of mascu n ty; nstead, she shock was descr bed as the product of woman sh, homosexua , or ch d sh mpu ses n men. W. H. R. R vers had argued that war neuros s was a form of regress on to an ear er form of deve opment, e ther to an ma nst ncts, pr m t ve defenses, or nfant e behav ors. Hugh Cr chton-M er a so observed that, espec a y among the ranks, war neuros s produced "a cond t on wh ch s essent a y ch d sh and nfant e n ts
324 nature." [149] T. A. Ross suggested that the tra n ng of a so d er "tended to make h m regress to a ch d sh att tude. . . . The so d er s above a th ngs to earn what he s to d at once w thout argument as a ch d s." [150] Wart me regress on to a ower eve of matur ty a so seemed to exp a n the pro ferat on of superst t ons, mag ca be efs, r tua s, and rumors that, as Pau Fusse has shown, made the Great War a "new wor d of myth." [151] When doctors d sm ssed she -shock cases as ma ngerers or s mu ateurs , they were often h nt ng at the effem nacy that had a ways been part of the ma e hyster a d agnos s. Freud ans shared th s v ew. Kar Abraham, among the Freud ans, was one who argued that war neurot cs were pass ve, narc ss st c, and mpotent men to beg n w th, whose atent homosexua ty was brought to the surface by the a -ma e env ronment. [152] In London, the t ny group pract c ng Freud an psychotherapy—Dav d Eder, Dav d Forsyth, and Ernest Jones—a so argued for a sexua et o ogy for she shock. The r nterpretat ons, however, were greeted w th pred ctab e outrage by such ant -Freud an members of the o der generat on as Char es Merc er. Report ng n The Lancet on a she -shock pat ent, Forsyth descr bed h m as "a case of unconsc ous homosexua ty w th marked ana erot c sm." Merc er made an angry response:
Unconsc ous pa n unconsc ous homosexua y unconsc ous Oed pus comp ex and o her unconsc ous s a es o consc ousness o he psychoana ys s express ons mean Th s poor man had su ered many h ngs or many mon hs rom many psycho-ana ys s un a as he urned upon h s ormen ors you ha have pu hem n o my m nd "
were a grea mys ery o me un earn rom one o he r v c ms wha hese w h hese words " s rue ha now have hese hy hough s bu s
The fo ow ng week, Merc er was seconded by Dr. Robert Armstrong-Jones, who ca ed for the profess ona out aw ng of psychoana ys s. Then came a rebutta from Forsyth, wonder ng how "those who st repud ate psycho-ana ys s and the sexua et o ogy of the neuroses can rema n b nd to what must ong have been recogn zed by every thoughtfu reader of your paper—name y, that the sexua nst nct s c ean and pure. It w not do nowadays to dress t up n m d-V ctor an pre ud ces as a repu s ve and d sreputab e bog e to fr ghten our nte gence." [153] Some famous she -shock pat ents, such as S egfr ed Sassoon, W fred Owen, and Robert Graves, were ndeed homosexua or b sexua . For most, however, the angu sh of she shock nc uded more genera but ntense anx et es about mascu n ty and fears of homosexua ty, even as
325 they refused to cont nue the masquerade of mascu n ty. What John Lynch has ca ed "the exp o tat on of courage" n the Great War may be more accurate y ca ed the exp o tat on of man ness. [154] So d ers were recru ted and soc a zed through appea s to "trad t ona mascu ne v rtues" and through prom ses of "the fu f ment of mascu n ty on the batt ef e d." [155] In combat, d sp ays of man y sto c sm and hero cs were expected and encoded. As Pau Fusse notes n h s g ossary of the romant c vocabu ary of Wor d War I, to be "man y" meant not to comp a n. [156] Mart n Stone po nts out that she shock was thus generated by the m tary ethos of mascu n ty: "The so d er was encouraged to k at the expense of un eash ng nfant e sad st c mpu ses that had prev ous y been successfu y repressed. He was encouraged to form c ose emot ona bonds w th other men and yet homosexua ty was forb dden." [157] If the essence of man ness was not to comp a n, then she shock was the body anguage of mascu ne comp a nt, a protest aga nst the concept of "man ness" as we as aga nst the war. The mpact of ma e hyster a n the f e d of psycho og ca med c ne was comp ex. On one hand, psycho og sts who had worked w th she shock cha enged Freud s v ew that sexua factors were bas c to the understand ng of hyster a. Unab e to rev se a theory based on fema e hyster a n the ght of ma e exper ence, these men nstead argued that "she shock had effect ve y d sproved Freud s theory of sexua ty." [158] On the other hand, the Freud an estab shment d d not take the essons of she shock as a c ue to expand ng the theory of hyster a. Indeed, the theory on y r g d f ed, w th psychoana ysts ns st ng that the cause of hyster a had to be sought n nfant traumas and repressed fam y exper ences, rather than mod fy ng the r pos t on to take mmed ate soc a factors nto account. The one or two vo ces who m ght have had someth ng new and mportant to add to the conversat on were premature y st ed. W. H. R. R vers was one of these. R vers was a Cambr dge psycho og st and anthropo og st who had stud ed n Germany, and who took an nterest n the work of Freud. In h s ear y f ft es and unmarr ed when he became a m tary doctor, he found n the study of she shock both a r ch source of mater a for h s theor es of the unconsc ous and a persona nvo vement that changed the course of h s career. The war, he wrote n Inst nct and the Unconsc ous , had been "a vast cruc b e n wh ch a our preconce ved v ews concern ng human nature have been tested." [159] In h s therapeut c pract ce, R vers re ed on what he ca ed "autognos s," or se funderstand ng, wh ch nvo ved the d scuss on of traumat c exper ences; and reeducat on n wh ch "the pat ent s ed to understand how h s new y
326 acqu red know edge of h mse f may be ut zed . . . and how to turn energy, morb d y d rected, nto more hea thy channe s." [160] R vers s work was trag ca y abbrev ated by h s death n 1922. R vers may have been part cu ar y effect ve as a therap st because he shared some of the character st cs of h s pat ents. Speech d sorders, espec a y stammer ng, were the most common neurasthen c symptom among off cers and p ayed a prom nent ro e n the case stud es of h s pat ents. [161] R vers, the son of a speech therap st who spec a zed n the treatment of stutterers, had stammered a h s fe, a though h s b ographer specu ates that he d d not stammer n German. He was a so sexua y repressed and a most certa n y homosexua . In h s postwar wr t ngs, R vers exp ored the psychoana yt c ssues of fear and anx ety wh ch had come out of h s war work at Cra g ockhart Hosp ta . Propos ng "suggest on-neuros s" as a term for hyster a, he argued that m tary tra n ng re nforced suggest b ty, espec a y n pr vate so d ers. In h s v ew, "the symptoms of hyster a are due to the subst tut on, n an mperfect form, of an anc ent nst nct ve react on n p ace of other forms of react on to danger." In exp a n ng the mut sm that was a frequent feature of she shock, R vers made connect ons to "the suppress on of the cry or other sound wh ch tends to occur n response to danger." He a so began to app y to fema e hyster a, or as he ca ed t, "the hyster a of c v an pract ce," some of the deas about gender anx ety he had deve oped n work ng w th men. "We have to d scover why hyster a shou d be so frequent n women, and so rare n men, under the ord nary cond t ons of c v fe . . .," R vers wrote. "Women are a ways ab e to dangers n connect on w th ch db rth to wh ch men are not exposed, wh e the danger e ement, rea or mag nary, s more pronounced n them than n the ma e n connect on w th co tus." [162] But theor es about women s fears seemed ess mportant by th s t me because after the war and the passage of women s suffrage n Eng and and the Un ted States, t was be eved that fema e hyster a dec ned and even d sappeared. Edward Shorter has noted that "the mage of the dynam c New Woman of the 1920s . . . p ays an obv ous ro e n the dec ne of the hyster ca para yses that once were qu te common among young women: the New Woman, who rode motorcyc es and smoked n pub c, s mp y d d not deve op a para ys s as a eg t mate way of commun cat ng her d stress." [163] Other scho ars have a so po nted to soc a changes as determ nants of the dec ne. W th the gradua emanc pat on of women, they have argued, the soc a cond t ons that had produced hyster a were no onger operat ve. Accord ng to the psychoana yst Mon que Dav d-Ménard, for examp e, "the repress on of sexua ty at the end of the n neteenth century" was the cause of hyster a; "through the
327 spectacu ar s de of hyster a, women expressed what was mposs b e to say concern ng sexua ty." [164] If hyster a was the resu t of the sexua repress on of the past, t made sense that t wou d van sh n our more berated age. [165] And ndeed for much of th s century, fema e hyster a seemed to be on the wane, as fem n sm was on the r se. It s str k ng as we that Freud s fema e d sc p es were v rtua y s ent on the quest on of hyster a. It s not a top c n the works of Karen Horney, Me an e K e n, Anna Freud, or other members of the postwar generat on. When a woman ana yst, E zabeth Rosenberg Zetze , f na y d d dea w th hyster a, she d d not quest on Freud an assumpt ons and sh bbo eths. A student of Ernest Jones and D. W. W nn cott, Zetze tra ned n psych atry at Mauds ey Hosp ta dur ng 1938-39 and then served for s x years dur ng the war n the Emergency Med ca Serv ce and Armed Forces. Zetze worked w th hyster ca so d ers and descr bed her exper ences n her f rst ana yt c paper, "War Neuros s: A C n ca Contr but on," pub shed n 1943. The three case stud es, she ater observed, served "as a mode or b uepr nt" for her ma or work. Zetze s qu te approv ng of her ma e pat ents: "They were a happ y marr ed; they a had a steady work record; they had a shown amb t on, soc a consc ence, and a good capac ty for sub mat on." [166] In contrast, when she worked w th fema e hyster cs n Boston after the war, Zetze was much more cr t ca . A though the women she ca ed "true good hyster cs" were "notab y successfu n the area of work," they had "fa ed to ach eve a mature heterosexua re at onsh p." Zetze echoed Freud n her nd fference to the doub e messages n the ves of her hyster ca women pat ents, most of whom were nte ectua s and students at var ous Boston un vers t es. Wh e she noted that "a of these pat ents have, n add t on, been ab e to make and keep fr ends," she was certa n that the r d ff cu t es w th men came from the r unreso ved oed pa conf cts and pen s envy, rather than from men s d scomfort w th g fted amb t ous women. [167] Instead of pursu ng the paradoxes of the r ves, and the apparent use essness of Freud an therapy n so v ng them, she focused nstead on the r ana yzab ty and su tab ty for treatment. For, she wrote,
There are many e g rs Whose comp a n s are e pear s O he c ass ca hys er ca neuro c And when h s s rue Ana ys s can and shou d ensue Bu when h s s a se Tw be chao c 168
328 In such contemporary psychoana yt c wr t ng by women as dea s w th hyster a, Freud an dogma has made t d ff cu t for women ana ysts to accept hyster ca symptoms n the r ma e pat ents. Mon que Dav d-Ménard stud ed psychoana ys s at the Eco e Freud enne n Par s. In her pract ce, ke most women ana ysts, she sees more women than men pat ents. Dav d-Ménard c a ms not to know "what mascu ne hyster a s. Somet mes I say to myse f when I hear a ma e pat ent who s very dent f ed w th a woman, Perhaps that came from hyster a, but I a ways end up say ng, It s not rea y that. " [169] Her book Hyster a from Freud to Lacan (1983) s a dense y argued ph osoph ca compar son of Freud and Lacan, rather than a fem n st read ng of the r work. Yet a fem n st nterpretat on of hyster a does not come natura y to women psychoana ysts or h stor ans s mp y because they are women. Dav d-Ménard, for examp e, has sa d n an nterv ew, "I don t def ne myse f as a fem n st whether as a ph osopher or as a psychoana yst." [170] A fem n st standpo nt s s tuated w th n a part cu ar cu tura and nte ectua framework, wh ch offers an nterpretat ve vocabu ary and a support network for those who put t to use. Thus we need to read and eva uate women s wr t ngs about hyster a w th n the r own h stor ca context and w th an understand ng of the mpact of gender at a part cu ar moment for profess ona women. I za Ve th s Hyster a (1965) s an exce ent case n po nt. Accord ng to Mark M ca e, the book "estab shed the standard h stor ca v ew of the sub ect for an ent re generat on of French, Br t sh, and North Amer can readers." [171] I za Ve th s one of the p oneer ng scho ars of the h story of med c ne n the Un ted States. Born n Germany n 1915, she stud ed med c ne n Geneva and V enna before com ng to the Un ted States n 1937. Wh e she had hoped to become a p ast c surgeon, "there was no thought n the th rt es that a woman cou d rece ve a res dency or ass stantsh p n surgery." [172] Instead she tra ned w th Henry S ger st at Johns Hopk ns and n 1947 rece ved the f rst doctorate n the h story of med c ne n the Un ted States. For contemporary h stor ans sens t zed by fem n st scho arsh p, Ve th may seem nd fferent to or unaware of the fem n st quest ons n hyster a. She accepts who ehearted y the Freud an v ew of hyster a and uses t as the reso ut on of the book, cred t ng psychoana ys s w th the conquest of hyster a; t was the ntens f ed understand ng of the cause of hyster a by ead ng psych atr sts dur ng th s century, she wrote, that "contr buted to the near-d sappearance of the ness." [173] Roy Porter n chapter 3 quest ons Ve th s uncr t ca acceptance of Freud and her b ndness to the m sogyny of prepsychoana yt c therap sts ke Carter. Mark M ca e, too,
329 po nts out that a though she "m ght have been expected to respond d fferent y," Ve th "ma nta ned a stud ed s ence on the ntersexua aspects of the d sorder." [174] Yet such a udgment carr es ts own assumpt ons about gender, gnores the c rcumstances n wh ch the book was wr tten, and m sses the way that Ve th, ke many women wr t ng about hyster a, fe t pressured to avo d a fem n sm trad t ona y nked w th the d sorder tse f. Ve th does ndeed po nt out a number of the ntersexua ssues of hyster a, a be t n a restra ned anguage. In one of the few metaphors of her book, she comments that "the scar et thread of sexua ty" runs throughout the "tang ed ske n" of the h story of hyster a. [175] She thus presents the ssue as sexua ty rather than fem n n ty, a though the a us on to the scar et etter (and to the great Amer can hero ne Scar ett O Hara) suggests that th s sexua ty was n fact re ated to women. For much of the book, when Ve th descr bes or quotes accounts that nk hyster a w th fema e sexua ty and reproduct on, she genera zes from them to d scuss a more un versa and ungendered "sexua ty." W th regard to the Greek or g ns of the term, for examp e, she notes that "the assoc at on of hyster a w th the fema e generat ve system was n essence an express on of awareness of the ma gn effect of d sordered sexua act v ty on emot ona stab ty." Ve th s carefu neutra ty extended a so to her d scuss on of w tchcraft and the w tch tr a s. "It s ev dent from the forgo ng that women were the ch ef targets n the w tch hunts," she m d y observes, w thout specu at ng further on the c er ca m sogyny and profound ma e anx et es that were pro ected onto women dur ng the w tch tr a s. [176] Ve th s s m ar y to erant w th regard to n neteenth-century med c ne. She attr butes Robert Brudene Carter s host ty toward women to h s "youthfu mpat ence" w th h s fema e pat ents, and when she ta ks about the "pun t ve" aspects of V ctor an treatment of hyster ca women, ca s them "m santhrop c" rather than "m sogyn st c." [177] In her most substant a d scuss on of sex ro es and att tudes, however, Ve th exp a ns that the "man festat ons of th s d sease tended to change from era to era qu te as much as d d the be efs as to et o ogy and the methods of treatment. The symptoms, t seems, were cond t oned by soc a expectancy, tastes, mores, and re g on, and were further shaped by the state of med c ne n genera and the know edge of the pub c about med ca matters." Women created or reproduced hyster ca symptoms n accordance w th the r age s deas about fem n n ty: "Throughout h story, the symptoms were mod f ed by the preva ng concept of the fem n ne dea . In the n neteenth century, espec a y, young women and g r s were expected to be de cate and vu nerab e both phys ca y and emo-
330 t ona y, and th s mage was ref ected n the r d spos t on to hyster a and the nature of ts symptoms. The r de cacy was enhanced by the r ness, and as a resu t, the nc dence of overt man festat ons was further ncreased." [178] Th s comes very c ose to contemporary fem n st ana yses of hyster a. Yet to udge Ve th s work by contemporary fem n st standards s to m sunderstand the h stor ca nature of gender deo ogy. Women h stor ans and psychoana ysts of Ve th s generat on, nc ud ng E zabeth Zetze , had a very d fferent context than our own for the r th nk ng about sexua d fference, as severa recent stud es have ustrated. Joan Scott shows n her overv ew of Amer can women h stor ans that the post-Wor d War II per od saw the emergence of "a new d scourse . . . that emphas zed the mascu ne qua t es of h stor ans, assoc at ng them w th the preservat on of nat ona trad t ons and democracy." Ve th, ke other women h stor ans rece v ng the r doctorates dur ng th s per od, "had the further cha enge of repud at ng the d sab t es assumed to come w th womanhood." [179] Ser ous h stor ans were ud c ous, unemot ona , ob ect ve, mpersona . S m ar y, n a ser es of nterv ews w th women psychoana ysts who tra ned dur ng the 1920s, 1930s, and 1940s, Nancy Chodorow found a very d fferent gender consc ousness from that of the 1980s operat ve n the r v ews of fem n sm and psychoana ys s. Gender was not a mean ngfu or sa ent category to them; few had not ced d scr m natory treatment; they had not thought about the conf cts between Freud an v ews of fem n n ty and the r own profess ona careers. But rather than accus ng them of bad fa th, b ndness, or repress on, Chodorow conc uded that "gender-emphas s" or the "re at ve downp ay of gender ssues" are "not on y ob ect ve y determ ned by a structura s tuat on" but are a so "sub ect ve features of dent ty and cu ture." The "sa ence of mean ng of gender" was not a h stor ca constant but rather "a h gh y constructed product of one s t me and p ace." [180] In Ve th s case, her pos t on as a woman academ c n a ma e-dom nated profess on may have ed her to emphas ze ob ect v ty, neutra ty, and nd rect on rather than to have taken a forcefu and exp c t fem n st stand. Her book appeared n the ast moments of ca m before the storm of the women s berat on movement; sexua po t cs, however, was a term st to be nvented by Kate M ett, and fem n st scho arsh p d d not yet ex st. I za Ve th s autob ograph ca wr t ngs cast much ght on the c rcumstances under wh ch she wrote Hyster a and make c ear that she was not unaware of sex sm and ts effects on the fema e psyche. In descr b ng herse f for Who s Who , she wrote, "In a ong and severe y hand capped
331 fe I have had to ve w th chron c ness and pa n. Thanks to my husband s end ess pat ence and he pfu ness, I have earned to accept what cannot be changed, and to change what can be a tered. I have had a successfu and h gh y sat sfactory academ c career n sp te of end ess obstac es that e n the way of a woman scho ar." Some of the deta s beh nd th s summat on can be found n Ve th s most recent book, Can You Hear the C app ng of One Hand? (1989). Here she descr bes the severe stroke that she suffered n 1964 wh e she was comp et ng Hyster a . Just f fty years o d, and hav ng moved to Ca forn a to take up a professorsh p at the Un vers ty of San Franc sco, Ve th woke up one morn ng to f nd that her ent re eft s de was para yzed. She had been exper enc ng odd symptoms for over a month, nc ud ng m gra ne headaches, d sturbed v s on, and o factory ha uc nat ons. Yet, desp te her tra n ng as a med ca h stor an, Ve th had not consu ted a doctor. Why? Because symptoms ke these were frequent y attr buted n the med ca terature to women w th "hyster ca persona ty." Ve th was embarrassed to th nk that she herse f m ght be a hyster c, and thus she gnored the warn ng s gna s of a ser ous stroke. Moreover, when she exper enced para ys s of the eft s de—the s de usua y aff cted n cases of hyster a—Ve th was persuaded that she was on y hyster ca and "de uded myse f that f I adm tted the hyster ca nature of my hem p ag a to myse f and others, t wou d s mp y go away." Patron zed and subt y pun shed by doctors n the hosp ta when she refused to behave ke a su tab y gnorant and doc e fema e pat ent, Ve th earned more about sex sm n med c ne than has ever been revea ed n her profess ona wr t ng. She has never recovered the use of her eft arm. In contrast to Ve th s emphas s on the ungendered nature of hyster a, contemporary fem n st cr t cs have argued that wh e "Freud s assert on that hyster a aff cted both men and women was a berat ng gesture n the n neteenth century," the most berat ng gesture for fem n sts today s to rec a m hyster a "as the d s-ease of women n patr archa cu ture." [181] Some have argued for a cont nu ty or even a s m ar ty between hyster a and fem n sm. In the 1970s, t became an mportant strategy of rad ca fem n sm to redef ne as terms of fema e power the host e abe s that had been attached to rebe ous or dev ant women through h story. Thus ear y women s groups were ca ed the W tches, the h gh y successfu Eng sh fem n st pub sh ng company s ca ed V rago, and a ma or French fem n st ourna was ca ed Sorc ères . Fem n sts sa uted the hyster cs of the past as hero nes of res stance to the patr archa order. Dora has ndeed become a parad gmat c f gure for contemporary fem n st cr t c sm. Because she wa ked out on her psychoana ys s, she has
332 appeared to some as a def ant f gure and precursor, what Mary Jacobus ca s "the f rst fem n st cr t c of Freud." [182] In her man festo on women s wr t ng, "The Laugh of the Medusa," Hé ène C xous takes Dora s story as a revo ut onary d scourse of the fem n ne, sa ut ng Dora as "the ndom tab e, the poet c body . . . the true m stress of the S gn f er." [183] In The New y-Born Woman (1975), C xous took the pos t on that hyster a was the "nuc ear examp e of women s power to protest," and that Dora be onged to the pantheon of fem n st h story: "Dora seemed to me to be the one who res sts the system, the one who cannot stand that the fam y and soc ety are founded on the body of women, on bod es desp sed, re ected, bod es that are hum at ng once they have been used." [184] C xous s p ay Portra t de Dora (1976) tr es to restore Dora s sub ect v ty and to reconst tute the other bur ed fema e f gure n Freud s case h story, the mother. Interpretat ons of Freud s case h story are now eg on, and the book In Dora s Case br ngs some of these fem n st read ngs together. It s mportant to note, however, that the fasc nat on w th Dora and hyster a has a so been controvers a w th n fem n st theory. In her debate w th C xous n The New y-Born Woman , Cather ne C ement was more skept ca about the u t mate power of hyster a as a form of fem n ne subvers on. She ma nta ned that the hyster c s unab e to commun cate because she s outs de of rea ty and cu ture—that, n Lacan an terms, her express on rema ns n the Imag nary, outs de the Symbo c. Thus "hyster ca symptoms, wh ch are metaphor ca y nscr bed on the body, are ephemera and en gmat c. They const tute a anguage on y by ana ogy." Hyster cs shou d be c assed not w th fem n st hero nes, but w th dev ants and marg na s who actua y re nforce the soc a structure by the r preorda ned p ace on the marg n. Indeed, the r ro es are u t mate y conservat ve: "Every hyster c ends up nur ng others to her symptoms, and the fam y c oses round her aga n, whether she s curab e or ncurab e." W th regard to Dora, C ément s coo and eve -headed: "You ove Dora, but to me she never seemed a revo ut onary character." [185] In order to affect the symbo c order, or the mater a wor d, she argues, the hyster c must somehow break through her pr vate anguage and act. Thus for C ément, the "successfu hyster c" s one, ke Anna O./Bertha Pappenhe m, who becomes a wr ter, soc a worker, and fem n st eader. Overa t seems paradox ca that Dora, a notor ous y unsuccessfu hyster c, shou d have emerged as a fem n st hero ne n the 1970s, s ng ed out by women wr ters and nte ectua s who had been ab e to have the educat on and act v ty Ida Bauer sought n va n. It s b zarre to f nd Dora put forward as a fem n st dea and sa uted by successfu wr ters ke C xous, when Dora s own asp rat ons were to become a woman of earn ng,
333 perhaps a wr ter. H stor ca y, Dora never found her own vo ce. Wh e fem n st art sts and cr t cs can attempt to re- mag ne her story, we must recogn ze, w th C ément, that her rebe on u t mate y turned back on the se f. Dora s fem n st power, paradox ca y, s as a trag c terary f gure. Fem n st cr t cs have taken up the concept of "hyster ca narrat ve" to descr be a story that s fragmented and ncoherent, ke Freud s case study; or the Lacan an concept of "hyster ca d scourse" to descr be the metaphor c anguage of the body. [186] The mpasse over Dora, fem n sm, and hyster ca narrat ve, however, needs to be p aced w th n the broader contexts of gender. As Tor Mo has po nted out, what Freud descr bes as the " ncoherence" of the hyster c s story has ess to do w th the nature of hyster a or w th the nature of woman than w th the soc a power essness of women s narrat ves: "The reason why the neurot c fa s to produce coherence s that she acks the power to mpose her own connect ons on her reader/ stener." [187] How can Dora s story have p aus b ty for ma e ears n a cu ture when women s p ots are so m ted? When narrat ve convent ons ass gn women on y the p ace of ob ect of des re, how can a woman become the sub ect of her own story? In order to understand the gender ssues n hyster ca narrat ve, we need to have case stud es of ma e hyster cs by women ana ysts. S nce "the dom nant narrat ve of a ma e doctor treat ng a woman pat ent ma nta ns the normat ve structure of men occupy ng pos t ons of author ty over women, the mportance of the gender of the part c pants n the therapeut c d a ogue s obscured." [188] On y n the past few years have women psychoana ysts begun to ook at the prob em of ma e hyster a and to exam ne ssues of transference and countertransference between ma e pat ents and fema e therap sts. Such stud es requ re a "new narrat ve ne that spec f ca y addresses the re at onsh p of boys to the r mothers and the qu te d fferent mean ngs of power and sexua ty for men and women n our cu ture." [189] When the r case stud es are pub shed, we w be ab e to ask whether the body anguage, speech, and narrat ve of the hyster c s a d scourse of fem n n ty or a narrat ve mposed by the man who te s the story. Other contemporary fem n st theor es ocate n hyster a an attempt to g ve we ght and mean ng to aspects of the fem n ne wh ch are desp sed or nonfunct ona n the patr archa soc a order. As D ane Hernd exp a ns, hyster a "has come to f gure as a sort of rud mentary fem n sm and fem n sm as a k nd of art cu ate hyster a." [190] Ju et M tche descr bes hyster a as a "pre-po t ca man festat on of fem n sm," an unconsc ous protest by women " n terms of the r def n t ona and den grated charac-
334 ter st c—emot ona ty. If fem n n ty s by def n t on hyster ca , fem n sm s the demand for the r ght to be hyster ca ." [191] Th s romant c zat on and appropr at on of the hyster c nosta g ca y assumes that she s a hero ne of the past. "Où sont-e es passées es hystér ques de ad s," asked Jacques Lacan n 1977, "ces femmes merve euses, es Anna O., es Emmy von N.? . . . Qu est-ce qu remp ace au ourd hu es symptômes hystér ques d autrefo s?" [192] We m ght answer that the desp sed hyster cs of yesteryear have been rep aced by the fem n st rad ca s of today, by contemporary women art sts and poets, and by gay act v sts. In the popu ar m nd, the pe orat ve assoc at on of fem n sm w th hyster a and morb d ty has not d ed yet. In 1983, for examp e, a controversy erupted n the T mes L terary Supp ement over the use of "hyster ca " as a cr t ca term for the poetry of Sy v a P ath and other "man-hat ng" fem n st poets. Defend ng her pos t on, Anne Stevenson wrote, "Hyster a s the very stuff of revo ut ons—and not on y fema e revo ut ons . . . a pass onate s ng e-m nded psycho og ca cond t on wh ch, mmune to humour as to reason, fa s to ach eve the detachment essent a for se f-cr t c sm." [193] Moreover, those revo ut ons connected to gender and race cont nue to seem more "hyster ca " than others. In December 1989, when the AIDS act v st group ACT-UP and the abort on r ghts group WHAM staged a demonstrat on at Sa nt Patr ck s Cathedra n New York C ty, nterrupt ng the Sunday Mass, the New York T mes ed tor a zed: "Arguments over AIDS, homosexua ty and abort on are not go ng to be advanced by hyster cs, threats or the d srupt on of re g ous serv ces." [194] What had been hyster ca hoo gan sm n the suffrage campa gns was now attr buted to other groups. B ack act v sts and rad ca s have a so been st gmat zed as hyster cs and neurot cs, ead ng to d strust of psychotherapy n the 1960s and 1970s among Afr can-Amer cans. [195] Yet, from another perspect ve, Freud an ns ghts can um nate the exper ence of rac sm and ts effects on the psyche. In h s autob ography Dusk of Dawn (1940), W. E. B. Du Bo s descr bed the gradua effects of rac a segregat on on the b ack m nd:
s as hough one ook ng ou rom a dark cave n a s de o an mpend ng moun a n sees he wor d pass ng and speaks o speaks cour eous y and persuas ve y bu gradua y pene ra es he m nds o he pr soners ha he peop e pass ng do no hear ha some h ck shee o nv s b e bu horr b y ang b e p a e g ass s be ween hem and he wor d They ge exc ed hey a k ouder hey ges cu a e Then some persons may become "hys er ca " They may scream and hur hemse ves aga ns he barr ers They may even here and here break hrough n b ood
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and d s guremen and nd hemse ves aced by a horr ed mp acab e and qu e overwhe m ng mob o peop e r gh ened or he r very own ex s ence
Du Bo s s descr pt on of the soc a or g ns of hyster ca behav or n rac sm has re evance for other oppressed groups, part cu ar y because t does not m n m ze the costs of hyster a. When unhapp ness and protest go unheard for a ong t me, or when t s too dangerous for these negat ve emot ons to be open y expressed, peop e do ose the r sense of humor and the r powers of se fcr t c sm, whether they are fem n sts, peop e w th AIDS, b ack act v sts, or East Germans, Ruman ans, and Bu gar ans. Anger that has soc a causes s converted to a anguage of the body; peop e deve op d sab ng symptoms, or may even become v o ent or su c da . "Hyster a," as Du Bo s knew, s pa nfu and d sf gur ng; rather than be ng a romant c dea , t s a desperate behav or for women or men. It s much safer for the dom nant order to a ow d scontented men and women to express the r d ssat sfact on through psychosomat c ness than to have them ag tat ng for econom c, ega , and po t ca r ghts. It s thus that D anne Hunter ca s hyster a "fem n sm ack ng a soc a network n the outer wor d." [197] What about hyster a now? In 1986, Et enne Tr at dec ared, "Hyster a s dead, that s for sure. It carr ed ts myster es w th t to the grave." [198] Ph p S avney descr bes h s study Perspect ves on "Hyster a" (1990) as "perhaps the ast book w th hyster a n ts t t e wr tten by a psych atr st." The terms "hyster a, hyster c and hyster ca ," he argues, "are on the verge of becom ng anachron sms." [199] These announcements of hyster a s death are sure y premature, for they neg ect the cu tura and symbo c mean ngs of the term, wh ch cannot be ob terated by profess ona f at. To wr te a h story of hyster a at the end of the twent eth century we need a so to recogn ze the correspondence that has deve oped between the two words. Wh e for centur es the etymo og ca nk between "hyster a" and hystera d ctated certa n assumpt ons about fema e sexua ty, today the correspondence between "hyster a" and h sto re seems much more mportant. Above a , the hyster c s someone who has a story, a h sto re , and whose story s to d by sc ence. Hyster a s no onger a quest on of the wander ng womb; t s a quest on of the wander ng story, and of whether that story be ongs to the hyster c, the doctor, the h stor an, or the cr t c. The stor es of race and gender n hyster a st rema n to be to d, and thus th s book cannot be the f na narrat ve, but s on y another nsta ment n the ong and unf n shed h story of hyster a n Western c v zat on.
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Five— The Image of the Hysteric Sander L. Gilman
The Function of the "Real" Image of the Hysteric in Defining the Nature of Hysteria In the h story of hyster a one mage haunts the eye. It s an 1887 pa nt ng by André Brou et of Jean-Mart n Charcot present ng h s pet hyster c, "B anche" (B anche W ttman), to the members of h s neuro og ca serv ce at the Sa pêtr ère. [1] Th s portra t, c ear y stand ng w th n the great trad t on of Rembrandt s anatom es and echo ng the 1876 portra t, P ne Free ng the Insane , by Tony RobertF eury, wh ch hung n the ma n ecture ha at the Sa pêtr ère, has one rather anoma ous moment. (Brou et [1824-1908] was after a a student of Gérôme, whose h story pa nt ngs a ways h de a mystery.) A of Charcot s staff are men, w th the except on of the one nurse, who s about to catch the somnambu st c pat ent. On y these two women are p aced n such a manner so as to see the rear of the ha ; a of the ma e f gures have the r backs (or s des) to the rear. And on the rear wa s an en arged draw ng by Charcot s co eague Pau R cher of the arc-en-cerc e stage of "grand" hyster a. Charcot descr bed th s stage n an 1877 ecture: "The pat ent sudden y fa s to the ground, w th a shr cry; oss of consc ousness s comp ete. The tetan c r g d ty of a her members, wh ch genera y naugurates the scene, s carr ed to a h gh degree; the body s forc b y bent backwards, the abdomen s prom nent, great y d stended, and very res st ng." [2] In Brou et s engrav ng, R cher tera y s ts at Charcot s r ght hand, sketch ng the pat ent who s rep cat ng h s own draw ng. [3] On y the women see (and "know," that s, act upon) the mage of the hyster c. The r mage of the hyster c, both as pat ent and as hea th-care pract t oner s con-
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André Brou et s mage of Jean-Mart n Charcot present ng h s "pet" hyster c, "B anche" (B anche W ttman), to the members of h s neuro og ca serv ce at the Sa pêtr ère (1887). (Bethesda, Md.: Nat ona L brary of Med c ne.) sc ous y formed by the v sua mage of the hyster c as created by a ma e phys c an. The ate n neteenth century understood such a pattern as the very mode for know ng the wor d. Oscar W de suggested that we earn about nature from the work of art. "Externa nature," accord ng to W de, " m tates Art. The on y effects that she can show us are effects that we have a ready seen through poetry, or n pa nt ngs." [4] And, we m ght add, n photographs. [5] Th s s prec se y what B anche W ttman d d at the Sa pêtr ère, as she earned from the representat ons of the hyster c how to appear as a hyster c. [6] Th s mage does not stand a one but s representat ve of a ser es of representat ons of the hyster c dur ng the atter ha f of the n neteenth century. In the Jacques-Joseph Moreau de Tours 1890 mage, Hyster cs of the Char té on the Serv ce of Dr. Luys , a w der range of representa-
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Tony Robert-F eury s P ne Free ng the Insane (1876), wh ch hung n the ma n ecture ha at the Sa pêtr ère. (Par s: The L brary of the Sa pêtr ère.)
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Jacques-Joseph Moreau de Tours, Hyster cs of the Char té on the Serv ce of Dr. Luys (1890). (Bethesda, Md.: Nat ona L brary of Med c ne.) Photo courtesy Ya e Med ca L brary.
349 t ons of the hyster c s present. [7] Dr. J.-B. Luys (1848-1897), the author of an ear y photograph c med ca at as, [8] stands to the rear of the room, w th h s wh te mutton-chop wh skers, as h s fema e pat ents perform. (Moreau de Tour had h mse f been an ntern under J.-É.-D. Esqu ro , the creator of the f rst modern psych atr c at as, at Charenton. [9] ) Luys had descr bed and photographed the hyster cs of the Sa pêtr ère for h s 1887 study of the effects of hypnot sm as therapy. [10] A of the pat ents n Moreau de Tours s mage are seem ng y ob v ous to what mmed ate y captures the eye of the v ewer. On the rear wa of th s ward, a permanent f xture of the room nhab ted by the pat ents, s a chart record ng the d fferent phases of hypnos s, the stages that the pat ent s expected to pass through as she performs for her ma e aud ence. It s part of the wor d of the pat ent, a means through wh ch to earn how to structure one s hyster a so as to make one an exemp ary pat ent. Indeed, th s s para e ed w th n the mages that are so centra to Ju es Luys s own work, by the photographs of h s pet pat ents, espec a y "Esther," taken by h s brother Georges, wh ch ustrate h s1887 study of the emot ons of the hyster c. [11] These pat ents are seen. There s no attempt to mask the r dent ty. In the case stud es of the per od (even as ear y as P ne ) there s the use of n t a s or masked names. But n the v sua mages that Esqu ro br ngs there s the assumpt on that the face ( ts structure or ts express on) s so mportant that t does not need to be masked. But there s a so the understand ng, g ven the art st c cense of the engrav ng and the thograph, that there wou d be suff c ent d fference between the mage of the pat ent and the f na representat on as to mask the pat ent s dent ty. (Th s s not a ways the case, as one can see n Georges-Franço s-Mar e Gabr e s adm tted y unpub shed mage of Eugéne Hugo, the brother of the author. [12] ) The except on to th s seems to prove the ru e. In the Nouve e conograph e de a Sa pêtr ère , Charcot s house organ, there are rare y mages of pat ents that are ntent ona y masked, usua y naked women, such as the mage of a young anorex c fema e reproduced n the f fth vo ume. [13] (The Nouve e conograph e de a Sa pêtr ère s not the on y ourna of ts type. The Revue photograph que des Hôp taux des Par s f our shed n the 1870s.) The mportance of the mage of the hyster c represented as earn ng from the med ca mages that surround her can be g eaned from the fo ow ng anecdote. In an account of Charcot s exper ments w th hypnot sm n the Br t sh Med ca Journa of 5 October 1878, Arthur Gamgee, Professor of Phys o ogy at Owens Co ege, Manchester, observed:
One o he pa en s was suspec ed o s ea ng some pho ographs rom he hosp a bu she nd gnan y den ed he charge One morn ng Mr
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The masked mage of the hyster c. From Lou s Batta e, "Deux Cas d Anorex e Hystér que," Nouve es Iconograph e de a Sa pêtr ère 5 (1892), p ate oppos te p. 277. Photo courtesy We come Inst tute L brary, London.
R cher a er hav ng made some exper men s upon o her sub ec s ound he suspec ed h e w h her hand n he drawer con a n ng he pho ographs hav ng a ready concea ed some o hem n her pocke Mr R cher approached her She d d no move she was xed—she was rans ormed n o a s a ue so o speak The b ows on he gong made n he ad o n ng ward had rendered her ca a ep c a he very momen when away rom he observa on o a she comm ed he he 14
It s Pau R cher, the creator of the archetypa mage, the ornament of the ecture room n wh ch rounds were he d, who captures the "cata ept c" woman, a f gure so m red n her nterna zat on of h s dea of the hyster c that she tera y freezes as an nc denta occurrence to the "exper ment" tak ng p ace ust beyond her ken. [15] Th s s not the wor d of Charcot n the ro e of P ne "free ng the nsane," whose mage graced the pub c ecture ha n wh ch the so-ca ed Tuesday ectures took p ace. For here the " nsane" pat ent s captured rather than freed by the ntervent on, no matter how nc denta , by the phys c an. But why s th s woman stea ng photographs?[16] And whose photographs are they? The photographs are those of the exemp ary pat ent taken by A bert Londe, the head of the photograph c serv ce at the Sa pêtr ère, ndeed
351
The hypnot zed pat ent and the tun ng fork. From Pau R cher, "Gonf ement du cou chez un hystér que," Nouve es Iconograph e de a Sa pêtr ère 2 (1889), p ate 34. Photo courtesy We come Inst tute L brary, London.
352 the f rst profess ona photographer to have a fu -t me appo ntment n any hosp ta n Europe. H s ob was to document the progress and man festat on of the pat ent s d sease, to capture the stages and processes as they represented themse ves on the v s b e surface of the pat ent, on the pat ent s phys ognomy, posture, act ons, as a means of cata og ng the d sease process. Th s L nnaean means of descr b ng nesses through the r v s b e s gns and symptoms (to use Jean-Mart n Charcot s term, taken from the w tch-hunt ng manua s of the Inqu s t on, the st gmata of the ness, from the st gmata d abo that marked the body of the w tch) dom nated n neteenth-century European, but espec a y French, psych atry. To descr be was to understand, to descr be n the most accurate manner meant to avo d the amb gu ty of words, and to re y on the mmed ate, rea mage of the sufferer. But the ma eab ty of the symptoms n hyster a troub ed the f n-de-s èc e sc ent st. As Charcot noted, "Symptoms . . . have the r dest ny: Habent sua fata ." Symptoms, "after hav ng en oyed a certa n degree of favour, doubt ess on account of the theoret ca cons derat ons connected w th [them, have] gone somewhat out of fash on . . ." But th s s to be understood from the standpo nt on y of the phys c an-noso og st; from the standpo nt of the pat ent, the symptoms are rea , even f the pat ents are dup c tous: "You w meet w th [s mu at on] at every step n the h story of hyster a, and one f nds h mse f somet mes adm r ng the amaz ng craft, sagac ty, and perseverance wh ch women, under the nf uence of th s great neuros s, w put n p ay for the purposes of decept on—espec a y when the phys c an s to be the v ct m. . . . It s ncontestab e that, n a mu t tude of cases, they have taken p easure n d stort ng, by exaggerat ons, the pr nc pa c rcumstances of the r d sorder, n order to make them appear extraord nary and wonderfu ." [17] Th s decept on s, for Charcot and h s t me, an abso ute s gn of the hyster c, and t can on y be read correct y by a good d agnost c an. For hyster a must be "seen" to have observab e symptoms, such as the changes of the sk n or the wast ng of the body, to be understood as a rea d sease: "Hyster a s a rea d sease, as rea as sma -pox or cancer, and . . . t has a phys ca bas s, probab y of a chem ca nature, a though th s s yet very mperfect y understood." [18] As an ear y rev ew of the f rst ma or ourna from the Sa pêtr ère devoted to the v sua representat on of the nsane noted, the camera was as necessary for the study of hyster a as the m croscope was for h sto ogy. [19] Th s fantasy of rea sm captured the be ef of the n neteenth century, both the doctor s and the pat ent s. For the doctor, the mage s the pat ent, as t s for the pat ent. Th s search for an onto og ca representat on of ness para e s the undertak-
353 ng of the exemp ary f n-de-s èc e sc ent st, Lou s Pasteur, whose germ theory of contag ous d sease re ed on the v s b ty of the germ for ts power. [20] As Georges Cangu hem notes: "After a , a germ can be seen, even f th s requ res the comp cated med at on of a m croscope, sta ns and cu tures, wh e we wou d never be ab e to see a m asma or an nf uence." [21] To see the pat ent means to deve op the techn que for see ng, a techn que that s "sc ent f c"; the pat ent, n turn, as the ob ect of the med ca gaze becomes part of the process of the creat on of an onto og ca representat on of the d sease, a representat on that s abe ed hyster a. Th s does not deny the under y ng patho ogy of the hyster c; t ref ects on y the mean ng attr buted to the symptoms created to represent the patho ogy as a d sease. One can specu ate on whether the off c a noso ogy of Amer can (and ncreas ng y, wor d) c n ca psych atry, the DSM-IIIR (soon to be DSM-IV), n ts restructur ng of hyster ca neuros s nto convers on d sorder, d ssoc at ve d sorder, h str on c persona ty d sorder, and br ef react ve psychos s, d d more than re abe an ex st ng d sease or whether these new abe s are the se f-consc ous descr pt on of the man festat on of the hyster c n the 1980s. [22] But at east the comp ers of DSM-IIIR saw the r undertak ng as the descr pt on of the d sease, rather than as the search for ts et o ogy. Th s does not mean, however, that the phys c an and the pat ent p ace any ess re ance on the mean ng of these def n t ons n order to shape our contemporary sense of the pat ent. How many pat ents today earn to have "convers on d sorders" or "fact t ous d sorders w th psycho og ca symptoms" from the med ca zed wor d n wh ch they—the sufferers from the d s-ease of hyster a —must funct on? For the pat ent knows how to be a pat ent, as we see m rrored so we n André Brou et s mage of Charcot, on y from the representat on of the way the phys c an w shes to see (and therefore to know) the pat ent as the vesse of a d sease, not any d sease, but the d sease of mages and mag n ng, hyster a. It s th s shared sense of the mportance of the mage, for the doctor as we as for the pat ent, wh ch s ref ected n the mage of the hyster c.
Toward a Theory of "Realistic Representation" in Nineteenth-Century Thought In my work on Hugh W. D amond s m d-n neteenth-century ntroduct on of photography nto the treatment of the menta y , I was struck by the fact that D amond be eved he cou d cure at east some of h s pat ents by expos ng them to photographs of themse ves. The "rea sm"
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Hugh W. D amond, a portra t of a case of "re g ous me ancho y." (London: Roya Soc ety of Med c ne.) of the photograph was assumed to have a therapeut c funct on because of ts mode of representat on. Such a v ew under ned the mportance of a mages for the a en sts of the n neteenth century. Thus there was a constant str v ng for ver s m tude, not on y for noso og ca purposes (that s, n order to categor ze the ness) but a so for therapeut c reasons. See ng one s own d fference prov ded the "hea thy" aspect of the m nd w th the uxtapos t on between the "norma " and the "abnorma ." The des re to see the abso ute border between these states encouraged the n neteenth-century sc ent st to seek out and "see" the d fference. As Fr edr ch N etzsche put t (paraphras ng C aude Bernard): "It s the
355 va ue of a morb d states that they show us under a magn fy ng g ass certa n states that are norma —but not eas y v s b e when norma ." [23] D sease tse f s seen as a means of "see ng" the norma . And norma ty s an unse f-consc ous state ke that of observers, who are never aware of that ro e unt they se f-consc ous y beg n to th nk of themse ves as observers through the r tra n ng as "sc ent sts" and, therefore, become aware of the mean ng attached to the act of see ng. But t was on y w th the ntroduct on of the photograph that the power of such contrast—for the pat ent—was c ear y art cu ated. D amond stated n h s 1856 paper "On the App cat on of Photography to the Phys ognom c and Menta Phenomena of Insan ty," read before the Roya Soc ety, that "there s another po nt of v ew n wh ch the va ue of portra ts of the nsane s pecu ar y marked—v z. n the effect wh ch they produce upon the pat ents themse ves—I have had many opportun t es of w tness ng th s effect—In very many cases they are exam ned w th much p easure and nterest, but more part cu ar y n those wh ch mark the progress and cure of a severe attack of Menta Aberrat on." [24] D amond s course of treatment was stra ghtforward. He presented h s pat ents w th mages of themse ves that seemed to start e them nto an awareness of the r madness, because of the rad ca y rea st c mage of them as demented. Through th s confrontat on w th a "rea st c" mage of the r nsane phys ognomy, they began to rea ze the r own a tered percept on of rea ty. In h s ta k, he presented the case of "A. D., aged 20," whose "de us ons cons sted n the supposed possess on of great wea th and of an exa ted stat on as a queen." [25] He photographed her. Her react on to the mages she saw ref ected the "start e" effect nherent n the newness of the med um of photography: "Her subsequent amusement n see ng the portra ts [of herse f n var ous stages of her ness] and her frequent conversat on about them was the f rst dec ded step n her gradua mprovement, and about four months ago she was d scharged perfect y cured, and aughed heart y at her former mag nat ons." [26] If we can extend D amond s argument, we can suppose that the n neteenth-century a en st saw the pat ent-observer as shar ng the mp cat on of the photograph c mage, the start e effect that accompan ed the ntroduct on of th s new med um of representat on. In further work on the use of photography as a means of psychotherapy, I d scovered that other a en sts of the per od, such as S r W am Char es Hood, the d rector of the Beth em Asy um, undertook s m ar app cat ons of photography. I n t a y extrapo ated certa n broader genera t es about the react on to the photograph by the f rst generat on to see photographs after the r nvent on n 1839. (Th s f rst per od oc-
356 curred a fu decade ater n Great Br ta n than n the rest of Europe because both Daguerre s and Fox Ta bot s methods of f x ng mages were under patent dur ng the 1840s on y n Great Br ta n. In the rest of Europe, the daguerreotype at east was n the pub c doma n by the ear y 1840s.) I be eved that the ear est photographs were such a rad ca mode of represent ng the rea ty of the se f as d fferent that they had some type of psycho og ca shock effect. That s, they so d sor ented pat ents as to where the a ready d storted ne between what s rea or unrea ay, that pat ents were forced to reexam ne the r own psycho og ca confus ons. I was conv nced, however, that t was the percept on of the se f, the mage of the se f as the mad person, wh ch caused the "start e" effect. [27] And that was the rad ca d fference of the photograph, as perce ved by those n th s f rst generat on to see photographs. George S. Layne, n an essay n 1981, contrad cted th s f nd ng, wh e st support ng my sense of the rad ca break w th ex st ng mode s of percept on. [28] He uncovered the fact that the brothers W am and Freder ck Langenhe m prov ded antern s des for the "mora " treatment of the pat ents n the Ph ade ph a Hosp ta for the Insane a year before (1851) D amond exposed h s pat ents to the r own mages n the Surrey County Lunat c Asy um. But the Langenhe m mages were not of the pat ents, but rather were genera mages such as andscapes and street scenes, yet they had shock va ue n treat ng the pat ents. So t seemed to be not the mage of the se f but the rad ca newness of the med um that caused the "start e" effect. One of the reasons that the "start e" effect was so pronounced as to be usefu n therapy n the pub c asy ums was that the work ng-c ass nmates of the asy ums d d not share the bourgeo s and upper-c ass trad t on of see ng and understand ng v sua ob ects wh ch had deve oped out of the "rea st c" ph osophy of En ghtenment art. Even pr nts and engrav ngs, understood as aesthet c ob ects, had been, for the most part, out of the f nanc a reach of the pro etar at. The rs was a wor d w th m ted access to mages—the absence of cheap ustrated newspapers (soon to appear n Great Br ta n n the m dd e-c ass form of the Graph c and the I ustrated London News ) meant that the r wor d of mages was the crude broads de w th ts thographed (or ndeed woodcut) mage. But the m dd e and upper c asses had a trad t on of see ng and speak ng about art, at east n terms of the reproduct on of the work of art as engrav ngs (such as the Brou et and Moreau de Tours mages). For them, even f the "start e" effect occurred (or perhaps because t occurred), the ob ects recorded were understood n terms of a h stor ca cont nu ty of perce v ng aesthet c mages. And, ndeed, the ent re h story
357 of ear y photography s fu of references to the cont nu ty of the photograph w th ear er modes of representat on. A etter from E zabeth Barrett Brown ng as ate as 1843 ref ects both the "start e" effect and the anguage n wh ch t was art cu ated:
My deares M ss M ord do you know any h ng abou ha wonder u nven on o he day ca ed he Daguerreo ype?— ha s have you seen any por ra s produced by means o ? Th nk o a man s ng down n he sun and eav ng h s acs m e n a s u comp e on o ou ne and shadow s ead as on a p a e a he end o a m nu e and a ha The Mesmer c d sembod men o sp r s s r kes one as a degree ess marve ous And severa o hese wonder u por ra s ke engrav ngs—on y exqu s e and de ca e beyond he work o he engraver—have seen a e y— ong ng o have such a memor a o every Be ng dear o me n he wor d s no mere y he keness wh ch s prec ous n such cases—bu he assoc a on and he sense o nearness nvo ved n he h ng he ac o he very shadow o he person y ng here xed or ever s he very sanc ca on o por ra s h nk and s no a a mons rous n me o say wha my bro hers cry ou aga ns so vehemen y ha wou d ra her have such a memor a o one dear y oved han he nob es Ar s s work ever produced 29
Such photograph c mages were perce ved as a c ear cont nuat on of other, o der means of the reproduct on of mages. E zabeth Barrett Brown ng s vocabu ary s n t a y taken from that of one of the f ne arts, engrav ng. She s start ed by the perce ved rea sm of the mage, but she p aces t w th n the V ctor an mode of progress n the reproduct on of v sua mages. The photograph seems to her to be "exqu s te and de cate beyond the work of the engraver." And yet her percept on of th s new med um s such that t draws on the sc ence of the day, mesmer sm, w th ts own "start e" effect, as ts n t a ana ogy. And, ndeed, the "art" of engrav ng s the most h gh y mechan ca of a the f ne arts of the per od. These assoc at ons, f rst between the var ous modes of creat ng and reproduc ng mages, and then between the aesthet c and the sc ent f c, dom nate the d scourse of the f rst generat on to v ew photographs. A exander von Humbo dt, n a etter dated 7 January 1839 to the Duchess Fr eder ke von Anha t-Dessau, stresses th s adm xture: "Ob ects that express themse ves n n m tab e f de ty, ght f xed by the art of chem stry to eave endur ng traces w th n a few m nutes and to c rcumscr be c ear y even the most de cate parts of contours—to see a of th s mag c (adm tted y w thout co or) . . . certa n y speaks ncontrovert b y for reason and the power of mag nat on." [30] The m x of the anguage of sc ence and the anguage of art s c ear here w th Humbo dt s
358 percept on of the photograph as the product of a sc ence rooted n the mag nat on, but produc ng aesthet c ob ects (wh ch he sees as f awed n part because of the r co or essness). Edgar A an Poe, n one of h s 1840 essays on the daguerreotype, makes many of the same verba assoc at ons. [31] Thus the art cu at on of the "start e" effect n the m dd e and upper c asses po nts to a confus on n the vocabu ary n wh ch th s effect was to be addressed: Is t a cont nuat on of the o der forms of representat on (and therefore to be cons dered "art") or s t a new and d fferent mode of representat on (and therefore to be cons dered "sc ence")? What a were agreed upon n that f rst generat on was that the mages were "rea ." It was that "rea sm," pref gured by the aesthet c theory of the En ghtenment, wh ch framed the percept on of the photograph and wh ch prov ded the vocabu ary n wh ch the "start e" effect was art cu ated. The presence of the "start e" effect wou d seem to be a un versa among those nd v dua s exposed to the f rst photographs. It s no surpr se that the f rst photographer-phys c ans, such as Hugh D amond, who ncorporated the " mage" w th n the r mode of treatment, were a so constra ned to see (and to know) the photograph n terms of ts "start e" effect. It s w th the genera understand ng of the funct on of the photograph that the aesthet c trad t on of represent ng the menta y beg ns to be submerged and there evo ves a sense of co aborat on—a ready mp c t n the mean ng g ven to the rea sm of the photograph by doctor and pat ent a ke—about the educat ve funct on of mages. But t s n the d fferent funct on of mages of the pat ent and mages of the phys c an that the app cat on of th s prob em n the h story of see ng s to be found. For w th the craze for the carte-de-v s te, wh ch began n the 1850s, a gent emen and gent ewomen had to have the r p ctures taken. Indeed, as I have argued e sewhere, the very absence of photographs of those who understood themse ves to be part of the wor d of soc ety s an nterpretab e fact. [32] How very d fferent for those whose mages are taken from them, the menta y , the cr m na , the ma med. For the r mages do not grace the storefronts of the photographers; the r mages become ersatz representat ons of the noso ogy that they represent. These "rea " mages, these mages that start e, are mages of the d sease and not of the pat ent. And aga n t s the movement from the aesthet c to the rea , from the art st c to the therapeut c, from the mage of the pat ent to the def n t on of the pat ent s rea ty that es at the center of th s wor d of mages. The mage s the essence of the pat ent, t g ves the pat ent form. The pat ent, or at east the presentat on of the pat ent, qu ck y becomes the creat on of the phys c an s sense of the cor-
359 rectness of the pat ent s d sease. W th the hyster c, the very nature of the ness prov des for the pat ent a demand for the form ng touch of the author ty, for the contro mp c t n the wor dv ew that generates "rea " mages. For hyster a s the c ass c d sease of the mag nat on—not of the uterus—as Charcot (and then Freud[33] ) understood. But the shap ng of the mag nat on through the "rea sm" of the photograph es beh nd the p ferage descr bed n Gamgee s account of the Sa pêtr ère nc dent. For can we mag ne that the pat ent n the Sa pêtr ère s stea ng back her dent ty, her sense of se f, n remov ng the mage of the hyster c from the grasp of the phys c ans?
Medical and Aesthetic Models for the Representation of the Hysteric The mage of the hyster c does not s mp y ar se out of Jean-Mart n Char-cot s persona nterest n the v sua representat on of the hyster c at the Sa pêtr ère. [34] Charcot does not nvent the act of "see ng" hyster a. H s own nterests n captur ng the v sua aspect of h s pat ents comb ned w th h s own percept on of h s hyster ca pat ents to record the mage of h s pat ents as ear y as h s f rst years at the Sa pêtr ère, the 1860s. Charcot comes to h s task of understand ng h s pat ent w th a ong persona need to see and represent the pat ent. But h s v ew s not un que, t s part of a ongstand ng European trad t on of represent ng the nsane, nto wh ch the mage of the hyster c must be f tted. Indeed, t s a trad t on wh ch s as much popu ar as t s sc ent f c. For Moreau de Tours s mage prov des us w th another context for the structur ng of the hyster c—the wor d of the hypnot zab e pat ent, the mage of the mesmer zab e fema e. For hyster a, from the e ghteenth century, s a d sease of the mag nat on, not a d sease of the womb. The mage of the pat ents of the V ennese phys c an Franz Anton Mesmer and h s students dur ng the 1780s prov des one of the keys to the representat on of the hyster c at the end of the n Par s n the w nter of 1778, the representat on of Mesmer becomes part of the trad t on of represent ng the nsane. In a contemporary cartoon ref ect ng a mesmer st sess on, t s not mere y that the quack phys c an s nd cated by h s ass s ears. More mportant s that the pat ents gathered about the mesmer st s "tub" are represented n the trad t ona pose of the me ancho c (w th head on hand on knee) and the oves ck (swoon ng n the cha r). The atter becomes dent f ed retrospect ve y w th the arc-en-cerc e pos t on of the hyster c ( n some of the h stor ca wr t ng of the m d-twent eth century), because of the assoc a1800s. [35] After h s arr va
360
The mage of the mesmer st. (Par s: B b othèque nat ona e: Cab net of Pr nts.) t on of the hyster c w th the sexua ( n many d fferent ways), wh e the me ancho c van shes from any cons derat on as a forerunner of the mage of the hyster c. The v sua representat on of the mesmer st and the pat ent are a means of m t ng the scope of the d seased to the dent f ab e nd v dua . The suppress on of the po t ca rad ca sm assoc ated w th one of the most nf uent a groups under N co as Bergasse after the French Revo ut on meant that there was a genera tendency to see the mesmer c pat ent as an asoc a be ng who on y shammed ness out of a sense of soc a use essness. L kew se, the mesmer st was understood, not as a force for change, but as a quack. The cartoons of the pat ent and the phys c an from the 1780s had a ready carr ed that message. In one such mage a mesmer c hea er, wear ng an ass head, beg ns to mesmer ze a young, fema e sufferer. [36] Her pos t on echoes the assoc at on of d sease and sex-
361
The "ass-mesmer sts." (Par s: B b othèque nat ona e: Cab net of Pr nts.) ua ty n the arc-en-cerc e pos t on of the grand hyster c, as she beg ns to e back n her cha r as her mora seduct on beg ns. M rrored n the background s the representat on of the sexua exp o tat on of the fema e pat ent by the mesmer st, warned aga nst n the secret append x to the Report of the Roya Comm ss on on Mesmer sm. Here the phys c an s as hypersexua as the pat ent. In another mage the conce t of the ass-mesmer sts s repeated. [37] They are be ng dr ven out of the scene by the sh n ng truth of the report of the Roya Comm ss on he d by Ben am n Frank n. What s centra to th s mage s that the mesmer sts are represented as a compound s gn. They are both madmen and dev s. They are v ewed as a parody of the mages of the demon c ev sp r ts re eased from the mad as hea ed by Chr st (and h s sa nts) n the trad t ona conography of madness. Here the sp t-hoofed mage of the dev as we as the broomst cks assoc ated w th f y ng w tches are emp oyed. But th s mage of the hea er s a so that of the nsane, for the sp t-hoofed f gure s brand sh ng a scourge, wh ch s one of the trad t ona cons of the nsane. The f gure of the arc-en-cerc e n the representat on of the pat ent s here reversed. The b ndfo ded, naked pat ent s seen n the c osed mesmer c tub, not arched but co aps ng nward. Th s can be seen as ant thet ca to another mage of the mes-
362 mer st hea ng process, the c rc e of "magnet zed" hands, n wh ch a seem ng y unconsc ous fema e s represented n the eft foreground; ba anc ng the portra t of Mesmer, the hea er, n the r ght foreground. [38] The magery of th s representat on s t ed to an understand ng of the "mean ng" of mesmer sm and the mesmer st treatment n the course of the n neteenth century. The d srepute of the mesmer st, abe ed as nsane or demon ca y possessed, and thus n need of the sort of contro represented by Frank n, Anto ne-Laurent Lavo s er, and the Roya Comm ss on, s carr ed over nto the d srepute assoc ated w th the very nam ng of the treatment. The mage of the phys c an, as we as the pat ent, s drawn nto quest on n these assoc at ons. Such mages rema n assoc ated w th the dea of the hyster c through the v sua representat on of the pat ent. The mesmer sm pat ent s understood at the c ose of the n neteenth century to be one of the precursors of the f n-de-s èc e hyster c. The mage of the phys c an, as n the portra ts of Charcot and Luys, must be qu te d fferent from that of the mesmer st; t must be separated from the mage of the quack. Rather th s mage must be assoc ated w th the hero c mage of the a en st, the mage of P ne as a force of soc a change ( ke Frank n). Mere y chang ng the abe of the mode of treatment from mesmer sm to hypnot sm or e ectro zat on was not suff c ent. The very re at onsh p between the hyster c and the phys c an must be merged nto the h ghest eve of nst tut ona zed med ca representat on—that of the mage of sc ence n the sc ence of creat ng mages. The mage of the hyster c n the med ca terature of the n neteenth century s an essent a mage of dev ance. It s an mage that s taken—at east n ts most rad ca form—out of another context. The centra mage of the hyster c, the essent a att tudes pass onne es n Charcot s vocabu ary of mages, s a s gn of qu te a d fferent d sease—tetanus. The arc-en-cerc e stage of R cher s mage of grand hyster a (and ts retrospect ve read ng of the mage of the swoon ng mesmer st pat ent) was consc ous y mode ed on an mage taken from the terature on the representat on of anatomy and patho ogy for art sts, rather than from a pure y med ca source. [39] Taken from the second ed t on of S r Char es Be s Essays on the Anatomy and Ph osophy of Express on (1824), th s mage s rooted n a spec f c understand ng of the nature of med ca sem ot cs. Be notes:
hrow n h s ske ch o rem nd he pa n er ha n convu s on a hough here may appear o h m an acc den a and deranged ac on o he muscu ar rame here s no such h ng n na ure de nab e symp oms and w ever presen se w h he same charac ers 40
s a d sease he s represen ng wh ch has
363
The range of the pos t ons of the hyster c. G ven best n Pau R cher, Études c n ques sur e grande hystér e ou hystéro-ép eps e (Par s: De ahaye & Lecrosn er, 1881), p ate 5. (Bethesda, Md.: Nat ona L brary of Med c ne.)
364
The op sthoton c pos t on. From S r Char es Be s Essays on the Anatomy and Ph osophy of Express on (London: John Murray, 1824), p. 101. (Bethesda, Md.: Nat ona L brary of Med c ne.) Be s observat on may we ho d true for tetanus, but the op sthoton c pos t on chosen by h m to represent the una terab ty of the re at onsh p between s gn and causat on s adapted by Charcot and ater by Freud and g ven spec f c mean ng n regard to the representat on of the ness of the nerves and m nd n the hyster c. One must note that Charcot s not the f rst "modern" sc ent st to ca upon tetanus as h s onto og ca representat on for "see ng" the body. John Brown (1735-1788), n evo v ng the concept of the rr tab ty of the musc es from the work of A brecht von Ha er, argues that hea th and d sease are not at a d fferent states s nce the forces that produce each have the same act on. [41] H s examp e s a compar son of the norma contract ons of the musc es and the patho og ca appearance of the op sthotonus n tetanus. The op sthotonus s one of the most str k ng man festat ons of any d sease. But t s a so an a most nfa b e s gn for the phys c an, s nce ts outcome s a most sure y negat ve. In a wor d n wh ch the power of the phys c an ay, not n the ab ty to cure, but n the ab ty to forete the course of a d sease, the mean ng of th s s gn for doctor and pat ent a ke was c ear. Thus Brown, Be , and Charcot a ca upon the mage of the op sthotonus as a s gn of the v sua nterpretab ty of d sease and, therefore, the power of the phys c an s ns ght over the d sease. At the end of the n neteenth century there was st a c ear need to prov de d fferent a d agnos s between tetanus and hyster a for the pract t oner. Among other s gns, tetanus was descr bed as present ng "pers stent r g d ty w th
365 tendency to op sthotonos . . ." wh e hyster a presented "op sthotonos pers stent, and ntense r g d ty between convu s ons." [42] In see ng the pat ent, tt e d st nct on was made between organ c and funct ona def c ts. Charcot n see ng the hyster c evo ves h s own system of represent ng the d sease. He sees the hyster c as suffer ng from a weakness of the nerves and the d sease as be ng caused by a trauma (such as an acc dent or v o ence). Thus the hyster c pat ent was pred sposed to the d sease—at east once he or she was exposed to some traumat c event. It s c ear that Charcot evo ved th s v ew through h s treatment of the pat ents at the Sa pêtr ère—ep ept c and hyster ca fema e pat ents who were as d fferent from h m (and h s c ass) as was poss b e. [43] The counterargument to th s v ew was evo ved by John Hugh ngs Jackson, whose n t a nterest was sparked by h s w fe s ep epsy. Th s v ew was one of un versa suscept b ty. See ng the d sease as a pattern of the d sso ut on of the h gher funct ons of the nervous system through the presence of a es on, Jackson understands the symptoms of the hyster c as s gns of the ower (and therefore ear er) funct ons of the nervous system. Th s evo ut onary mode sees the symptoms of the hyster c as s gns of the structure of the more pr m t ve psych c organ zat on. Both v ews—the v ew that ca s upon trauma and b o og ca predeterm n sm as we as the v ew that ca s upon the mode of the nervous system be ng ayered to represent the evo ut onary h story of the m nd—come to be absorbed n the f n-des èc e debates about hyster a. [44] As ear y as 1888, S gmund Freud ca s up the f gure of the op sthotonus n the context of attacks of hystero-ep epsy. [45] He cont nues th s argument as ate as 1908 when he understands co t on to be a form of "m nor ep epsy." For "a hyster ca attack s the ref ex mechan sm of the act of co t on—a mechan sm wh ch s ready to hand n everybody, nc ud ng women, and wh ch we see com ng nto man fest operat on when an unrestra ned surrender s made to sexua act v ty." [46] Thus Freud exp a ns the op sthotonus as the ant thes s of the embrace—the nterna zed enactment of co tus. But th s s an mage that does not van sh, but s rather cons stent y transmuted. Freud uses the mage of the op sthotonus as the ant thet ca mage to co tus w th n h s n t a rework ng of Charcot s noso og ca cr ter a. See ng the rea ty of the op sthotonus as the key to the somat c nature of hyster a meant understand ng the concept of trauma as ex st ng n rea exper ence rather than n fantasy. Sándor Ferencz , n h s c n ca d ary of 1932, can ca upon "a case n wh ch n re axat on ( trance ) op sthoton c pos t ons d d appear: when contact cou d be estab shed w th the pat ent, she reported that the pos t on was a react on to a fee ng of
366 pa nfu exc tat on n the gen ta passage, wh ch the pat ent descr bed as pa nfu hunger: n th s pos t on, psych c unp easure and defense aga nst ardent des re are s mu taneous y represented." [47] Ferencz traces th s react on format on back to the actua seduct on of the fema e ch d by her father. A of these references—and Charcot s own vocabu ary of mages, espec a y the op sthotonus— stem from a vocabu ary of mages wh ch c ear y (at east n the med ca terature of the n neteenth century) def ned the ne between the hea thy and the d seased. The op sthotonus s a s gn of the presence of a d sease—whether a form of hysteroep epsy or a s gn f er of patho og ca sexua ty or a rea seduct on. There s a one-to-one re at onsh p between the s gn and the mean ng. G ven Freud s own comp cated formu as for the generat on of symbo c mean ng, a ready documented n deta n h s 1900 Interpretat on of Dreams , t s str k ng that n return ng to the sub ect matter of the hyster c, wh ch he and Josef Breuer had begun to exp a n n 1895 as the resu t of the suppress on of rea traumat c events—that s, prec se y the sort of seduct on of ch dren by adu ts n author ty (parents) to wh ch Ferencz , qu te opposed by Freud, returns some three decades ater—he reverts to a pattern of exp anat on that re es on the mean ng of the v sua mage. The assoc at on between mages of the tetana op sthotonus s n no way m ted to the neuro og ca terature com ng out of the Sa pêtr ère or out of the V ennese schoo s of psychoana ys s. Dur ng Wor d War I, Arthur F. Hurst ref ected on the re at onsh p between the hyster ca et o ogy of "war contractures" ("batt e fat gue" or posttraumat c neuros s) as opposed to those contractures wh ch have the r or g n n a oca zed nfect on. [48] For Hurst the quest on of the d fferent a d agnos s of hyster ca contracture (here oca zed n contrast to the fu -body op sthotonus) as opposed to oca zed tetanus s quest onab e. It s c ear that n t me of war the durat on of the cure—a "s ng e s tt ng by persuas on and reeducat on" n the f rst case or "months of treatment" n the atter—wou d p ace emphas s on see ng the ma or ty of such cases as qu ck y hea ab e. The assumpt on n Hurst s presentat on s that the confus on between rea ( .e., somat c) and hyster ca contractures advocated by cont nenta neuro og sts such as Josef Bab nsk and Ju es Froment marks a fau ty d st nct on between a b o og ca and a psycho og ca ness. [49] Such an argument wou d be para e to Freud s attempt to co apse the d st nct on between rea ep epsy and hyster ca ep epsy. The mages of the case of tetanus as opposed to the hyster c are, however, qu te um nat ng. For the ha f-body portra t of the so d er w th h s wound prom nent y d sp ayed re ates the mage of the contracted arm
367 to the ent re nd v dua ; the hyster ca arm stands a one. Here the ro e of the representat on of the arm comes to p ay a centra ro e. The case descr bed, that of "Sergt. M" who "was wounded n the r ght forearm on Apr 10, 1917," s "recogn zed as hyster ca . . . as the deform ty was dent ca w th that shown n a photograph of a so-ca ed ref ex contracture n Bab nsk and Froment s book." It s the representat on of the hyster c wh ch def nes the d sease and wh ch def nes both the treatment of the d sease and the pat ent s response: "On the day of adm ss on the hand was cont nuous y man pu ated, the pat ent be ng persuaded at the same t me that t wou d rap d y re ax. In ten m nutes comp ete re axat on was obta ned and the deform ty d sappeared." The re at onsh p between see ng correct y and the pat ent s response s here made abso ute. As E a ne Showa ter notes, the trans t on from the mage of the fema e pet pat ent of n neteenth-century c n ca psych atry to the mage of the ma e sufferer from traumat c neuros s (she shock) meant a drast c rea gnment of the presuppos t ons of gender. [50] Hurst sees the ma e hyster c as but as qu ck y curab e, a factor that sets the so d er apart from the ong trad t on of more or ess profess ona ( .e., ong-term) fema e pat ents at the Sa pêtr ére. What he teaches h s hyster cs s to see themse ves as "men"—to confront the r ness and return to serv ce. Jean-Mart n Charcot (and h s co eague Pau R cher) prov de the reader (and v ewer) of these ate n neteenth-century mages of the hyster c w th a set of antecedent mages from sources other than the unspoken one of the mesmer st. [51] In the r study of the representat on of the nsane—spec f ca y the hyster c n the art of the West—they create the r own h story and conc ude t w th a c n ca chapter out n ng the r "un versa " noso og ca categor es of hyster a, wh ch they see as "va d for a countr es, a t mes, a races." [52] Charcot and R cher beg n by out n ng the representat on of possess on n re g ous art from the ear y m dd e ages through the seventeenth century. They offer s xty-seven ustrat ons, often n ne form, to prov de v sua proof of the cont nu ty between the mages of the Catho c myst c and the modern hyster c. Beg nn ng w th the f fth-century representat on of possess on n the Romanesque mosa cs of Ravenna to mages of Sa nt Cather ne of S enna, Charcot and R cher beg n to bu d the r case for the para e (and therefore the un versa ty) of the r v sua categor es of hyster a. The assumpt on s that there s an exp c t cont nu ty between Catho c re g ous exper ence, as represented by the pract t oners, and the neuro og ca patho og es of n neteenth-century c representat on of ecstasy becomes a c n ca s gn of psychopatho ogy. The r movement s however not mere y on the eve of the equat on of
France. [53] Thus the aesthet
368
The mage of the possessed as the hyster c. From J.-M. Charcot and Pau R cher, Les Dénon aques dans art (Par s: Adr en De ahaye et Em e Lecrosn er, 1887), p. 4. Photo courtesy We come Inst tute L brary, London. the re g ous-aesthet c and the c n ca . For they c te one mage (and text) from the genera rea m of med c ne, and that s S r Char es Be s mage of op sthotonus. The passage they quote s dent ca to the one c ted above. The r argument s that the mage of op sthotonus s para e to a number of the mages of possess on that they offer, spec f ca y the ear y seventeenth-century mage of Sa nt N us by Domen cho Zamp er ca ed Domen ch no (1581-1641). L ke the r d scuss on of a sketch for the ch d n Raphae s Transf gurat on , there s a stated assumpt on that the rea ty of the symptoms of hyster a are exact y para e to the mmutab e rea ty of the symptoms of tetanus. In the r f na chapter, on the contemporary representat on of the hyster c, Charcot and R cher draw on the mages of the stages of the "hyster ca convu s on" wh ch Charcot had estab shed n the 1880s. The parod es of re g ous exper ences, from the pos t on of prayer to the pos t on of cruc f x on f nd the r v sua representat ons n th s chapter, [54] as does the c ass c arc-en-cerc e pos t on of the op sthotonus taken from Be . [55] What s most str k ng from the v ewpo nt of the h story of the representat on of the hyster c s that there s a cont nu ty to the overa recept on of the mage of the hyster c wh ch transcends the schoo of the
369
One of the topo used to dep ct the h story of the hyster c s th s sketch for the ch d n Raphae s Transf gurat on . From J.-M. Charcot and Pau R cher, Les Démon aques dans art (Par s: Adr en De ahaye et Em e Lecrosn er, 1887), p. 29. Photo courtesy We come Inst tute L brary, London.
370
The se f-cruc f ed hyster c. From J.-M. Charcot and Pau R cher, Les Démon aques dans art (Par s: Adr en De ahaye et Em e Lecrosn er, 1887), p. 100, ower mage. Photo courtesy We come Inst tute L brary, London. Sa pêtr ére. Thus f we return to the Br t sh mages taken from Arthur F. Hurst s study of hyster ca contractures, we can see that Charcot and R cher, n c t ng mages from Lou s Bas e Carré de Montgeron s account of the Jansen st m rac es, [56] had a ready set the stage for the representat on of the nonfunct ona mb as a pr mary s gn of hyster a. The nk between the fema e and the v ct m of she shock s made through the representat on of the body part that makes them unab e to be mob e n a soc ety that demands mob ty as a s gn of group dent ty. The mean ng ascr bed to mob ty from the e ghteenth century to the twent eth century s qu te d fferent (the m dd e-c ass woman becomes a fu member of the new re g ous sect when she s hea ed; the so d er returns to h s f ght ng un t when he s hea ed). But centra to the mage of cure s the mage of mob ty. The v s b y nonfunct ona mb, w th the a terat on n ga t or n posture, marks the hyster c as d seased. The mages taken from the h story of re g on have a ready prov ded a mode for the representat on of the affected area as the target for hea ng. The ana ogy between the menta y and the enthus ast c and/or r gorous fundamenta sm of re g ous sch smat cs such as the Jansen sts had a ready been made by Ph ppe P ne n the wake of the French Revo ut on. C t ng a range of Br t sh sources n a French Catho c context, P ne was forced to see the hypermora sm of the Jansen sts as sett ng them apart from French soc ety. He abe ed them the patho og ca equ va ents of the Method sts. [57] Charcot s c tat on of Jansen sm as the centra v sua c ue to the h story of hyster a t es the mage of the hyster c, not mere y
371
The re g ous cure of the "hyster c." From Lou s Bas e Carré de Montgeron, La ver té des m rac es operés par ntercess on de M. de Pêr s et autres appe ans demontrée contre M. L archevêque de Sens , 3 vo s. (Co ogne: Chez es bra res de a Campag e, 1745-47), as reproduced n J.-M. Charcot and Pau R cher, Les Démon aques dans art (Par s: Adr en De ahaye et Em e Lecrosn er, 1887), p. 81. Photo courtesy We come Inst tute L brary, London.
372 to "re g on" but to the re g on of sp r tua excess, to re g ons such as Method sm and, n a spec f c manner that w be d scussed be ow, to the myst ca re g on of the Eastern Jews. [58] The re g ous r g d ty and the enthus asm of the Jansen sts came to stand for the pervers on of the sp r t wh ch was as patho og ca as the d seases of the hyster c. Pau Regnard br ngs a ser es of the att tudes pass onne es n h s photographs of August ne from the second vo ume of the Iconograph e de a Sa pêtr ére . [59] These mages m m c the pos t ons of the Jansen sts, but they are w thout doubt mages of patho ogy. The para e s make both sets of mages pathognomon c. [60] As w th the mages of the Jansen sts, the mages of the hyster cs are c ose y assoc ated w th v sua ha uc nat ons, w th the see ng of what s not there as a s gn of the fa s f cat on of the mag nat on. W am Hammond, n h s 1876 h story of hyster a, cont nued th s " bera " d scourse of the Sa pêtr ére wh ch assoc ated d sease and re g on. He noted that " n these undeve oped forms of both d seases, as not ced among the Jansen st convu s onna res, the affected nd v dua s appeared as f struck by the s ght of some ob ect before unseen, and the contemp at on of wh ch f ed them w th the most rav sh ng oy." [61] Here the patho og zat on of see ng s the m rror mage of the c n ca gaze of Charcot, who sees the d sease, the d sease of the fantasy, the d sease of re g on. Thus Charcot and R cher undertake what many sc ent sts of the n neteenth and twent eth centur es do—to wr te the h story of the r own d scovery n order to show ts un versa ty across t me ( f not across cu tures). But th s h story of the representat on of hyster a, draw ng on the power of the new secu ar zed re g on of sc ence n d sp ac ng ts antecedent Chr st an ty, becomes the mode through wh ch the hyster c s v sua y categor zed. Th s trad t on does not stop w th R cher and Charcot. Students of Charcot s prov de some of the ater mater a . Henry Me ge (after 1901 the ed tor of the Nouve e Iconograph e de a Sa pêtr ére ) and Jean He tz both contr bute essays to the Nouve e Iconograph e de a Sa pêtr ére on the art st c mage of the hyster c we nto the twent eth century. [62] W th n the German trad t on, the phys c an-h stor an-art cr t c Eugen Ho änder ncorporates many of these mages n wr t ng h s h story of the mage of the mpa red n c ass ca art. [63] Ho ä nder quotes bera y from the same v sua sources as Charcot and R cher—c t ng Raphae and the var ous mages of re g ous possess on. Jean Rousse ot cont nues th s mage n h s study of med c ne n art nto the post-Wor d War II era. [64] H s work beg ns w th the representat on of the Greeks, such as the Bacch c scene of "dy ng Bacchante," now n the Uff z . He comments n h s capt on: "In po nt of fact, a dep ct on of hyster a. At
373
The representat on of re g ous ecstasy as patho og ca s gn. From Pau Regnard, Les ma ad es ép dém ques de espr t: sorce er e magnét sme, morph n sme, dé re des grandeurs (Par s: E. P on, Nourr t et C e., 1887), p. 95. The mage s an engrav ng of a photograph taken from the Iconograph e de a Sa pêtr ée . (Bethesda, Md.: Nat ona L brary of Med c ne.)
374 the far r ght, a hyster ca woman, her body bent n the shape of an arc." A of these works assume a cont nu ty of the mean ng of the mage of the hyster c from the anc ent Greeks to the r contemporar es. And a of them stress the cont nu ty between the anc ent representat on of re g ous exper ence (rather than mages of patho ogy) and modern exper ences of d sease (rather than re g on). Th s asymmetry prov des a powerfu subtext for the assoc at on between mages of re g on and those abe ed n the popu ar m nd as be ng assoc ated w th categor es constructed as or abe ed as re g ous ones—such as the Catho c (or at east the Catho c c er c) and, n an equa y comp ex manner, the Jew. The "warfare between theo ogy and sc ence," to paraphrase the t t e of A. D. Wh te s c ass c n neteenth-century study, [65] wh ch s p ayed out w th n the secu ar zed Chr st an d scourse of ate n neteenth-century psychopatho ogy, s nowhere more c ear y ev dent than n Pau Regnard s 1887 monograph (w th 120 mages) on the v sua re at onsh p between magnet sm, morph n sm, and madness, wh ch beg ns w th the v sua equat on between the w tch and the mad. [66] Regnard, a phys c an and the professor of phys o ogy at the Nat ona Schoo of Agronomy, was the coed tor (w th Dés re-Mag o re Bournev e of the B cêtre) of the or g na , three-vo ume ed t on of the Iconograph e photograph que de a Sa pêtr ére[67] as we as a we -rece ved med ca at as. [68] H s study of 1887, wh ch s ded cated to "cher ma tre," Charcot, assumes the nterre at onsh p of a forms of mass hyster a. H s f rst examp e s the w tch. He prov des a ser es of p ates from Abraham Pa ngh s study of w tchcraft to document the v sua representat on of the w tch as the "grand hyster c." [69] In th s context Regnard br ngs n other mages of demon c possess on from the Rena ssance to the seventeenth century (p. 41), nc ud ng—as one of the mages that becomes standard to the reperto re of v sua proof—the f gure of the boy from Raphae s Transf gurat on (P. 59). It s assumed that these patho og ca pos t ons are nd cat ve of the assoc at on w th other forms of possess on, such as hyster a. To make th s abso ute y c ear n the reader s eye, he reproduces, n the form of draw ngs wh ch thus resemb e the format of the ear er mages he has reproduced, a ser es of photograph c mages from the Iconograph e photograph que de a Sa pêtr ére . Of these the mage of the gaze, the ha uc nat on as exper enced by the observer rather than the hyster c, stands as the con of patho ogy (p. 87). Regnard makes s m ar v sua c a ms n assoc at ng the mage of the hyster c w th that of the s eepwa ker, the drug add ct, and the person suffer ng from monoman a. Images are produced that draw on the v sua assoc at on of abnorma states—there s
375
The mage of the w tch. From Abraham Pa ngh, t Afgeruckt Mom-Aans ght der Tooverye: Daar n het bedrogh der gewaande Toverye, naakt ontdeckt, en emt gezone Redenen en exemp en dezer Eeuwe aangewezen wort (Amsterdam: Andr es van Damme, 1725), p. 50, as used n Pau Regnard, Les ma ad es êp dém ques de espr t: sorce er e magnét sme, morph n sme, dé re des grandeurs (Par s: E. P on, Nourr t et C e., 1887), p. 19. (Bethesda, Md.: Nat ona L brary of Med c ne.)
376
The representat on of a v sua ha uc nat on, the centra ty of the eye and the gaze. From Pau Regnard, Les ma ad es êp dém ques de espr t: sorce er e magnét sme, morph n sme, dé re des grandeurs (Par s: E. P on, Nourr t et C e., 1887), p. 87. (Bethesda, Md.: Nat ona L brary of Med c ne.)
377 a ways the assumpt on that there s a norma mage of the product ve, hea thy human, and the dev ant s marked by externa s gns, such as pos t on, c oth ng, handwr t ng, and so on. These s gns represent the symptoms of menta d sorder, and a are nterre ated because the s gns are nterre ated. But more than th s s shown by mov ng from the w tch (and the torture and crue ty nf cted on the w tch [p. 33] to the m rac es assoc ated [as n Charcot] w th hea ng the hyster c, to use h s term [pp. 133, 135]. Re g on and ts hypocr sy, ts ant thet ca re at onsh p to the act of modern med ca hea ng, are c ted, and the cures of the church are ascr bed to the nature of the d sease ent ty—to hyster a. The cure of the d sease of hyster a s the mass hyster a of re g on. The mode for th s s the ant quated one of homeopath c med c ne— ke cur ng ke. It s c ear that Regnard, ke Charcot and R cher, s ook ng for a more modern approach to therapy—to e ectr zat on or to the new y re abe ed sc ence of hypnot sm—for the r cure, not to re g on. For the church, represent ng the nst tut ona zat on of re g on n contemporary soc ety, s the root cause of the hyster a, not ts cure. The other centra mode c ted by Charcot and R cher n the r sc ent f c work s the mode of the ep ept c. [70] Stemm ng from Charcot s n t a observat ons on h s pat ents n the Sa pêtr ére show ng the symptoms of "hystero-ep epsy" (h s own compos te category, wh ch Freud borrowed), the v sua mage of the d fference of the hyster c stems to no tt e degree from the trad t on of represent ng the ep ept c. [71] The mage of the ep ept c s n many ways para e to that of the hyster c. Thus the "s mu at on" of the hyster c s para e ed by the "contrad ct ons and exaggerat ons of sent ment [wh ch] are sa ent character st cs of ep ept cs," accord ng to Cesare Lombroso. He cont nues: "Ep epsy has a d sastrous effect on the character. It destroys the mora sense, causes rr tab ty, a ters the sensat ons through constant ha uc nat ons and de us ons, deadens the natura fee ngs or eads them nto morb d channe s." [72] Th s need to see the patho og ca character of the ep ept c as para e to h s or her d sease s rep cated n the v sua mage of the ep ept c. Wh e many of the v sua mages of the ep ept c n the med ca terature of the n neteenth century dea w th the prob ems of oca z ng the bra n es on, [73] there s a so a trad t on of represent ng the symptoms of ep epsy through represent ng the pat ent. Char es Féré, n the Nouve e Iconograph e de a Sa pêtr ére , represents hyster a as tera y wr tten on the sk n of the hyster c. [74] The para e mage s to be found n the representat on of hyster ca u cerat on. [75] If one exam nes L. P erce C ark s argument from 1898 that there are "tetano d se zures n ep epsy," one can see the argument com ng fu c rc e to the organ c mode
378
The sens t ve sk n of the ep ept c becomes a tabu a rasa upon wh ch the d sease can be nscr bed. From Char es Féré, "Note sur un cas de mé anoderm e récurrente chez un ép ept que apath que," Nouve e conograph e de a Sa pêtr ére , 10 N.F. (1897): 332-339. (Bethesda, Md.: Nat ona L brary of Med c ne.)
379 of tetanus. [76] Indeed, the fasc nat on w th the mark ng of the s gns and symptoms of d sease on the body permeates the mage of the ep ept c n ways other than the search for the Jackson an bra n " es on" that must necessar y cause the se zures. [77] Thus there are mages of the ma formed hands of an ep ept c woman or of the corporea asymmetry of the ep ept c fema e. [78] The mage of the ep ept c s a so found w th n the trad t on of represent ng the phys ognomy of the nsane. Thus W am A exander prov des the reader w th a photograph of each of the pat ents whose cases he reports n h s 1889 study n order to present the r phys ognomy. [79] It s the v sua appearance of the ep ept c that prov des the c ue to h s or her spec a , h dden f aw. The es on must, n some overt way, wr te tse f on the body. Some essays, such as on the ba dness [80] or the a tered appearance of the ha r[81] of an ep ept c man as a s gn of h s ness, are more than rem n scent of the extraord nary mages of the "p nca po on ca" or "Judenkratze," the fantasy sk n d sease attr buted by Western dermato og sts to the Jews of the East. In some of the recent h stor ca terature on the h story of ep epsy, much of the same trad t on c ted by Charcot and R cher reappear—now n the context of document ng the ongo ng h story of ep epsy. Thus mages of re g ous ecstasy and possess on from the ear y M dd e Ages appear as precursors of the mage of the ep ept c. [82] A of these mages re ate to the dea of the hyster c as cont nuous over t me and across cu tures. Th s s the bas c assumpt on of the def n t on of a pos t v st c d sease ent ty at the c ose of the n neteenth century. D sease s rea on y f t s un versa . And t s un versa on y f t can be seen and the act of see ng reproduced. Th s atter ax om s rare y stated (except by the head of the Sa pêtr ére s photograph c serv ce, A bert Londe), but t s assumed. Thus the mage of the mpa red pat ent s the touchstone for the rea ty of the d sease.
Creating a Composite Image of the Hysteric It s v ta to understand that the creat on of a h story of the mage of the hyster c s not the same th ng as Charcot and R cher s attempt to p ace the d agnost c cr ter a app ed to hyster a n the d stant past (wh e gnor ng the more recent past). What can be undertaken n a m ted way (because of the extraord nary range of v sua sources) s to sketch the v sua aspects assoc ated w th the dea of hyster a at the turn of the century as a means of de neat ng the scope of the mage. Thus th s sect on w be devoted to a cata og of those v sua qua t es ascr bed to the hys-
380
On the mage of asymmetry of the ep ept c, see p ate XLI: "Asymetr e du corps chez une ep ept que," n F. Raymond and P erre Janet, "Ma format ons des ma ns en p nces de humard, " Nouve e conograph e de a Sa pêtr ée 10 (1897 ): 369-373 (an extract from the r book Nécroses et dées f xes [Par s: F. A can, 1898]). Photo courtesy We come Inst tute L brary, London. ter c. We sha seek to sketch the boundar es of the representat on of the v sua nature of the hyster c n f n-de-s éc e med ca terature. It s centra to any understand ng of th s compos te mage that the des re of a of these stud es, no matter what the r nat ona context, s to p ace themse ves w th n the myth of the rea sm of the act of represen-
381
The face of the ep ept c. From W am A exander, The Treatment of Ep epsy (Ed nburgh and London: Young J. Pent and, 1889), p. 107. Photo courtesy We come Inst tute L brary, London. tat on and the h gh y spec a zed ro e that the phys c an (as nterpreter) p ays n reproduc ng and "read ng" the mage of the pat ent. And th s read ng has a c ear re at onsh p w th the means of reproduc ng and d ssem nat ng the mage of the hyster c. The start e effect has now b ended nto an dea of a rea sm that nd cates a contro by the sc ent st and the sc ent st a one over the new med um. (As anyone cou d make and possess photographs after the m d-1890s, t became more and more mportant for the sc ent f c photograph to be the ob ect of sc ent f c nterpretat on. Th s att tude perm tted many nterpreters of the photograph of the pat ent seam ess y to become the nterpreters of the new hermet c sm of the X ray when t was ntroduced n 1895.) The read ng of the photograph had a so b ended n w th the aesthet c (or, perhaps better, art st c) trad t on nto wh ch the "new" sc ence of representat on had p aced the mage of the hyster c. Charcot and R cher, n a paper they f rst pub shed n the Journa of Nervous and Menta D sease n 1883, stated the case best. In not ng the " mmob e" phys ognomy of a hyster ca pat ent whose fac a musc es had been e ectr ca y st mu ated, they
382
Images of the a terat on of the ha r n the menta y are a ready evoked n Darw n s study of the nature of express on. Here the mage of the a tered appearance of the ha r evokes o der mages of the d seases of the Eastern Jews. From Dr. Rä uber, "E n Fa von per od sch w ederkehrender Haarverä nderung be e nem Ep ept ker," [V rchows] Arch v für patho og sche Anatom e und Phys o og e 97 (1884): 50-83, p ate no. 2. (Bethesda, Md.: Nat ona L brary of Med c ne.)
383 observe: "The phys ognomy reta ned mmob e, n a state of cata epsy. The same s true of the att tude and the gesture that accompan ed t. The sub ect of th s transformed nto a sort of express ve statue, a mot on ess mode , represent ng w th str k ng accuracy most var ed express ons, wh ch art sts, w thout doubt, m ght ava themse ves of to a very great extent. The mmob ty of the att tudes thus provoked s em nent y favorab e to photograph c reproduct on." [83] They then reproduce a ser es of these photographs. Th s argument s s m ar to that cr t que by Wa ter Ben am n n h s essay from the m d-1920s on the reproduc b ty of mages n the age of techno ogy. [84] For t s mportant to understand that observ ng s not suff c ent. Charcot (and R cher) turn the ob ect observed (the hyster c) nto the work of art and then are ab e to commod fy th s work of art through the reproduct on of her mage w th n the sc ent f c text. Th s s not qu te ke the c nemat c examp es that Ben am n br ngs. It s much more s m ar to the extens ve photograph c reproduct ons of "great works of art" wh ch dom nated the m dd e-c ass market for art dur ng the 1880s and 1890s. Ben am n s d scuss on of the "exchange of g ances" between the observed and the observer creates a cr t ca context for the earn ng exper ence of the hyster c. For t seems that the exchange of g ances n th s system of representat on s one between an aware hyster c and an unaware phys c an. But the Sa pêtr ére gave b rth to other means of see ng d fference and a so of record ng t. In many of these mages the confus on between acqu red pathognomon c s gns and nherent ones s man fest. There evo ves n the f nde-s éc e d scuss on of the phys ognomy the assumpt on that there s an abso ute re at onsh p between the form of the sku and the shape of the face. [85] And g ven the emphas s on cran ometr c measurements as a means of speak ng about the nature of the m nd/psyche t s c ear that the re at onsh p between the structure of the face and the m nd, a ready present n the phys ognomy of Johann Caspar Lavater (and h s predecessors) becomes an easy one. Franc s Warner summar zes many of the d scuss ons of h s contemporar es, such as Char es Darw n, n The Express on of Emot ons n Men and An ma s (1872). [86] Warner stresses the "resu ts of cerebra act on upon musc es" rather than the "shape of the bra n case" n seek ng to f nd the source for the asymmetry on the face of the hyster c. She descr bes, however, the ex stence of faces that "express nte ectua ty" and others that express "vu gar ty." The atter are an examp e of the "co nc dent defect ve or coarse deve opment of the bra n-case and face." The former are the resu t of "the nerve-muscu ar cond t on of the face" and are "more d rect y nd cat ve of the nte ectua ty of the bra n; hence we shou d study a face as the ndex of the bra n, when t
384 s seen n act on as we as when at rest." Th s v ew can be seen as representat ve of the med ca terature of phys ognomy at the turn of the century. The stress on the asymmetry of the face, an asymmetry caused by the forces of the m nd, rather than the marked "vu gar ty" of the menta defect ve, can be traced back to Ph ppe P ne and h s representat on of the "man c" and the " d ot" at the very beg nn ng of the century. The concept of asymmetry ( ndeed a faces become asymmetr ca w th the passage of t me) can ntroduce the mportance of an aesthet cs of the face of the hyster c. James Shaw stresses the "swe ng of the upper p" n cases of "chron c hyster ca nsan ty" as we as a "fac a express on [that] often nd cates the presence of m gra ne." [87] The face of the hyster c, spec f ca y the hem p eg a that marks the face of the hyster c at the Sa pêtr ére, s an overt s gn of d fference. It s a d stort on of the norma face—the base ne for the "beauty" of the nd v dua . [88] Anthropo og ca terature of the e ghteenth and n neteenth centur es had debated the mean ng of the var et es of beauty, espec a y fema e beauty, throughout the wor d. [89] The consensus was that there was a "great cha n of beauty" runn ng from the beaut fu down to the ug y races wh ch was para e ed w th n each race by a normat ve—that s, hea thy—appearance as opposed to a s ck appearance. Th s patho ogy of appearance under es the representat on of the asymmetr ca , unaesthet c face of the hyster c. In a paper by Hurst (1918) on batt e fat gue, the face of the hyster c marks the nd v dua who can be qu ck y cured and sent back nto batt e. [90] But f the face s marked, t s the eyes that prov de the rea c ue. The st gmata that mark the face are most apparent n the representat on of the eyes. For both the " ook" of the hyster c and the gaze of the phys c an mark the hyster c. Bu d ng upon the noso ogy of hyster ca b ndness deve oped by Charcot as we as the Ph ade ph a ophtha mo og st George Edmund de Schwe n tz, Wa ter Baer We d er traces the qua t es of the eyes from the "contractures, spasms and pa s es" of the "eye ds and extra-ocu ar musc es" ( .e., the representat on of the appearance of the eye) to the man festat on of hyster ca b ndness (amb yop a or amauros s, part a or comp ete oss of v s on). [91] In the work of L. Lattes and A. Sacerdote from the 1920s, s m ar changes n the qua ty of the face are descr bed n the case of a hyster ca pseudo-hemorrhage of the eye. [92] It s the qua ty of the gaze n the photographs of the pat ents that s str k ng. The phys ca anoma es represented a so prov de the s gns for the mean ng read nto the phys ognomy. The droop ng ds or the b ack eye add a qua ty of the abnorma , of the patho og ca , to the gaze of the pat ent, mark ng h m or her as d seased.
385
A scu pture of a case of hem p eg a from the teach ng co ect on of the Sa pêtr ére. (Par s: The Sa pêtr ére.) The d sease that s sought s not n the eye. It s n the centra nervous system, n the neura network that contro s the eye. It s n the bra n, the source of a hyster a, that the source of hyster a s to be found. The mage of the bra n becomes the mage of the nterna error of the hyster c. Ju es Luys, n a paper of 1881, stresses th s n both h s text and n the accompany ng mages of oca zat on. [93] E. S emer ng and J. Grasset see "cerebra -sp na degeneracy" as the source of hyster a. [94] In the work of the Hamburg phys c an Pau Steffens the oca zat on of the es on s represented n the post-mortem mage of the bra n. [95] A of these searches evoke the specter of the bra n mytho ogy that dom nated much of the oca zat on stud es at the end of the century. The search after
386
The eyes and the s ght of the hyster c. From Wa ter Baer We d er, "Some Ocu ar Man festat ons of Hyster a," Internat ona C n cs , 22d ser. 2 (1912): 249-261. P ate (f g. 5) oppos te p. 252. Photo courtesy We come Inst tute L brary, London. the source of the anoma ous appearance of the hyster c was qu te para e to the search after the or g ns of other neuro og ca d sorders. A. A zhe mer represented such a search n h s 1911 paper on cerebra p aques, us ng photographs of dyed bra n spec mens as h s v sua proof of the r ex stence. [96] A of these mages were seen as hav ng para e va ue. Each of them demanded (accord ng to the r nterpreter) a tra ned eye to see and represent the source of the error. The nterre at onsh p between the sc ent f c draw ng and the photograph, both understood as ver d ca n oca z ng the source of the patho ogy, stressed the gaze of the sc ent st, n see ng the nature of the bra n through the nterpretat on of the symptoms. For the hyster c, the symptoms are often wr tten on the body. The
387
The bra n of the hyster c. From Ju es Luys, "Recherches nouve es sur es hém p ég es émot ves," L Encepha e: Journa des Ma ad es Menta es et Nerveuses 1 (1881): 378-398, p ate 7. (Bethesda, Md.: Nat ona L brary of Med c ne.)
388
The bra n structure of the hyster c. From C. von Höb n and A. A zhe mer, "E n Be trag zur K n k und patho og schen Anatom e der Westpha -Strümpe schen Pseudosk erose," Ze tschr ft für d e gesamte Neuro og e und Psych atr e 8 (1911): 203. Photo courtesy We come Inst tute L brary, London. funct on of the sk n as the map of the body s one of the o dest topo of med c ne. Read ng the sk n meant read ng nto the nature of the pat ent, h s or her act ons, and h s or her resu tant d seases. The n neteenth-century terature on masturbatory d sease s fu of such mages, [97] as s, not surpr s ng y, the terature on hyster a. The ab ty of the hyster cs to record wr tten mages on the r sk n, the hypersens t v ty to touch, became one of the most fasc nat ng symptoms for the f n-de-s éc e phys c an. In the "modern" Revue de hypnot sme a str k ng mage of such "sk n wr t ng" appears. [98] In Sa nt Petersburg the f n-de-s éc e mage of the hyster c was brought nto the context of the st gmata, not Charcot s, but the st gmata of Chr st. [99] The d scuss on of the pat ent presented n th s "d ff cu t case of hyster a" centered on the suggest b ty of young Roman Catho c g r s. The search after un que or strange man festat ons
389
The u cerated sk n of the hyster c. From S. We r M tche , "Hyster ca Rap d Resp rat on, W th Cases; Pecu ar Form of Rup a Sk n D sease n an Hyster ca Woman," Transact ons of the Co ege of Phys c ans of Ph ade ph a 14 (1892): 233. (Bethesda, Md.: Nat ona L brary of Med c ne.) of hyster a ed S. We r M tche , whose rest cure had been genera y accepted as the treatment of cho ce by the end of the century, to exam ne a case of a hyster ca u cer n a twenty-fouryear-o d woman. [100] The d fferent a d agnos s to th s u cer was to the u cerat on of syph s, wh ch was "ver f ed by the m croscope." S. Róna cont nued the work that Mor z Kapos had begun n V enna, ook ng at spec f c forms of the man festat on of sk n erupt ons wh ch cou d be abe ed hyster c. [101] Thomas D. Sav , n London, undertook a s m ar study of the sk n of h s ch d pat ents and saw the r hyster a nscr bed thereupon. [102] In 1900 Dr. Bettmann from the He de berg C n c of W he m Erb descr bed a further case of "atyp ca " sk n nf ammat on n the hyster c; n 1901, a case of hyster ca gangrene was descr bed n Buffa o; n 1919, a s m ar case n P sa. By 1930 a ma or survey of the nature of hyster ca sk n d seases was produced by Roberto Casazza n Pav a. [103] A of these stud es (and more) are extens ve y ustrated. A of them re ate, on one eve or another, to the genera assumpt on (countered by Jean-Mart n Charcot n h s theory of hyster a) that syph s or the pred spos t on to syph s p ayed a ma or ro e n the r sk for hyster a. Many of these stud es of the sk n (such as that of We r M tche ) re ate the appearance of the sk n to the state of the gen ta a, e ther n
390
The assoc at on between the syph t c and the hyster c was made as much on dermato og c ev dence (as seen on the sk n) as on psycho og ca ev dence. From Thomas D. Sav , "A C n ca Lecture on Hyster ca Sk n Symptoms and Erupt ons," The Lancet (January 30, 1904): 273-278, p. 276. (Bethesda, Md.: Nat ona L brary of Med c ne.)
391 terms of gyneco og ca exam nat ons that are part of the case study or n terms of a d scuss on of the appearance of the sk n n the gen ta reg ons. Charcot assoc ated hyster a w th the area of the ovar es, those areas of he ghtened sens t v ty n the hyster c, a touch upon wh ch cou d actua y create hyster ca ep sodes. Th s fasc nat on w th the compress on of the ovar es as therapy as we as et o ogy s nked n the med ca d scourse of the per od w th the fasc nat on about hyster ca schur a, the retent on of ur ne and feces. The number of charts of the gen ta reg ons are eg on, yet the number of deta ed (and ustrated) stud es of the form and structure of the gen ta a are few. De S néty, a h sto og st at the Co ege de France, pub shed a ser es of un ustrated case stud es of the gen ta a of fema e hyster cs n the m d-1870s, support ng Charcot s thes s of the centra ty of sexua st mu at on for the creat on of the hyster ca ep sode. [104] W th the ntroduct on of X-ray ana ys s there was even an attempt to represent the pe v c structure of the hyster ca fema e, as a means of represent ng the d sease. [105] The X ray was but a techn ca nnovat on. For the fantas es about nterna zed hyster a had ex sted pr or to Charcot. [106] In 1847 E ogoro Gu tt had presented an ustrated study of the hyster ca gut. [107] The representat on of the extrem t es, espec a y the hand and the foot, ref ect not on y the mportance a d upon the hand and foot as s gns of re g ous possess on (st gmata, para ys s) but a so the phys ca s gns assoc ated w th ep epsy. Pau So er presents a case of contracture of the hand n a ma e hyster c n the fourth vo ume of the Nouve e Iconograph e de a Sa pêtr ére . [108] Some of the stud es, such as those of Hurst, concentrate on the prob em of hyster ca contractures, such as Charcot s "g ove anaesthes a" n the hyster ca traumat c para ys s of the hand; others on the appearance of the hand, ts co orat on (usua y b ue, accord ng to G es de a Tourette[109] ) and marked swe ng. [110] The egs are s m ar y exam ned for the contractures of "hyster ca parap eg a" (and the r cure). [111] The mages taken from Charcot s schemat c representat on of areas of anesthes a reappear over and over aga n to ustrate cases of the d m n shed ab ty to fee (and often to move) the mbs. [112] The v sua representat on of posture and para ys s s used as a mode of v sua proof of Charcot s noso og ca categor es. [113] In an essay from the very f rst ssue of the Nouve e Iconograph e de a Sa pêtr ére n 1888, by Georges G es de a Tourette, we are not on y made to see the hem p eg c pat ent but a so h s ga t, through a schemat c representat on. [114] In th s case, descr bed by Henr Lamarque and Em e B tot, there s a comment on the p ate that they had ntended to use a photograph but an acc dent at the ast moment ru ned the p ate and they were forced to
392
The X ray perm tted the phys c an to see w th n the hyster c. From Jose M. Jorge, "Coxa g a h stér ca," Rev sta de a Asoc ac on Med ca Argent na 32 (1920): 18-29, p ate oppos te p. 80. (Bethesda, Md.: Nat ona L brary of Med c ne.) use a photo thograph. The form of the representat on becomes centra to ts message. For the photograph rema ns more rea than any other mode of represent ng the hyster c. Thus n an essay by Byrom Bramwe —one of the ead ng Scott sh spec a sts on nervous d seases such as hyster a and, one can add, one of the ead ng be evers n a set pathognomon c representat on of d sease—the photograph rema ns the centra proof for the d fferent a d agnos s between "hyster a" and ts contractures and other forms of organ c d sease. [115] But th s photograph has been qu te ev dent y cut to remove the presence of the phys c an or nurse whose hands rema n support ng the pat ent. A s m ar undertak ng can be seen n the photograph contracture represented n the essay by A. Ste nd er n Iowa C ty, except here the pat ent s g ven a staff on wh ch to rest. [116] The rea sm of the photograph concentrates the gaze of the phys c an-reader on the representat on of the d sease n the mage of the pat ent. Peter Dav dson fo ows th s ead w th h s presentat on of a case of hystero-cata epsy from L verpoo . [117] The number and range of Dav dson s
393
The hyster ca gut as an nterna man festat on of the d sease. E ogoro Gu tt , "Osservaz on C n che," G orna e per Serv re a Progress de a Pato og a e de a Terapeut ca , 2d ser. 22 (1847): 229-258, p ate fo ow ng p. 258. (Bethesda, Md.: Nat ona L brary of Med c ne.) cases (runn ng from rheumato d arthr t s to hystero-cata epsy) wou d have enab ed the author to ustrate any (or ndeed a ) of h s cases. He chose to ustrate the case of hystero-cata epsy. As ate as n 1930, n an essay by Pr nce P. Barker, at the Veterans Hosp ta n Tuskegee, A abama, the mage of the hyster c b ack comes to represent the mage of the hyster c whose mbs are frozen. [118] Us ng Charcot s categor es ex-
394
The hand of the ma e hyster c. From Pau So er, "Contracture Vo onta re chez un Hystér que," Nouve es Iconograph e de a Sa pêtr ére 4 (1891): 100-106, p ate oppos te p. 106. Photo courtesy We come Inst tute L brary, London.
395
The posture of the schemat c "pat ent." From Henr Lamarque and Em e B tot, "Sur un cas d hystérotraumat srne chez homme," Bu et ns de a Soc été d Anatom e et de Phys o og e Norma es et Patho og ques de Bordeaux 9 (1888): 242-257, p ate w th f gures 6 and 8. (Bethesda, Md.: Nat ona L brary of Med c ne.)
396
A "doctored" photograph of the hyster c. From Byrom Bramwe , "C n ca Lecture on a Case of Hyster ca Contracture," Ed nburgh Med ca Journa , ns 1 (1897): 128-138, p ate 5. (Bethesda, Md.: Nat ona L brary of Med c ne.)
397
Above and verso: The hyster c posed. From A. Ste nd er, "On Hyster ca Contractures," Internat ona C n cs , 4th ser. 45 (1935): 221-229, f g. 2, oppos te p. 222. Photos courtesy We come Inst tute L brary, London. press y, Barker shows three mages. F rst, an mage of the "norma ," that s, patho og ca , posture of the pat ent; second, an mage that n ts b urred state s to represent the range of mot on n the pat ent; and f na y, an mage of the body restored through "ether zat on and suggest on." Here the mpact of the c nema on the dea of rea sm s ev dent. Whereas n the work of Lamarque and B tot such an mage wou d be understood as ru ned, here t revea s a further aspect of the rea sm assoc ated w th the act of photograph ng. One ast form of rea st c representat on of the hyster c shou d be d scussed. For throughout the vast terature of hyster a (and other forms of menta ness) n the n neteenth century there are uncountab e
398
399
The us on of movement n represent ng the hyster c. From Pr nce P. Barker, "The D agnos s and Treatment of Hyster ca Para ys s," Un ted States Veteran s Bureau Med ca Bu et n 6 (1930): 663-670, 3 p ates fo ow ng p. 670. (Bethesda, Md.: Nat ona L brary of Med c ne.)
400
401
402 charts, graphs, and stat st ca tab es. It s v rtua y un mportant what source one uses. From the med ca per od ca s n France[119] to those n Japan[120] or Germany, [121] one cons stent mage of the hyster c s that of the sc ent f c reduct on of the sufferer and the d sease to schemat c representat ons. The cry of these mages s that they are the rea , transcendent mage of the hyster c. L ke Ga ton s compos te photographs (wh ch w be d scussed be ow), they g ve the observer an mage of the tota ty of the d sease. Th s fantasy of reduc ng the comp ex ty of hyster a to stat st cs or charts rests on a not on of n neteenth-century sc ence that everyth ng s reduc b e to nonverba form (read: mathemat ca ), and that s prec se y the c a m of the photograph. For once, t s sa d, you e m nate narrat ve, you remove the sub ect ve aspect from the eva uat on of the d sease and you have a rea representat on of the pat ent. Thus the use of charts and stat st cs n represent ng the hyster c s another v sua means of creat ng an mage of the d sease, as sure as the mages of the sk n, or bra n, or ce u ar structure of the hyster c.
Hysteria, Race, and Gender S gmund Freud s read ng of the anc ent Greek myth of the wander ng womb, wh ch, when odged n the throat, created the g obus hyster cus , can serve us as a deta ed examp e of the prob ems attendant to "see ng" the hyster c. It s we known that Freud, n the autob ograph ca account he wrote of the occas on some forty years after the event, reca ed the bad recept on that h s n t a paper on ma e hyster a had when he presented t before the V ennese Soc ety of Phys c ans on 15 October 1886. [122] Return ng from h s work w th Jean-Mart n Charcot n Par s and des r ng to present h s new y acqu red ns ghts about ma e hyster a to h s home aud ence n V enna, Freud presented h s paper. H s powerfu reco ect on was that h s hearers thought that what he "sa d was ncred b e. . . . One of them, an o d surgeon, actua y broke out w th the exc amat on: But, my dear s r, how can you ta k such nonsense? Hysteron [s c] means the uterus. So how can a man be hyster ca ? " [123] Freud s angry memory was a med at the narrow-m nded c a m of the V ennese estab shment, that t, and t a one, had command of Greek. It was the young, French-tra ned Freud who knew that the concept of hyster a was t ed to un versa s (wh ch, at that po nt, he understood as trauma) and was not mere y a ref ex of the b o og ca un queness of a subgroup. It was hyster a (the ha mark of the new sc ence) that Freud w shed to rescue from the crabbed c aws of a V ennese med ca estab shment that cou d not even get ts Greek correct, for hystera s the correct form of the Greek noun
403
The chart as the representat on of the ma e hyster c n Japan, as n the mage of psych c forces n H. N sh , "[Ma e Hyster a Cured by Suggest on]," Chuga I Sh npo 405 (1897): 5-9; 406 (1897): 11-16, mage on p. 9. (Bethesda, Md.: Nat ona L brary of Med c ne.)
404
The chart as the representat on of the hyster c n Germany, as n the eva uat on of operat ons on the heat ng of the hyster c n K. Rudo phy, "Ohroperat onen be Hyster schen," Ze tschr ft für Ohrenhe kunde und für d e Krankhe ten der Luftwege 44 (1903): 209-221, p ate 17, oppos te p. 220. (Bethesda, Md.: Nat ona L brary of Med c ne.) for uterus. Thus the young Jew (and Freud understood h mse f from h s exposure to the v ru ent "sc ent f c" ant -Sem t sm of the V ennese Un vers ty as a Jew) showed h s command over not on y the anguage of sc ence (represented by Charcot s d scourse on hyster a) but a so the anguage of cu ture (Greek). (The s gn f cance of th s factor w be shown n the course of th s ana ys s.) Freud s understand ng, ke the understand ng of h s t me, was that hyster a d d not man fest tse f as a d sease of the womb but of the mag nat on. Th s d d not abso ve the fema e from be ng the group most at r sk, however, for the dea of a patho og ca human mag nat on structura y rep aced the mage of the f oat ng womb as the centra et o ogy of hyster a. What was removed from the
405 category of hyster a as Freud brought t back to V enna was ts ns stence on another group, the Jews, wh ch rep aced the woman as essent a y at r sk. The dea of the hyster c was a centra one for the mag nat ve wor d of S gmund Freud as t was c ose to h s se f-def n t on. For at the c ose of the n neteenth century the dea of see ng the hyster c was c ose y bound to the dea of see ng the Jew—and very spec f ca y the ma e Jew. [124] For f the v sua representat on of the hyster c w th n the wor d of mages of the n neteenth century was the mage of the fema e, ts sub-text was that fem n zed ma es, such as Jews, were a so hyster cs, and they too cou d be "seen." The face of the Jew was as much a s gn of the patho og ca as was the face of the hyster c. But even more so, the face of the Jew became the face of the hyster c. Let us quote from one of the defenders of the Jews aga nst the charge of be ng ta nted by hyster a. Maur ce F shberg s The Jews: A Study of Race and Env ronment (1911) states the case bo d y: "The Jews, as s we known to every phys c an, are notor ous sufferers of the funct ona d sorders of the nervous system. The r nervous organ zat on s constant y under stra n, and the east n ury w d sturb ts smooth work ngs." [125] The or g n of th s pred spos t on s ne ther consangu neous marr age ("the modern v ew . . . [ s that they] are not at a detr menta to the hea th of the offspr ng") nor the occupat ons of the Jew ("hyster a [ s] . . . met w th n the poorer c asses of Jews . . . as we as n the r cher c asses"). [126] It s the resu t of the urban concentrat on of the Jews and "the repeated persecut ons and abuses to wh ch the Jews were sub ected dur ng the two thousand years of the D aspora." [127] These nf uences, found at the turn of the century pr mar y among Eastern Jews, accord ng to F shberg show the pred spos t on of these spec f c groups of Jews to nesses such as hyster a: "Organ c as we as funct ona derangements of the nervous system are transm tted hered tar y from one generat on to another." [128] It s not a Jews who are hyster cs, but Eastern Jews, and pr mar y Eastern ma e Jews, accord ng to F shberg: "The Jew sh popu at on of [Warsaw] a one s a most exc us ve y the nexhaust b e source for the supp y of spec mens of hyster ca human ty, part cu ar y the hyster a n the ma e, for a the c n cs of Europe." [129] Here F shberg, an Amer can Jew, m squotes the French psych atr st Fu gence Raymond, who had stated that Jews of Warsaw formed a ma or sector of the menta y of that c ty. [130] It was F shberg s m squote of Raymond that became the standard v ew n German psych atry. [131] It appeared w th n Freud s c rc e when Is dor Sadger noted at the 11 November 1908 meet ng of the V enna Psycho-
406 ana yt c Soc ety: "In certa n races (Russ an and Po sh Jews), a most every man s hyster ca ." [132] It s the ma e Jew from the East, from the prov nces, who s most at r sk for hyster a. Th s v ew had been espoused by Charcot, who d agnosed on 19 February 1889 the case of a Hungar an Jew named K e n, "a true ch d of Ahasverus," as a case of ma e hyster a. K e n had a hyster ca contracture of the hand and an extended numbness of the r ght arm and eg. It was K e n s mp ng that Charcot stressed. K e n "wandered s ck and mp ng on foot to Par s" where he arr ved on 11 December 1888. He appeared at the Sa pêtr ère the next day, "h s feet so b oody that he cou d not eave h s bed for many days." K e n " mped at the very beg nn ng of h s ness." Charcot rem nded h s steners that the pat ent " s a Jew and that he has a ready revea ed h s patho og ca dr ves by h s wander ngs." H s "trave -man a" cou d be seen n the fact that "as soon as he was on h s feet aga n, he wanted to go to Braz ." [133] K e n a so suffered from the standard numbness ascr bed to the hyster c on ha f of h s body. Wander ng and mp ng mark the hyster ca Jew as d seased, and d seased because of ncestuous ntermarr age. H. Strauss of Ber n, n one of the most c ted stud es of the patho ogy of the Jews, prov des a bar chart represent ng the r sk of the Jews for hyster a. [134] It shows that ma e Jews suffer tw ce as often from hyster a as do ma e non-Jews. Wh e t s c ear that women st are the predom nant sufferers from the d sease, t shows a c ear "fem n zat on" of the ma e Jew n the context of the occurrence of hyster a. Freud s teacher, the bera -Jew sh neuro og st Mor z Bened kt, a so nks the "Amer can" qua ty of fe w th the appearance of hyster a, a d sease that he understood as "a un que y fem n ne nervous d sease"— n men. [135] The strugg e for fe n the c ty causes the madness of the ma e Jew: "Menta anx ety and worry are the most frequent causes of menta breakdown. They are a exc tab e and ve exc tab e ves, be ng constant y under the h gh pressure of bus ness n town." [136] The reason for th s nab ty to cope w th the stresses of modern fe es n "hered tary nf uences," that s, the r be ng Jews. [137] And that s wr tten on the r faces, as on the faces of women. W am Thackeray, n Cod ngsby , h s parody of D srae s nove s, has h s eponymous protagon st reve n the aesthet c zed s ght of the "r ng ets g ossy, and cur y, and etty—eyes b ack as n ght—m dsummer n ght—when t ghtens; haughty noses bend ng ke beaks of eag es—eager qu ver ng nostr s— ps curved ke the bow of Love" of the Jews. [138] "Every man or ma den," ooks Jew sh, but a so ooks fem n ne; "every babe or matron n that Eng sh Jewry bore n h s countenance one or more of these
407
The Jew sh hyster c, as represented by a chart from H. Strauss, "Erkrankungen durch A koho und Syph s be den Juden," Ze tschr ft für Demograph e und Stat st k der Juden , 4 N.F. (1927): 33-39; chart on p. 35. (Bethesda, Md.: Nat ona L brary of Med c ne.)
408
The dea zed "Jew sh face," n a draw ng by the famed f n-de-s èc e V ennese Jew sh art st Ephra m Moses L en, s that of the fema e. In Maur ce F shberg, The Jews: A Study of Race and Env ronment (London: Wa ter Scott Pub sh ng Co., 1911), p. 95. Photo courtesy We come Inst tute L brary, London.
409 character st cs of h s peer ess Arab race." Cod ngsby muses: "How beaut fu they are!" when the arr ng vo ce of Rafae Mendoza breaks h s revery: "D you vant to ook at a n she coat?" But the accent s not a true s gn of the Jew s d fference: "A traces of the accent w th wh ch he f rst addressed Lord Cod ngsby had van shed, t was d sgu se: ha f the Hebrew s fe s a d sgu se. He sh e ds h mse f n craft, s nce the Norman boors persecuted h m." The assoc at on between the fa s ty of the anguage of the Jews (wh ch s not mere y accented but dup c tous) s ba anced by the "true" s ght of the Jews—a factor that Thackeray parod es. What rema ns s that the "s ght" of the Jew—the reg strat on of the externa s gns of Jew shness— s a truer nd cator of the nature of the Jew (or at east the percept on of the Jew s nature n Thackeray s re at v st c manner of represent ng the Jew) than s the mutab e s gn of the Jews anguage, a anguage that s corrupted by as we as corrupt ng the wor d n wh ch the Jew n the D aspora ves. Franc s Ga ton actua y tr es to capture th s "Jew sh phys ognomy" n h s compos te ( .e., mu t p e exposure) photographs of "boys n the Jews Free Schoo , Be Lane." Ga ton prov des types generated by mu t p e exposures. There he sees the "co d, scann ng gaze" of the Jew as the s gn of the r d fference, of the r potent a patho ogy. [139] It s n the Jews gaze that the patho ogy can be found. Th s v ew s at east as o d as Robert Burton s Anatomy of Me ancho y , where Burton wr tes of the "gogg e eyes" of the Jews, as we as "the r vo ce, pace, gesture, [and] ooks" as a s gn of "the r cond t ons and nf rm t es." [140] But t s not mere y that Jews " ook Jew sh" but that th s marks them as nfer or: "Who has not heard peop e character ze such and such a man or woman they see n the streets as Jew sh w thout n the east know ng anyth ng about them? The street arab who ca s out Jew as some ch d hurr es on to schoo s unconsc ous y g v ng the best and most d s nterested proof that there s a rea ty n the Jew sh express on." [141] The gaze of the non-Jew see ng the Jew s mmed ate y trans ated nto act on. The comp ex ty of the Jew sh response to th s v ew can be measured n Joseph Jacob s d scuss on of Ga ton s f nd ng of the abso ute Jew sh-ness of the gaze:
Cover up every par o compos e A bu he eyes and ye ancy any one am ar w h Jews wou d say "Those are Jew sh eyes " am ess ab e o ana yze h s e ec han n he case o he nose a o see any o he co d ca cu a on wh ch Mr Ga on no ced n he boys a he schoo a any ra e n he compos es A B and C There s some h ng more ke he dreamer and h nker han he merchan n A n ac on my show ng h s o an em nen pa n er o my acqua n ance he exc a med " mag ne ha
410
Franc s Ga ton s "compos te" and "component" mages of the Jew (here the Jew sh ma e stands as representat ve for the Jew). Front sp ece to Joseph Jacobs, Stud es n Jew sh Stat st cs (London: D. Nutt, 1891). Photo courtesy We come Inst tute L brary, London.
s how Sp noza ooked when a ad " a p ece o ar s c ns gh wh ch s remarkab y con rmed by he por ra s o he ph osopher hough he ar s had never seen one The co d somewha hard ook n compos e D however s more con rma ory o Mr Ga on s mpress on s no ewor hy ha h s s seen n a compos e o young e ows be ween seven een and wen y who have had o gh a hard ba e o e even by ha ear y age
For the Jew sh soc a sc ent st such as Jacobs the nexp cab e nature of the Jew sh gaze ex sts (even more than the "nostr ty" that character zes the Jew sh nose) to mark the Jew. H s rat ona e s qu te d fferent than that of Ga ton—he seeks a soc a reason for the "hard and ca cu at ng" g ance seen by Ga ton, but c a ms to see t neverthe ess. Th s v ew reappears w th n the med ca terature n the work of Jew sh phys c ans, such as Moses Ju us Gutmann, who wr tes of the structure of the Jew sh face, of ts typ ca form, as be ng the resu t of a comb nat on of features that produce "the me ancho y, pa ned express on" (the nebb sh face) that s assoc ated w th the Jew. For Gutmann, and others, t s the resu t of the "psycho og ca h story of the Jew." [142]
411 S gmund Freud s own fasc nat on for Ga ton s "fam y" photographs must a so be stressed. For Freud the compos te photograph s v rtua y the representat on of the dream n h s Interpretat on of Dreams (1990). It s an obsess ve metaphor, wh ch recurs throughout the course of h s work. [143] The centra ty of th s metaphor s a res due of Freud s ear er acceptance of Charcot s re ance on the act of see ng as the pr v eged form of d agnos s. It s not see ng the un que but rather the un versa . And yet h dden w th n those c a ms for un versa ty are the mages of race wh ch Ga ton produces para e to h s other compos tes, n wh ch the eyes of the Jew (read: S gmund Freud) and h s gaze are patho og zed. The c n ca gaze of the Jew sh phys c an now becomes the ob ect of the gaze of study. The mage of the eyes, found n the ca cu at ng g ance of the hyster c and the ep ept c, reappears n the context of race. In Henry Me ge s d ssertat on of 1893 on the wander ng Jew n the c n ca sett ng of the Sa pêtr ère, the mage of the Jew and the gaze of the Jew become one. [144] Me ge undertakes to p ace the appearance of Eastern European (ma e) Jews n the Sa pêtr ère as a s gn of the nherent nstab ty of the Eastern European Jew. He sketches the background to the egend of the wander ng Jew and prov des ( ke h s superv sor, Char-cot) a set of v sua " mages of Ahasverus." He then prov des a ser es of case stud es of Eastern (ma e) Jews, two of wh ch he ustrates. The f rst p ate s of "Moser C. ca ed Moses," a forty-f ve- or forty-s x-year-o d Po sh Jew from Warsaw who had a ready wandered through the c n cs n V enna and e sewhere; the second p ate s of "Gott eb M.," a forty-two-year-o d Jew from V n us, who kew se had been treated at many of the psych atr c c n cs n Western Europe. G ven the extraord nary movement of m ons of Eastern Jews through Western Europe, beg nn ng n the ear y 1880s, toward Eng and and Amer ca, the appearance of these few cases of what comes to be ca ed "Munchausen syndrome" shou d not surpr se. W thout any goa , these Jews "wandered" on y n the sense that they were dr ven West, and that some shou d seek the so ace of the c n c where they wou d at east be treated as nd v dua s, even f s ck nd v dua s, shou d not make us wonder. What s str k ng s that Me ge prov des mages and ana yses that stress the pathognomon c phys ognomy of the Jew—espec a y h s eyes. The mages gaze at us, nform ng us of the r nherent hyster ca patho ogy. The Jew s the hyster c; the Jew s the fem n zed Other; the Jew s seen as d fferent, as d seased. Th s s the mage of the hyster c w th wh ch the Jew sh sc ent st was confronted. H s "start e" effect was to see h mse f as the Other, as the d seased, but most mportant as the fem n zed Other, the a tered form of h s c rcumc sed gen ta a ref ect ng the form of that of the woman.
412
The "wander ng Jew" as the mode for the psychopatho ogy of the Eastern Jew. From Henry Me ge, Étude sur certa ns néuropathes voyageurs: Le u f-errant a a Sa pêtr ère (Par s: L. Batta e et c e., 1893), p. 17. (Bethesda, Md.: Nat ona L brary of Med c ne.) No wonder that Jew sh sc ent sts such as Jacobs, F shberg, and Freud— n very d fferent ways—sought to f nd the hyster c outs de of the r own se f- mage. For that mage was mmutab e w th n the b o ogy of race. F shberg quotes the accepted w sdom ( n order to refute t for h mse f and pro ect t onto the Eastern Jew) when he c tes R chard An-
413
The mage of "Moser C. ca ed Moses," one of the modern "wander ng Jews," gazes at the reader. From Henry Me ge, Étude sur certa ns néuro-pathes voyageurs: Le u f-errant a a Sa pêtr èe (Par s: L. Batta e et c e., 1893), p. 25. (Bethesda, Md.: Nat ona L brary of Med c ne.) dree: "No other race but the Jews can be traced w th such certa nty backward for thousands of years, and no other race d sp ays such a constancy of form, none res sted to such an extent the effects of t me, as the Jews. Even when he adopts the anguage, dress, hab ts, and customs of the peop e among whom he ves, he st rema ns everywhere the same. A he adopts s but a c oak, under wh ch the eterna Hebrew surv ves; he s the same n h s fac a features, n the structure of h s body, h s temperament, h s character." [145] And th s constancy of character, w th ts de-
414
The phys ognomy and the gaze of "Gott eb M.," a forty-two-year-o d Jew from V na, "proves" the psychopatho ogy of the Jew. From Henry Me ge, Étude sur certa ns néuropathes voyageurs: Le u f-errant a a Sa pêtr ère (Par s: L. Batta e et c e., 1893), p. 29. (Bethesda, Md.: Nat ona L brary of Med c ne.) v ant sexua nature, eads to the d sease that marks the Jew, that eads to hyster a. Because the et o ogy of the Jew s hyster a, ke the hyster a of the woman, was to be sought n "sexua excess." [146] Spec f ca y n the " ncestuous" nbreed ng of th s endogenous group: "Be ng very neurot c, consangu neous marr ages among Jews cannot but be detr menta
415 to the progeny." [147] Jews (espec a y ma e Jews) are sexua y d fferent; they are hyster ca and they ook t. The c n ca gaze of the Jew sh phys c an now becomes the ob ect of the gaze of study. The mage of the eyes attr buted to the Jew reappears n the context of the sc ence of race. It s th s b o og ca def n t on of a aspects of the Jew that he ps form the f n-de-s èc e dea of the Jew. The sc ent f c gaze shou d be neutra . The sc ent f c gaze shou d be beyond or above a of the vagar es of nd v dua d fference. [148] As George Herbert Mead put t: "Know edge s never a mere contact of our organ sms w th other ob ects. It a ways takes on a un versa character. If we know a th ng, exp a n t, we a ways put t nto a texture of un form t es. There must be some reason for t, some aw expressed n t. That s the fundamenta assumpt on of sc ence." [149] But race s but one of the categor es of the v sua zat on of the hyster c that p ayed a ro e n shap ng the mage of the hyster c n the course of the n neteenth century. For the construct on of see ng the hyster c took many d fferent forms n prov d ng a compos te mage of the hyster c, an mage n b ts and snatches, an mage that revea ed the "truth" about the hyster c s d fference to h mor herse f. The noso ogy of the "categor es" of d fference are rea y qu te ana ogous to Charcot s construct on of the v sua pattern of the act ons of the hyster c. One can argue that Freud s nte ectua as we as ana yt c deve opment n the 1890s was a movement away from the mean ng of v sua s gns (a sk that he ascr bes to Charcot n h s ob tuary of 1893) and to the nterpretat on of verba s gns, from the crud ty of see ng to the subt ety of hear ng. [150] Charcot understands the rea sm of the mage to transcend the crud ty of the spoken word. In a etter to Freud on 23 November 1891 he commented concern ng the transcr pt on of h s famed Tuesday ectures that "the stenographer s not a photographer." [151] The assumpt on of the nherent va d ty of the gaze and ts mechan ca reproduct on forms the mage of the hyster c. The centra argument that can be brought s that th s vocabu ary of see ng rema ns embedded n Freud s act of understand ng the hyster c, who must be seen to be understood. Th s s not present n the ear est papers on hyster a wr tten d rect y under Charcot s nf uence, such as Freud s d fferent a d agnos s of organ c and hyster ca para ys s wr tten n 1886. [152] For Freud the re ect on of Charcot s mode of see ng the hyster c s a so a re ect on of the spec a re at onsh p that the Jew has w th the d sease. The theme of the spec f c, nher ted r sk of the Jew for hyster a (and other forms of menta ness) was ref ected n the work of Charcot wh ch Freud trans ated. [153] But even more so th s genera c a m about the hered tary r sk of the Jew was
416 nked to a d agnost c system rooted n be ef n externa appearance as the source of know edge about the patho og ca . For the see ng of the Jew as d fferent was a topos of the wor d n wh ch Freud ved. Sat r ca car catures were to be found throughout the German-speak ng wor d, wh ch stressed the Jew s phys ca d fference, and n the work of Charcot (and h s contemporar es) these representat ons took on patho og ca s gn f cance. Indeed, Freud s purchase of a thograph of Brou et s pa nt ng of Charcot n August of 1889 can we be understood as a compensat on of Freud s re ect on of Charcot s mode of see ng and represent ng the hyster c. Indeed, t must a so be understood as a compensat on for h s abandonment of h s dent f cat on w th the ant -Sem t c Jean-Mart n Charcot [154] —for whom Jews, as the essent a "moderns," were at spec a r sk as hyster cs—and h s new a ance w th the prov nc a Jew H ppo yte Bernhe m. [155] Such a movement para e s the abandonment of deas of trauma—st for Charcot the cause of hyster a ( n women as we as n Jews)—and ts rep acement w th the et o ogy of hyster a n the psyche. As Freud states:
For he phys c an w be ab e o conv nce h mse o he correc ness o he asser ons o he schoo o Nancy Bernhe m a any me on h s pa en s whereas he s scarce y ke y o nd h mse observa on he phenomena descr bed by Charco as "ma or hypno sm " wh ch seem on y o occur n a ew su erers rom grande hys er e 156
n a pos on o con rm rom h s own
It s the sc ent f c "observat on," the gaze of the Jew rather than the gaze d rected at the Jew, wh ch marks the d st nct on between Charcot and Bernhe m. Freud s convers on to Bernhe m s mode of see ng the "usua " rather than see ng the "un que" a so marks the beg nn ng of h s re ect on of reduc ng the or g n of hyster a to the s ng e, traumat c event. Th s returns us to the prob em of def n ng the v sua precursors for Charcot and for Freud. We must trace the mage of the ep ept c and the mean ng of trauma—two c ear y nked mages n Freud s vocabu ary of the hyster c—to see how Freud s read ng of the hyster c s nked through these mages of trauma to the centra mage of d fference, the Eastern European Jews as hyster cs (or perhaps more accurate y, prov nc a Jews as parvenus, out of the r m nds because they are out of the r natura p ace). It s the d scourse on the re at onsh p between trauma and hyster a that prov des the key to Freud s—and many of h s contemporar es —amb va ence concern ng mode s for therapy. Trauma s not a neutra concept. There has been a genera acceptance
417 of the h stor ca mode of the "ra way sp ne," hyster ca trauma resu t ng from ra way acc dents, as a means of understand ng the traumat c nature of hyster a at the turn of the century. [157] Indeed, n much of the ear y work on hyster a these mages haunt the terature. The hyster c s the sufferer from traumat c neuros s s m ar to that caused by exper enc ng a tra n acc dent, as out ned by Herbert Page n h s c ass c work, In ur es of the Sp ne and Sp na Cord (1883), and accepted n toto by Charcot n h s work on the neuros s of fr ght or shock. Both men and women are therefore equa y at r sk for such forms of psychopatho ogy. Hyster a s thus mere y the d rect (bra n or sp na cord es on) or nd rect (shock) resu t of trauma. And here the confus on between the mode s of hyster a evo ved by Charcot and Hugh ngs Jackson must be stressed. For the traumat c event causes hyster a on y n those who are pred sposed to be ng hyster c (Charcot), but the es on caused by trauma a so re eases those subterranean aspects of our ear er evo ut on he d n check by the h ghest order of neuro og ca organ zat on (Hugh ngs Jackson). The Jew s pred sposed to hyster a both because of hered tary and consangu n ty ( ncestuous nbreed ng) and, as we sha see, by the trauma of c v zat on as represented by the Jews pred spos t on to the somat c d seases nked to hyster a, such as syph s. The f n-de-s èc e mage of trauma s one w th modern c v zat on, w th the tra n. As S r C fford A butt, Professor of Med c ne at Cambr dge Un vers ty, stated n an essay n the Contemporary Rev ew of 1895:
To urn now o nervous d sab y o hys er a o he r gh u ness he me ancho y he unres due o v ng a a h gh pressure he wor d o he ra way he pe ng o e egrams he s r e o bus ness sure y a any ra e hese ma ad es or he causes o hese ma ad es are more r e han hey were n he days o our a hers? To h s ques on here s know bu one op n on on he sub ec n soc e y n he newspapers n he books o ph osophers even n he ourna s and rea ses o he med ca pro ess on 158
And thus the ra road, ra way acc dents, and the speed of modern fe a co aborate to create the hyster c. But n neteenth-century "ra way" med c ne faced a d emma that ater faced S gmund Freud. Trauma—such as nvo vement n a ra way crash— s the cause of hyster a, but why do not a nd v dua s who are nvo ved n ra way crashes become hyster c? Th s quest on was answered n part by the neuro og st C. E. Brown-Séquard, who, as ear y as 1860, had argued that there were hered tary transm ss ons of acqu red n ur es, as n the case of "an ma s born of parents hav ng been rendered ep ept c by an n ury to the sp na
418 cord." [159] Th s v ew qu ck y becomes a standard one n the terature on "ra way sp ne." [160] The mage of the hyster c be ng at r sk because of h s or her nher tance m ted the f e d from wh ch the hyster c cou d be drawn. Thus the phys c an cou d, under most c rcumstances, see h m- or herse f as a separate category, as d stanced from the hyster c as from the ch d of a coho cs or cr m na s. But not the Jew sh phys c an. For the Jew sh phys c an s at r sk no matter wh ch theory of hyster a one accepted. [161] Some v ews us ng the mode of b o og ca determ n sm had t that the Jew was at r sk s mp y from nher tance; some v ews sought after a soc o og ca exp anat on. But both v ews, no matter what the et o ogy, saw a resu tant nab ty of the Jew to dea w th the comp ex t es of the modern wor d, as represented by the Rousseauean c ty. The trauma of "modern fe" was c ose y nked to the mage of the c ty. For n neteenth-century med c ne (whether psych atry or pub c hea th), c t es are p aces of d sease and the Jews are the qu ntessent a c ty dwe ers, the Amer cans of Europe. R chard Krafft-Eb ng be eved that c v zat on regu ar y br ngs forth degenerate forms of sexua ty because of the "more str ngent demands wh ch c rcumstances make upon the nervous system," c rcumstances that man fest themse ves n the "psychopatho og ca or neuropatho og ca cond t ons of the nat on nvo ved." [162] For h m (and for most c n ca psych atr sts at the turn of the century) the Jew s the u t mate "c ty person" whose sens b t es are du ed, whose sexua ty s patho og ca , whose mater a st c, money-grubb ng goa s are "Amer can," whose fe s w thout a center. It s a so the c ty that tr ggers the weakness h dden w th n the corrupted nd v dua . It s ts turbu ence, ts exc tement, what August Fore n The Sexua Quest on (1905) ca s ts "Amer can sm," that eads to nesses such as hyster a:
Amer can sm —By h s erm des gna e an unhea hy ea ure o sexua e common among he educa ed c asses o he Un ed S a es and apparen y or g na ng n he greed or do ars wh ch s more preva en n Nor h Amer ca han anywhere e se re er o he unna ura e wh ch Amer cans ead and more espec a y o s sexua aspec 163
Th s s an mage seen by phys c ans of the per od as "Jew sh" n ts d mens ons. Jews man fest an "abnorma y ntens f ed sensua ty and sexua exc tement that ead to sexua errors that are of et o og ca s gn f cance." [164] Jew sh sc ent sts, when they address th s quest on d rect y, seek for a deve opmenta rather than a hered tary reason for th s ev dent h gher rate of hyster a. They seek out the two-thousand-year D aspora as the or g n of trauma. [165] But th s does not free them. G ven the v ews
419 of Brown-Séquard, there s rea y tt e escape no matter what the cause. The Jew becomes the hyster c and the hyster a s measured by the sexua abnorma ty of the Jew. Thus when we turn to Freud s case stud es, e ther n the co aborat ve Stud es n Hyster a of 1895 or n h s ater and much more comp ex stud es, such as h s study of Dora (1905 [1901]), we face the quest on of Freud s (and Breuer s) representat on of the Jew—of h s "see ng" (or, perhaps better, "hear ng") the Jew. In an ear er study I argued that the mage of Anna O. n Breuer s casestudy contr but on to the Stud es n Hyster a masked the "Jew shness" of Bertha Pappenhe m. [166] In Freud s own contr but ons (such as the case of Kather na or M ss Lucy R.) there s the attempt to un versa ze the mage of the hyster c through the c tat on—not of cases of ma e hyster a—but those of non-Jew sh hyster cs. But the common qua t es ascr bed to the hyster c and the Eastern, ma e Jew rema n centra to the representat on of th s noso og ca category for Freud. Th s can be seen n a c ose read ng of what has become the exemp ary "case of hyster a" for our contemporary read ng of the h story of hyster a, Freud s case of Dora. [167] Seen by contemporary fem n st cr t cs, such as Hé ène C xous, as "the core examp e of the protest ng force of women," [168] t s a so the c ass c examp e of the transmutat on of mages of gender and race (mascu n ty and "Jew shness") nto the race ess mage of the fem n ne. Freud used the case of Dora to argue not on y for the necessary pub cat on of case stud es, but a so for the needed mask ng of the ana ysand. The d sgu s ng of the dent ty of Dora s comp ete. There s no s gn n the case study of the "rac a " dent ty of Ida Bauer, the Eastern European Jew sh daughter of Ph p Bauer, whose syph s was treated by Freud some s x years before the beg nn ng of Dora s ana ys s. Charcot (and Freud) had attempted to d stance the d seases of syph s and hyster a, and yet a re at onsh p between the two patterns of ness rema ned. Th s om ss on, such as Josef Breuer s om ss on of h s pat ent s "rac a " dent ty n h s narrat ve of Anna O. s case, wh e nc ud ng t n h s case notes, masks a sa ent aspect of the case. We can best quote Freud n th s regard, when he returns to the 1895 case of Kather na n 1924 and observes concern ng h s rep acement of the re at onsh p w th the pat ent s father w th the word "unc e": "D stort ons ke the one wh ch I ntroduced n the present nstance shou d be a together avo ded n report ng a case h story." [169] Perhaps as mportant for our read ng of the suppressed aspects of the case of Dora (Ida Bauer) s the fact that her be oved brother Otto Bauer was one of the founders of the Austr an Soc a st Party. H s att tude toward h s Jew sh dent ty s of mportance. For Austro-Marx sm
420 advocated cu tura -nat ona autonomy for a peop e w th n the d verse Hapsburg Emp re—except for the Jews. These Marx sts saw ass m at on as nev tab e and pos t ve, and they t ed ass m at on to a d st nct d staste for Y dd sh (and subsequent y Hebrew) as ngu st c s gns of a negat ve separat sm (a s gn that took on pos t ve mean ng when ascr bed to Czech or Hungar an as "nat ona " anguages). Wh e Otto Bauer was an "Eastern Jew" h mse f, as he was born of Bohem an ancestry n V enna, he was amb va ent about the dea of race. "Race" was an acceptab e abe for the other nat ona groups, s nce t was assoc ated by them w th pos t ve deas of autonomy, but for the Jews (espec a y Eastern Jews) t was a ways a s gn of the patho og ca . [170] Bertha Pappenhe m, Breuer s Anna O., stated t qu te ba d y n an essay pub shed at the turn of the century. Ra sed n an orthodox Jew sh home, for her the German- anguage schoo s deve oped n the Eastern reaches of the Hapsburg Emp re were "a strongho d, often conquered n batt e, n the f ght aga nst the ma a se from wh ch Ga c an Jewry suffers as from a hered tary d sease." [171] It s the cure of th s hered tary d sease that Freud undertakes n treat ng Dora (and thus treat ng an aspect of h s own dent ty). Th s s, ndeed, the h dden mean ng of the deve opment of the dea of transference and countertransference wh ch s nascent n the case of Dora and why Freud s own understand ng of th s process s b ocked n th s case. The centerp ece of Freud s study of Ida Bauer s, accord ng to Freud s argument, the attempt to exp a n the or g n of a case of hyster a through the ana ys s of the Oed pa tr ang e as perce ved by a pat ent whose ob ect of attract on s of the same sex. The comp ex re at onsh ps are between her father (Ph p), her mother (Käthe), and Dora; the father s over (Frau K.) and her husband (Herr K.), the attempted seducer of Dora, who has trad t ona y been the focus of the nterpretat on of the study. Much t me and effort has been expended to understand Freud s comp ex m sread ng of th s case. What s c ear s that there are a number of m sread ngs by Freud n the text. Jacques Lacan po nted out one of the centra ones: that the g obus hyster cus man fested by Dora s nterpreted by Freud as the symbo c representat on of ora ty w th n a spec f c context n the case study. The over s seduct on of the mpotent father s descr bed n Freud s ana ys s as an act of fe at o rather than be ng understood as cunn ngus. [172] Th s d sp acement s, however, not mere y the sh ft of Freud s focus from the gen ta a of the fema e to those of the ma e. Rather t s a doub e d sp acement—for the act of fe at o s a so the emb emat c act of ma e homosexua contact. What such a d sp acement means can be found f the "sc ent f c" context of the mean ng of the act of fe at o n the med ca debates of the n neteenth
421 century are fo owed. Through such a contextua zat on we can out ne Freud s understand ng of the transm ss on of a "d sease" (the co apse of anguage as represented by the symptom of the g obus hyster cus n Ida Bauer) as necessar y assoc ated w th the act of suck ng a ma e s pen s. Let us beg n w th th s m sread ng as a s gn of Freud s representat on of the dea of race n the gu se of the representat on of the fem n ne, as t rep aces the ma e s gen ta a as the ob ect of attract on—and, therefore, s ght—w th the woman s. For Freud the act of see ng one s gen ta a s one wh ch s espec a y "fem n ne": "The pr de taken by women n the appearance of the r gen ta s s qu te a spec a feature of the r van ty; and the d sorders of the gen ta s wh ch they th nk ca cu ated to nsp re fee ngs of repugnance or even d sgust have an ncred b e power of hum at ng them, of ower ng the r se f-esteem, and of mak ng them rr tab e, sens t ve, and d strustfu ." [173] The spec a qua ty of see ng the fema e s gen ta a, gen ta a norma y understood by Freud as presence n the fantasy of the r absence, po nts toward the other gen ta a, the ma e gen ta a, seen by the ma e, wh ch when "d sordered" po nts toward patho og ca nature of the ma e. But what s th s d sorder? In the case study t s, on one eve , the or g n of Ida Bauer s understand ng about the d seased nature of her gen ta a, the syph t c nfect on of her father. One of the most nterest ng qua t es ascr bed to the father from the very beg nn ng of the case study s the fact that he was syph t c. The re at onsh p between the phys ca trauma of syph s and the mage of the syph t c s centra to understand ng the mage of the hyster c wh ch Freud evo ves n h s study. In the case of Dora s father, h s "gravest ness . . . took the form of a confus ona attack, fo owed by symptoms of para ys s and s ght menta d sturbance." [174] Freud d agnoses th s as a case of "d ffuse vascu ar affect on; and s nce the pat ent adm tted hav ng had a spec f c nfect on before h s marr age, I prescr bed an energet c course of ant uet c treatment." [175] Four years ater the father br ngs h s daughter to Freud for treatment. Freud argues n a footnote for the retent on of the re at onsh p between the et o ogy of hyster a n the offspr ng and the syph t c nfect on of the father. "Syph s n the ma e parent s a very re evant factor n the et o ogy of the neuropath c const tut on of ch dren." [176] Here s the trauma—th s case of hyster a s a form of hered tosyph s transm tted by the father. Freud s emphas s on th s ne of nher tance s not so e y because Ida Bauer s father had ev dent y (accord ng to the account n the case study) nfected her mother (and therefore h s daughter), but because the genera aws of the nher tance of d sease wh ch were accepted dur ng th s per od argued that the son nher ts the d seases of the mother (and therefore her father) wh e the daughter n-
422 her ts the d seases of the father (and therefore h s mother). [177] Freud ater uncovers another s gn of th s b o og ca pred spos t on n the fact that "she had masturbated n ch dhood." [178] Th s s the nk that br ngs together the trauma (the syph t c nfect on of the father), the mode of transm ss on (sexua ntercourse w th a c rcumc sed pen s), the Jew shness of the father as represented n h s patho og ca sexua ty, and the hyster ca neuros s of the daughter. The merg ng of var ous forms of ness, from syph s to hyster a, s through the mode of nher ted character st cs. The "rea " d sease s the degeneracy of the parent, and ts man festat on n spec f c ness can vary from nd v dua to nd v dua . [179] Thus syph s and hyster a are tru y forms of the same pattern of ness. One read ng of the case wou d be to say that hypersexua Jew sh ma es pass on the r Jew sh d sease to the r daughters n the form of hyster a. But th s d scourse s present n Freud s text on y f we contextua ze the mean ng of syph s w th n the context of Freud s se f-def n t on as a Jew and that of h s pat ent, Ida Bauer. Freud creates very ear y on a d fferent a d agnos s between tabes dorsa s (a abe for one of the ate man festat ons of syph s) and hyster a, at east when t appears n a woman who s nfected w th syph s. He undertakes th s n an extended footnote at the very beg nn ng of the study n wh ch he documents the centra d agnost c thes s of th s case study: that t s the ordered narrat ve of the pat ent about her ness wh ch s d srupted n the hyster c. In other words, the hyster c es: "The pat ent s nab ty to g ve an ordered h story of the r fe nsofar as t co nc des w th the h story of the r ness s not mere y character st c of the neuros s. It a so possesses great theoret ca s gn f cance." [180] The re at onsh p between the sexua et o ogy of the hyster c and the hyster c s d scourse represents the under y ng sh ft from an mage of race to one of gender (for as we sha see, the d scourse of the Jew s a pr mary marker of d fference). The counterexamp e s brought n Freud s notes, a case study of a pat ent who "had been for years . . . treated w thout success for hyster a (pa ns and defect ve ga t)." She narrates her "story . . . perfect y c ear y and connected y n sp te of the remarkab e events t dea t w th." Freud conc udes th s "cou d not be . . . [a case] of hyster a, and mmed ate y nst tuted a carefu phys ca exam nat on. Th s ed to the d agnos s of a fa r y advanced stage of tabes, wh ch ater was treated w th Hg n ect ons (O . c nereum) by Professor Lang w th marked y benef c a resu ts." [181] Here the mage of the "defect ve ga t," wh ch s one of the ha marks of the "hyster c" n the n neteenth century (and the h story created for th s mage at the Sa pêtr ère), recurs, on y to be revea ed
423 as the f na stages of syph s. The rony s that t s Joseph Bab nsk whose neuro og ca work at the Sa pêtr ère prov ded the c ue for such an ana ys s of the mpa red p antar ref ex [182] and Charcot h mse f, n h s work on nterm ttent c aud cat on, who prov ded the rac a context for such mpa rment. [183] (And, ndeed, there s a nk of nterm ttent c aud cat on to the mage of the hyster c.)[184] In th s case of Dora, t s revea ed on y at the very c ose of the case that one of Dora s pr mary symptoms was that "she had not been ab e to wa k proper y and dragged her r ght foot. . . . Even now her foot somet mes dragged." [185] Freud sees th s "d sorder, the dragg ng of one eg," as hav ng a "secret and poss b y sexua mean ng of the c n ca p cture." [186] Freud nterprets th s as a s gn of the "fa se step" that Dora had maged herse f to have taken dur ng the attempted seduct on by Herr K. at the ake. Later Fe x Deutsch, who treated Ida Bauer after she broke off her ana ys s w th Freud, observed w th surpr se that the "dragg ng of her foot, wh ch Freud had observed when the pat ent was a g r , shou d have pers sted twenty-f ve years." [187] Th s rema ned a centra s gn for her aff ct on, a s gn that s not so e y the assoc at on between the acc dent she had as a ch d and the bed rest that accompan ed t. For the ncapac ty of ga t s a so a rac a s gn n Ida Bauer s V enna and s assoc ated w th the " mpa rment" of the Jew. For t s the Jew, n a ong Austr an trad t on as o d as the e ghteenth century, who s at greatest r sk n hav ng both mpa red ga t [188] and syph s. It s th s mage n the case of Dora that nks the mpa rment of the syph t c and the h dden mage of the Jew. The assoc at on of the syph t c nfect on of the father and the neuros s of the daughter s nked by Freud n h s ana ys s of the phys ca symptom of eukorrhea, or gen ta catarrh, an ncreased "d sgust[ ng] . . . secret on of the mucous membrane of the vag na." [189] Dora assoc ates th s w th her esb an "d sgust" toward Herr K. s attempted heterosexua seduct on ( n Freud s read ng) and the fee ng of h s "erect member aga nst her body." [190] Freud s conc us on s that for Ida Bauer "a men were ke her father. But she thought her father suffered from venerea d sease— for had he not handed t on to her and to her mother? She m ght therefore have mag ned to herse f that a men suffered from venerea d sease, and natura y her concept on of venerea d sease was mode ed upon her one exper ence of t—a persona one at that. To suffer from venerea d sease, therefore, meant for her to be aff cted w th a d sgust ng d scharge." [191] Freud thus nterprets one of two dreams narrated to h m by Dora n terms of the connect on among the "d sgust ng catarrh," the wetness of bed-wett ng and masturbat on, and her mother s compu s ve c ean ness. "The two groups of deas met n
424
Charcot s d agnost c category of nterm ttent c aud cat on was used as a marker for rac a d fference. From P. O v er and A. Ha pré, "C aud cat on nterm ttente chez un homme hystér que atte nt de pou s ent permanen," La Normand e Méd ca e 11 (1896): 23. (Bethesda, Md.: Nat ona L brary of Med c ne.)
425 th s one thought: Mother got both th ngs from father: the sexua wetness and the d rty ng d scharge. " [192] In the recurrent dream the connect on (r ght word) s made through the symbo c representat on of the "drops," the ewe s that her mother w shes to rescue from the f re that threatens the fam y. [193] Freud nterprets the "drops"—the ewe ry [Schmuck ]—as a sw tch-word, wh e " ewe ry" [Schmuck ] was taken as an equ va ent to "c ean" and thus as a rather forced contrary of "d rt ed." [194] Freud stresses that the " ewe s" become a " ewe case" n the dream and that th s term (Schmuckkasten ) s "a term common y used to descr be fema e gen ta s that are mmacu ate and ntact." [195] One can add another ayer of m sread ng. As I have shown, there s a subtext n the h dden anguage of the Jews. In V ennese urban d a ect, borrowed from Y dd sh, Schmock has another mean ng. Schmock even n German urban deo ect had come to be the standard s ang term for the ma e gen ta s. The h dden mean ng of the anguage of the Jews s dent ca to the y ng of the hyster c, the centra symptom of hyster a, accord ng to Freud. Th s transference can be seen n Freud s ear y descr pt on of the d scourse of two Eastern ma e Jews n a etter to h s fr end Em F uss on the return tr p from Fre burg to V enna n 1872:
Now h s Jew a ked he same way as had heard housands o o hers a k be ore even n Fre burg H s ace seemed am ar—he was yp ca So was he boy w h whom he d scussed re g on He was cu rom he c o h rom wh ch a e makes sw nd ers when he me s r pe cunn ng mendac ous kep by h s ador ng re a ves n he be e ha he s a grea a en bu unpr nc p ed and w hou charac er have enough o h s rabb e 196
The m sread ng of the text s a repress on of the d scourse of the ma e Eastern Jew—the parvenu marked by h s anguage and d scourse as d fferent and d seased. H dden w th n the fema e gen ta a (the Schmuckkasten ) s the mage of the ma e Jew as represented by h s gen ta a (the Schmock ). The rep acement of the "Jew sh" pen s— dent f ab e as c rcumc sed and, as we sha see, as d seased, by the "German" vag na stands at the center of Freud s rev s on of the dent ty of Ida Bauer. In my study Jew sh Se f-Hatred , I have extens ve y shown that an anc ent Western trad t on abe s the anguage of the Jew as corrupt and corrupt ng, as the s gn of the nherent d fference of the Jew. [197] Th s trad t on sees the Jew as nherent y unab e to have command of any "Western"—that s, cu tura — anguage ( ndeed, even the "ho y anguage," Hebrew). The Jew s not on y "not of our b ood," as Mons gnor Joseph Fr ngs of Co ogne expressed t n 1942, but a so "does not speak our anguage." [198] For the accu turated Eastern Jew n V enna, mausche n ,
426 the speak ng of German w th a Y dd sh accent, ntonat on, or vocabu ary, s the s gn of th s d fference. And th s s the anguage of Freud s mother, Ama a Freud née Nathanson, the nv s b e woman n a of h s autob ograph ca accounts. As Freud s son Mart n noted, she was a Ga c an Jew from Brody who rema ned a typ ca Po sh Jew, " mpat ent, se f-w ed, sharp-w tted and h gh y nte gent." She reta ned the anguage, manner, and be efs of Ga c a:
She was abso u e y d eren rom Jews who had ved n he Wes or some genera ons These Ga c an Jews had e grace and no manners and he r women were cer a n y no wha we shou d ca " ad es " They were h gh y emo ona and eas y carr ed away by he r ee ngs They were no easy o ve w h and grandmo her a rue represen a ve o her race was no excep on She had grea v a y and much mpa ence 199
It s n the mage of the mother that the qua t es ascr bed to the hyster c, to Ida Bauer, can be found. In suppress ng the sh ft of anguage, Freud a so suppresses the "h dden" reference to the "Jew sh" pen s. The h dden d scourse of the Jew, h dden w th n the h gh German cu ture d scourse, s gnored. Th s "m sread ng" of the fema e for the ma e organ s n truth a "m ssee ng" of the gen ta a as Freud traces the or g n of Ida Bauer s know edge of the act of fe at o, the "see ng" as we as suck ng of the ma e member. Freud understands th s "so-ca ed sexua pervers on" as be ng "very w de y d ffused among the who e popu at on, as everyone knows except med ca wr ters upon the sub ect. Or, I shou d rather say, they know t too; on y they take care to forget t at the moment when they take up the r pens to wr te about t. So t s not to be wondered at that th s hyster ca g r of n neteen, who had heard of the occurrence of such a method of sexua ntercourse (suck ng at the ma e organ), shou d have deve oped an unconsc ous phantasy of th s sort and shou d have g ven t express on by an rr tat on n her throat and by cough ng." [200] Freud reports that Dora s governess, to whom she was ev dent y as attracted as she was to Frau K., "used to read every sort of book on sexua fe and s m ar ob ects, and ta ked to the g r about them, at the same t me ask ng her qu te frank y not to ment on the r conversat ons to her parents, as one cou d never te what ne they m ght take about them." [201] But t s c ear accord ng to Ida Bauer s account that she d d not on y "hear" about such sexua act v ty but earned about t n qu te another way. Later n the case study, after Freud had begun to exp a n the homosexua attract on wh ch Dora fe t for Frau K., th s narrat ve sh fts.
427 After Dora s father wr tes to Herr K. to demand an exp anat on of h s act ons toward h s daughter, Herr K. "spoke of her w th d sparagement, and produced as h s trump card the ref ect on that no g r who read such books and was nterested n such th ngs cou d have any t t e to a man s respect. Frau K. had betrayed her and had ca umn ated her; for t had on y been w th her that she had read Mantegazza and d scussed forb dden top cs." [202] It s the book, a fore gn book, that " nfects" her, and makes her "s ck," that s, "hyster c." L ke her governess, Frau K. had used her to get access to her father. Th s "error" n Freud s mage of the et o ogy of hyster a s a d sp acement of the mage of the nfected and the nfect ng onto the wor d of h gh cu ture—not "German" h gh cu ture (B dung ), of course, but the med ca cu ture of the sexo og st. Pao o Mantegazza (1831-1901) was one of the standard ethno og ca sources for the ate n neteenth century for the nature of human sexua ty. H s three-vo ume study of the phys o ogy of ove, the hyg ene of ove, and the anthropo ogy of ove was the standard popu ar ntroduct on to the acceptab e soc a d scourse on sexua ty n ate n neteenth-century Europe. [203] H s mportance for Freud shou d not be underest mated. One of a group of phys c an-anthropo og sts (such as Cesare Lombroso), Mantegazza had p oneered the ntroduct on of the study (and en oyment) of Erthroxy on coca and ts der vat ve, coca ne, n the ate 1850s. Fo ow ng the pub cat on of Darw n s Descent of Man , Mantegazza became one of Darw n s most av d correspondents (and sources), supp y ng Darw n w th a ser es of "anthropo og ca " photographs that Darw n used for h s ater work. Mantegazza s work, ke that of Charcot, emphas zed the "see ng" of d fference, a v ew that s ep tom zed n Mantegazza s bas c study of phys ognomy and express on of 1885. But for ate n neteenth-century sc ence the controvers a centerp ece of Mantegazza s work s h s tr ogy on ove and sex: F s o og a de amore (1872), Ig ene de amore (1877), and G amor deg uom n (1885). [204] C ted w de y by sexo og sts from Cesare Lombroso, R chard Krafft-Eb ng, Have ock E s, and Iwan B och to Magnus H rschfe d, Mantegazza rema ned one of the access b e, "popu ar" sources for sc ent f c know edge (and m s nformat on) for the educated pub c at the turn of the century. It s c ear that Ida Bauer cou d have read (and probab y d d read) e ther Mantegazza or s m ar texts, whether under the tute age of her compan on or on her own n t at ve. What s of nterest s how Freud reads th s contrad ct on n her account: D d she read them, or on y hear about the r content? What s nherent y dangerous about Mantegazza from the standpo nt of Freud s refusa to re ate to the accusat on that Ida Bauer had read h m? If we turn to
428 the tr ogy, t s c ear (and Made on Spregnether agrees [205] ) that the text that best f ts the pe orat ve descr pt on of Herr K. s the f na text n th s ser es, on the anthropo ogy of sexua ty. [206] There one f nds an extended d scuss on of "the pervers ons of ove," nc ud ng "mutua onan sm," " esb an sm and tr bad sm," as we as "h stor es" of these pract ces. (However, there are s m ar d scuss ons n the seventh chapter of Mantegazza s study on the "hyg ene of ove," wh ch deta s the "errors of the sexua dr ve.") Now th s s c ear y what Freud shou d have understood—g ven h s read ng—as of mportance to Ida Bauer, but what n th s vo ume wou d have been of mportance to S gmund Freud? If we turn to the chapter after the one on "pervers ons," we come to a deta ed d scuss on of the "mut at on of the gen ta s," wh ch recounts the h story of these pract ces among "savage tr bes" nc ud ng the Jews. Indeed, t s on y n Mantegazza s d scuss on of the Jews that the text turns from a t t at ng account of "unnatura pract ces" nto an En ghtenment po em c aga nst the perverse pract ces of that peop e out of the r correct "space" and "t me"—the Jews:
C rcumc s on s a shame and an n amy and who am no n he eas an -Sem c who ndeed have much es eem or he srae es who demand o no v ng sou a pro ess on o re g ous a h ns s ng on y upon he bro herhood o soap and wa er and o hones y shou and sha con nue o shou a he Hebrews un my as brea h Cease mu a ng yourse ves cease mpr n ng upon your esh an od ous brand o d s ngu sh you rom o her men un you do h s you canno pre end o be our equa As s you o your own accord w h he brand ng ron rom he rs days o your ves proceed o proc a m yourse ves a race apar one ha canno and does no care o m x w h ours
It s c rcumc s on that sets the (ma e) Jew apart. In h s d ssertat on of 1897 Armand-Lou s-Joseph Béraud notes that the Jews needed to c rcumc se the r young ma es because of the r nherent y unhyg en c nature, but a so because the "c mate n wh ch they dwe t" otherw se encouraged the transm ss on of syph s. [207] The Jew n the D aspora s out of t me (hav ng forgotten to van sh ke the other anc ent peop es); s out of correct space (where c rcumc s on had va d ty). H s Jew shness (as we as h s d sease) s nscr bed on h s pen s. But what does c rcumc s on mean for a V ennese Jew sh sc ent st at the end of the 1800s? The debates w th n and w thout the Jew sh commun t es concern ng the nature and mp cat on of c rcumc s on surfaced aga n n Germany dur ng the 1840s. German Jews had become
429 accu turated nto German m dd e-c ass va ues and had come to quest on the abso ute requ rement of c rcumc s on as a s gn of the r Jew sh dent ty. Led by the rad ca reform rabb Samue Ho dhe m n Germany and respond ng to a Chr st an trad t on that den grated c rcumc s on, the debate was carr ed out as much n the sc ent f c press as n the re g ous one. [208] There were four "trad t ona " v ews of the "mean ng" of c rcumc s on s nce the r se of Chr st an ty. Fo ow ng the wr t ngs of Pau , the f rst saw c rcumc s on as nherent y symbo c and, therefore, no onger va d after the r se of Chr st an ty (th s v ew was espoused by Euseb us and Or gen); the second saw c rcumc s on as a form of med ca prophy ax s (as n the wr t ng of Ph o but a so n the work of the centra German commentator of the e ghteenth century, Johann Dav d M chae s); the th rd saw t as a s gn of a po t ca dent ty (as n the work of the ear y e ghteenth-century theo og an Johann Spencer); the fourth saw t as a remnant of the ear y Jew sh do or pha us worsh p (as n the work of the ant quar an Georg Fr edr ch Daumer—th s v ew reappears qu te often n the terature on Jew sh r tua murder). In the med ca terature of the t me, two of these v ews dom nated. They were the v ews that bracketed the mages of "hea th" and "d sease." These v ews saw c rcumc s on e ther as the source of d sease or as a prophy ax s aga nst d sease—and n both cases syph s and masturbat on, the two "d seases" that dom nate the case of Dora, p ay a ma or ro e. Mantegazza notes that "the hyg en c va ue of c rcumc s on has been exaggerated by the h stor ans of Juda sm. It s true enough that the c rcumc sed are a tt e ess d sposed to masturbat on and to venerea nfect on; but every day, we do have Jew sh masturbators and Jew sh syph t cs. C rcumc s on s a mark of rac a d st nct on; . . . t s a sangu nary protest aga nst un versa brotherhood; and f t be true that Chr st was c rcumc sed, t s kew se true that he protested on the cross aga nst any symbo wh ch wou d tend to part men asunder." The oppos ng v ew of c rcumc s on n the sc ent f c terature of the t me saw c rcumc s on as a mode of prevent on that prec uded the transm ss on of sexua y transm tted d seases because of the ncreased capac ty for "c ean ness." [209] It s c ass f ed as an aspect of "hyg ene," the favor te word to cr t que or support the pract ce. (Th s v ew s c ose y assoc ated w th the therapeut c use of c rcumc s on throughout the n neteenth century as a means of "cur ng" the d seases caused by masturbat on, w th, of course a s m ar sp t n the dea of eff cacy: c rcumc s on was e ther a cure for masturbat on, as t e m nated the st mu at on of the prepuce and deadened the sens t v ty of the pen s, or t was the source of Jew sh ma e hypersexua ty.) A deta ed med ca terature nks the very act of c rcumc s on w th
430 the transm ss on of syph s, so that the prophy ax s becomes the source of nfect on. The terature that d scusses the transm ss on of syph s to new y c rcumc sed nfants through the r tua of mets tsah , the suck ng on the pen s by the mohe , the r tua c rcumc ser, n order to staunch the b eed ng, s extens ve and deta ed. [210] The mets tsah was understood by the sc ent f c commun ty of the n neteenth century as a "patho og ca " one, as t was abe ed as the source of the transm ss on of d sease from the adu t ma e to the ma e ch d. In the estab shment of the V ennese Jew sh commun ty dur ng the course of the ear y n neteenth century the debate on the abo t on of c rcumc s on was heard as oud y as anywhere e se n Centra Europe. Isaac Noah Mannhe mer, the rabb of the Se tenstettengasse synagogue and the de facto "ch ef rabb " of V enna (a though th s t t e d d not off c a y ex st), wh e a fo ower of Reformed Juda sm, opposed the more rad ca "reforms" of theo og ans such as Samue Ho dhe m. He strong y advocated the retent on of Hebrew as the anguage of prayer (even though he had preached n Dan sh dur ng h s tenure n Copenhagen) and opposed m xed marr ages and the abo t on of c rcumc s on. (The nk among these three centra ssues n the se f-def n t on of V ennese Jewry at m d-century shou d be stressed.) Wh e no comprom se was found on the f rst two ssues (Hebrew was ma nta ned as the anguage of the turgy and m xed marr ages were not author zed), a str k ng comprom se was found n the th rd case. Together w th Rabb Lazar Horow tz, the sp r tua eader of the orthodox commun ty n V enna, they abo shed the pract ce of the mets tsah . [211] A though Horow tz was a fo ower of the u traorthodox Pressburg Rabb Moses Sofer, the abo t on of the mets tsah became a marker between the pract ces of V ennese Jewry (wh ch d d not perm t t for "hyg en c" reasons) and the trad t on of Eastern Jewry, such as the Jews of Pressburg and Fre burg (where Freud was c rcumc sed). Here s the nk between the emphas s on fe at o n Freud s read ng of the case of Dora and the syph s that haunts the mage of the (ma e) Jew n the case. It s the ma e suck ng the pen s of a ma e n the act of c rcumc s on. Espec a y n the V ennese debates concern ng the retent on or abo t on of c rcumc s on, th s "act" p ayed a spec a ro e. For Freud the act of fe at o wou d be a s gn not on y of "pervers on" but a so of the transm ss on of d sease; t wou d a so be a s gn that ncorporated h s own re at onsh p between h s rac a dent ty w th h s core g on sts and, ndeed, w th other ma e author ty f gures. Thus the act of the fema e suck ng on the pen s of the ma e, a "patho og ca " act as t represents the spread of d sease (hyster a) to the daughter, s a sub-
431 mat on of the act of the ma e suck ng on the pen s of the ma e and spread ng another d sease, syph s. It a so represents, n the per od dur ng wh ch Freud was wr t ng and rewr t ng the case of Dora, Freud s own art cu at on of the end of h s "homosexua " ( .e., homoerot c) re at onsh p w th W he m F ess, whose theor es about the re at onsh p between the nose and the pen s are echoed n th s case study as we as e sewhere n the f n-de-s èc e work of Freud. [212] But read ng Mantegazza, we can go one step farther n our ana ys s of Freud s understand ng of the mean ng of sexua y transm tted d sease and ts re at onsh p to hyster a. For Mantegazza ntroduces h s d scuss on of the exc us v ty of the Jews w th the fo ow ng d scuss on:
s a oge her ke y ha he mos mpor an reason ha has ed men o var ous ages and o vary ng c v za ons o adop he cus om o cu ng o he prepuce has been ha was e o be necessary o mpr n upon he human body a c ear and nde b e s gn ha wou d serve o d s ngu sh one peop e rom ano her and by pu ng a sea o consecra on upon na ona y wou d end o mpede he m x ure o races A woman be ore accep ng he embraces o a man mus rs make sure w h her eyes and w h her hands as o whe her he was o he c rcumc sed or he unc rcumc sed nor wou d she be ab e o nd any excuse or m ng ng her own b ood-s ream w h ha o he ore gner had however no occurred o he eg s a or ha h s same nde b e charac er s c wou d nsp re n he woman a cur os y o see and o hand e men o a d eren sor
The seduct on of the Jew sh woman by the Other—whether the non-Jew or the esb an— s the resu t of the "see ng" of the d fference n the form of the gen ta a. The need to "see" and "touch" the Other s the fau t of the c rcumc sed (ma e) Jew, whose very phys ca form tempts the fema e to exp ore the Other. Here we have another form of the d sp acement of the act of touch ng (sexua contact) w th the perm tted ( ndeed, necessary) act of see ng, but g ven a patho og ca nterpretat on. The re ect on of m xed marr age and convers on by even "god ess" Jews such as S gmund Freud at th s t me s a s gn of the need to understand the separateness of the Jew as hav ng a pos t ve va ence. The abe ng of converts as "s ck" becomes a w de y used f n-de-s èc e trope. [213] Ida Bauer s act of see ng her father s the act of see ng the (ma e) Jew. Centra to the def n t on of the Jew—here to be understood a ways as the "ma e" Jew— s the mage of the ma e Jew s c rcumc sed pen s as mpa red, damaged, or ncomp ete and therefore threaten ng. The terature on syph s—wh ch certa n y p ayed a ro e n Freud s understand ng of her father s ness as we as that of the daughter—conta ns a substant a d scuss on of the spec a re at onsh p of Jews to the transm ss on and
432 mean ng of syph s. For t s not on y n the act of c rcumc s on that th s assoc at on s made— t s n the genera r sk of the Jews as the carr ers of syph s and the genera zed fear that such d sease wou d underm ne the strength of the body po t c. Centra to the case of Ida Bauer s a subtext about the nature of Jews, about the transm ss on of syph s, and about the act of c rcumc s on. [214] Both are assoc ated w th the mage of the hyster c. It s Jew shness that s the centra category of rac a d fference for the German reader and wr ter of the turn of the century. [215] For the Jew n European sc ence and popu ar thought was c ose y re ated to the spread and nc dence of syph s. Such v ews had two read ngs. The f rst mode saw the Jews as the carr ers of sexua y transm tted d seases who transm tted them to the rest of the wor d. And the r ocat on s the c ty—V enna. Here the nk between the dea of the Jew as c ty dwe er, as the d sease that urks w th n the conf nement of the urban env ronment, becomes man fest. The source of the hyster a of the c ty s the d seased sexua ty of the Jew. Th s v ew s to be found n Ado f H t er s d scuss on of syph s n turn-of-the-century V enna n Me n Kampf (1925). There he ( ke h s V ennese compatr ot Bertha Pappenhe m[216] ) nks t to the Jew, the prost tute, and the power of money:
Par cu ar y w h regard o syph s he a ude o he na on and he s a e can on y be des gna ed as o a cap u a on The nven on o a remedy o ques onab e charac er and s commerc a exp o a on can no onger he p much aga ns h s p ague The cause es pr mar y n our pros u on o ove Th s Jew ca on o our sp r ua e and mammon za on o our ma ng ns nc w sooner or a er des roy our en re o spr ng 217
H t er s v ews a so nked Jews w th prost tutes and the spread of nfect on. Jews were the archp mps—Jews ran the brothe s—but Jews a so nfected the r prost tutes and caused the weaken ng of the German nat ona f ber. [218] But a so, Jews are assoc ated w th the fa se prom se of a med ca cure separate from the soc a cures that H t er w shes to see mposed— so at on and separat on of the syph t c and h s or her Jew sh source from the body po t c. H t er s reference s to the be ef that espec a y the spec a ty of dermato ogy and syph o ogy was dom nated by Jews, who used the r med ca status to se quack cures. The second mode that assoc ated Jews and syph s seemed to postu ate exact y the oppos te—that Jews had a stat st ca y ower rate of syph t c nfect on—because they had become mmune to t through centur es of exposure. In the med ca terature of the per od, reach ng across a of European med c ne, t was assumed that Jews had a notab y
433 ower rate of nfect on. In a study of the nc dence of tert ary ues n the Cr mea undertaken between 1904 and 1929, the Jews had the owest cons stent rate of nfect on. [219] In an e ghteen-year ong tud na study H. Bude demonstrated the extraord nar y ow rate of tert ary ues among Jews n Eston a dur ng the prewar per od. [220] A these stud es assumed that b o og ca d fference as we as the soc a d fference of the Jews were at the root of the r seem ng mmun ty. Jew sh sc ent sts a so had to exp a n the stat st ca fact of the r mmun ty to syph s. In a study of the rate of tert ary ues, the f na stage of the syph t c nfect on, undertaken dur ng Wor d War I, the Jew sh phys c an Max S che responded to the genera v ew of the re at ve ower nc dence of nfect on among Jews as resu t ng from the sexua d fference of the Jews. [221] He responds— out of necess ty—w th a soc a argument. The Jews, accord ng to S che , show ower nc dence not on y because of the r ear y marr age and the patr archa structure of the Jew sh fam y, but a so because of the r much ower rate of a coho sm. They were, therefore, accord ng to the mp c t argument, more rare y exposed to the nfect on of prost tutes, whose attract veness was a ways assoc ated w th the greater oss of sexua contro n the ma e attr buted to nebr ety. The re at onsh p between these two "soc a " d seases s made nto a cause for the h gher nc dence among other Europeans. The Jews, because they are ess ke y to dr nk heav y, are ess ke y to be exposed to both the deb tat ng effects of a coho (wh ch ncrease the r sk for tert ary ues) as we as the occas on for nfect on. In 1927 H. Strauss ooked at the nc dences of syph t c nfect on n h s hosp ta n Ber n n order not on y to demonstrate whether the Jews had a ower nc dence but a so to see (as n the nfamous Tuskegee exper ments among b acks n the Un ted States) whether they had "m der" forms of the d sease because of the r fe-sty e or background. [222] He found that Jews had ndeed a much ower nc dence of syph s (wh e hav ng an extraord nar y h gher rate of hyster a) than the non-Jew sh contro . He proposes that the d sease may we have a d fferent course n Jews than n non-Jews. The marker for such a v ew of the he ghtened suscept b ty or res stance to syph s s the bas c s gn of d fference of the Jews, the c rcumc sed pha us. The need to "see" and " abe " the Jew at a t me when Jews were becom ng more and more ass m ated and therefore " nv s b e" n Germany made the assoc at on w th soc a y st gmat z ng d seases that bore spec f c v s b e "s gns and symptoms" espec a y appropr ate. Mantegazza s v ew nks the act of "see ng" the Jew sexua y w th the defamed pract ce of c rcumc s on. In the German emp re of the ate n neteenth century a of the arguments p aced the Jew n a spec a re at onsh p to
434 syph s and, therefore, n a very spec a re at onsh p to the hea thy body po t c that needed to make the Jew v s b e. (The centra med ca parad gm for the estab shment of the hea thy state was the pub c hea th mode that evo ved spec f ca y to combat the ev s of sexua y transm tted d sease through soc a contro .) Western Jews had been comp ete y accu turated by the end of the n neteenth century and thus bore no externa s gns of d fference (un que c oth ng, group anguage, group-spec f c ha r and/or beard sty e). They had to bear the st gma of th s spec a re at onsh p to the r d seased nature tera y on the sk n, where t cou d be seen. Not on y on the pen s where (because of soc a pract ce) t cou d be "seen" on y n the sexua act. And then, because of the gradua abandonment of c rcumc s on, be "seen" not to ex st at a ! Just as the hyster c s constructed out of the perce ved ab ty to categor ze and c ass fy categor es of d fference v sua y, the syph t c Jew has h s ness wr tten on h s sk n. The sk n of the hyster c, ke the phys ognomy of the hyster c, ref ects the essence of the d sease. Thus the sk n becomes a ver tab e canvas onto wh ch the ness of the hyster c s mapped. See ng the hyster c means read ng the s gns and symptoms (the st gmata d abo ) of the d sease and represent ng the d sease n a manner that captures ts essence. It s the reduct on of the amb guous and f eet ng s gns of the constructed ness of the hyster c (constructed by the very nature of the def n t on of the d sease n the n neteenth century). If the dea of the hyster c s t ed to the dea of the fem n zat on of the hea thy Aryan ma e, or h s "Jew f cat on" (to use one of H t er s favor te terms), then the representat on of the d sease must be n terms of mode s of ness that are convert b e nto the mages of the fem n zed ma e. But these mages of fem n zat on are a so t ed to other, sa ent, f n-de-s èc e mages of race. For Jews bear the sa ent st gma of the b ack sk n of the syph t c, the syph t c rup a . The Jews are b ack, accord ng to n neteenth-century rac a sc ence, because they are "a mongre race wh ch a ways reta ns th s mongre character." That s Houston Stewart Chamber a n argu ng aga nst the "pure" nature of the Jew sh race. [223] Jews had "hybr d zed" w th b acks n A exandr an ex e. They are, n an ron c rev ew of Chamber a n s work by Nathan B rnbaum, the V ennese-Jew sh act v st who co ned the word Z on st , a "bastard" race the or g n of wh ch was caused by the r ncestuousness, the r sexua se ect v ty. [224] But the Jews were a so seen as b ack. Adam Gurowsk , a Po sh nob e, "took every ght-co ored mu atto for a Jew" when he f rst arr ved n the Un ted States n the 1850s. [225] Jews are b ack because they are d fferent, because the r sexua ty s d fferent, because the r sexua patho ogy s wr tten upon the r sk n. Gurowsk s
435 "German-Jew sh" contemporary, Kar Marx, assoc ates eprosy, Jews, and syph s n h s descr pt on of h s archr va Ferd nand Lassa e ( n 1861): "Lazarus the eper, s the prototype of the Jews and of Lazarus-Lassa e. But n our Lazarus, the eprosy es n the bra n. H s ness was or g na y a bad y cured case of syph s." [226] The pathognomon c s gn of the Jew s wr tten on the sk n; t s ev dent for a to see. The patho og ca mage of the Jew was part of the genera cu tura vocabu ary of Germany. H t er used th s mage over and over n Me n Kampf n descr b ng the Jew s ro e n German cu ture: "If you cut even caut ous y nto such an abscess, you found, ke a maggot n a rott ng body, often dazz ed by the sudden ght—a k ke! . . . Th s was pest ence, sp r tua pest ence, worse than the B ack Death of o den t mes, and the peop e were be ng nfected by t." "P ague" (Seuche ) and pest ence (Pest enz )—a d sease from w thout, wh ch, ke syph s, rots the body—was the mode used to see the ro e of the Jew. The syph t c weaken ng of the rac a y pure Germans by the Jews was kened by H t er to the corrupt on of the b ood of the race through another form of "mammon zat on," nterrac a marr age:
Here we have be ore us he resu s o procrea on based par y on pure y soc a compu s on and par y on nanc a grounds Th s one eads o a genera weaken ng he o her o a po son ng o he b ood s nce every depar men s ore Jewess s cons dered o augmen he o spr ng o H s H ghness—and ndeed he o spr ng ook n bo h cases comp e e degenera on s he consequence
If the Germans (Aryans) are a "pure" race—and that s for turn-of-the-century sc ence a pos t ve qua ty—then the Jews cannot be a "pure" race. The r status as a m xed race became exemp f ed n the con of the M sch ng dur ng the 1930s. The Jew shness of the M sch ng , to use the term from rac a sc ence that s para e to "bastard" (the offspr ng of a "B ack" and a "Wh te" "race"), " ooks" and sounds degenerate. They can have "Jew sh-Negro d" [ üd sch-negro d ] features. [227] And th s s often assoc ated w th the r fac e use of anguage, "the use of nnumerab e fore gn words and new y created words to enr ch the German anguage n sharp contrast to the necessary s mp c ty of the anguage of German c students." [228] The Jew s anguage ref ects on y the corrupt on of the Jew and h s or her d scourse. It s the s gn of the "patho og ca ear y deve opment" of the M sch ng , who, as an adu t, s unab e to fu f the prom se of the member of a pure race. The weakness, but a so the degenerate fac ty, of the M sch ng s ana ogous to the mage of the offspr ng of the syph t c. And thus we come fu c rc e. For the Jew s contam nated
436 by hyster a, whether t s the resu t of the trauma of nfect on or of hered ty. And th s weakness of the race s h dden w th n the corrupted (and corrupt ng) nd v dua . Thus H t er s mage of the M sch ng s on the offspr ng of a "Jew sh" mother and an "Aryan" father—h dden w th n the name and German c neage of the ch d s the true corrupt on of the race, the materna neage of the Jew. And as Jews c a med the r neage through the mother (rather than through the father as n German aw) the M sch ng becomes the exemp ary h dden Jew ust wa t ng to corrupt the body po t c. The mage of the M sch ng , the person mpa red because of h s or her her tage, br ngs us back fu c rc e to the wor d of Ida Bauer. For here we have a of these themes of Jew sh d spos t on and rac a d agnos s summar zed. The mages that haunt Freud s representat on of Ida Bauer—her anguage, the sexua acts of her mag nat on, the r source, the re at onsh p between patho ogy and nfect on—are a "rac a y" marked (at east not ona y) n turn-of-the-century med ca cu ture. For Freud, abandon ng the act of see ng, an act made canon ca n the work of h s ant Sem t c mentor Charcot, s an abandonment of the assoc at ons of s ght w th n th s d scourse of sexua d fference. The case of Dora s an examp e of the power over anguage, of Freud s contro over the anguage of h s text, wh ch revea s h m not to be an Eastern Jew. L ke h s cr t que of the bad Greek of h s cr t cs when he he d h s f rst ta k on ma e hyster a n V enna, Freud s the master of the d scourse of sc ence and cu ture. Freud s a sc ent st who uses anguage as a sc ent st. In ntroduc ng the quest on of the nature of Ida Bauer s attract on to Frau K. he remarks: "I must now turn to cons der a further comp cat on, to wh ch I shou d certa n y g ve no space f I were a man of etters engaged upon the creat on of a menta state ke th s for a short story, nstead of be ng a med ca man engaged upon ts d ssect on." The act of wr t ng the story s the s gn of h s spec a contro of a "neutra " anguage, one that, as we have shown, s hard y neutra when t comes to p ac ng Freud, the Eastern ma e Jew, at ts center of r sk. The mean ng of the act of see ng for the Jew sh phys c an shows the nherent truth of Robert Re n nger s c a m that "Unser We tb d st mmer zug e ch e n Wertb d," [229] that we construct our understand ng of the wor d from our nterna zed system of va ues. Notes INTRODUCTION— THE DESTINIES OF HYSTERIA 1 See Jan Go ds e n Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1988) 2 See H E enberger The D scovery o he Unconsc ous The H s ory and Evo u on o Dynam c Psych a ry (New York Bas c Books 1962) E enberger was no ron ca y one o he pr nc pa rev ewers o Ve h s book (see n 3) 3 These are he wo men oned and here have been no h s or es o hys er a s nce 1900 The as one n French be ore Tr a s was G Abr cosso s L hys er e aux 17 e 18 s èc es (Par s G S e nh 1897) O n eres here s Tr a s br e bu va uab e d scuss on o he me hodo og ca ssues nvo ved n wr ng he rad ona h s ory o hys er a see E Tr a "Tro s néra res a ravers h s o re de hys er e " H s or e des Sc ences Méd ca es 21 (1987) 27-31 4 An dea o he d sc p nary m eu among med ca h s or ans n wh ch Ve h wro e s ga ned by consu ng Edw n C arke ed Modern Me hods n he H s ory o Med c ne (London A h one 1971) who wro e be ore he deo og es o c ass race and gender he d any sway n he h s ory o med c ne—h s p ea was or a ba ance be ween med ca ra n ng and know edge o h s ory bu was a nom na s c rea s c h s ory o persons p aces and h ngs n wh ch gender and sex c ass and race anguage and represen a on p ayed a sma ro e Ano her con emporary approach no very d eren rom Ve h s s ound n Maca p ne and R chard Hun er George and he Mad Bus ness (New York Pan heon Books 1969) wh ch sheds ur her gh on he d sc p ne o he h s ory o med c ne a he me and he ep s emo og ca prob ems nvo ved n he percep on o wr ng he h s ory o madness dur ng he 1960s For he h s or ography o med c ne se a scan d scourse n he as ha cen ury and as wou d have appeared n he m ndse o scho ars ke Ve h and o hers o her genera on see R H Shyrock "The H s or an Looks a Med c ne " Bu e n o he H s ory o Med c ne 5 (1937) 887-894 G Rosen "A Theory o Med ca H s or ography " b d 8 (1940) 655-665 dem "Leve s o n egra on n Med ca H s or ography " Journa o he H s ory o Med c ne 4 (1949) 460-467 George Mora Psych a ry and s H s ory Me hodo og ca Prob ems n Research (Spr ng e d Mass C C Thomas 1970) works ha represen a por on o he me hodo og ca a mosphere n wh ch Ve h wro e 3 These are he wo men oned and here have been no h s or es o hys er a s nce 1900 The as one n French be ore Tr a s was G Abr cosso s L hys er e aux 17 e 18 s èc es (Par s G S e nh 1897) O n eres here s Tr a s br e bu va uab e d scuss on o he me hodo og ca ssues nvo ved n wr ng he rad ona h s ory o hys er a see E Tr a "Tro s néra res a ravers h s o re de hys er e " H s or e des Sc ences Méd ca es 21 (1987) 27-31 4 An dea o he d sc p nary m eu among med ca h s or ans n wh ch Ve h wro e s ga ned by consu ng Edw n C arke ed Modern Me hods n he H s ory o Med c ne (London A h one 1971) who wro e be ore he deo og es o c ass race and gender he d any sway n he h s ory o med c ne—h s p ea was or a ba ance be ween med ca ra n ng and know edge o h s ory bu was a nom na s c rea s c h s ory o persons p aces and h ngs n wh ch gender and sex c ass and race anguage and represen a on p ayed a sma ro e Ano her con emporary approach no very d eren rom Ve h s s ound n Maca p ne and R chard Hun er George and he Mad Bus ness (New York Pan heon Books 1969) wh ch sheds ur her gh on he d sc p ne o he h s ory o med c ne a he me and he ep s emo og ca prob ems nvo ved n he percep on o wr ng he h s ory o madness dur ng he 1960s For he h s or ography o med c ne se a scan d scourse n he as ha cen ury and as wou d have appeared n he m ndse o scho ars ke Ve h and o hers o her genera on see R H Shyrock "The H s or an Looks a Med c ne " Bu e n o he H s ory o Med c ne 5 (1937) 887-894 G Rosen "A Theory o Med ca H s or ography " b d 8 (1940) 655-665 dem "Leve s o n egra on n Med ca H s or ography " Journa o he H s ory o Med c ne 4 (1949) 460-467 George Mora Psych a ry and s H s ory Me hodo og ca Prob ems n Research (Spr ng e d Mass C C Thomas 1970) works ha represen a por on o he me hodo og ca a mosphere n wh ch Ve h wro e 5 For med c ne and me aphor see Susan Son ag ness as Me aphor (New York Random House 1979) C M Anderson R chard Se zer and he Rhe or c o Surgery (Carbonda e Sou hern nv s b e nvaders The S ory o he Emerg ng Age o V ruses (New York L e Brown
no s Un vers y Press 1989) P Rades sky The
6 The newer approaches had been an c pa ed n he 1960s by E L En ra go n Doc or and Pa en (London We den e d & N cho son 1969) bu see a so C Webs er "Med c ne as Soc a H s ory Chang ng deas on Doc ors and Pa en s n he Age o Shakespeare " n A Ce ebra on o Med ca H s ory ed L S evenson (Ba more Johns Hopk ns Un vers y Press 1982) Roy and Doro hy Por er Pa en s Progress Doc ors and Doc or ng n E gh een h Cen ury Eng and (Ox ord Po y Press 1989) Roy and Doro hy Por er n S ckness and n Hea h The Br sh Exper ence 1650-1850 (London Four h Es a e 1988) Roy Por er Hea h or Sa e Quackery n Eng and 166o-1850 (Manches er Manches er Un vers y Press 1989) 7 For he broad h s or ca approach see G S Rousseau ed The Languages o Psyche M nd and Body n En gh enmen Though (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1990) 8 The mos horough h s or ca background rema ns Go ds e n s Conso e and C ass y bu ano her good p ace o s ar w h n he rea m o heory s he d verse d scourse o pos -Lacan an em n s heory as ound n E Grosz Jacques Lacan A Fem n s n roduc on (New York Rou edge Chapman & Ha 1990) E Page s Adam Eve and he Serpen (New York V n age Books 1989) C J Adams The Sexua Po cs o Mea (Ox ord Po y Press 1990) hemse ves mmense y d verse and as u e and nked on y by he r concern or he ema e p gh n he wor d o pos s ruc ura sm and pos modern sm An mpor an s a emen o he ep s emo og ca prob ems nvo ved s ound n n Dora s Case Freud — Hys er a — Fem n sm ed C K Bernhe mer and C a re Kahane (New York Co umb a Un vers y Press 1985) For conography and hys er a see H Speer conograph a Gyn a r ca A P c or a H s ory o Gyneco ogy and Obs e r cs (New York Macm an 1973) or em n sm and Freud D S verman Ar Nouveau n F n-de-S èc e France Po cs Psycho ogy and S y e (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1989) An approach o some o hese prob ems grounded n Roman c era ure s ound n D L Hoeve er Roman c Androgyny The Woman W h n (Un vers y Park Pa Penn S a e Un vers y Press 1990) 9 For anguage and soc a h s ory as hey mp nge on he d scourses o hys er a and on var ous heor es o med c ne see G S Rousseau "Towards a Sem o cs o he Nerve The Soc a H s ory o Language n a New Key " n Language Se Soc e y A Soc a H s ory o Language ed Pe er Burke and Roy Por er (Ox ord Po y Press 1991) 213-275 Rousseau "L era ure and Med c ne The S a e o he F e d " s s 52 (1981) 406-424 10
and
um na ng or br ng ng oge her many o he deas o hese heor s s s E Grosz Sexua Subvers ons Three French Fem n s s (Sydney Bos on A en & Unw n 1989)
11 As ev denced n he w de a en on g ven o h s unc ure n con emporary psychoana y c era ure and n he con emporary ourna L era ure and Med c ne as we as n such books (chrono og ca y arranged and a mere samp ng) as J B Lyons James Joyce and Med c ne (Dub n Do men Press 1973) R An on o Rabe a s e a medec ne (Geneva Dros 1976) E Pesche Med c ne and L era ure (New York Nea e Wa son Academ c Pub ca ons 1980) S S Lanser "Fem n s Cr c sm The Ye ow Wa paper and he Po cs o Co or n Amer ca " Fem n s S ud es 15 (1989) 415-441 T Caramagno V rg n a Woo (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1991) a s udy o her depress on and men a ma ad es R Lu z Neuras hen a (New York 1991) For more popu ar s a emen s abou he rea and represen a ona a n es o he wo rea ms see McG chr s "D sease and he Nove 1880-1960 " TLS January 17 1986 61 and Leon Ede "D sease and he Nove " TLS May 30 1986 591 con r bu ons o a deba e on he sub ec 12 However s gn can he Darw n an me aphors o r se and a evo u on and ow are n h s con ex hey are ess v a han he soc a cons ruc on o hys er a ndeed he deba e be ween soc a cons ruc on s s and rea s s or essen a s s has reached ep c propor ons as group a er group decodes he s reng hs o each me hod some com ng down on he s de o he one some on he o her and some (such as John Boswe he Ya e h s or an o homosexua y n ear y modern c v za on) or a b end ng o he wo Bu he po cs o represen a on a so pose cruc a ques ons do we choose our represen a ons because hey are power- n uenced and hereby capab e o enhanc ng our own pos ons (as M che Foucau argued) or because hey are n some abs rac on o og ca sense rue (as n he ongo ng curren deba es n he new y deve op ng e d o era ure and sc ence)? The an agon sms o rea sm and soc a cons ruc on sm have emerged as a e d n se pos ng new prob ems or he decade o mu cu ura sm and no w hou genu ne mp ca ons or he cons ruc on o he ca egory hys er a For an c pa ons o he deba e n bo h med c ne and ph osophy see P Wr gh and A Treacher eds The Prob em o Med ca Know edge Exam n ng he Soc a Cons ruc on o Med c ne (Ed nburgh Ed nburgh Un vers y Press 1982) O Moscucc The Sc ence o Woman Gyneco ogy and Gender n Eng and 1800-1929 (Cambr dge Cambr dge Un vers y Press 1990) C E Russe Sexua Sc ence The V c or an Cons ruc on o Womanhood (Cambr dge Mass Harvard Un vers y Press 1989) Paperno Chernyshevsky and he Age o Rea sm A S udy n he Sem o cs o Behav or (S an ord Ca S an ord Un vers y Press 1989) J Lep n ed Sc en c Rea sm (Berke ey Los Ange es London Un vers y o Ca orn a Press 1984) D F Greenberg The Cons ruc on o Homosexua y (Ch cago Un vers y o Ch cago Press 1989) 13 An essen a ask o h s book or examp e s he char ng o hese ga ns and osses n some de a dur ng he cen ur es ha orm he bas s o modern European cu ure rom he Rena ssance o he end o he En gh enmen v a epochs whose med c ne and cer a n y whose hys er a have been d scussed much ess han hey deserve 14 One correc ve o h s h s or ca y a se v ew s ound n he mpor an work o Jan Go ds e n see espec a y her Conso e and C ass y 15 The "mechan ca revo u on" has pro ed rom hree decades o super or scho arsh p bu he s udy o he "nervous revo u on" con nues o e n a more pr m ve s a e w h n he h s ory o sc ence and med c ne has been he sub ec o recen scho arsh p among neurochem s s neurophys o og s s med ca h s or ans and h s or ans o sc ence or a comprehens ve s a emen o he prob em see G S Rousseau "Cu ura H s ory n a New Key Towards a Sem o cs o he Nerve " n n erpre a on n Cu ura H s ory ed Joan P ock and Andrew Wear (London Macm an 1991) 25-81 J Mu an Hypochondr a and Hys er a Sens b y and he Phys c ans " 25 (1984) 141-177 w h n he h s ory o deas M Ka ch The Assoc a on o deas and Cr ca Theory n E gh een h Cen ury Eng and (The Hague Mou on 1970) M H Abrams The M rror and he Lamp Roman c Theory and he Cr ca Trad on ( haca N Y Corne Un vers y Press 1953) or he V c or ans J Oppenhe m " Sha ered Nerves" Doc ors Pa en s and Depress on n V c or an Eng and (Ox ord Ox ord Un vers y Press 1991) 16 These cons s enc es and con rad c ons and he r par cu ar cu ura and h s or ca appearances orm one o he cen ra hemes o h s book They cons u e a ur her reason ha we do no c a m o wr e here pr mar y as "h s or ans o med c ne" bu as s uden s o he n ersec on o d scourse and cu ure For aspec s o h s n ersec on see S Bens ock Tex ua z ng he Fem n ne On he L m s o Genre (Norman Un vers y o Ok ahoma Press 1991) and T mo hy Re ss The D scourse o Modern sm ( haca N Y Corne Un vers y Press 1982) 17 For an examp e o wha he abs rac po n means or he prac c ng h s or an see Londa Sch eb nger The M nd Has No Sex? Women n he Or g ns o Modern Sc ence (Cambr dge Harvard Un vers y Press 1989) 18 Ano her examp e proceed ng n h s care u ph o og ca manner or he M dd e Ages s he work o Caro ne Bynum n Ho y Feas and Ho y Fas The Re g ous S gn cance o Food o Med eva Women (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) dem Gender and Re g on On he Comp ex y o Symbo s (Bos on Beacon Press 1986) 19 For hese a er nven ons see S mon Benne M D M nd and Madness n Anc en Greece ( haca N Y Corne Un vers y Press 1978) L F Ca me De a o e cons derée sous e po n de vue pa ho og que ph osoph que h s or que e ud c are (Par s Ba ére 1845) an anonymous work a r bu ed o "a soc e y o phys c ans n London" and pub shed as "Med ca Observa ons and nqu r es " Cr ca Rev ew June 1757 540-541 544-545 L M Dan or h F rewa k ng and Re g ous Hea ng The Anas enar a o Greece and he Amer can F rewa k ng Movemen (Pr nce on N J Pr nce on Un vers y Press 1990) 20 For he wo-body mode see Laqueur Mak ng Sex or New on an sm and med c ne see hree books by L K ng The Med ca Worm o he E gh een h Cen ury (Ch cago Un vers y o Ch cago Press 1958) The Road o Med ca En gh enmen 1660-1695 (London Macdona d 1970) The Ph osophy o Med c ne The Ear y E gh een h Cen ury (Cambr dge Mass Harvard Un vers y Press 1978) esp pp 152-181 For he ph osoph ca ssues nvo ved n sexua y n genera and he r re a on o h s or c sm and soc a cons ruc on see A Dav dson "Sex and he Emergence o Sexua y " Cr ca nqu ry 11 (1987) 17-48 21 For he e gh een h-cen ury deba e on ema e gender n re a on o unc on ng soc e y see P Ho mann La emme dans a pensée des Lum ères (Par s Ophrys 1977) D Spender ed Fem n s Theor s s Three Cen ur es o Key Women Th nkers (New York Pan heon Books 1983) B H Women Work and Sexua Po cs n 18 h-Cen ury Eng and 1990) L Sch eb nger The M nd Has No Sex? Women n he Or g ns o Modern Sc ence (Cambr dge Mass Harvard Un vers y Press 1989) Moscucc Sc ence o Woman B S Anderson e a A H s ory o The r Own Women n Europe rom Preh s ory o he Presen (New York Harper & Row 1988) 22 Va d as he re nv gora on was here s no men on o hys er a n some o he c ass c n erpre a ons o he per od or examp e n P Gay s The En gh enmen An n erpre a on 2 vo s (New York A red A Knop 1966-69) wh ch devo es much space o med c ne The canvas pa n ed by Gay and o her syn he c h s or ans o he En gh enmen prov des a ur her reason or our rev s on s rea men s c ear ha over a cen ury ago Sydenham s s gn cance or hys er a was n u ed bu no demons ra ed see J Brown M D Horae Subsec vae Locke and
23 A hough here s no such subgenre as he h s or ography o Sydenham s ud es Sydenham and O her Papers (Ed nburgh Dav d Doug as 1890)
24 An ear y an c pa on o h s approach w h n he Br sh rad on s ound n A exander Thomson An Enqu ry n o he Na ure Causes and Me hod o Cure o Nervous D sorders (London 1781) an examp e o he common y ound phys o og ca d sser a on n France s H G rard Cons dera ons phys o og ques e pa ho og ques sur es a ec ons nerveuses d es hys er ques (Par s 1841) 25 See G D d -Huberman nven on de Hys er e Charco e
conograph e Pho ograph que (Par s Macu a 1982) use u as h s work s
acks he sweep and erud on o Sander G man s chap er conc ud ng h s book
26 Par s Hache e 1970 rans n 1968 as The Fear o Women (New York Grune & S ra on 1968) 27 See Wh e s n uen a essay "The Forms o W dness Archaeo ogy o an dea—Nob e Savage as Fe sh " n The W d Man W h n An mage n Wes ern Though rom he Rena ssance o Roman c sm ed E Dud ey and M E Novak (P sburgh Pa Un vers y o P sburgh Press 1972) 3-38 28 An mpor an excep on s Jan Go ds e n s work espec a y as ound n "The Hys er a D agnos s and he Po cs o An c er ca sm n La e N ne een h-Cen ury France " Journa o Modern H s ory 54 (1982) 209-239 and her Conso e and C ass y T Laqueur s "Orgasm Genera on and he Po cs o Reproduc ve B o ogy " Represen a ons 14 (1986) 1-14 The ma er s ur her subs an a ed b b ograph ca y n he horough researches o M M ca e re erred o n many o he chap ers o h s book 29 O hers who he ped re r eve hese os vo ces nc ude Pa r c a Fed kew "Marguer e Duras Fem n ne F e d o Hys er a " Enc c 6 (1982) 78-86 Bernhe mer and Kahane eds 20 1990 1345-1346
n Dora s Case Terry Cas e "Learned Lad es " TLS December 14-
30 These rad ons o earn ng are brough oge her n Rousseau ed Languages o Psyche 31 Por er s d scuss on shou d be comp emen ed w h he mpor an wr ngs on n ne een h-cen ury hys er a o Mark M ca e 32 Some o he heore ca cruxes have been addressed n he con rovers es surround ng R chard Ror y and h s n uen a book Ph osophy and he M rror o Na ure (Pr nce on N J Pr nce on Un vers y Press 1980) and o hers such as G Lev ne ed One Cu ure Essays n Sc ence and L era ure (Mad son Un vers y o W scons n Press 1987) he prob em o me aphor n bo h he rea s and represen a ve doma ns by M B Hesse Mode s and Ana og es n Sc ence (No re Dame Un vers y o nd ana Press 1966) The S ruc ure o Sc en c n erence (Berke ey Los Ange es London Un vers y o Ca orn a Press 1974) dem "Habermas Foucau and Me aphor n Sc ence " Proceed ngs o he Von Leer ns u e o he Hebrew Un vers y o Jerusa em (1992 Jerusa em) Bu see a so an mpor an s a emen by Hayden Wh e "H s or ca Emp o men s and he Prob em o Tru h " presen ed o he Con erence on he Ho ocaus Un vers y o Ca orn a Los Ange es 1990 and or he ro e o represen a on as a pres d ng ca egory n con emporary sens b y J F Lyo ard The Pos modern Cond on A Repor on Know edge (M nneapo s Un vers y o M nneso a Press 1984) 33 See S G man See ng he nsane (New York John W ey & Sons 1982) D erence and Pa ho ogy S ereo ypes o Sexua y Race and Madness ( haca N Y Corne Un vers y Press 1985) D sease and Represen a on mages o rom Madness o A ds ( haca N Y Corne Un vers y Press 1988) as we as many ar c es and rev ews
ness
34 One can mag ne Hans Mayer s en ng o he s o hese par ahs and recons der ng h s om ss on o hys er cs rom h s br an s udy o he represen a on o he ou s der see h s Ou s ders A S udy n L e and Le ers (Cambr dge Mass M T Press 1984) see W J McGra h Freud s D scovery o Psychoana ys s The Po cs o Hys er a ( haca
35 W am McGra h s ev dence s correc abou he po cs o hys er a we may have enhanced he va d y o our work by h s exc us on ra her han harmed N Y Corne Un vers y Press 1986) 36 For ano her orm o decons ruc on see McGra h Freud s D scovery 37 Pr nce on N J Pr nce on Un vers y Press 1990
38 See Mark S M ca e "Hys er a and s H s or ography A Rev ew o Pas and Presen Wr ngs " H s ory o Sc ence 27 (Sep ember December 1989) 223-262 319-351 dem "Hys er a and s H s or ography The Fu ure Perspec ve " H s ory o Psych a ry 1 (March 1990) 33-124 dem "Charco and he dea o Hys er a n he Ma e Gender Men a Sc ence and Med ca D agnos s n La e N ne een h-Cen ury France Med ca H s ory 34 (1990) 363-411 and dem "Hys er a Ma e Hys er a Fema e Re ec ons on Compara ve Gender Cons ruc on n N ne een h-Cen ury France and Br a n" n Sc ence and Sens b y Gender and Sc en c Enqu ry 1780-1945 ed Mar na Ben am n (Ox ord Bas B ackwe 1991) 200-239 39 As ev dence we aga n sugges ha he reader consu Go ds e n s Conso e and C ass y or ev dence o wha he pos -Fouca d an me hodo ogy does n prac ce
One— Once upon a Text: Hysteria from Hippocrates Many of the anc ent wr ters c ted here—for examp e, Hes od, Mart a , and P ato—are eas y access b e n trans at on. Where no part cu ar ed t on s spec f ed, the Loeb C ass ca L brary vers on may be used. Th s g ves the anc ent text w th an Eng sh trans at on on the fac ng page. The med ca wr ters are ess read y ava ab e to the genera reader. In part cu ar, few of the re evant works of the H ppocrat c corpus have been trans ated nto Eng sh. In the nterests of cons stency, a texts from the H ppocrat c corpus are c ted from the standard Greek ed t on w th French trans at on of E. L ttré, Oeuvres comp etes d H ppocrate , 10 vo s. (Par s: Ba ère, 1839-61), abbrev ated L. References are g ven n the form L vo ume.page number; for examp e, L 8.34. The spec f c ocat ons, n the L ttré ed t on, of the texts used, w th the abbrev at ons used n the notes, are as fo ows: A rs, Waters, P aces , L 2.12-93 Aphor sms , L 4.458-609 Coan Prognoses , L 5.588-733 D seases of Women , L 8.10-463 = DW D seases of Young G r s , L 8.466-471 Ep dem cs 2, L 3.24-149; 6, L 5.266-357 = Ep . Generat on , L 7.470-484 = Gen . G ands , L 8.556-575 Nature of the Ch d , L 7.486-538 = NC On Jo nts , L 4.78-339 On the Sacred D sease , L 6.352-397 Prorrhet cs 1, L 5.510-577
66 Nature of Man , L 6.32-69 Nature of Woman , L 7-312-431 = NW P aces n Man , L 6.276-349 Reg men , L 6.466-637 Reg men n Acute D seases, Append x , L 2.394-529 = Acut. Sp . Superfetat on , L 8.476-509 Generat on and Nature of the Ch d are ava ab e n an exce ent Eng sh trans at on by I. M. Lon e, The H ppocrat c Treat ses "On Generat on," "On the Nature of the Ch d," "D seases IV " (Ber n: De Gruyter, 1981). Ann Hanson s prepar ng an ed t on and Eng sh trans at on of D seases of Women for the Corpus Med corum Graecorum ser es. The fo ow ng abbrev at ons are used for the works of Art stot e: GA = Generat on of An ma s HA = H story of An ma s PA = Parts of An ma s MA = Movement of An ma s The text referred to n the notes as "Ps-Ar stot e, On Ster ty " s found n the Loeb C ass ca L brary as the tenth book of H story of An ma s . Its authent c ty as a work of Ar stot e has ong been doubted, a though t s poss b e that t was an ear y work. It may date to the th rd century B.C . Ps-Ar stot e, Prob ems s someth ng very d fferent, a co ect on of quest ons and answers—on matters rang ng from why the o d have wh te ha r to why man sneezes more than any other an ma —brought together perhaps as ate as the f fth century A.D . and, w th other works wrong y ascr bed to Ar stot e such as the Masterp ece , h gh y popu ar n the ear y modern era. Severa med ca wr ters of ant qu ty are c ted n the ed t ons of the Corpus Med corum Graecorum (hereafter CMG) and the Corpus Med corum Lat norum (hereafter CML). They are referred to n the form CMG vo ume number, page. ne (e.g., CMG vo . 2, p.34-7). For the works of Ga en, the standard ed t on rema ns that of C. G. Kuhn, C aud Ga en Opera omn a , 20 vo s. (H dehe m: O ms, 1964-5 [repr nt of the vers on of 1821-1833]). References to Ga en are g ven n the form K vo ume.page (e.g., K 14.176). 1 The da es rad ona y ass gned o H ppocra es are ca 460-ca 370 B C Desp e a rad on deve oped severa cen ur es a er h s dea h c a m ng o g ve h s b ography and am y ree e s known o h s e and work The ex s assoc a ed w h h s name— he H ppocra c corpus—cover a per od ar onger han a e me show w de var a ons n s y e and con en and n many cases are "mu -au hor concoc ons" see G E R L oyd The Revo u ons o W sdom (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) 132 On he manuscr p rad on and assemb y o he var ous rea ses n o a "H ppocra c corpus " poss b y as a e as he en h cen ury A D see n genera J r go n "Trad on manuscr e e h s o re du ex e Que ques prob èmes re a s à a Co ec on H ppocra que " Revue d h s o re des ex es 3 (1973) 1-13 w h F P a "D e Ueber e erung des Corpus H ppocra cum n der nacha exandr n schen Ze " W ener S ud en 50 (1932) 67-82 On he papyr so ar ound wh ch g ve ragmen s o H ppocra c ex s see M -H Marganne nven a re ana y que des papyrus grecs de médec ne (Geneva Cen re de recherches d h s o re e de ph o og e de a V e sec on Eco e pra que des Hau es E udes 3 12 1981) upda ed by A E Hanson Papyr o Med ca Con en " Ya e C ass ca S ud es 28 (1985) 25-47 "Genu ne Works" comes rom he e o Franc s Adams s The Genu ne Works o H ppocra es (London Sydenham Soc e y 1849) A hough he search or a eas one sec on o he H ppocra c corpus ha can secure y be a r bu ed o H ppocra es— he so-ca ed "H ppocra c ques on " on wh ch see G E R L oyd "The H ppocra c Ques on " C ass ca Quar er y 25 (1975) 171192— s no onger he ma n a m o H ppocra c s ud es s exer s a power u asc na on Thus or examp e even W D Sm h whose d scuss on n The H ppocra c Trad on ( haca N Y Corne Un vers y Press 1979) cha enges he dom nan parad gm n order o expose he deve opmen rom he h rd cen ury B C onward o he my h o he e and works o H ppocra es r es o prove ha Reg men s a "genu ne work " Shor y a er he pub ca on o Sm h s H ppocra c Trad on Mans e d produced an ar c e argu ng he case or ano her ex o he H ppocra c corpus A rs Wa ers P aces —mak ng use o prec se y he same ev dence as Sm h drew on n de ense o Reg men See J Mans e d "P a o and he Me hod o H ppocra es " Greek Roman and Byzan ne S ud es 21 (1980) 341-362 2 n 1922 Char es S nger descr bed ( mag ned?) H ppocra es as "Learned observan humane order y and ca m grave hough u and re cen pure o m nd and mas er o h s pass ons" see h s Greek B o ogy and Greek Med c ne (Ox ord C arendon Press 1922) The soc a pos on o he H ppocra c doc or s bes hand ed by L oyd n Mag c Reason and Exper ence (Cambr dge Cambr dge Un vers y Press 1979) Sc ence Fo k ore and deo ogy (Cambr dge Cambr dge Un vers y Press 1983) and Revo u ons o W sdom Compe on was an mpor an soc a va ue n he Greek wor d seen as a norma par o human ac v y see he poe Hes od Works and Days 11-20 where "po er v es w h po er " Th s descr p on o prec ass ca soc e y cou d be used o sugges ha he H ppocra c doc or (Greek a ros ) wou d norma y be n compe on no on y w h mages pur ers begg ng pr es s and quacks ( era y "dece vers") or h s s see he H ppocra c ex On he Sacred D sease 1 (L 6 354-356) 3 Dr Robb "H ppocra es on Hys er a " Johns Hopk ns Hosp a Bu e n 3 (1892) 78-79 4 E S a er "D agnos s o Hys er a " Br sh Med ca Journa (1965) 1395-1399 quo a on s aken rom p 1396 5 Ve h Hys er a The H s ory o a D sease (Ch cago Un vers y o Ch cago Press 1965) 10 For an apprec a on o Ve h s cons derab e con r bu on o he h s ory o med c ne see Showa er (chap 4 h s vo ume) and M M ca e "Hys er a and s H s or ography A Rev ew o Pas and Presen Wr ngs (1) " H s ory o Sc ence 27 (1989) 223-261 here pp 227-228 6 R A Woodru D W Goodw n and S B Guze "Hys er a (Br que s Syndrome)" (1974) n Hys er a ed A Roy (Ch ches er John W ey 1982) 117-129 (quo a on p 118) P B Bar and D H Scu y "The Po cs o Hys er a The Case o he Wander ng Womb " n Gender and D sordered Behav or Sex D erences n Psychopa ho ogy ed E S Gomberg and V Frank (New York Brunner Maze ) 354-380 (quo a on p 354) S B Guze "The D agnos s o Hys er a Wha Are We Try ng o Do?" Amer can Journa o Psych a ry 124 (1967) 491-498 (quo a ons pp 491 493) see a so J Saur "La concepc on H pocra ca de a h s er a Ac as Luso-Espano as de Neuro og a Ps qu r a y C enc as A nas 1 4 (1973) 539-546 esp p 539 Ve h s con ro o he Greek ma er a s ques oned by H Merskey "Hys er a The H s ory o a D sease za Ve h " Br sh Journa o Psych a ry 147 (1985) 576-579 he Hys er a Gone?" Psychoana y c Rev ew 66 (1979 80) 463-477 (quo a on pp 463-464)
7 R Sa ow "Where Has A
8 Saur "Concepc on H pocra ca de a h s er a " 539-546 o ow ng Ve h a r bu es he be e n a m gra ory womb o he anc en Egyp ans who were supposed o have exer ed a par cu ar y s rong n uence on he "Cn d an" ex s o he H ppocra c corpus see esp pp 540 and 542 The rad ona c ass ca on o he corpus n o "Cn d an" and "Coan " w h s sugges on ha he Cn d an ex s represen an ear er prera ona s rand n oppos on o he ra ona med c ne o he schoo o Cos w h wh ch H ppocra es was assoc a ed s ncreas ng y seen as an unnecessary comp ca on n he s udy o Greek med c ne See ur her R Jo y Le n veau de a sc ence h ppocra que Con r bu on à a psycho og e de h s o re des sc ences (Par s Eds Be es Le res 1966) M Lon e "Cos versus Cn dus and he H s or ans " H s ory o Sc ence 16 (1978) 42-75 77-92 A Th ve Cn de e Cos? Essa sur es doc r nes méd ca es dans a co ec on h ppocra que (Par s Eds Be es Le res 1981) G R Wes ey A H s ory o Hys er a (Lanham Md Un vers y Press o Amer ca 1980) 1-8 (wh ch g ves H ppocra es "cred or co n ng h s erm hys er a " bu a eges an Egyp an or g n or he c n ca descr p on however by a r bu ng he words o P a o T maeus 91c o he Egyp an Papyrus Ebers he shoo s h mse n he oo ) L oyd Sc ence Fo k ore and deo ogy 65 n 21 and 84 n 100 does no however accep he mp ed nk be ween Egyp an and Greek heor es o he wander ng womb See ur her on h s po n Hanson "Papyr o Med ca Con en " 25-47 and he d scuss on o he re evan papyr n H Merskey and P Po er "The Womb Lay S n Anc en Egyp " Br sh Journa o Psych a ry 154 (1989) 751-753 wh ch conc udes ha " he wander ng womb d d no come rom Egyp " 9 E Tr a H s o re de hys ér e (Par s Eds Seghers 1986) see esp p 14 10 Adams Genu ne Works o H ppocra es 50-54 B Chance "On H ppocra es and he Aphor sms " Anna s o Med ca H s ory 2 (1930) 31-46 For cr c sm see Sm h H ppocra c Trad on esp p 238 On he mpor ance o he Aphor sms n he a e an que rad on and n he M dd e Ages see Mü er-Roh sen D e La e n sche Ravenna sche Überse zung der h ppokra schen Aphor smen aus dem 5 6 Jahrhunder n chr Ge s es- und soc a w ssenscha che D sser a on 55 Har mu Lüdke Hamburg 1980 p xv A Beccar a "Su e racce d un an co canone a no d ppocra e e d Ga eno G A or sm d ppocra e ne a vers one e ne commen de pr mo med oevo " a a Med oeva e e Uman s ca 4 (1961) 1-75 P K bre "H ppocra es La nus Reper or um o H ppocra c Wr ngs n he La n M dd e Ages " Trad o 32 (1976) 257-292 11 A Rousse e " mages méd ca es du corps Observa on ém n ne e déo og e mascu ne Le corps de a emme d après es médec ns grecs " Anna es E S C 35 (1980) 1089-1115 esp p 1115 n 27 es chap er 11 o h s On he Causes and Symp oms o Chron c D seases book 4 "Concern ng Hys er ka " (CMG vo 2 79-82) A separa e
12 ndeed s used n h s way by he second-cen ury A D wr er Are aeus o Cappadoc a who en chap er n h s work on acu e d seases 2 11 dea s w h hys er ke pn x (CMG vo 2 pp 32-35)
13 P ny s Na ura H s ory g ves many examp es o hese uses or mus ard (P ny Na ura H s ory 20 87 237) b ack or wh e he ebore (25 31 53) and cas oreum (beaver-o n ercourse sneez ng cou d cause m scarr age (P ny Na ura H s ory 7 6 42)
he H ppocra c Aphor sms 5 49 (L 6 550) A er
32 13 28) And c
14 P ny Na ura H s ory 20 87 238 No e ha "convers on" n h s con ex has none o he a er pos -Freud an mp ca ons o "hys er ca convers on " s mp y mean ng a phys ca urn ng Beaver-o s a so used by P ny as a um ga on or pessary or women su er ng " rom he r wombs" ( Na ura H s ory 32 13 28) n o her words he subs ances promo ng sneez ng can expe rom above or rom be ow and rom e her oca on can succeed n re urn ng wombs o he r correc pos on 15 P ny Na ura H s ory 7 52 175 see be ow page 34 or he use o h s case n he
era ure o hys er a
16 Ve h Hys er a 10 n Ar s o e On he Genera on o An ma s 776a11 we are o d ha woman s he on y hys er kon an ma he Loeb rans a on g ves "a one o a an ma s women are ab e o u er ne a ec ons " A L Peck Ar s o e Genera on o An ma s (London He nemann 1942) 467 C he H ppocra c ex s Prorrhe cs 1 119 (L 5 550) and Coan Prognoses 343 (L 5 658) and 543 (L 5 708) 17 Gyna ke a s a word o some comp ex y and hence d cu o rans a e n o one Eng sh word era y "women s h ngs " can mean no on y "d seases o women" bu a so "mens rua on " och a " "ex erna ema e gen a a " and "cures or women s d seases " For examp es see D seases o Women 1 20 (L 8 58) 1 74 (L 8 156) Na ure o Woman 67 (L 7 402) Ep dem cs 2 1 8 (L 3 88) 6 8 32 (L 5 356) Coan Prognoses 511 (L 5 702) 516 (L 5 704) Ps-Ar s o e On S er y 634b12 18 Robb "H ppocra es on Hys er a " 78-79 19 C Tr a H s o re de hys ér e 14 20 Rousse e " mages méd ca es du corps " 1090 21 Adams Genu ne Works o H ppocra es v 22 Sm h H ppocra c Trad on 31 "La recherche h ppocra que au ourd hu " H s ory and Ph osophy o he L e Sc ences 2 (1979) 153-181 esp p 154 (my rans a on)
23 M -P Dum n
24 L 8 275 on H ppocra es s D seases o Women 2 128 herea er DW
8 327 on DW 2 150 8 309 on DW 2 137
25 Ve h Hys er a 13 26 Adams Genu ne Works o H ppocra es J Chadw ck and W N Mann The Med ca Works o H ppocra es (Ox ord Bas B ackwe Harvard Un vers y Press 1931) 167
1950) 166 W H S Jones H ppocra es V (Loeb C ass ca L brary London He nemann and Cambr dge
27 C ed n Tr a H s o re de hys ér e 272 28 D W Abse Hys er a and Re a ed Men a D sorders 2d ed (Br s o Wr gh 1987) 91 29 G Lew s Day o Sh n ng Red (Cambr dge Cambr dge Un vers y Press 1980) 71-72 30 Tr a H s o re de hys ér e 10 31 b d 274 30 Tr a H s o re de hys ér e 10 31 b d 274 32 R A Woodru
nesses " Br sh Journa o Psych a ry 114 (1967) 1115-1119 esp p 1119 1
"Hys er a An Eva ua on o Ob ec ve D agnos c Cr er a by he S udy o Women w h Chron c Med ca
33 Guze "D agnos s o Hys er a " 494-495 Goodw n and Guze "Hys er a (Br que s Syndrome) " n Hys er a ed Roy 122-123
34 See a so Woodru
35 H K ng "Sacr c a B ood The Ro e o he Amn on n Anc en Gyneco ogy " He os 13 2 (1987) 117-126 ( = Rescu ng Creusa ed M B Sk nner Lubbock Texas Tech Un vers y Press 1987 ) 36 S a er "D agnos s o Hys er a " 1395-1399 37 b d 1399 E S a er "Wha s Hys er a?" n Hys er a ed Roy 40 See a so H Merskey "The mpor ance o Hys er a " Br sh Journa o Psych a ry 149 (1986) 23-28 "Whenever we are a he marg n o our ab y o dec de on a d agnos s hys er a s a d agnos c poss b y" (p 24) 36 S a er "D agnos s o Hys er a " 1395-1399 37 b d 1399 E S a er "Wha s Hys er a?" n Hys er a ed Roy 40 See a so H Merskey "The mpor ance o Hys er a " Br sh Journa o Psych a ry 149 (1986) 23-28 "Whenever we are a he marg n o our ab y o dec de on a d agnos s hys er a s a d agnos c poss b y" (p 24) 38 E Shor er "Les désordres psychosoma ques son - s hys ér ques ? No es pour une recherche h s or que " Cah ers n erna onaux de Soc o og e 76 (1984) 201-224 esp p 208 39 C D Marsden "Hys er a—A Neuro og s s V ew " Psycho og ca Med c ne 16 (1986) 277-288 esp pp 282-283 For a genera d scuss on o re rospec ve d agnos s and s per s see M ca e "Hys er a and s H s or ography " 43-46 40 S a er "D agnos s o Hys er a " 1396 41 F Wa she "D agnos s o Hys er a " Br sh Med ca Journa (1965) 1451-1454 esp 1452 42 Roy Hys er a 43 R Mayou "The Soc a Se ng o Hys er a " Br sh Journa o Psych a ry 127 (1975) 466-469 here p 466 44 J Wr gh "Hys er a and Mechan ca Man " Journa o he H s ory o deas 41 (1980) 233-247 esp p 233 W M ch nson "Hys er a and nsan y n Women—A N ne een h-Cen ury Perspec ve " Journa o Canad an S ud es 21 (1986) 87-105 here p 92 45 E Shor er "Para ys s—The R se and Fa o a Hys er ca Symp om " Journa o Soc a H s ory 19 (1986) 549-582 here p 551 46 Tr a H s o re de hys ér e 54 47 R sse "Hys er a a he Ed nburgh n rmary The Cons ruc on and Trea men o a D sease 1770-1800 " Med ca H s ory 32 (1988) 1-22 48 Mayou "Soc a Se ng o Hys er a " 466 49 Marsden "Hys er a—A Neuro og s s V ew " 279 50 Quo ed n Shor er "Para ys s " 578 n 51 51 Mayou "Soc a Se ng o Hys er a " 466-468 Shor er "Désordres psychosoma ques son - s hys ér ques ?" 205 Shor er "Para ys s " 550-551 see a so Abse Hys er a and Re a ed Men a D sorders 23-25 52 Shor er "Para ys s " 574 and 549 see Shor er "Désordres psychosoma ques son - s hys ér ques ?" 202 53 D C Tay or "Hys er a P ay-ac ng and Courage " Br sh Journa o Psych a ry 149 (1986) 37-41 de nes hys er a as " he ay ng c a m o s ckness or wh ch here s no ob ec ve ev dence" and hus ha hys er a s "a commonp ace reac on" (p 40) The "non-verba anguage" sugges on s made by E M R Cr ch ey and H E Can or Charco s Hys er a Rena ssan " Br sh Med ca Journa 289 (1984) 1785-1788 here p 1788 54 J M N Boss "The Seven een h-Cen ury Trans orma on o he Hys er c A ec on and Sydenham s Bacon an Med c ne " Psycho og ca Med c ne 9 (1979) 221-234 here p 221 55 J Gabbay "As hma A acked? Tac cs or he Recons ruc on o a D sease Concep " n The Prob em o Med ca Know edge Exam n ng he Soc a Cons ruc on o Med c ne ed P Wr gh and A Treacher (Ed nburgh Ed nburgh Un vers y Press 1982) 23-48 quo a on p 29 56 Gabbay "As hma A acked?" n Prob em o Med ca Know edge Wr gh and Treacher 33 57 b d 42 56 Gabbay "As hma A acked?" n Prob em o Med ca Know edge Wr gh and Treacher 33 57 b d 42 58 The H ppocra c P aces n Man 47 (L 6 344) 59 Boss "Seven een h-Cen ury Trans orma on " 221-234 60 W M ch nson "Hys er a and nsan y n Women " 89 61 Boss "Seven een h-Cen ury Trans orma on " 232 62 R sse "Hys er a a he Ed nburgh n rmary " 2-4 63 b d 17 64 b d 16 62 R sse "Hys er a a he Ed nburgh n rmary " 2-4 63 b d 17 64 b d 16 62 R sse "Hys er a a he Ed nburgh n rmary " 2-4 63 b d 17 64 b d 16 65 C H Landouzy Tra é comp e de hys ér e (Par s and London Ba ère 1846) w h L ré Landouzy accep s he cura ve powers o marr age bu asks an mpor an ques on ha o ows rom he H ppocra c recommenda on "Peu -on épouser avec sécur é une hys ér que?" (p 303) See a so H Merskey The Ana ys s o Hys er a (London Ba ère T nda 1979) 12 H Ey "H s ory and Ana ys s o he Concep " (1964) n Hys er a ed Roy 3-19 66 M ch nson "Hys er a and nsan y n Women " 90 67 F M Ma and H Merskey "Br que s Concep o Hys er a An H s or ca Perspec ve " Canad an Journa o Psych a ry 26 (1981) 57-63 68 B C Brod e Lec ures
us ra ve o Cer a n Loca Nervous A ec ons (London Longman 1837) 46
69 Robb "H ppocra es on Hys er a " 78-79 70 b d 79 Saur "Concepc on H pocra ca de a h s er a " 539-546 uses DW 1 7 and 2 123-125 J Pa s E Rossopou os and L C Tr arhou "The H ppocra c Concep o Hys er a A Trans a on o he Or g na Tex s " n egra ve Psych a ry 3 (1985) 226-228 rans a e NW 3 (L 7 314-316) 73 (L 7 404) 75 (L 7 404) and 87 w h DW 2 123-125 wh e Ve h Hys er a p 10 n 1 s pr mar y based" on DW 1 7 1 32 and 2 123-127 69 Robb "H ppocra es on Hys er a " 78-79 70 b d 79 Saur "Concepc on H pocra ca de a h s er a " 539-546 uses DW 1 7 and 2 123-125 J Pa s E Rossopou os and L C Tr arhou "The H ppocra c Concep o Hys er a A Trans a on o he Or g na Tex s " n egra ve Psych a ry 3 (1985) 226-228 rans a e NW 3 (L 7 314-316) 73 (L 7 404) 75 (L 7 404) and 87 w h DW 2 123-125 wh e Ve h Hys er a p 10 n 1 s pr mar y based" on DW 1 7 1 32 and 2 123-127 71 Acu Sp 35 (L 2 522) Th s s an n eres ng d s nc on c ass ca Greek u er ne pn x wh ch so many wr ers wan o den y as "hys er a " s d s ngu shed by norma sensa ons ye "hys er a" n a er h s or ca per ods s supposed o nvo ve " oca oss o sensa on " See Wr gh "Hys er a and Mechan ca Man " 233 72 Robb "H ppocra es on Hys er a " 78-79 73 M R Le kow z Hero nes and Hys er cs (London Duckwor h 1981) 13 74 The en ry o he word "hys er a" n o European anguage s surpr s ng y a e The French hys ér e appears n d c onar es n 1731 and "hys er a" se o "hys er a " he med ca pro ess on has sough o g ve some respec ab y by pro ec ng back n o H ppocra c med c ne
n 1801 One conc us on ha cou d be drawn rom h s s ha because o he very recen or g n
75 G Lew s "A V ew o S ckness n New Gu nea " n Soc a An hropo ogy and Med c ne ed J B Loudon (London ASA Monograph 13 Academ c Press 1976) 88 76 L Bourgey Observa on e exper ence chez es médec ns de a co ec on h ppocra que (Par s J Vr n 1953) 149-152 med co e a ma a a La sc enza d ppocra e (Tur n E naud Paperbacks 172 1986) 18-21 89-91 4
77 v D Benede o
78 b d 21-23 L oyd n Revo u ons o W sdom 203-206 po n s ou ha he erm no ogy o c ass ca Greek med c ne s charac er zed by "a cer a n concep ua vagueness" ord nary Greek s pre erred o echn ca erms med co e a ma a a La sc enza d ppocra e (Tur n E naud Paperbacks 172 1986) 18-21 89-91 4
77 v D Benede o
78 b d 21-23 L oyd n Revo u ons o W sdom 203-206 po n s ou ha he erm no ogy o c ass ca Greek med c ne s charac er zed by "a cer a n concep ua vagueness" ord nary Greek s pre erred o echn ca erms 79 C M T C o oge Essa sur h s o re de a gynéco og e dans an qu é grecque usqu à a co ec on H ppocra que (Bordeaux Arnaud 1905) 63 "Les anc ens s é a en beaucoup occupés de a mens rua on " 80 DW 1 1 (L 8 10-12) Greek schyros s ereos pyknos See W A He de H ppocra c Med c ne s Sp r and Me hod (New York Co umb a Un vers y Press 1941) 91 P Manu "Donne masco ne emm ne s er verg n perpe ue La g neco og a greca ra ppocra e e Sorano " n Madre Ma er a by S Campese P Manu and G S ssa (Tur n Bor ngh er 1983) 147-192 here p 188 See A E Hanson "Ana om ca Assump ons n H ppocra es D seases o Women 1 1 " paper de vered a he APA 1981 and R Parker M asma (Ox ord C arendon Press 1982) 230 on he sheepsk n ana ogy he a er po n s ou ha he powers o absorp on o he eece accoun or s use n r ua s o pur ca on n Super e a on 34 (L 8 506) sheepsk n s used n herapy A young g r who does no mens rua e a erna es among hunger h rs ever and vom ng excess u d The remedy warm ambsk ns p aced on her abdomen may be n ended o draw ou he excess u d wh ch shou d have come ou as mens rua b ood 81 Ar s o e GA 728a17 and 737a S R L C ark Ar s o e s Man (Ox ord C arendon Press 1975) M C Horow z "Ar s o e and Woman " Journa o he H s ory o B o ogy 9 (1976) 183-213 L Dean-Jones "Mens rua B eed ng Accord ng o he H ppocra cs and Ar s o e " Transac ons o he Amer can Ph o og ca Assoc a on 119 (1989) 177-192 82 Hes od Works and Days 45-105 and 373-375 dem Theogony 594-602 N Loraux "Sur a race des emmes e que ques-unes de ses r bus " Are husa 11 (1978) 43-87 83 P a o T maeus 90e-91a 84 P DuBo s Sow ng he Body Psychoana ys s and Anc en Represen a ons o Women (Ch cago Un vers y o Ch cago Press 1988) N Loraux "Le Sk nner)
a guerre " L Homme 21 (1981) 37-67 K ng "Sacr c a B ood " 117-126 ( = Rescu ng Creusa
85 E g A rs Wa ers P aces 10 (L 2 44 and 2 50) Na ure o he Ch d 15 (L 7 494) G ands 16 (L 8 572) 86 n Greek s rephon a ha me ra
c ose o he La n conver o
87 Younger women have he mos b ood due o " he grow h o he body and he d e " D seases o Young G r s (L 8 466) con rmed n DW 2 111 (L 8 238-240) 88 Cas oreum and eabane ( konyza ) appear oge her on many occas ons e g DW 2 128 (L 8 274) 2 200 (L 8 382) 2 201 (L 8 384) 89 Bandages around he body occur n 2 127 (L 8 272) and 2 129 (L 8 278) 90 A rans a on o h s ex was g ven n my Ph D hes s From Par henos o Gyne The Dynam cs o Ca egory Un vers y o London 1985 am ak ng he Greek s omachos here o mean "mou h o he womb" ra her han "mou h " a hough can have many ana om ca mean ngs and occurs n 2 203 (L 8 388) w h he mean ng "mou h " Th s s c ear y no a "pa n by numbers" orma he reader r es o carry ou he ns ruc ons n he order g ven he ar w be sea ed be ore he gar c and sea o go n S m ar warn ngs abou he poss b y o exhaus on n he pa en occur a DW 2 181 (L 8 364) 3 230 (L 8 442) and 3 241 (L 8 454) The vege ab e subs ances used n scen herapy are d scussed n S By s L odeur végé a e dans a hérapeu que gynéco og que du Corpus h ppocra que " Revue Be ge de Ph o og e e d H s o re 67 (1989) 53-64 91 DW 2 126 (L 8 272) c 2 203 (L 8 390) 92 E g DW 2 131 (L 8 278) where he subs ances o be used are no spec ed 93 NW 87 (L 7 408) reads " n su oca on caused by movemen o he womb mpregna ed and nser A so g ve her a dr nk o res n d sso ved n o "
gh up he w ck o a amp hen snu
ou ho d ng
under he nos r s so ha she draws n he smoke Then soak myrrh n per ume d p woo n so
s horough y
94 B S mon M nd and Madness n Anc en Greece ( haca N Y Corne Un vers y Press 1978) 238 95
M Lew s Ecs a c Re g on (Harmondswor h M dd esex Pengu n 1971) and Mayou "Soc a Se ng o Hys er a " 467
96 S mon M nd and Madness n Anc en Greece 242 251 97 b d 243 96 S mon M nd and Madness n Anc en Greece 242 251 97 b d 243 98 Four een s he dea age o menarche n med ca wr ers (D W Amundsen and C J D ers "The Age o Menarche n C ass ca Greece and Rome " Human B o ogy 41 1969 125-132) or age a marr age see W K Lacey The Fam y n C ass ca Greece (London Thames & Hudson 1968) 162 and M L Wes Hes od The Works and Days (Ox ord Ox ord Un vers y Press 1978) 327 99 DW 2 126 (L 8 270-272) DW 2 130 (L 8 326) DW 2 203 (L 8 386-392) 100 DW 2 128 (L 8 274) DW 2 129 (L 8 276) DW 2 131 (L 8 278-280) 101 Ps-Ar s o e Prob ems 30 S mon M nd and Madness n Anc en Greece 222 102 Marr age and ch db r h are recommended herap es n many H ppocra c ex s ou s de he hys er a rad on e g DW 1 37 (L 8 92) 2 115 (L 8 250) 2 119 (L 8 260) 2 128 (L 8 276) 2 133 (L 8 302) Gen 4 (L 7 476) 103 DW 2 150 (L 8 326) 2 201 (L 8 384) 104 DW 3 222 (L 8 430) med co e a ma a a 4
105 D Benede o
106 A Rousse e Porne a On Des re and he Body n An qu y (Ox ord Bas B ackwe
1968) 69
107 D Gourev ch Le ma d ê re emme La emme e a médec ne dans a Rome an que (Par s Eds Be es Le res 198 4) 119 "Donne masco ne emm ne s er " n Madre Ma er a by Campese Manu
108 Hanson "Ana om ca Assump ons n H ppocra es" Manu
and S ssa 157
109 E g DW 2 146 (L 8 322) 3 214 (L 8 414-416) 3 219 (L 8 424) 3 230 (L 8 440) Super e a on 25 (L 8 488-490) NW 96 (L 7 412-414) Aphor sms 5 59 (L 4 554) 110 L 8 310 Greek ano ka o 111 DW 2 123 (L 8 266) 2 154 (L 8 330) a descr p on o a "w d" womb rans a ed by L ré as " rr a ed" 2 201 (L 8 384) a d scuss on o pn x See By "L odeur végé a e " 56-58 112 DW 2 125 (L 8 268) 2 137 (L 8 310) 2 143 (L 8 316) 2 145 (L 8 320) 113 C M Turbayne "P a o s Fan as c Append x The Procrea on Mode o he T maeus " Pa de a spec a ssue 1976 125-140 quo a on rom p 132 114 b d 140 n 11 113 C M Turbayne "P a o s Fan as c Append x The Procrea on Mode o he T maeus " Pa de a spec a ssue 1976 125-140 quo a on rom p 132 114 b d 140 n 11 115 F Kud en "Ear y Greek Pr m ve Med c ne " C o Med ca 3 (1968) 305-336 quo a ons rom p 330 See a so S By and A F De Ran er "L é o og e de a s ér é ém n ne dans e Corpus h ppocra que " 303-322 n La ma ad e e es ma ad es dans a Co ec on h ppocra que (Ac es du V e Co oque h ppocra que) ed P Po er G Ma oney and J Desau e s (Quebec Eds du Sph nx 1990) 321 116 Are aeus 2 11 (CMG vo 2 pp 32 28-33 1) he re evan passage reads "and he sum o he ma er s ha he womb n he ema e s hoko on
zoon en zoo "
117 DW 1 7 (L 8 32) 118 Ann Hanson pers comm F Adams The Med ca Works o Pau us Aeg ne a vo known propens y o mys ca on "
(London We sh 1834) 458 sugges s ha he T maeus passage "ough perhaps no o be aken n oo
era a sense cons der ng ha ph osopher s we -
119 Soranus o Ephesus Gyneco ogy 3 29 (CMG vo 4 P 113 3-6) O Tem-k n Soranus Gyneco ogy (Ba more Johns Hopk ns Un vers y Press 1956) rans a es "For he u erus does no ssue or h ke a w d an ma rom he a r de gh ed by ragran odors and ee ng bad odors ra her s drawn oge her because o he s r c ure caused by he n amma on " "W d an ma " s he Greek her on n con ras o Are aeus s more neu ra zoon " v ng h ng " 120 Based on R E S ege Ga en on he A ec ed Par s (Base and New York S Karger 1976) 187 rans a ng On he A ec ed Par s 6 5(K 8 425-426) he La n vers on o wh ch reads "Haec d cen e P a one qu dam add derun u erum quum a per corpus errans ad sep um ransversum pervener resp ra onem n er urbare A errare psum ve u an ma non d cun sed ub suppressa sun mens rua ex cca um ac humec ar cup en em ad v scera usque ascendere quum vero ascendendo nonnunquam sep um ransversum con nga dc rco an ma resp ra one pr var " "Fema e Par s n T maeus " Ar on 2 (1975) 400-421 esp p 404
121 D F Kre
122 P a o T maeus 70e Greek hos hremma agr on 123 b d 89b-c 124 b d 71a 91a-b 122 P a o T maeus 70e Greek hos hremma agr on 123 b d 89b-c 124 b d 71a 91a-b 122 P a o T maeus 70e Greek hos hremma agr on 123 b d 89b-c 124 b d 71a 91a-b 125 No ho on zoon bu zoon ep hyme kon enon es pa dopo as (91c) 126 Ar s o e PA 666a 20-23 and 666b 16-17 MA 703b 21-26 see S By Recherches sur es grands ra és b o og ques d Ar s o e Sources écr es e pré ugés (Brusse s Pa a s des Académ es 1980) 124 127 P a o T maeus 73c 128 Gen (L 7 473-474) Na ure o Man 11 (L 6 58) 129 L 7 478-480 130 Shor er "Para ys s " 574 and 549 131 Tr a H s o re de hys ér e 16 132 E g DW 1 2 (L 8 32) use o he gyne " he woman " 133 Pn ge DW 2 201 (L 8 384) DW 2 124 (L 8 266) 134 M ch nson "Hys er a and nsan y n Women " 91 135 E Jorden A Br e e D scourse o a D sease Ca ed he Su oca on o he Mo her (London J W nde 1603) 136 See Tr a H s o re de hys ér e 7 137 L 8 326 138 See Tr a H s o re de hys ér e 33 Abse Hys er a and Re a ed Men a D sorders 2 139 P aces n Man 47 (L 6 344) c " he cause o number ess d seases " L 9 396 140 Pro on ergon Soranus Gyneco ogy 3 6 141 Na ure o he Ch d 15 (L 7 494) he rans a on g ven s ha o na ure
M Lon e The H ppocra c Trea ses "On Genera on " "On he Na ure o he Ch d " "D seases V " (Ber n De Gruy er 1981) 8 he or g na Greek
era y means "her or g na
142 Ep 7 123 (L 5 468) 143 Ep 6 8 32 (L 5 356) DW 3 230 (L 8 444) 144 L 7 476 145 Ar s o e PA 650a 8
GA 775a 14-20 Horow z "Ar s o e and Woman " 183-213
146 P u arch Mora a 650a-651e 147 Ar s o e PA 648a 28-30 GA 765b 19 148 L 8 12-14 149 L 6 512 150 Greek kam nos Ar s o e GA 764a 12-20 151 Herodo us 5 92 152 Ar em dorus One rocr ca The n erpre a on o Dreams
rans R J Wh e (Park R dge N J Noyes Press 1975) 2 10
153 Gen 4 (L 7 474-476) NC 12 (L 7 486)—Greek en hermo eousa
rans Lon e H ppocra c Trea ses 6— NC 30 (L 7 536)
154 Greek paue pn geran ege s ( ne 122) 155 The use o s m ar magery does no end n he c ass ca Greek per od Around A D 1565 Teresa o Av a su ered symp oms ha n he n ne een h cen ury were re rospec ve y d agnosed as hys er a These nc uded con rac ve spasms swea ng and ch s as we as ee ng " ke a person who has a rope around h s neck s be ng s rang ed and ry ng o brea he" (C M Bache "A Reappra sa o Teresa o Av a s Supposed Hys er a " Journa o Re g on and Hea h 24 (1985) 300315 esp pp 310 and 305) 156 M -P Dum n "Recherche h ppocra que au ourd hu " 156 D J Fur ey and J S W k e Ga en on Resp ra on and he Ar er es (Pr nce on N J Pr nce on Un vers y Press 1984) 22 A s m ar d cu y ex s s be ween he La n con-cep o mean ng re en on o he ma e seed and our "concep on " mean ng he er za on o he ovum by he sperm see he Budé ed on o Soranus (ed P Burgu ére D Gourev ch and Y Ma nas 1988) p xcv 157 Empedoc es n H D e s and W Kranz D e Fragmen e der Vorsokra ker (Ber n We dmannsche 1951) ragmen 31 B 100 Fur ey and W k e Ga en on Resp ra on 3-5 158 P a o T maeus 76b1-e9 d scussed by Fur ey and W k e Ga en on Resp ra on 7-8 159 On Ar s o e see above n 150 he quo a ons are rom Ga en On he Use u ness o Brea h ng chap 3 (K 4 492 and 4 508) us ng he Fur ey and W k e ed on Ga en on Resp ra on 109 and 131 160 Ga en On he A ec ed Par s (K 8 415) 161 See d scuss on n M D Grmek "Les nd c a mor s dans a médec ne gréco-roma ne " n La mor es mor s e au-de à dans e monde greco-roma ne ed F H nard (Caen Cen re des Pub ca ons de Un vers é 1987) 129-144 and A Debru "La su oca on hys ér que chez Ga en e Ae us Réécr ure e emprun de e " n Trad z one e ecdo ca de es med c ardoan ch e b zan n (A de Convegno n ernaz ona e Anacapre 29-31 o obre 1990) ed A Garzya (Napo M D Aur a 1992) 79-89 162 D ogenes Laer us L ves o he Ph osophers 8 61 The rema n ng ragmen s o Apnous or Per es apnou (On he absence o brea h a so known as On he causes o d sease) are g ven n he ed on o he ragmen s o Herac e des ed ed by F Wehr D e Schu e des Ar s o e es He V Herak e des Pon kos (Base Schwabe 1953) On Empedoc es as a "showman" among ear y cosmogon s s see L oyd Revo u ons o W sdom 101 163 P ny Na ura H s ory 7 52 175 La n exan m s "w hou brea h " can a so mean "w hou e " The ed o pr nceps o P ny was pub shed n 1469 bu abr dgmen s and ex rac s c rcu a ed hroughou he M dd e Ages see M Ch bna "P ny s Na ura H s ory and he M dd e Ages" n S ver La n ed T A Dorey (London Rou edge & Kegan Pau 1975) 57-78 book 7 was cer a n y n c rcu a on rom he ear y n n h cen ury A D see L D Reyno ds ed Tex s and Transm ss on A Survey o he La n C ass cs (Ox ord C arendon Press 1983) 307-316 164 L era y convers o vo vae The Budé ed on o P ny g ves a "med ca " rans a on " a ré rovers on " wh e he Loeb uses he ra her vague "d s or on " 165 P e er van Forees (1522-1597) Observa onum e cura onum med c na um ber v ges mus-oc avus de mu erum morb s (Leyden P an n 1599) Obs 27 167-168 he s ory s a so g ven by N co as de a Roche (
1542) n De morb s mu erum
v
curand s (Par s V Gau hero 1542) 65
166 Or gen Aga ns Ce sus 2 16 402 Herac e des rag 78 Wehr 167 Soranus Gyneco ogy 3 4 29 (CMG 4 112 18-23) rans O Temk n 153 168 J Longr gg "Super a ve Ach evemen and Compara ve Neg ec A exandr an Med ca Sc ence and Modern H s or ca Research " H s ory o Sc ence 19 (1981) 155-200 P Po er "Heroph us o Cha cedon An Assessmen o H s P ace n he H s ory o Ana omy " Bu e n o he H s ory o Med c ne 50 (1976) 45-60 H von S aden Heroph us The Ar o Med c ne n Ear y A exandr a (Cambr dge Cambr dge Un vers y Press 1989) 169 Man as rag 11 Soranus Gyneco ogy 3 4 29 (CMG V p 112 22-23) von S aden Heroph us 517-518 On he e ec s o hese d scover es on med ca wr ng see D Gourev ch "S ua on de Soranos dans a médec ne an que " n Soranos d Ephèse Ma ad es des emmes 1 1 Budé ed (Par s Eds Be es Le res 1988) xxx v-xxxv 170 Marganne nven a re ana y que des papyrus grecs no 155 PP 283-286 P Ry 3 531 ( = PACK 2 2418) On he huge herapeu c reper ory o H ppocra c gyneco ogy see D Benede o med co e a ma a a 17 s poss b e ha he remed es ha occur on y once n he med ca corpus s mp y represen he a emp o a hea er o h nk o some h ng en re y new n order o mpress he pa en See he descr p ons o he compe ve soc a con ex o ear y med c ne n G E R L oyd s Mag c Reason and Exper ence (Cambr dge Cambr dge Un vers y Press 1979) Sc ence Fo k ore and deo ogy (Cambr dge Cambr dge Un vers y Press 1983) and Revo u ons o W sdom 68-69 and 96 on he mpor ance o nnova on n H ppocra c med c ne and 103-104 on r va ry 171 Marganne no 93 PP 168-169 P H beh 2 191 ( = PACK 2 2348) 172 Marganne nven o re ana y que des papyrus grecs no 8 pp 16-17 B K T 3 33-34 ( = PACK 2 2394) 173 La n vu va Ce sus 4 27 CML vo 1 pp 180-181 174 DW 1 77 (L 8 172) n wh ch b ood s e a he ank e n order o ease a ong and d
abor P Bra n Ga en on B ood e ng (Cambr dge Cambr dge Un vers y Press 1986) 113-114
cu
175 Soranus Gyneco ogy 3 28 4 (CMG vo 4 p 111 8) Ga en On Venesec on aga ns he Eras s ra eans n Rome (K 11 201 Bra n Ga en on B ood e ng 45) away rom he womb ( On Trea men by Venesec on K 11 283 11 302-303 Bra n Ga en on B ood e ng 93)
s recommended ha h s be done a he ank e o encourage he ow o b ood
176 See n genera M H Green The Transm ss on o Anc en Theor es o Fema e Phys o ogy and D sease hrough he Ear y M dd e Ages Ph D d sser a on Pr nce on Un vers y 1985 w h M U mann s am c Med c ne (Ed nburgh Ed nburgh Un vers y Press 1978) 11-15 and he d scuss on o he red scovery o H ppocra sm n V Nu on "H ppocra es n he Rena ssance " n D e h ppokra schen Ep dem en ed G Baader and R W nau Sudho s Arch v Be he 27 (S u gar 1990) 420-439 177 On he con en o Are aeus see O Temk n "H s ory o H ppocra sm n La e An qu y The Th rd Cen ury and he La n Wes " n The Doub e Face o Janus and O her Essays n he H s ory o Med c ne by O Temk n (Ba more Johns Hopk ns Un vers y Press 1977) 167-177 esp p 170 Are aeus uses he word hymenes or hese membranes see 2 11 5 (CMG vo 2 P 33 29) 4 11 9 (CMG vo 2 p 81 28) and 6 10 1 (CMG vo 2 p 139 27) Scen herapy s d scussed n a separa e sec on on remed es or hys er ca su oca on a 6 10 3 (CMG vo 2 p 140 17-19) s wor h no ng here ha he d scuss on o Are aeus n Ve h s Hys er a 22-23 wrong y asser s ha he g ves a "br e re erence o ma e hys er a " n ac a hough he men ons an unnamed cond on descr bed as hav ng some symp oms n common w h su oca on o he womb and a ec ng bo h sexes n h s d scuss on o sa yr as s n 2 12 4 he exp c y den es ha su oca on o he womb can a ec men s nce men do no have wombs (CMG vo 2 P 35 11-12) Are aeus nc udes he symp om o " pn x as
178 n h s d scuss on o ep epsy se
s rang ed" see 1 5 6 (CMG vo 2 P 4 27)
rans a e ph ebes as "channe s "
179 2 11 4 (CMG vo 2 P 33 15-17)
180 "H gh-sa ng" s akrop oos 2 11 5 (CMG vo 2 P 33 29) he membranes around he womb are " ke he sa s o a sh p" n 4 11 9 (CMG vo 2 p 81 31) and 6 10 1 (CMG vo 2 p 140 3-4) 181 Are aeus goes beyond Aphor sms 5 35 and says ha sneez ng when accompan ed by pressure on he nos r s can make he womb re urn o s p ace 6 10 5 (CMG vo 2 p 141 7-9) 182 Venesec on occurs a 6 10 3 (CMG vo 2 p 140 14) and 6 10 6 (CMG vo 2 p 141 14-15) where he remova o ha rs s a so d scussed 183 Sm h H ppocra c Trad on 184 Gourev ch "S ua on de Soranos " n Soranos d Éphèse Budé ed xxx On he es ab shmen o he ex o Soranus see P Burgu ère "H s o re du ex e " n Soranos d Éphèse Budé ed x v - xv On Cae us Aure anus see M F Drabk n and E Drabk n Cae us Aure anus Gynaec a ragmen s o a La n vers on o Soranus s Gynaec a rom a h r een h-cen ury manuscr p (Ba more Johns Hopk ns Un vers y Press 1951) and J P geaud "Pro Cae o Aure ano " Mémo res du Cen re Jean Pa erne 3 Médec ns e Médec ne dans An qu é (Un vers é de Sa n -E enne 1982) 105-117 185 n genera see P Manu "E og a de a cas à La G neco og a d Sorano " Memor a 3 (1982) 39-49 Gourev ch "S ua on de Soranos " n Soranos d Éphèse Budé ed v -x v p x d scusses he correc erms or he hree cond ons o he body On he d cu y n read ng our ma n source or he "sec s " see O Temk n "Ce sus On Med c ne and he Anc en Med ca Sec s " Bu e n o he H s ory o Med c ne 3 (1935) 249-264 W D Sm h "No es on Anc en Med ca H s or ography " Bu e n o he H s ory o Med c ne 63 (1989) 73-109 L oyd Revo u ons o W sdom 158-171 See a so M Frede "The Me hod o he So-ca ed Me hod ca Schoo o Med c ne " n Sc ence and Specu a on ed J Barnes J Brunschw g M Burnyea and M Scho e d (Cambr dge Cambr dge Un vers y Press 1821) 1-23 186 Gourev ch "S ua on de Soranos " n Soranos d Éphèse Budé ed x v 187 O Temk n Soranus Gyneco ogy (Ba more Johns Hopk ns Un vers y Press 1956) 9 Green Anc en Theor es o Fema e Phys o ogy and D sease 34 L oyd Revo u ons o W sdom (Berke ey and Los Ange es Un vers y o Ca orn a Press 1987) 164-165 188 Soranus Gyneco ogy 3 29 5 (CMG vo 4 P 113 5-6) 189 b d (CMG vo 4 P 113 3-5) rans Temk n 153 190 b d 3 28 4 (CMG vo 4 P 111 8) he acu e and chron c orms are d s ngu shed a 3 28 1 (CMG vo 4 P 110 22) 188 Soranus Gyneco ogy 3 29 5 (CMG vo 4 P 113 5-6) 189 b d (CMG vo 4 P 113 3-5) rans Temk n 153 190 b d 3 28 4 (CMG vo 4 P 111 8) he acu e and chron c orms are d s ngu shed a 3 28 1 (CMG vo 4 P 110 22) 188 Soranus Gyneco ogy 3 29 5 (CMG vo 4 P 113 5-6) 189 b d (CMG vo 4 P 113 3-5) rans Temk n 153 190 b d 3 28 4 (CMG vo 4 P 111 8) he acu e and chron c orms are d s ngu shed a 3 28 1 (CMG vo 4 P 110 22) 191 P D epgen D e Frauenhe kunde der A en We Handbuch der Gynäko og e X 1 (Mun ch Bergmann 1937) 233 On he den y o he shor rea se De gynaec s ber hoc es de pass on bus mu erum a r bu ed o Ga en and nc ud ng re erences o hys er ca su oca on oge her w h scen herapy see M H Green "The De Genec a A r bu ed o Cons an ne he A r can " Specu um 62 (1987) 299-323 esp p 30 n 9 There a so ex s s an Arab c commen ary on D seases o Women 1 1-11 wh ch s a r bu ed o Ga en Green Anc en Theor es o Fema e Phys o ogy and D sease 118-119 n 5 argues ha h s a r bu on mer s ur her nves ga on s nce Ga en wro e ha he p anned a commen ary on h s ex 192 Ga en On he A ec ed Par s 6 5 (K 8 414-437) 193 On he A ec ed Par s 6 5 (K 8 414) See T C A bu
Greek Med c ne n Rome (London Macm an 1921) 344
néra res à ravers h s o re de hys ér e " H s o re des Sc ences méd ca es 21 (1987) 27-31 esp p 28
194 E Tr a "Tro s
195 On he A ec ed Par s 6 5 (K 8 424) use o on hys er kon egomenon symp oma on see a so he commen ary on Aphor sm 5 35 K17B 824 196 On he A ec ed Par s 6 5 (K 8 417) he Eng sh rans a on g ven here s ha o S ege wh ch s no a ways o be rus ed p 184 ke On he A ec ed Par s was rans a ed n o Arab c see M U mann D e Med z n m s am (Le den Br
197 K 8 426 and K 8 430 rans S ege p 189 Ga en h mse wro e a rea se ca ed "On he Ana omy o he U erus " wh ch
1970) 35-68
198 See n par cu ar he H ppocra c ex Genera on Lon e H ppocra c Trea ses esp pp 1-5 For he wr er o hese ex s ema e seed s weak and h n ma e s rong and h ck On Soranus and he con ex o h s work see Gourev ch "S ua on de Soranos " n Soranos d Éphèse Budé ed x x 199 On he A ec ed Par s 6 5 (K 8 420 424 and 432-433) 200 On he A ec ed Par s 6 5 (K 8 421-424) 201 Sympasche
K 8 424 ade ph x a On o n s 57 (L 4 246) n he s x een h cen ury he La n commun as s he pre erred erm
202 Fur her d scuss on o he mechan sm by wh ch hese symp oms are produced may be ound n On he Me hod o Hea ng o G aucon 1 15 (C Daremberg Oeuvres ana om ques phys o og ques e méd ca es de Ga en Par s Ba ère 1854-6 Vo p 735) where he seed becomes we and co d ch ng he body 203 Green Anc en Theor es o Fema e Phys o ogy and D sease 50-52 Scen herapy oo s descr bed n On he Me hod o Hea ng o G aucon 1 15 (Daremberg Oeuvres ana om ques Vo accord ng o S e 9 10 (K 13 320)
p 735) and a so n On Compound Med c nes
204 On he A ec ed Par s 6 5 (K 8 420) c DW 2 201 (L 8 384) on rubb ng aroma cs n o he gro n and nner h ghs 205 PGM V 260-272 K Pre sendanz and A Henr chs Papyr Graecae Mag cae 2 (S u gar Teubner 1974) The rans a on s ha o J Scarborough n The Greek Mag ca Papyr n Trans a on by H D Be z (Ch cago Un vers y o Ch cago Press 1986) 123-124 206 Pandora s crea ed w h a kyneos noos
he m nd o a b ch (Hes od Works and Days 67) On he sexua y o he dog see or examp e Ar s o e HA 540a 24 and 574b 27 Kuon dog can mean he gen a s o e her sex
207 Marce us Emp r cus A D 395 see De med camen s ber chap 1 25 (CML vo 5 pp 60 35-61 3) The ed o pr nceps o Cornar us was pr n ed n 1536 p 32 has a no e n he marg n by h s passage say ng su oca o de vu va (J Cornar us De med camen s emp r c s phys c s ac ra onab bus ber Base Froben 1536 ) 208 On encyc oped sm see P Lemer e Byzan ne Human sm The F rs Phase Aus ra an Assoc a on or Byzan ne S ud es Byzan na Aus ra ensa 3 Canberra 1986 chap 10 med ca rea ses rece ve on y a br e men on on p 341 209 See M Meyerho and D Joann des La Gynéco og e e Obs é r que chez Av cenne ( bn S na) e eurs rappor s avec ce es des Grecs (Ca ro R Sch nd er 1938) 6 A reassessmen o he per od s g ven by V Nu on "From Ga en o A exander Aspec s o Med c ne and Med ca Prac ce n La e An qu y " n Dumbar on Oaks Papers 38 (1984) 1-14 ( = V Nu on From Democedes o Harvey London Var orum Repr n s 1988 chap 10 2-3) 210 J Ko esch Un ersuchungen zu den pseudoga en schen De n ones Med cae (Ber n Akadem e-Ver ag 1973) 14 J Du y "Byzan ne Med c ne n he S x h and Seven h Cen ur es Aspec s o Teach ng and Prac ce " n Dumbar on Oaks Papers 38 ed Scarborough 21-27 211 J Du y "Byzan ne Med c ne n he S x h and Seven h Cen ur es Aspec s o Teach ng and Prac ce " n Dumbar on Oaks Papers 38 ed Scarborough 21-27 here 21-22 212 N G W son Scho ars o Byzan um (London Duckwor h 1983) 48 and see a so 85-86 213 Or bas us Co ec ones med cae 24 31 (CMG vo 6 2 1 pp 41-46) 214 Or bas us Synops s 9 45 (CMG vo 6 3 p 305 10-28) rans C Daremberg n Oeuvres d Or base ed U Bussemaker and C Daremberg 6 vo s (Par s mpr Na ona e 1851-1876) vo 6 pp 539-540 Ph umenos o A exandr a was he au hor o a work on gyneco ogy and ano her on venomous an ma s and remed es or he r s ngs and b es (see A bu Greek Med c ne n Rome ) The a er s ava ab e as CMG vo 10 1 1 Ph umenos uses he same remed es or cer a n po sons as or hys er ke pn x (pp 14 19 and 22) hus echo ng Ga en s v ew ha re a ned seed and menses ac ed ke a po son on he body Abou Ph umenos h mse e s known even h s da e s var ous y g ven as he rs cen ury A D ca A D 180 or he h rd cen ury A D He does no exp c y use Ga en—wh ch ends suppor o he ear es da e bu he above re erence o hys er ke pn x may mp y know edge o Ga en s heor es 215 Or bas us Synops s 9 41 (CMG vo 6 3 p 301) 216 G Baader "Ear y Med eva La n Adap a ons o Byzan ne Med c ne n Wes ern Europe " n Dumbar on Oaks Papers 38 ed Scarborough 251-259 esp p 252 W son Scho ars o Byzan um 57-58 Du y "Byzan ne Med c ne " n Dumbar on Oaks Papers 38 ed Scarborough 21-27 esp 25-27 217 W son Scho ars o Byzan um 142-143 218 16 68 wh e he comp e on o he CMG Ae us s awa ed Book 16 appears on y n he unsa s ac ory ed on o S Zervos Ae sermo sex dec mus e u mus (Le pz g Mangkos 1901) o wh ch see pp 95 Soranus s c ed on p 97 26 An Eng sh rans a on s ava ab e n J V R cc Ae os o Am da The Gyneco ogy and Obs e r cs o he S x h Cen ury A D (Ph ade ph a B ak s on 1950) where he re evan sec ons may be ound on pp 70-76 See a so A Garzya "Prob èmes re a s à éd on des vres X-XV du Té rab b on d Aé os d Am da " Revue des E udes Anc ennes 86 (1984) 245-257 219 Zervos Ae
sermo p 96 1-3
220 Ga en On he A ec ed Par s 6 5 (K 8 415) 221 Zervos Ae sermo P 97 14 See ur her J M R dd e Con racep on and Abor on rom he Anc en Wor d o he Rena ssance (Cambr dge Mass and London Harvard Un vers y Press 1992) 92-97 R dd e argues ha Ae us "d sp ayed a know edge o con racep ves and abor ac en s grea er han anyone e se n an qu y excep Soranus and D oscor des" (92) 222 b d p 97 26-28 223 b d p 98 1 Debru argues ha he use o he rs person n o her peop e s s or es s charac er s c o h s genre see Debru "La su oca on hys ér que " No e ha h s read ness o urn a genera s ory n o a persona exper ence s ev den even n he wr ngs o one person Nu on shows ha he s or es Ga en had read or heard h r y years be ore were rans ormed n o h s own eye-w ness accoun s n h s a er wr ngs See V Nu on "S y e and Con ex n he Me hod o Hea ng " n Ga en s Me hod o Hea ng ed F Kud en and R J Dur ng (Le den Br 1991) 1-25 see pp 12-13 221 Zervos Ae sermo P 97 14 See ur her J M R dd e Con racep on and Abor on rom he Anc en Wor d o he Rena ssance (Cambr dge Mass and London Harvard Un vers y Press 1992) 92-97 R dd e argues ha Ae us "d sp ayed a know edge o con racep ves and abor ac en s grea er han anyone e se n an qu y excep Soranus and D oscor des" (92) 222 b d p 97 26-28 223 b d p 98 1 Debru argues ha he use o he rs person n o her peop e s s or es s charac er s c o h s genre see Debru "La su oca on hys ér que " No e ha h s read ness o urn a genera s ory n o a persona exper ence s ev den even n he wr ngs o one person Nu on shows ha he s or es Ga en had read or heard h r y years be ore were rans ormed n o h s own eye-w ness accoun s n h s a er wr ngs See V Nu on "S y e and Con ex n he Me hod o Hea ng " n Ga en s Me hod o Hea ng ed F Kud en and R J Dur ng (Le den Br 1991) 1-25 see pp 12-13 221 Zervos Ae sermo P 97 14 See ur her J M R dd e Con racep on and Abor on rom he Anc en Wor d o he Rena ssance (Cambr dge Mass and London Harvard Un vers y Press 1992) 92-97 R dd e argues ha Ae us "d sp ayed a know edge o con racep ves and abor ac en s grea er han anyone e se n an qu y excep Soranus and D oscor des" (92) 222 b d p 97 26-28 223 b d p 98 1 Debru argues ha he use o he rs person n o her peop e s s or es s charac er s c o h s genre see Debru "La su oca on hys ér que " No e ha h s read ness o urn a genera s ory n o a persona exper ence s ev den even n he wr ngs o one person Nu on shows ha he s or es Ga en had read or heard h r y years be ore were rans ormed n o h s own eye-w ness accoun s n h s a er wr ngs See V Nu on "S y e and Con ex n he Me hod o Hea ng " n Ga en s Me hod o Hea ng ed F Kud en and R J Dur ng (Le den Br 1991) 1-25 see pp 12-13 224 Zervos Ae
sermo p 98 1-8 P 99 18-22
225 b d p 100 7 p 101 1-3 (= Or bas us Synops s 9 45 6) 224 Zervos Ae
sermo p 98 1-8 P 99 18-22
225 b d p 100 7 p 101 1-3 (= Or bas us Synops s 9 45 6) 226 3 71 (CMG vo 9 1 p 288 8-289 21) Th s s rans a ed n o Eng sh n Adams The Med ca Works o Pau us Aeg ne a 345-346 227 CMG vo 9 1 p 288 8 Greek anadrome 228 CMG vo 9 1 p 288 19-20 229 CMG vo 9 1 p 288 24-27 c Zervos Ae 230 CMG vo 9 1 p-289 6-8 Zervos Ae
sermo P 97 12-14
sermo p 99 8-10 g ves he same hree subs ances
231 CMG vo 9 1 p 289 16 c Soranus Gyneco ogy 3 28 1 (CMG vo 4 p 110 22) bro d Me rodora (M an Cesch na 1953) 41 and "La med c na b zan na e
232 G De Guerra
cod ce med co-g neco og ca d Me rodora " Sc en a Ve erum 118 (1968) 67-94 89
233 Green Anc en Theor es o Fema e Phys o ogy and D sease 135 and 174-175 nn 5 and 6 234 Baader "Ear y Med eva La n Adap a ons o Byzan ne Med c ne " n Dumbar on Oaks Papers 38 (1984) 251-252 235 Musc o shou d be consu ed n he V Rose ed on o Soran Gynaec orum ve us rans a o La na (Le pz g Teubner 1882) 4 26-29 (pp 58-61) compare w h M F Drabk n and ascenden e sursum ad pec us ma r ce and occurs a Rose p 58 9-10 and Drabk n p 76 367-368 236 V Rose Theodor Pr sc an Eupor s on L br Temk n 174
E Drabk n Cae us Aure anus The added phrase s
(Le pz g Teubner 1894) 228-230 On Theodorus Pr sc anus see O Temk n "H s ory o H ppocra sm n La e An qu y The Th rd Cen ury and he La n Wes " n Doub e Face o Janus by
237 V Rose Cass Fe c s De Med c na ex Graec s Log cae Sec ae Auc or bus L ber Trans a us (Le pz g Teubner 1879) chap 77 PP 187-189 See Temk n "H s ory o H ppocra sm " n Doub e Face o Janus by Temk n 228 and Green Anc en Theor es o Fema e Phys o ogy and D sease 167 238 Rose Soran Gynaec orum 131-139 Baader "Ear y Med eva La n Adap a ons o Byzan ne Med c ne " n Dumbar on Oaks Papers 38 ed Scar-borough 251 239 Green Anc en Theor es o Fema e Phys o ogy and D sease 153 240 For cr c sm o he v ew ha H ppocra c wr ngs were unknown n he Wes be ore he een h cen ury see P K bre "H ppocra c Wr ngs n he M dd e Ages " Bu e n o he H s ory o Med c ne 18 (1945) 373-412 and "H ppocra es La nus " Trad o 36 (1980) 347-372 esp p 347 n 1 Green Anc en Theor es o Fema e Phys o ogy and D sease 142 146-147 La n manuscr p s such as he ear y n n h-cen ury Par s BN 11219 wh ch con a ns DW 1 7-38 can be raced o Ravenna On Ravenna see Mü er-Roh sen D e La e n sche Ravenna sche 241 See ur her Mazz n and G F amm n De concep u (Bo ogna Pa ron Ed ore 1983) M E Vazquez Bu an E de mu erum a ec bus de corpus H ppocra cum Es ud o y ed c ón cr ca de a an gua raducc ón a na (Compos e a Un vers dad de San ago 1986) r go n "Trad on manuscr e " 1-13 242 For a rans a on o h s commen ary see N Pa m er "Un an co commen o a Ga eno de a scuo a med ca d Ravenna " Phys s 23 (1981) 197-296 esp 288-289 d scussed n Green Anc en Theor es o Fema e Phys o ogy and D sease 153153 243 Green " De genec a A r bu ed o Cons an ne " 311 Mazz n " ppocra e a no de seco o V-V n ernaz ona e Un vers à d Macera a Bre schne der 1985 383-387 esp p 385
ecn ca d raduz one " n Tes d Med c na La n An ch Prob em F o og c e S or c
Mazz n and F Fusco A
de
Convegno
244 Beccar a "An co canone a no d ppocra e " 36 and 38-39 K bre "H ppocra es La nus " 280-282 J Agr m "L H ppocra es La nus ne a rad z one manoscr a e ne a cu ura a omed eva " n Tes d Med c na La n An ch Fusco 391-392 On he re a onsh p be ween he Ep s u a ad Maecena em and V nd c anus see M E Vazquez Bu an "V nd c ano y e ra ado De na ura gener s human " Dynam s 2 (1982) 25-56
Mazz n and
245 P D epgen "Res e an ker Gynäko og e m rühen M e a er " Que en und S ud en zur Gesch ch e der Na urw ssenscha en 3 (1933) 226-242 esp 228-229 G Wa er "Per Gyna ke on A o he Corpus H ppocra cum n a La n Trans a on " Bu e n o he ns u e o he H s ory o Med c ne 3 (3935) 599-606 246 M U mann s am c Med c ne (Ed nburgh Ed nburgh Un vers y Press 1978) 8 The erms Arab c med c ne and s am c med c ne are m s ead ng many o hose whose work s cons dered here were no Mus ms or were no o Arab or g n The reader shou d ake warn ng Ve h Hys er a 94-97 pays e a en on o he Arab wor d say ng mere y ha " he hree ead ng Mus m phys c ans bn S na Rhazes and Ha y Abbas d d no wr e much abou hys er a " The d cu y n s udy ng he or unes o he hys er a rad on n he Arab wor d s he pauc y o ex s ava ab e n European anguages however s nce many o hese works were rans a ed n o La n s a eas poss b e or he scho ar w hou Arab c o make some pre m nary commen s 247 r go n "Trad on manuscr e " 1-13 D L pp and S Ar e "La r cez one de Corpus h ppocra cum ne s am " n Tes d Med c na La n An ch Av cenne 6 U mann s am c Med c ne 11 M Meyerho "New L gh on Huna n bn shaq and H s Per od " s s 8 (1926) 685-724
Mazz n and Fusco 399-402 Meyerho and Joann des Gynéco og e e
248 R J Dur ng "A Chrono og ca Census o Rena ssance Ed ons and Trans a ons o Ga en " Journa o he Warburg and Cour au d ns u es 24 (1961) 230-305 esp p 232 See a so L pp and Ar e Tes d Med c na La n An ch by Mazz n and Fusco 401
Obs é r que chez
"R cez one de Corpus h ppocra cum " n
De morb s mu ebr bus " Med z nh s or sches Journa 12 (1977) 245-262 Green " De genec a A r bu ed o Cons an ne " 303 n 15 305 n 22 U mann s am c Med c ne
249 M U mann "Zwe spä an ke Kommen are zu der h ppokra schen Schr 11-12
250 On a -Tabar see M Meyerho "A a -Tabar s Parad se o W sdom One o he O des Arab c Compend ums o Med c ne " s s 16 (1931) 6-54 esp 13-15 5 E G Browne Arab c Med c ne (Cambr dge Cambr dge Un vers y Press 1921) 3740 251 F rdaws 2 1 chap 16 A S gge "Gynäko og e Embryo og e und Frauenhyg ene aus dem Parad es der We she Über d e Med z n des Abu Hana A b Sah Rabban a -Tabar nach der Ausgabe von Dr Zuba r as-S dd q 1928 " Que en und S ud en zur Gesch ch e der Na urw ssenscha en und der Med z n 8 (1941) 216-272 esp p 242 252 F rdaws 4 9 chap 17 S gge "Gynäko og e Embryo og e " 244-245 253 U mann s am c Med c ne 43 am us ng he ed on o 1534 Rhas s Ph osoph Trac a us nonus ad regem A mansorem de cura one morborum par cu ar um (Par s S mon de Co nes 1534)
254 Chap 87 De prae oca one ma r c s
255 Kam 9 39 A A Gewarg s Gynäko og sches aus dem Kam as-S na a a -T bb ya des A bn a - Abbas a -Magus Med c ne (1921) 53-57 and Meyerho and Joann des Gynéco og e e Obs é r que chez Av cenne 7 256 Kam
naugura d sser a on Fr edr ch-A exander-Un vers ä Er angen-Nürnberg 1980 43 On a -Ma us see Browne Arab c
8 12 Gewarg s Gynäko og sches 76
257 Gewarg s Gynäko og sches 18 see ur her U We sser Zeugung Vererbung und Präna a e En w ck ung n der Med z n des arab sch- s am schen M e a ers (Er angen Lü ung 1983) 146-147 and U We sser "Das Corpus H ppocra cum n der arab schen Med z n " n D e h ppokra schen Ep dem en ed G Baader and R W nau Sudho s Arch v Be he 27 (1990) 377-408 258 Gewarg s Gynäko og sches 44 and 80 p ck ng up Ae us (Zervos p 97 13) on he suscep b y o he young o su oca on See a so Green Anc en Theor es o Fema e Phys o ogy and D sease 114 and Ar b bn Sa d Le L vre de a Généra on du Foe us e e Tra emen des Femmes ence n es e des Nouveau-nés ed ed and rans a ed by H Jah er and N Abde kader (A g ers L bra r e Ferrar s 1956) 259 Gewarg s Gynäko og sches 77 260 On bn a -Jazzar see J Schön e d "D e Zahnhe kunde m K ab Zad a -musa r des a -Gazzar Sudho s Arch v 58 (1974) 380-403 R Jaz "M éna re d bn a -Jazzar pharmac en maghréb n médec n des pauvres e des déshér és " Revue d H s o re de a Pharmac e 33 (1986) 5-12 108-120 dem "Aphrod s aqu es e méd camen s de a reproduc on chez bn a -Jazzar méde-c n e pharmac en maghréb n du x e s èc e " Revue d H s o re de a Pharmac e 34 (1987) 155-170 943-959 M W Do s Med eva s am c Med c ne bn R dwan s Trea se On he Preven on o Bod y s n Egyp (Berke ey Los Ange es London Un vers y o Ca orn a Press 1973) 67-69 261 Here am us ng he La n rans a on o he V a cum g ven n Opera Ysaac (Lyons B Tro & J de P a ea 1515) an abbrev a ed orm o he Arab c ex Fema e Phys o ogy and D sease 249
he V a cum vers on o h s chap er s conven en y g ven by Green n Anc en Theor es o
262 U mann s am c Med c ne 46 on Av cenna n he Wes see N S ra s Av cenna n Rena ssance a y The Canon and Med ca Teach ng n a an Un vers es a er 1500 (Pr nce on N J Pr nce on Un vers y Press 1987) 263 Qanun 21 4 16-19 am us ng he ed L br n re med ca omnes (2 vo s ) 949-943 (Ven ce Va gr s 1564) Meyerho and Joann des Gynéco og e e Obs é r que chez Av cenne p 66 argue ha rubb ng aroma c o n o he mou h o he womb o m a e copu a on as recommended by Av cenna s absen rom Greek med c ne—ye s presen no on y n Ga en bu a so n he H ppocra c corpus 264 Green Anc en Theor es o Fema e Phys o ogy and D sease 75-76 and 119-120 nn 9-10 265 D seases o Young G r s a so known as On V rg ns L 8 466-470 U mann D e Med z n m s am 32 266 D agnoses o hys er a n E T W h ng on "The Asc ep adae and he Pr es s o Asc ep us " n S ud es n he H s ory and Me hod o Sc ence ed C S nger vo 2 (Ox ord C arendon Press 1921) 192-905 esp p 200 D epgen D e Frauenhe kunde der A en We 194 W D Sm h "So-ca ed Possess on n Pre-Chr s an Greece " Transac ons and Proceed ngs o he Amer can Ph o og ca Assoc a on 96 (1965) 403-426 esp p 406 B S mon M nd and Madness n Anc en Greece 243 Le kow z Hero nes and Hys er cs 14 Manu "Donne masco ne emm ne s er " n Madre Ma er a Campese Manu and S ssa (Tur n Bor ngh er 1983) 147-192 esp p 161 For d scuss on o he ex and s probab e con ex o menarche see H K ng "Bound o B eed Ar em s and Greek Women " n mages o Women n An qu y ed A Cameron and A Kuhr (London Croom He m 1983) 109-127 H K ng From Par henos o Gyne The Dynam cs o Ca egory Ph D hes s Un vers y o London 1985 175-182 267 Green Anc en Theor es o Fema e Phys o ogy and D sease 132-133 268 J L He berg Pau Aeg ne ae br er
n erpre a o La na an qua (Le pz g Teubner 1912) x
c ed by Green Anc en Theor es o Fema e Phys o ogy and D sease 184 n 82
269 F P Eger Gynäho og sche Fragmen e aus dem rühen M e a er nach e ner Pe ersburger Handschr 270 b d
26
271 b d
16 see d scuss on on p 54
272 b d
23
aus dem V - X Jahrhunder (Ber n Eber ng 1936)
269 F P Eger Gynäho og sche Fragmen e aus dem rühen M e a er nach e ner Pe ersburger Handschr 270 b d
26
271 b d
16 see d scuss on on p 54
272 b d
23
aus dem V - X Jahrhunder (Ber n Eber ng 1936)
269 F P Eger Gynäho og sche Fragmen e aus dem rühen M e a er nach e ner Pe ersburger Handschr 270 b d
26
271 b d
16 see d scuss on on p 54
272 b d
23
aus dem V - X Jahrhunder (Ber n Eber ng 1936)
269 F P Eger Gynäho og sche Fragmen e aus dem rühen M e a er nach e ner Pe ersburger Handschr 270 b d
26
271 b d
16 see d scuss on on p 54
272 b d
23
aus dem V - X Jahrhunder (Ber n Eber ng 1936)
273 H Sch pperges "D e Ass m a on der arab schen Med z n durch das a e n sche M e a er " Sudho s Arch v Be he 3 (W esbaden 1964) Green " De genec a A r bu ed o Cons an ne " 299-323 G Baader "Ear y Med eva La n Adap a ons o Byzan ne Med c ne " n Dumbar on Oaks Papers 38 (1984) 259 Dur ng "Rena ssance Ed ons and Trans a ons o Ga en " 233 on Cons an nus A r canus see P O Kr s e er The Schoo o Sa erno s Deve opmen and s Con r bu on o he H s ory o Learn ng " Bu e n o he H s ory o Med c ne 17 (1945) 138-194 274 Green "Cons an nus A r canus and he Con c be ween Re g on and Sc ence " n The Human Embryo Ar s o e and he Arab c and European Trad ons ed G R Duns an (Exe er Un vers y o Exe er Press 1990) 47-69 esp pp 49 and 62 n 7 275 U mann s am c Med c ne 53-54 Green Anc en Theor es o Fema e Phys o ogy and D sease 220 276 Green Anc en Theor es o Fema e Phys o ogy and D sease 234 On he schoo o Sa erno see Kr s e er "Schoo o Sa erno " 138-194 G Baader "D e Schu e von Sa erno " Med z nh s or sches Journa 13 (1978) 124-145 277 S de Renz Co ec o Sa ern ana
(Nap es F a re-Sebez o 1853) 338-339 Green Anc en Theor es o Fema e Phys o ogy and D sease 263-266 and Mon ca Green pers comm 16 11 91
278 Green Anc en Theor es o Fema e Phys o ogy and D sease 267-268 279 b d 303 nn 49 and 50 306 n 68 310 n 90 S M S uard "Dame Tro " S gns 1 (1975) 537-542 J F Ben on "Tro u a Women s Prob ems and he Pro ess ona za on o Med c ne n he M dd e Ages " Bu e n o he H s ory o Med c ne 59 (1985) 30-53 Mon ca Green s curren y ed ng he Tro u a manuscr p s 278 Green Anc en Theor es o Fema e Phys o ogy and D sease 267-268 279 b d 303 nn 49 and 50 306 n 68 310 n 90 S M S uard "Dame Tro " S gns 1 (1975) 537-542 J F Ben on "Tro u a Women s Prob ems and he Pro ess ona za on o Med c ne n he M dd e Ages " Bu e n o he H s ory o Med c ne 59 (1985) 30-53 Mon ca Green s curren y ed ng he Tro u a manuscr p s 280 Green Anc en Theor es o Fema e Phys o ogy and D sease 274-275 281 b d 285 and n 91 he ex s a so g ven n n 91 282 b d 316 280 Green Anc en Theor es o Fema e Phys o ogy and D sease 274-275 281 b d 285 and n 91 he ex s a so g ven n n 91 282 b d 316 280 Green Anc en Theor es o Fema e Phys o ogy and D sease 274-275 281 b d 285 and n 91 he ex s a so g ven n n 91 282 b d 316 283 On s da e see D W Pe erson "Observa ons on he Chrono ogy o he Ga en c Corpus " Bu e n o he H s ory o Med c ne 51 (1977) 484-495 on Rena ssance ed ons see Dur ng "Rena ssance Ed ons and Trans a ons o Ga en " 243 284 K bre "H ppocra c Wr ngs n he M dd e Ages " 380 bu see Nu on "H ppocra es n he Rena ssance " n H ppokra schen Ep dem en by Baader and W nau p 437 po n s ou ha he Parace s an Pe rus An on us Sever nus re ec ed he Aphor sms as par o h s recas ng o H ppocra es n a Parace s an mo d 285 P O Kr s e er "Bar ho omaeus Musand nus and Maurus o Sa erno and O her Ear y Commen a ors o he Ar ce a w h a Ten a ve L s o Tex s and Manuscr p s " a a Med oeva e e Uman s ca 19 (1976) 57-87 esp pp 59 and 65 G A or sm d ppocra e ne a vers one e ne commen de pr mo med oevo " a a Med oeva e e Uman s ca 4 (1961) 1-75 esp p 23
286 A Beccar a "Su e racce d un an co canone a no d ppocra e e d Ga eno 287 Mü er-Roh sen D e La e n sche Ravenna sche xv -x x and 72
288 am us ng he rs ed on o 1476 pub shed by N Pe r a Padua On he Ar ce a see K bre "H ppocra c Wr ngs n he M dd e Ages " 382-384 Baader "Ear y Med eva La n Adap a ons o Byzan ne Med c ne " n Dumbar on Oaks Papers 38 ed Scarborough 259 Nu on "H ppocra es n he Rena ssance n H ppokra schen Ep dem en ed Baader and W nau 420-439 Kr s e er "O her Ear y Commen a ors o he Ar ce a " 57-87 on he rans a on o Aphor sms used see pp 6667 289 De s ernu a one p x
De membr s genera on s n eme s p x v
290 See Nu on "H ppocra es n he Rena ssance " n H ppokra schen Ep dem en ed Baader and W nau pp 425-426 d scuss how he "un y be ween Ga en and H ppocra es was re n orced by he power o pr n " 291 Ga en n H ppocra s Aphor sm
K 17B 824 see Ugo Benz Senens s super aphor smos Hypo e super commen us Ga e us n erpre s (Ferrara Lauren um de Va en a e Andrea de Cas ro Novo 1493) For he u
292 The 1493 ed on does no g ve he aphor sms hemse ves n u
vers on see Expos o Ugon s Senens s super aphor smos Hypocra s e super commen um Ga en (Ven ce B Loca e us 1498) p 125 See D P Lockwood Ugo Benz Med eva Ph osopher and Phys c an 1376-1439 (Ch cago Un vers y o Ch cago Press 1951) 35-36 and 217-219 Benz d es up he rans a on g v ng he correc orm mo es a ur n p ace o he mo es a or mo es an o o her vers ons n Sen en as H ppocra s prae a o (F orence An on us M scom nus) 1494
293 Lorenzo Laurenz an
294 N cco ò Leon ceno Commen um N co super aphor smos (Bonon e Bened c um Hec or s 1522) 295 An on o Musa Brasavo a n oc o bros aphor smorum H ppocra s e Ga en Commen ar a e Anno a ones (Base Froben 1541) 828 On Brasavo a see Nu - on "Med c ne D p omacy and F nance The Pre aces o a H ppocra c Commen ary o 1541 " n New Perspec ves on Rena ssance Though Essays n he H s ory o Sc ence Educa on and Ph osophy n Memory o Char es B Schm eds J Henry and S Hu on (London Duckwor h 1990) 230-243 296 Leonhar Fuchs n H ppocra s Co sep em Aphor smorum br s commen ar a (Par s Ro gny 1545) 412-413 he d scuss on o unga versus pn ga s on pp 414-415 297 Gu aume P ancy Ga en n Aphor sm H ppocra s commen ar us (Lyons Rov e 1552) 340 298 C aude Champ er Aphor sm ex nova C aud Campens n erpre a one (Lyons C Ravo 1579) 120 Jacques Hou er n Aphor smos H ppocra s commen ar sep em (Par s Jacques de Puys 1582) 284-285 299 M Lon e "The Par s H ppocra cs Teach ng and Research n Par s n he Second Ha o he S x een h Cen ury " n The Med ca Rena ssance o he S x een h Cen ury ed A Wear and R K French (Cambr dge Cambr dge Un vers y Press 1985) 155-174 esp pp 158-160 300 The Who e Aphor smes o Grea H ppocra es ( rans S H ) (London H L or R chard Redmer 1610) 93 301 B L S oane ms 2811 p 23 302 B L S oane ms 2117 p 23 v and p 281 303 See or examp e he h r een h-cen ury work o Wa er Ag on n P D epgen Gua er Ag on s Summa med c na s Nach den Münchener Cod a Nr 325 und 13124 ers ma g ed er m e ner verg e chenden Be rach ung ä erer med z n scher Kompend en des M e a ers (Le pz g Johann Ambros us Bar h 1911) chap 42 o wh ch on su oca on o he womb s heav y dependen on bn S na and nc udes a vers on o he woman who ay as dead n wh ch Ga en becomes he heronarra or (p 149) A so rom he h r een h cen ury s he De na ur s rerum o Thomas o Braban chap 59 on he womb d scusses su oca on See C Fercke D e Gynäko og e des Thomas von Braban E n Be rag zur Kenn n s der m e a er chen Gynä ko og e und hrer Que en (Mun ch Car Kühn 1912) The De propr e a bus rerum o Bar ho omeus Ang cus (d 1260) a so nc udes su oca on n a genera chap er on he womb n Book 5 chap 49 (S rasbourg G Husner 1485) so does he h r een h-cen ury work o Joannes Ac uar us Me hod Medend br sex n Book 4 chap 8 (Ven ce Gua er o Sco o 1554) The ma er a s hus cop ed rom ex o ex becom ng ncreas ng y am ar—an essen a sec on n any work c a m ng he s a us o encyc oped a For s appearance n a more spec a zed work see a so he een h-cen ury M dd e Eng sh ex g ven by M -R Ha aer The Sekenesse o wymmen A M dd e Eng sh Trea se on D seases n Women Scr p a 8 (Brusse s OM REL UFSAL 1982) n wh ch nes 375-482 descr be "su oca on o he mo her" ( e o he womb) 304 P e er van Forees Observa onum e cura onum med c na um ber v ges musoc avus de mu erum morb s (Leyden P an n 1599) 305 b d 154-155 306 b d 167 Hys er ca v u o se s mu a esse mar o 307 b d 167 E hoc es verum 304 P e er van Forees Observa onum e cura onum med c na um ber v ges musoc avus de mu erum morb s (Leyden P an n 1599) 305 b d 154-155 306 b d 167 Hys er ca v u o se s mu a esse mar o 307 b d 167 E hoc es verum 304 P e er van Forees Observa onum e cura onum med c na um ber v ges musoc avus de mu erum morb s (Leyden P an n 1599) 305 b d 154-155 306 b d 167 Hys er ca v u o se s mu a esse mar o 307 b d 167 E hoc es verum 304 P e er van Forees Observa onum e cura onum med c na um ber v ges musoc avus de mu erum morb s (Leyden P an n 1599) 305 b d 154-155 306 b d 167 Hys er ca v u o se s mu a esse mar o 307 b d 167 E hoc es verum 308 Jorden A Br e e D scourse o a D sease Ca ed he Su oca on o he Mo her 309 T Laqueur Mak ng Sex Body and Gender rom he Greeks o Freud (Cambr dge Mass and London Harvard Un vers y Press 1990) 99 or a more op m s c v ew o he re a onsh p be ween sc ence and exper ence n h s per od see D Jacquar and C Thomasse Sexua y and Med c ne n he M dd e Ages (Cambr dge Po y Press n assoc a on w h Ox ord Bas B ackwe 1988) 46 310 Jorden D sease Ca ed he Su oca on o he Mo her 10 v 311 Gu aume de Ba ou De v rg num e mu erum morb s (Par s J Quesne 1643) 206 312 Thomas Laycock A Trea se on he Nervous D seases o Women (London Longman 1840) 317-318 based on Dan e Le C erc H s o re de a Médec ne p 85 o he ed on o 1702 313 Le gh Hun A Legend o F orence (London Edward Moxon 1840) 314 Dur ng "Rena ssance Ed ons and Trans a ons o Ga en " 245 Geo warg s Gynäko og sches 6 315 M F Wack Loves ckness n he M dd e Ages The V a cum and s Commen ar es (Ph ade ph a Un vers y o Pennsy van a Press 1990) 292 n 6
Two— "A Strange Pathology": Hysteria in the Early Modern World, 1500-1800 1 Th s ra ses he ph osoph ca ques on abou med ca ca egor es as d s nc rom o hers some d scuss on o he sub ec s ound n Les er K ng The Ph osophy o Med c ne The Ear y E gh een h Cen ury (Cambr dge Mass Harvard Un vers y Press 1978) 49-50 n he con ex o Greek ph osophy and med c ne Throughou h s chap er he ques on o med ca ca egor es never es ar rom my mag na on Wha can a "med ca ma ady" or "med ca cond on" be can embrace a mos every ype o symp om? 2 Th s ac shou d no cause s uden s such as hose o us who con r bu e o h s book o become pos v s s and h nk we can know every h ng abou hys er a as a ph osoph ca med ca and represen a ona ca egory or hys er a and represen a on see be ow n h s sec on and n sec on X V or he dangers o such be e see Edward Davenpor "The Dev s o Pos v sm " n L era ure and Sc ence Theory and Prac ce ed S uar Pe er reund (Bos on Nor heas ern Un vers y Press 1990) 17-31 The " s" and "as s" o hys er a s a doub e-headed hydra 3 The genera za on mus be qua ed For he n ma e connec on be ween hys er a and psychoana ys s pre- and pos -Lacan an see A an Krohn "Hys er a The E us ve Neuros s " n Psycho og ca ssues (New York n erna ona Un vers es Press 1978) Mon que Dav d-Ménard Hys er a rom Freud o Lacan Body and Language n Psychoana ys s ( haca N Y Corne Un vers y Press 1989) and he mpor an b b ograph ca de ec ve work o Mark M ca e "On he D sappearance o Hys er a A S udy n he C n ca Decons ruc on o a D agnos s " unpub shed paper de vered o he ns u e o Neuro ogy Queen Square London (1988) and "Hys er a and s H s or ography A Rev ew o Pas and Presen Wr ngs " H s ory o Sc ence 27 (1989) 223-260 317-351 4 D scuss ons o he s range d sappearance o hys er a nc ude Mark M ca e s works (n 3) Krohn "Hys er a" and rom a erary po n o v ew he c on o Marguer e Duras (see sec ons Hys er ca Convers on Reac ons A C n ca Gu de o D agnos s and Trea men (Lancas er MTP Press 1983) Dav d-Ménard Hys er a rom Freud o Lacan
and
) For convers on syndrome see M
We n raub
5 Fema e sexua y s no o course synonymous w h em n sm or any o her po ca women s movemen wha des gna e by he hrea o ema e sexua y n h s ory s e oquen y d scussed n Caro ne Bynum ed Gender and Re g on On he Comp ex y o Symbo s (Bos on Beacon Press 1986) E a ne Showa er The Fema e Ma ady Women Madness and Eng sh Cu ure 1830-1980 (London V rago 1987) Susan Rub n Su e man ed The Fema e Body n Wes ern Cu ure Con emporary Perspec ves (Cambr dge Mass Harvard Un vers y Press 1985) 6 Such v g ance pa d o he ngu s c aspec s o sc en c and med ca d scourse has been a he op o my own agenda or wo decades see G S Rousseau En gh enmen Borders Sc en c—Med ca Pre- and Pos modern D scourses (Manches er Manches er Un vers y Press 1991) use he erm "emp o " ( e emp o ed emp o men emp o men s) o deno e he way cu ura prac ces and ma er a cond ons are encoded n a d scourse and hroughou h s chap er par cu ar y wan o unders and how var ous med ca heor es o hys er a assume a par cu ar v s on o cu ure and hen emp o ha v s on n o a ex Ques ons o ur her represen a on genre and rhe or c are ano her ma er 7 For he c a m and s m s see G S Rousseau "Med c ne and he Muses An Approach o L era ure and Med c ne " n Med c ne and L era ure ed Mar e Rober s and Roy Por er (London Rou edge 1993) 23-57 For numbness and headache among hys er ca ypes see O ver Sacks M gra ne The Evo u on o a Common D sorder (Berke ey Los Ange es London Un vers y o Ca orn a Press 1985) 196-207 See a so sec on X or W s s mode o hys er a n re a on o m gra ne 8 See sec ons
and X or de a ed d scuss on o Sydenham s heor es and herap es
9 See Krohn "Hys er a " 343 10 Even he mos heore ca and ph osoph ca y advanced o med ca heor s s has avo ded h s ma er o ca egory and M ca e s var ous b b ograph ca s ud es (n 3) do no address he ssue 11
ake h s o be a ma n po n o Dav d Morr s s chap er on hys er a n h s ne s udy o The Languages o Pa n (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1992)
12 W am Shakespeare Ham e The R vers de Shakespeare ed G B Evans (Bos on Hough on M n Co 1974) 82 The s andard work s by R K bansky e a Sa urn and Me ancho y (London Ne son 1964) For he re a on o eros and ecs asy see Ar hur Evans The God o Ecs asy (New York S Mar n s Press 1988) and M Screech Ecs asy and he Pra se o Fo y (London Duck-wor h 1980) For Lacan b ograph ca y and n re a on o hys er a see S uar Schne derman Jacques Lacan The Dea h o an n e ec ua Hero (Cambr dge Mass Harvard Un vers y Press 1983) E zabe h Roud nesco Jacques Lacan and Co A H s ory o Psychoana ys s n France (New York A red A Knop 1987) Ca her ne C emen The L e and Legend o Jacques Lacan rans Ar hur Go dhammer (New York Co umb a Un vers y Press 1983) 13 Th s rema ns one o he ma n po n s co ec ve y speak ng o he en au hors wr ng n G S Rousseau ed The Languages o Psyche M nd and Body n En gh enmen Though (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1990) 14 See Ju a Kr s eva Des re n Language A Sem o c Approach o L era ure and Ar (New York Co umb a Un vers y Press 1980) and dem B ack Sun Depress on and Me ancho a (New York Co umb a Un vers y Press 1989) The rope o hys er a and me ancho y s pervas ve n her wr ng as her bes commen a ors have recogn zed see or examp e J F e cher and A Ben am n eds Ab ec on Me ancho a and Love The Work o Ju a Kr s eva (London Rou edge 1989) The H s ory o Sexua y Vo 1 An n roduc on (London Pengu n 1978) 104
15 M che Foucau
16 "Numb ng" was no a erm common y used n any anguage n he per od preem nen y d scussed n h s chap Lu s L ger " Cr ca Rev ew (Apr 1760) 283-288 Never he ess con nue o nvoke u y aware o s somewha such "nervous wr ers" as V rg n a Woo S mon de Beauvo r Marguer e Duras and Samue Becke n Eng sh vocabu ary o he nerves For he s andard de n ons n Eng sh ca 1750 see Samue Johnson A D c onary o
er a hough or a con emporary use n a med ca con ex see M L ger M D "A Trea se on he Gou From he French o M Char es anachron s c usage and based on s common appearance n wen e h-cen ury par ance and pr n ed wr ng espec a y n he works o he word had acqu red severa usages by 1800 espec a y n phys o og ca and med ca con ex s bu was no regu ar y used n he he Eng sh Language 2 vo s (London 1755)
17 The ex ended quarre o he anc en s and moderns wh ch s sem na or any unders and ng o he per od covered by h s chap er augh s con es an s as much and we do we o earn rom he n e ec ua ravages o hree cen ur es see R F Jones Anc en s and Moderns (S Lou s Wash ng on Un vers y Press 1936) and Joseph Lev ne Human sm and H s ory Or g ns o Modern Eng sh H s or ography ( haca N Y Corne Un vers y Press 1987) 18 See George L nco n Burr "The L era ure o W chcra " Papers o he Amer can H s or ca Assoc a on 4 (1890) 37-66 Henry Char es Lea "Ma er a s oward a H s ory o W chcra " (Ph ade ph a 1939 repr n New York and London T Yose o 1957) Russe Hope Robb ns The Encyc oped a o W chcra and Demono ogy (New York Crown 1959) and he severa books by W am Mon er he acknow edged exper on European w chcra 19 The
era ure s rev ewed n J Da Ava San ucc Des sorc è aux mandar nes H s o re des emmes médec ns (Par s Ca mann-Levy 1989)
20 s ound n and has s own cur ous provenance hav ng been quo ed by many wr ers n he as cen ury and by some who gure n h s chap er hav ng o en been c ed by Marguer e Duras and mos recen y by Dav d Morr s see Marguer e Duras Wr ng on he Body (Urbana and Ch cago Un vers y o no s Press 1987) and Dav d Morr s The Cu ure o Pa n (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1991) chap 5 Cur ous y Mon er does no d scuss he accoun n h s many books on w chcra 21 Ju es M che e Sa an sm and W chcra
A S udy n Med eva Supers
on (New York C ade Press 1939) 23 39 41 79 327-329
22 See Kr s eva Des re n Language and Dav d-Ménard Hys er a rom Freud o Lacan who ex ends Kr s eva s ou ssance o he who e e d o know edge bu w hou re a ng
o hys er a n he way a emp here
23 T F Graham Med eva M nds Men a Hea h n he M dd e Ages (London A en & Unw n 1967) T K Oes erre ch Possess on Demon aca and O her (New York R chard R Sm h 1930) Robb ns The Encyc oped a o W chcra and Demono ogy John Demos En er a n ng Sa an W chcra and he Cu ure o Ear y New Eng and (New York Ox ord Un vers y Press 1982) 24 For mass hys er a see Bryan W son Mag c and he M enn um A Soc o og ca S udy o Re g ous Movemen s o Pro es among Tr ba and Th rd-Wor d Peop es (London He nemann 1973) M chae J Co gan e a eds Mass Psychogen c ness A Soc a Psycho og ca Ana ys s (H sda e N J L Er baum Assoc 1982) As a e as 1989 severa hundred mus ca per ormers became v o en y n he San a Mon ca C v c Aud or um n Ca orn a A eam o UCLA psych a r s s nves ga ed he case and pub shed he r nd ngs n he Amer can Journa o Psych a ry repor ng ha h s was a c ass c case o "group psychogen c ness " See J Sco "1989 San a Mon ca ness Tha S ruck 247 ca ed Mass Hys er a " Los Ange es T mes Sep ember 4 1991 (B1 3) The Los Ange es r o s o Apr 1992 may n me rece ve a s m ar d agnos s 25 An ear y work mak ng h s po n s A ber us Kran z s De pass on bus mu erum (1544) see a so Ka e Campbe Hurd-Mead A H s ory o Women n Med c ne rom he Ear es T mes o he Beg nn ng o he N ne een h Cen ury (Haddam Conn Haddam Press 1938) M chae MacDona d "Women and Madness n Tudor and S uar Eng and " Soc a Research 53 no 2 (1986) 261-281 Caro ne Wa ker Bynum Ho y Feas and Ho y Fas The Re g ous S gn cance o Food o Med eva Women (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) A exander Wa ker Woman Phys o og ca y Cons dered as o M nd Mora s Marr age Ma r mon a S avery n de y and D vorce (Har ord Conn 1851) D P Wa ker Sp r ua and Demon c Mag c rom F c no o Campane a (London Warburg ns u e 1958) dem Unc ean Sp r s Possess on and Exorc sm n France and Eng and n he La e S x een h and Ear y Seven een h Cen ur es (London Scho ar Press 1981) Ke h Thomas Re g on and he Dec ne o Mag c (Harmondswor h M dd esex Pengu n 1973) Br an Eas ea W ch Hun ng Mag c and he New Ph osophy (Br gh on Sussex Harves er 1980) esp chap 4 26 For ur her ev dence see Graham Med eva M nds B L Gordon Med eva and Rena ssance Med c ne (London Pe er Owen 1959) R chard Neugebauer "Trea men o he Men a y n Med eva and Ear y Modern Eng and A Reappra sa " Journa o he H s ory o he Behav ora Sc ences 14 (1978) 158-169 Bery Row and Med eva Woman s Gu de o Hea h (Ken Oh o Ken S a e Un vers y Press 1981) Mary Frances Wack Loves ckness n he M dd e Ages The V a cum and s Commen ar es (Ph ade ph a Un vers y o Pennsy van a Press 1990) he mos use u o hese works or hys er a espec a y or her commen ary on Bona For- una s our een h-cen ury Trea se on he V a cum see Wack Loves ckness n he M dd e Ages 131 174-179 290-291 27 Wack Loves ckness n he M dd e Ages 175 The c ass c work s o course Jacques Ferrand s 1623 Trea se on Loves ckness ed Dona d A Beecher and Mass mo C avo e a (Syracuse N Y Syracuse Un vers y Press 1989) 28 Examp es are ound n S Ang o The Damned Ar Essays n he L era ure o W chcra (London Rou edge & Kegan Pau 1985) Compar son o hese mages w h modern ones o he hypno c prove use u see Leon Cher ok and sabe e S engers Le coeur e a ra son L hypnose en ques on de Lavo s er a Lacan (Par s Ed ons Payo 1989) 29 Oes erre ch s Possess on Demon aca and O her s s
use u bu a so see A Rodewyk D e dämon sche Besessenhe
n der S ch des R ua e Romanum (Ascha enburg Pau Pa och Ver ag 1963)
30 See hese works by Marguer e Duras The Lover (New York Grove Press 1976) The Ma ady o Dea h (New York Grove Press 1986) and Wr ng on he Body 31 Th s examp e assumes upper-c ass hys er cs hys er a n re a on o pover y and poor nerves s d scussed n sec ons X and X V 32 The po n has been e oquen y made by Morr s n The Languages o Pa n chap 5 The oca es a so prov de sur e s o p easure h s po n abou p easure mus be s ressed 33 Eas ea W ch Hun ng esp chap 4 Demos En er a n ng Sa an 34 P Jane L é a men a des hys ér ques 2d ed (Par s F A can 1911) 708 35 See A ce Jard ne Gynes s Con gura ons o Woman and Modern y ( haca N Y Corne Un vers y Press 1985) R Sa ow "Where Has A he Hys er a Gone?" Psychoana y c Rev ew 66 (1979-80) 463-477 Pa r c a Fed kew "Marguer e Duras Fem n ne F e d o Hys er a " Enc c 6 (1982) 78-86 Th s orm o ana ys s has been deve oped w h regard o Kr s eva and Lacan n Dav d-Ménard Hys er a rom Freud o Lacan and n W am Ho sz Sexua Subvers ons (London A en & Unw n 1989) 36 Such numbness however does no gure n o recen med ca ana yses see G ber H G aser "Ep epsy Hys er a and Possess on " Journa o Nervous and Men a D sease 166 no 4 (1978) 268-274 S B Guze "The D agnos s o Hys er a Wha Are We Try ng o Do?" Amer can Journa o Psych a ry 124 (1967) 491-498 For compar son be ween he n ne een h cen ury and ear er per ods and he broad cu ura ac ors nvo ved see J Go ds e n "The Hys er a D agnos s and he Po cs o An c er ca sm n La e N ne een h Cen ury France " Journa o Modern H s ory 54 (1982) 209-239 and dem Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1991) 37 See W am B Ober "Margery Kempe Hys er a and Mys c sm Reconc ed " n Bo oms Up A Pa ho og s s Essays on Med c ne and he Human es (Carbonda e o Teresa o Av a s Supposed Hys er a " Journa o Re g on and Hea h 24 (1985) 300-315
Sou hern
no s Un vers y Press 1987) 203-220 C M Bache "A Reappra sa
38 No surpr s ng y here s no ma e equ va en con a n ng an deo ogy even remo e y s m ar o he one ound n he em n s agenda Wha ndeed do con emporary em n s s say abou ma e hys er a? For a s ar see M ca e above 39 For he ph osoph ca prob em o represen a on a eas s nce he adven o he Car es an revo u on n hough see Da a Judov z Sub ec v y and Represen a on n Descar es The Or g ns o Modern y Cambr dge S ud es n French ed Ma co m Bow e (Cambr dge Cambr dge Un vers y Press 1988) and or more recen mes James L Larson Reason and Exper ence The Represen a on o Na ura Order n he Worm o Car yon L nné (Berke ey Los Ange es London Un vers y o Ca orn a Press 1971) and R chard Ror y Con ngency rony and So dar y (Cambr dge Cambr dge Un vers y Press 1989) dem Ph osophy and he M rror o Na ure (Pr nce on N J Pr nce on Un vers y Press 1980) 40 Sources or Sydenham are prov ded n n 41 and n Sec ons V-V 41 For Sydenham see espec a y Kenne h Dewhurs Dr Thomas Sydenham (1624-1689) H s L e and Or g na Wr ngs (Berke ey and Los Ange es Un vers y o Ca orn a Press 1966) Lady Mary Wor ey Mon agu he br an ar s ocra wor d rave er and r end o poe A exander Pope was deep y mpressed by Sydenham s ab y o descr be he rea cond on o hys er a have seen so much o hys er ca comp a n s ho Heaven be pra sed never e hem know s an obs na e and very uneasy d s emper ho never a a un ess when Quacks under ake o cure have even observed ha hose who are roub ed w h common y ve o o d age Lady S a r s one ns ance remember her scream ng and cry ng when M ss Pr mrose my se e and o her g r s were danc ng 2 rooms d s an Lady Fanny has bu a s gh ouch o h s d s emper read Dr Sydenham you w nd he ana yse o ha and many o her d seases w h a candor never ound n any o her au hor con ess never had a h n any o her phys c an v ng or dead Mr Locke p aces h m n he same rank w h S r saac New on and he a ans ca h m he Eng sh H ppocra es own am charmed w h h s ak ng o he reproach wh ch you men so sauc y hrow on our sex as we a one were sub ec o vapours He c ear y proves ha your w se honourab e sp een s he same d sorder and ar ses rom he same cause bu you v e usurpers do no on y engross earn ng power and au hor y o yourse ves bu w be our super ors even n cons u on o m nd and ancy you are ncapab e o he woman s weakness o ear and enderness" ( The Comp e e Le ers o Lady Mary Wor ey Mon agu ed Rober Ha sband Ox ord C arendon Press 1965 3 171) Dr Thomas Tro er he n uen a ear y n ne een h-cen ury Eng sh phys c an hough ha Sydenham and Cheyne had been he wo mos n uen a phys c ans o he as hundred years barr ng none see da Maca p ne and R chard Hun er George and he Mad Bus ness (New York Pan heon Books 1969) 290 42 For he word "nervous" se n o s cu ura con ex and a h s ory o h s deve opmen see G S Rousseau "The Language o he Nerves A Chap er n Soc a and L ngu s c H s ory " n Language Se 2d ed ed Pe er Burke and Roy Por er (Ox ord Po y Press 1991) 213-275
and Soc e y A Soc a H s ory o Language
43 Good surveys o h s sc ence and Sydenham s ro e n are ound n M chae Hun er Sc ence and Soc e y n Res ora on Eng and (New York and Cambr dge Cambr dge Un vers y Press 1981) dem The Roya Soc e y and s Fe ows 16601700 The Morpho ogy o an Ear y Sc en c ns u on (Cha on S G es Bucks Br sh Soc e y or he H s ory o Sc ence 1982) 44 Sydenham s no on o m a on ( m a o ) was he rad ona Ar s o e an one descr bed n he Poe cs or ex ua examp es see Thomas Sydenham "Processes n egr Chap 1 On he A ec on Ca ed Hys er a n Women and Hypochondr as s n Men " n The Works o Thomas Sydenham M D rans R G La ham 2 vo s (London Sydenham Soc e y 1848-1850) 1 281-286 and dem The Who e Works o Tha Exce en Prac ca Phys c an (London 1705) 45 A synchron c v ew o hys er a eva ua es a s heor es a once by compara ve and d a ec ca means a d achron c v ew a ows hem o evo ve chrono og ca y decade by decade The d cu y w h he a er s ha narra ors genera ng he d achron c s ory pre end n one decade (e g he 1730s) ha hey do no know s n uence on he nex (e g he 1740s) wh ch hey o course do and h s en a s a my h abou d achron c me hod hey hemse ves never be eve The ngu s c heor s s o he per od covered n h s chap er were o en search ng or synchron c s ruc ures n he deve opmen o anguages 46 See sec ons X and X V 47 b d See n 174 be ow 46 See sec ons X and X V 47 b d See n 174 be ow For examp e n J m Harr son s 1990 shor s ory "The Woman L by F re es " he pro agon s su ers rom he same agon es see The New Yorker Ju y 23 1990 pp 26-
48 The hys er a o Duras s women con nues o be narra ed by o hers as we 55
49 Th s po n rema ns he hrus o Krohn s work n "Hys er a" (n 3) n wh ch he au hor ays equa emphas s on psychosoma c med c ne and psychoana ys s For he psychosoma c connec on n he Eng sh En gh enmen see John M dr s marve ous y sa r ca and humorous Observa ons on he Sp een and Vapours Con a n ng Remarkab e Cases o Persons o bo h Sexes and a Ranks rom he asp r ng D rec ors o he Humb e Bubb er who have been m serab y a c ed w h hese Me ancho y D sorders s nce he Fa o he Sou h-sea and o her pub ck S ocks w h he proper Me hod or he r Recovery accord ng o he new and uncommon C rcums ances o each Case (London 1720) and W F Brown "Descar es Dua sm and Psycho-soma c Med c ne " n The Ana omy o Madness ed W F Bynum Roy Por er and M chae Shepherd (London Tav s ock Pub ca ons 1985) 2 40-62 50 For he background see A E Tay or A Commen ary on P a o s T maeus (Ox ord C arendon Press 1928) 638-640 G E R L oyd Sc ence Fo k ore and deo ogy (Cambr dge Cambr dge Un vers y Press 1983) 51 P a o s v ew as have sugges ed was ha o he womb as v ng an ma see D F Kre "Fema e Par s n T maeus " Ar on 2 (1975) 400-421 For pha o-cra c d scourse and he ro e o women see Eva C Keu s The Re gn o he Pha us Sexua Po cs n Anc en Greece (New York Harper & Row 1985) For he Rena ssance mod ca on o h s v ew see Kran De pass on bus mu erum (1544) Edward Shor er A H s ory o Women s Bod es (Harmondswor h Pengu n 1983) dem Women n he M dd e Ages and he Rena ssance L erary and H s or ca Perspec ve (Syracuse Syracuse Un vers y Press 1986) Mary Be h Rose Women n he M dd e Ages and he Rena ssance L erary and H s or ca Perspec ve (Syracuse Syracuse Un vers y Press 1986) MacLean The Rena ssance No on o Woman (Cambr dge Cambr dge Un vers y Press 1980) Joan Ke y-Gado "D d Women Have a Rena ssance?" n Becom ng V s b e Women n European H s ory ed Rena e Br den ha and C aud a Koonz (Bos on Hough on M n Co 1967) 52 Nowhere s h s be er seen han n he h s or ography o hys er a prov ded by M ca e n h s var ous works see n 3 53 See espec a y he con emporary es mon es n J De Va mon D sser a on sur es Ma é ces e es Sorc ers se on es pr nc pes de a héo og e e de a phys que où on exam ne en par cu er é a de a e de Tourco ng (Tourco ng 1752) A Ga op n Les hys ér ques des couven s des ég ses des emp es des hea res des synagogues e de amour (Par s 1886) K bansky e a Sa urn and Me ancho y (n 12) Ca her ne-Laurence Ma re Les convu s onna res de Sa n -Médard M rac es convu s ons e propé es Par s au XV e s éc e Co ec on Arch ves (Par s Ga mard Ju ard 1985) 54 Krohn "Hys er a " a
he more ev den because hys er a s so "rea " and a
c s pa en s su er ng rea " symp oms
55 Look ng ahead h s w be one o Sydenham s ma n po n s abou hys er a n re a on o a o her med ca cond ons desp e he neg ec o by med ca h s or ans see or examp e Dewhurs Dr Thomas Sydenham Je rey M N Boss "The Seven een h-Cen ury Trans orma on o he Hys er c A ec on and Sydenham s Bacon an Med c ne " Psycho og ca Med c ne 9 (1979) 221-234 56 Re ec on hrough power and marg na a on had been one o Foucau s ma n po n s abou hys er a n Madness and C v za on A H s ory o nsan y n he Age o Reason (New York Pan heon Books 1965) see a so Dav d Arms rong Po ca Ana omy o he Body (Cambr dge Cambr dge Un vers y Press 1983) 57 For hese deba es see he va uab e work o an Hack ng Nancy Car wr gh Mary Hesse (her a e works she exper enced a convers on rom her ear er more n erna s pos on) Larry Laudan Ernan McMu n Ar hur F ne and Rona d G ere 58 Va uab e n orma on s ound n Co gan Mass Psychogen c
ness (n 24) and W son Mag c and he M enn um
"Fema e Par s n T maeus " see a so Shor er H s ory o Women s Bod es
59 As emphas zed by Kre 60 b d
"Fema e Par s n T maeus " see a so Shor er H s ory o Women s Bod es
59 As emphas zed by Kre 60 b d
61 See he d scuss on o Shakespeare and Rabe a s n sec on V 62 E a ne Page s Adam Eve and he Serpen (New York V n age Books 1989) MacLean Rena ssance No on o Woman Carro Camden The E zabe han Woman (New York E sev er Press 1952) 63 For he psychophys o og ca mp ca ons o h s urn ng po n as hey a ec hys er a see R chard B Car er Descar es Med ca Ph osophy The Organ c So u on o he M nd-Body Prob em (Ba more Johns Hopk ns Un vers y Press 1983) Brown "Descar es Dua sm and Psychosoma c Med c ne " 64 For Sydenham s re a on o Car es an sm see Dewhurs Dr Thomas Sydenham 65 As he rave ed hrough he Levan n he 1590s W am R chard searched or Or en a equ va en s see h s H s ory o Turkey (London 1603) ness as Me aphor (New York Random House 1979) The de ec or gou w soon be remed ed n a book n prepara on by G S Rousseau and Roy Por er Gou The Pa r c an Ma ady (Pr nce on N J Pr nce on Un vers y
66 See Susan Son ag Press 1994)
67 A po n d scussed by Henry S eger s C v za on and D sease ( haca N Y Corne Un vers y Press 1944) Freder ck F Car wr gh D sease and H s ory (London Har -Dav s 1972) Leon Ede "D sease and he Nove " TLS 30 May 1986 591 68 Susan Son ag A DS and s Me aphors (New York Farrar S raus and G roux 1989) Woman The Longes Revo u on (London 1984) 288-290
69 Ju e M che
70 For some o he soc oeconom c causes see Da Ava San ucc Des sorc eres aux mandar nes Br dge H R chardson and D dero (Cambr dge Cambr dge Un vers y Press 1984) 71 Rose Women n he M dd e Ages and he Rena ssance Page s Adam Eve and he Serpen
Women and Work n E gh een h-Cen ury Eng and (New York Ox ord Un vers y Press) R a Go dberg Sex and En gh enmen Women n
ess as u e s Camden E zabe han Woman
72 No even he rad on o he "good surgeon" n he Rena ssance and En gh enmen changes h s s ua on n h s sense Jona han Sw s Lemue Gu ver he "good surgeon" o Sw s exo c rave s comes a he end o a rad on ra her han he beg nn ng o a new one 73 See n 34 or Jane 74 See S ephen W son Sa n s and The r Cu s (Cambr dge Cambr dge Un vers y Press 1989) H R Lemay "Human Sexua y n Twe h- hrough F een h-Cen ury Sc en c Wr ngs " n Sexua Prac ces and he Med eva Church ed Vern Bu ough and James Brundage (Bu a o Prome heus Books 1982) 187-206 Here ph o ogy s a so ns ruc ve he word "hys er a" d d no en er Ang o-Saxon M dd e Eng sh or he Romance anguages un he s x een h cen ury bu "me ancho a" (as b ack b e) was a ready be ng used by he med ca doc ors n he h r een h o en as a synonym o " ch oros s The appearance o " uror u er nus " beg ns n he h r een h cen ury bu "nymphoman a" ( he word) had no ye been nven ed s rs use as a cond on s ound as a e as 1775 n M D T B env e Nymphoman a or A D sser a on concern ng he Furor U er nus (London 1775) see G S Rousseau "The nven on o Nymphoman a " n Per ous En gh enmen (Manches er Manches er Un vers y Press 1991) 44-64 No work br ngs hese rad ons—verba and v sua ph o og ca and sc en c—so we oge her as K bansky e a Sa urn and Me ancho y 75 A br e accoun s ound n Wack Loves ckness n he M dd e Ages (n 26) The c ass c source or me ancho y as bo h ma e and ema e rema ns Rober Bur on s Ana omy o Me ancho y (1621) See a so T S Sou as Me ancho y and he Secu ar M nd n Span sh Go den Age L era ure (Co umb a Un vers y o M ssour Press 1990) who cons ders me ancho y he key o he rans on be ween med eva and Rena ssance men a es bu who s ra her s en on s gender za on n he Rena ssance n Me ancho y and Soc e y (Cambr dge Harvard Un vers y Press 1992) Wo Lepen es expands on he n ersec on o me ancho y and secu ar sm n s u op an and po ca d mens ons 76 Sou as Me ancho y and he Secu ar M nd 131 77 b d 76 Sou as Me ancho y and he Secu ar M nd 131 77 b d 78 s sure y anachron s c o mag ne ha he ob ec on was hen made or cou d have been made among he m dw ves and he r pa en s n he name o esb an sm ha was never a concern here was concern was on grounds ha he m dw ves ( he obs e r ces ) as we as pa en s were becom ng sexua y aroused and carna y sacr ced see B Ehrenre ch W ches M dw ves and Nurses (O d Wes bury N Y Fem n s Press 1973) Jacques Ge s La sage- emme ou e médec n Une nouve e concep on de a v e (Par s Fayard 1988) 79 For he ear y gender za on and pa ho og za on o he sou see Joseph Schumacher D e see schen Vo kskrankhe en m deu schen M e a er (Ber n Neue Deu sche Forschungen 1937) R B On ans The Or g ns o European Though abou he Body he M nd he Sou he Wor d T me and Fa e (Cambr dge Cambr dge Un vers y Press 1951) and an ear y work Johann Ambros us H g Ana om e der See en (Le pz g 1737) For hys er a and possess on see Oes erre ch Possess on Demon aca and O her G aser "Ep epsy Hys er a and Possess on " (n 36) and a modern ph osoph ca approach J D Berna The Wor d he F esh and he Dev An nqu ry n o he Fu ure o he Three Enem es o he Ra ona Sou (London Cape 1970) The m eu o hese ear y hys er cs was a cu ure o ecs asy marked by a gap be ween rs - and h rd-person d scourse The rs -person narra ves (con ess ons o hys er cs) were a mos never wr en hey nc ude he d ar es o mad women and o her convu s onar es ne her o whom had any pub c au hor y 80 Ferrand s Trea se o Loves ckness has been as u e y d scussed by Foucau and now magn cen y ed ed (n 27) or P a erus (P a er) and h s works as hey re a e o he rad ons o hys er a see S an ey W Jackson Me ancho a and Depress on (New Haven Conn Ya e Un vers y Press 1987) and P a erus Be oved Son The Journa o Fe x P a er a Med ca S uden n Mon pe er n he S x een h Cen ury (London Freder ck Mu er 1961) Ferrand makes he mpor an observa on ha ma es whom he v ewed gener ca y as homo pub cus su ered many o her d sappo n men s han ove bu ha even among amorous ma es here s no grea er oss or cause or unhapp ness and despa r 81 deas adumbra ed by he n uen a B nswangers n Freud s V enna See he wr ngs o Freud s con emporary Aus r an psych a r s O o Ludw g B nswanger esp D e hys er e (V enna 1904) a work o a mos one housand pages and he mpor an book o h s son Ludw g Me ancho e und Man e (P u ngen 1960) a s udy o anger n re a on o hys er a The e der B nswanger wro e s ud es o hys er a neuras hen a ep epsy and madness From he ear y modern per od (ca 1500 orward) anger was assoc a ed w h possess on and demon sm a er n he seven een h cen ury w h war and a en on ye he modern soc a h s ory o anger awa s s s uden 82 See A Luyend k "O Masks and M s The En gh ened Doc or and H s Fr gh ened Pa en " n The Languages o Psyche ed Rousseau (n 13) 186-231 he c ass c e gh een h-cen ury s a emen s by John Bond An Essay on he ncubus or N gh -Mare (London W son & Durham 1753) a heore ca approach o he spec a or a n gh me wor d ha g ances a he ear y per od s ound n Terry Cas e "Phan asmagor a " Cr ca nqu ry 15 (1988) 26-61 was pure possess on see Graham Med eva M nds 99-101
83 For he oppos e v ew ha
84 Ve h Hys er a 59-66 and chap 6 "The Non-con orm s s " 85 b d 61 86 b d 110 84 Ve h Hys er a 59-66 and chap 6 "The Non-con orm s s " 85 b d 61 86 b d 110 84 Ve h Hys er a 59-66 and chap 6 "The Non-con orm s s " 85 b d 61 86 b d 110 87 Bod n he au hor o De a démonoman e des sorc ers (Par s Jacques du Pays 1581) and o her works on mag c reasoned ha "madwomen are never burned and H ppocra es whom you Weyer shou d know eaches you on h s par ha hose women who have he r menses are no sub ec o me ancho y madness ep epsy" (quo ed n Ve h Hys er a 111) For Weyer see Graham Med eva M nds J J Cobben Jan W er Dev s W ches and Mag c (Ph ade ph a Dorrance 1976) Car B nz Doc or Johann Weyer E n rhe n scher Arz der 1 Bekaemp er des Hexenwahns E n Be rag zur Gesch ch e der Au k aerung und der He kunde (We sbaden Dr Mar n Saend g 1969) 88 See a so Ba d nus Ronsseus De humanae v ae pr mord s hys er c s a ec bus (Le den 1594) or a s m ar po n 89 For one approach o Weyer s e see Cobben Jan W er Dev s W ches and Mag c See a so he appara us n Johannes Weyer W ches Dev s and Doc ors n he Rena ssance Johannes Weyer s De Praes g s Daemonum ed George Mora M D (B ngham on N Y Un vers y Cen er a B ngham on 1990 or g na y pub shed 1583) 90 T mo hy Br gh A Trea se o Me ancho e Con a n ng he Causes hereo & reasons o he s range e ec s worke h n our m nds and bod es w h he phys cke cure and sp r ua conso a on or such as haue here o ad oyned an a c ed consc ence The d erence be w x and me ancho e w h d uerse ph osoph ca d scourses ouch ng ac ons and a ec ons o sou e sp r and body he par cu ars whereo are o be seene be ore he booke (London 1586 repr n Ams erdam and New York Da Capo Press 1969) For Br gh see a so Jackson Me ancho a and Depress on 91 The ex has now been ed ed w h use u commen ary by M chae MacDona d n W chcra and Hys er a n E zabe han London Edward Jorden and he Mary G over Case—Tav s ock C ass c Repr n s n he H s ory o Psych a ry (London Rou edge 1990) 92 Dur ng he per od 1550-1650 he nomenc a ure was var ab e some au hors pre err ng one erm over ano her and s a mos mposs b e o d eren a e among hese erms n he med ca era ure A hree are used n John Sad er The S cke Womans Pr va e Look ng-G asse where n Me hod ca y are hand ed a u er ne a ec s or d seases ar s ng rom he wombe enab ng Women o n orme he Phys c an abou he cause o he r gr e e (London Anne Gr n 1636) 130 93 For he cu ura m eu o he dev see Wa ker Sp r ua and Demon c Mag c (n 25) Br an V ckers Sc en c and Occu Men a es n he Rena ssance (Cambr dge Cambr dge Un vers y Press 1984) Wayne Shumaker The Occu Sc ences n he Rena ssance (Berke ey Los Ange es London Un vers y o Ca orn a Press 1972) A Mac ar ane W chcra n Tudor and S uar Eng and (London Rou edge & Kegan Pau 1970) and or he connec on w h ero c e and sexua y oan P Cu anu Eros and Mag c n he Rena ssance (Ch cago Un vers y o Ch cago Press 1989) 94 Edward Jorden A Br e D scourse o a D sease Ca ed he Su oca on o he Mo her (London John W nde 1603) B3 2 95 See A E Tay or (n 50) or he P a on c sources 96 The po cs o Jorden s " uror u er nus " s d scussed n D H Bar Scu y e a "The Po cs o Hys er a The Case o he Wander ng Womb " n Gender and D sordered Behav or Sex D erences n Psychopa ho ogy ed E S Gomberg and V Franks (New York Brunner Maze 1979) 354-380 For mode s o he u erus n he prev ous ew cen ur es espec a y he seven-ce u erus see Rober Re ser Der se benkammer ge u erus (Hanover Würzburger med z nsh s or sche Forschungen 1986) 97 A ong he ne o Scu y s "po cs o hys er a " one wonders why he ema e cou d no mas urba e o prov de he much-needed mo s ure Was ma e sperm a one capab e o prov d ng he mo s ure or was mas urba on oo de ca e a op c o address? For he po cs and deo ogy o mas urba on n h s ory see Jean Pau and Roger Kemp Aron Le pén s e a démora sa on de Occ den (Par s Bernard Grasse 1978) 98 Jorden Su oca on o he Mo her G2 2 99 Nor w he gender za on cease w h he nnova ve Jorden Throughou he seven een h cen ury he "mo her" w become ncreas ng y assoc a ed w h na ure see James W nn " When Beau y F res he B ood" Love and Ar s n he Age o Dryden (Ann Arbor Un vers y o M ch gan Press 1992) L kew se s me aphors a ach o ana omy hen cons s en y sa d o be he "mo her o sc ence" see A J Luyend k Ana omy Mo her o Ar and Sc ence Con rovers es be ween Eng sh and Du ch Sc en s s 1690-1725 " a a k de vered a he We -come ns u e Sympos um on he H s ory o Med c ne 1988 By he e gh een h cen ury ana om ca preoccupa on w h he "su oca on o he mo her" w have moved ana om ca y and gyneco og ca y rom he womb o " he mo her s mag na on " now sa d by doc ors o be he mos mpor an aspec o e a mark ng dur ng he ac o reproduc on see G S Rousseau "P neapp es Pregnancy P ca and Peregr ne P ck e " n Tob as Smo e B cen enn a Essays Presen ed o Lew s M Knapp ed G S Rousseau and P G Boucé (New York Ox ord Un vers y Press 1971) 79-110 And by he ear y n ne een h he "mo her" becomes he key o he mys ery o androgyny see D L Hoeve er Roman c Androgyny The Woman W h n (Un vers y Park Pennsy van a S a e Un vers y Press 1990) Wh e a s udy o he med ca za on o he mag na on n he Rena ssance and En gh enmen s bad y needed a s udy o he rans orma ons o he mage o " he mo her " cons rued era y and me aphor ca y v sua y and conograph ca y a so rema ns a des dera um 100 The ung e o rhe or c s so dense n hese rea ses espec a y n Jorden s ha s wor hwh e o cons rue hese works as med ca romances des gned o sway a par cu ar ma e aud ence n a pred c ab e d rec on W h n hese dense rop cs o d scourse ( o borrow a phrase aga n rom Hayden Wh e s Trop cs o D scourse Ba more Johns Hopk ns Un vers y Press 1982 ) one rope a one s ands ou over and over aga n ana ogy Ana ogy common n he med ca era ure o he me s everywhere presen n h s cons ruc on o hys er a as n h s mpor an passage by Jorden abou he "a ec ons o he m nd" " he per urba ons o he m nde are o en mes o b ame or h s e hys er a and many o her d seases For ee ng we are no mas ers o our owne a ec ons wee are ke ba ered C es w hou wa es or sh ppes ossed n he Sea exposed o a manner o assau s and daungers even o he over hrow o our owne bod es" (Jorden Su oca on o he Mo her G2 2) 101 See Ve h Hys er a 122-123 102 C E McMahon "The Ro e o mag na on n he D sease Process n Pre-Car es an H s ory " Psycho og ca Med c ne 6 (1976) 179-184 103 Ve h Hys er a 122 104 b d 123 103 Ve h Hys er a 122 104 b d 123 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 105 Jorden Su oca on o he Mo her B3 3 106 b d B3 107 b d 25 108 b d G3 3 109 b d 110 b d A3 111 b d 112 b d A4 Ep eps es and convu s ons were cons dered mpor an s gns hroughou he seven een h cen ury see Jean Chas e a n Tra é des convu s ons (Lyon 1691) 113 Jouber was an es eemed phys c an and con emporary o Rabe a s see h s Erreurs popu a res e propos vu ga res ouchan a médec ne e e rég me de san é (Bordeaux 1579) Bakh n was asc na ed by h m or h s erary con r bu ons o he "H ppocra c nove " and o he sem o cs o augh er "The amous phys c an Lauren Jouber pub shed n 1560 a spec a work under he charac er s c r e Tra é du R s con enan son essence ses causes e ses merve heus e e s cur eusemen recherchès ra sonnés e observés par M Laur Jouber n 1579 Jouber pub shed ano her rea se n Bordeaux La cause mora e du R s de exce en e res renommé Démocr e exp quée e emo gnée par ce dev n H ppocra e en ses ép res (The mora cause o augh er o he em nen and very amous Democr us exp a ned and w nessed by he d v ne H ppocra es n h s ep s es) Th s work was ac ua y a French vers on o he as par o he "H ppocra c nove " (M kha Bakh n Rabe a s and H s Wor d Cambr dge Mass M T Press 1968 68) 114 Georges Lo e La v e e cen ury "
oeuvre de Franço s Rabe a s (Par s Droz 1938) 163 "Med c ne became he sc ence o he s x een h cen ury
exerc sed a grea n uence and nsp red con dence wh ch
no onger re a ned n he seven een h
115 See R An on o Rabe a s e a médec ne (Geneva Dros 1976) Luc en Febvre The Prob em o Unbe e n he S x een h Cen ury The Re g on o Rabe a s (Cambr dge Mass Harvard Un vers y Press 1982) Graham Med eva M nds and Bakh n Rabe a s and H s Worm esp 316-317 355-363 Bakh n a ways sens ve o he H ppocra c rad on or s g or ous narra ve egacy ra ses he asc na ng poss b y o a "gro esque hys er a" "These wo areas he bowe s and he pha us p ay he ead ng ro e n he gro esque mage and s prec se y or h s reason ha hey are predom nan y sub ec o pos ve exaggera on o hyperbo za on hey can even de ach hemse ves rom he body and ead an ndependen e or hey h de he res o he body as some h ng secondary" (317)—so oo he gro esque mage o he "wander ng womb" and he sugges on o s " ndependen e " 116 Samue Pu nam ed The Por ab e Rabe a s (New York V k ng Press 1946) 477-479 espec a y he passage n Pan agrue beg nn ng " ca
an an ma
n accordance w h he doc r ne o he Academ cs
"
117 Joseph L eu aud H s or a ana om co-med ca 2 vo s (Par s 1767) 118 See L J Ra her "Thomas F enus (1567-1631) D a ec ca nves ga on o he mag na on as Cause and Cure o Bod y D sease " Bu e n o he H s ory o Med c ne 41 (1967) 349-367 119 Use u here s K E W ams "Hys er a n Seven een h Cen ury Pr mary Sources " H s ory o Psych a ry 1 (1990) 383-402 120 Supp emen a o he works on women n he Rena ssance men oned n nn 51 and 62 are Barbara and Henr van der Zee 1688 Revo u on n he Fam y (London Pengu n Books 1988) Bonn e S Anderson A H s ory o The r Own Women n Europe rom Preh s ory o he Presen (New York Harper & Row 1988) K M Rogers The Troub esome He pma e A H s ory o M sogyny n L era ure (Sea e Un vers y o Wash ng on Press 1966) 121 The d gen h s or an wan s o know o course wha does rema n and he rep y s e Wha s c ear s ha vo ces are be ng s enced hose o hys er cs ry ng o nd he r own rs -person vo ces and den es when a hose ns s en on genera ng h rd-person d scourse d d no wan o hear hem For he d re psycho og ca consequences o such s enc ng w h n a pa r archa Wes ern cu ure n wh ch ema e sexua y has been he source o err c ma e error see Wo gang Lederer Gynophob a ou a peur des emmes (Par s N ze 1967) rans a ed as The Fear o Women (New York Grune & S ra on 1968) Jard ne Gynes s (n 35) E F scher-Homberger Krankhe Frau und andere Arbe e zur Med z ngesch ch e der Frau (Bern S u gar V enna Hans Huber 1979) 122 MacDona d "Women and Madness n Tudor and S uar Eng and" (n 25) 123 For he r ua o he danse macabre n re a on o ma ngerers see chap 5 (Sander G man) and Haro d Speer
conograph a Gyn a r ca A P c or a H s ory o Gyneco ogy and Obs e r cs (New York Macm an 1973)
124 G Greer The Fema e Eunuch (London MacG bbon & Kee 1970) 47-53 125 See esp Ga op n Les hys ér ques des couven s (n 53) bu a so Thomas Re g on and he Dec ne o Mag c (n 25) Human Body (New York Zone 1989) vo 1 Bynum Gender and Re g on (n 5)
M Lew s Ecs a c Re g on (Harmondswor h Pengu n 1971) M che Feher e a
eds Fragmen s or a H s ory o he
126 A hough he deo og ca v ew o women con nued o a er dur ng he seven een h cen ury he be e ha he r hys er a was pr mar y he resu o a rampag ng menarche con nued o be s rong and doc ors d d wha hey cou d o assuage he e ec s o he paroxysm and gen a upheava The menses prov ded doc ors and pa en s a ke w h a paradox ca s ua on on he one hand hey cou d no be suppressed on he o her once rampag ng hey wreaked vas phys o og ca damage Pharmaco og ca y u eps and apozems were adm n s ered w h hops o nduce he menses on he heory ha hops produced noc urna dreams and wou d ca m he hys er ca y when under he spe o a ever o s eep Th s prepara on con nued o be used n o he e gh een h cen ury see Johann De aeus Upon he Cure o he Gou by M k D e & An Essay upon D e by W am S ephens (London Sm h & Bruce 1732) 127 may a so be ha homophob a ( n our modern sense a prob ema c word ha has come o be a me onymy deno ng ear o he excess ve y ma e ) has a p ace n h s h s ory and s ngu s c con gura ons See Ka her ne Cumm ngs Te ng Ta es The Hys er c s Seduc on n F c on and Theory (S an ord Ca S an ord Un vers y Press 1991) n "Freud and F ess Homophob a and Seduc on " n Seduc on and Theory Read ngs o Gender Represen a on and Rhe or c ed D anne Hun er (Urbana Un vers y o no s Press 1989) 86-109 S N Garner s ud es he anguage o Freud s hys er ca women n he gh o he r ear o same-sex re a ons Fur hermore one wonders here s any connec on be ween he so-ca ed dem se o hys er a n our cen ury and he monumen a grow h o homophob a 128 J W Hebe ed The Works o M chae Dray on (Ox ord Shakespeare Head B ackwe
1961) "Po y-O b on " p 128 Song V
nes 19-28
129 Mar e E Addyman "The Charac er o Hys er a n Shakespeare s Eng and " doc ora d sser a on Un vers y o York York Eng and 1988 Jane Ade man appears o agree bu embro ders he dea rom a psychoana y c perspec ve n Su oca ng Mo hers Fan as es o Ma erna Or g n n Shakespeare s P ays Ham e o The Tempes (London Rou edge 1990) 130 Ade man Su er ng Mo hers 3 For ur her background see F D Hoen ger Med c ne and Shakespeare n he Eng sh Rena ssance (Newark Un vers y o De aware Press 1992) 131 Hoen ger Med c ne and Shakespeare 2 132 b d 137 131 Hoen ger Med c ne and Shakespeare 2 132 b d 137 133 The po n seems o be bu ressed by M ca e s s ud es on he h s ory o ma e hys er a see n 3 134 The be e o G S Rousseau "L era ure and Med c ne The S a e o he F e d " s s 72 (1981) 406-424 and Pe er B Medawar The Hope o Progress A Sc en s Looks a Prob ems n Ph osophy L era ure and Sc ence (Garden C y N Y Anchor Books 1973) 135 Devon Hodges Rena ssance F c ons o Ana omy (Amhers Un vers y o Massachuse s Press 1985) B G Lyons Vo ces o Me ancho y S ud es o L erary Trea men s o Me ancho y n Rena ssance Eng and (London Rou edge & Kegan Pau 1971) who s par cu ar y use u n descr b ng Bur on s rhe or ca s ra eg es and dev ces o persuas on n he "Per urba ons o he M nde" see esp pp 132-134 136 Th s rans orma on o know edge s d scussed by Josce yn Godw n A hanas us K rcher A Rena ssance Man and he Ques or Los Know edge (London Thames & Hudson 1979) M che Foucau The Archaeo ogy o Know edge (New York Pan heon Books 1972) C C Camden "The Go den Age and he Rena ssance " L erary V ews (1988) 1-14 n he con ex s o he body n F Bo om ey A udes o he Body n Wes ern Chr s endom (London 1979) n he carn va za on o know edge n Bakh n Rabe a s and H s Wor d 137 Compare he n ne een h-cen ury med ca za on o homosexua y Work on pos v sm or per ods be ore 1800 seems o be v r ua y nonex s en One wonders whe her he pr nc p e was a so opera ve n he a e n ne een h cen ury when he w nds o pos v sm were b ow ng so s rong y 138 One obv ous p ace o s ar w h s Thomas Laqueur s Mak ng Sex Body and Gender rom he Greeks o Freud (Cambr dge Mass Harvard Un vers y Press 1990) 139 b d 98-132 P Ho mann La emme dans a pensée des Lum ères (Par s Ophrys 1977) R Thompson Un
or Modes Ears (London Macm an 1979)
138 One obv ous p ace o s ar w h s Thomas Laqueur s Mak ng Sex Body and Gender rom he Greeks o Freud (Cambr dge Mass Harvard Un vers y Press 1990) 139 b d 98-132 P Ho mann La emme dans a pensée des Lum ères (Par s Ophrys 1977) R Thompson Un
or Modes Ears (London Macm an 1979)
140 Laqueur Mak ng Sex (n 138) 70-98 dem "Orgasm Genera on and he Po cs o Reproduc ve B o ogy " Represen a ons 14 (1986) 1-14 dem "Amor Vener s ve Du cedo Appera ur " n Fragmen s or a H s ory o he Human Body ed Feher (see n 125) 3 90-131 141 (London Anne Gr n 1636) The as ro og ca herba and Hebrew s gns on he ron sp ece are wor h cons der ng n he gh o Sad er s approach o hys er a Chap 13 "O he genera on o mons ers " cons ders he "D v ne" or "Na ura Genera on o Mons ers n re a on o he hea h o he mo her s womb and he s a e o her mag na on wh ch "workes on he ch d a er concep on" (139) The per od produced o her works s m ar o Sad er s many o wh ch re er o he "mo her s s" as a common express on represen ng he "green-s ckness " now endem c among pubescen v rg ns Bu Rober P erce Ba h memo rs or Observa ons n Three and For y Years Prac ce a he Ba h wha Cures have been here wrough (Br s o Hammond 1697) 34-37 cau oned ha "Women s D seases cou d a ec women a a mes n he r ves hey are sub ec o when hey are young or when more adu when marry d or when unmarry d when Ch d ess or when hey have had Ch dren " P erce c a ms ha " he Hys er ck Pass on or F s o he Mo her " o en arose ou o he green s ckness e he cond on o pubescen eenage g r s Thus Mrs E zabe h Ey es rom he Dev zes n he Coun y o W s age 16 be ng very ar gone n he "green-s ckness " deve oped "Mo her- s w ha " 142 The quo a ons rom Harvey n h s paragraph are ound n W am Harvey "On Par ur on " n h s Works (London Sydenham Soc e y 1847) 528-529 542-543 dem Exerc a ones de genera one an ma um (London 1651) 542 See a so R Bra n "The Concep o Hys er a n he T me o Harvey " Proceed ngs o he Roya Soc e y o Med c ne 56 (1963) 317-324 A ong s m ar nes Jane Sharp warned ha re en on o seed (pu re ed mens ruum) was harm u and hence adv sed us y ma ds o marry see her M dw e s Book or he Who e Ar o M dw ery D scovered D rec ng Ch dbear ng Women How o Behave Themse ves n The r Concep on Breed ng Bear ng and Nurs ng Ch dren (London 1671) 52 143 n h s Nymphoman a (n 74) B env e wr es as
he erm had been perenn a y used preda ng he E zabe han wor d o Jorden and Br gh
144 Such had been he a eged po cs n parad se see J G Turner One F esh Parad sa Marr age and Sexua Re a ons n he Age o M on (Ox ord Ox ord Un vers y Press 1987) Trad on had ha hys er a was nonex s en among he preAdam es he sec o men and women who ran abou he pr mord a garden naked and n a s a e o per ec na ure or he neo-Adam e sec s o he Rena ssance and En gh enmen see M chae Mu e Rad ca Re g ous Movemen s n Ear y Modern Europe (Bos on Rou edge 1980) 145 See Pe er Brown The Body and Soc e y Men Women and Sexua Renunc a on n Ear y Chr s an y (New York Co umb a Un vers y Press 1990) Lemay "Human Sexua y n Twe h- hrough F een h-Cen ury Sc en more eso er c vers on o he deba es Ma re Les convu s onna res de Sa n -Médard (n 53)
c Wr ngs" (n 74) or a
146 Sharp M dw e s Book 52 was no uncommon n he per od or ma e quacks o assume ema e pseudonyms espec a y one as common as "Jane Sharp " Sharp c a med ha h s book was based on "vas know edge" and ha he wro e pr mar y or women n s mp e anguage hey cou d unders and 147 See W am Harvey Exerc a ones de genera one an ma um (n 142) 543 For compar son n he sexua doma n see he v ews o N co as Vene e The Mys er es o Con uga Love Revea ed 3d ed (London 1712) and Roy Por er "Love Sex and Med c ne N co as Vene e and h s Tab eau de Amour Con uga " n Ero ca and he En gh enmen ed P Wagner (Frank ur Pe er Lang 1990) 90-122 148 Harvey Exerc a ones 542 See a so Laqueur "Orgasm Genera on and he Po cs o Reproduc ve B o ogy" (n 140) 149 See L Jordanova Sexua V s ons mages o Gender n Sc ence and Med c ne Be ween he E gh een h and he Twen e h Cen ur es (Mad son Un vers y o W scons n Press 1989) MacLean Rena ssance No on o Woman (n 51) or he soc a cons ruc on o womanhood and gender n h s ory L Sch eb nger The M nd Has No Sex? Women and he Or g ns o Modern Sc ence (Cambr dge Mass Harvard Un vers y Press 1989) 150 The po n was made n he e gh een h cen ury espec a y see Henry Burdon The Foun a n o Hea h or a V ew o Na ure (London 1734) James MacKenz e The H s ory o Hea h and he Ar o Preserv ng h s ory o he no on Roy Por er and Doro hy Por er n S ckness and n Hea h The Br sh Exper ence 1650-1850 (London Four h Es a e 1988) chap 10
2d ed (Ed nburgh 1759) or he
151 These are deo og ca ma ers au ond and cou d no be po e y pu un h s cen ury see Page s Adam Eve and he Serpen (n 62) The sermon s s o he seven een h and e gh een h cen ur es o en a uded o e s on or bo h rea ms phys o og ca and re g ous see P Zacch a De a ec on bus hypochondr ac s br res Nunc n La num sermonem rans a ab A phonso Khonn (Augsburg 1671)
bu n he anguage o
Women and Work who accep s Lawrence S one s marr age s a s cs n The Fam y Sex and Marr age n Eng and 1500-1800 (London We den e d & N cho son 1977) as re ab e
152 See H
153 A so sugges ed by con emporary soc a commen a ors such as Pe er Anne n Soc a B ss cons dered n marr age and d vorce cohab ng unmarr ed and pub c whor ng Con a n ng h ngs necessary o be known by a ha seek mu ua e c y and are r pe or he en oymen o (London 1749) Examp es o he prescr p on o sexua n ercourse are ound n Ada he d G edke D e L ebeskrankhe n der Gesch ch e der Med z n Un vers y o Düsse dor Ph D hes s 1983 154 For anger n re a on o me ancho y n ear y modern h s ory see L B nswanger Me ancho e und Man e (n 81) 155 For he sexes see J H Hags rum Sex and Sens b y dea and Ero c Love rom M on o Mozar (Ch cago Un vers y o Ch cago Press 1980) Turner One F esh (n 144) or sex gender w h a g ance a hys er a n M on see Annabe e Pa erson "No meer ama or us nove ?" n Po cs Poe cs and Hermeneu cs n M on s Prose ed D Loewens e n and J G Turner (Cambr dge Cambr dge Un vers y Press 1990) 85-101 esp 101 n 18 156 The mos mpor an o he many works on h s op c s R chard Bax er s The Cure o Me ancho y and over much Sorrow by Fa h and Phys ck (London 1682) see a so Bax er s Re qu ae Bax er anae par
sec 184 (London 1696)
157 As was apparen n he deve opmen o he Theophras an charac er n he a e seven een h cen ury as we as n he arrangemen o he genders see rs s h s ory and re a on o he rad ons o hys er a n Ches er Noyes Greenough A B b ography o he Theophras an Charac er n Eng sh w h Severa Por ra Charac ers (Cambr dge Mass Harvard Un vers y Press 1947) and wo mpor an s ud es Ben am n Boyce The Theophras an Charac er n Eng and o 1642 (Cambr dge Mass Harvard Un vers y Press 1947) J W Smeed The Theophras an "Charac er" The H s ory o a L erary Genre (Ox ord Ox ord Un vers y Press 1985) 158 See H M Weber The Res ora on Rake-Hero Trans orma ons n Sexua Unders and ng n Seven een h Cen ury Eng and (Mad son Un vers y o W scons n Press 1986) and Turner One F esh (n 144) For he broader ph osoph ca ssues nvo ved n he cons ruc on o sexua y see A Dav dson "Sex and he Emergence o Sexua y " Cr ca nqu ry 11 (1987) 16-48 159 S one Fam y Sex and Marr age n Eng and 1500-1700 (n 152) and R Trumbach The R se o he Ega ar an Fam y (New York New York Un vers y Press 1978) 160 See R Trumbach "Sodomy Trans ormed Ar s ocra c L ber nage Pub c Repu a on and he Gender Revo u on o he E gh een h Cen ury " n Love Le ers be ween a Cer a n La e Nob eman and he Famous Mr W son ed M S K mme (New York Harr ng on Park Press 1990) 106 161 See H s hypo hes s abou ema e mob y n re a on o he r se o pros u on n Women and Work 162 For he rans orma on o hese gender re a ons n he per od see R Trumbach "The B r h o he Queen Sodomy and he Emergence o Gender Equa y n Modern Cu ure 1660-1750 " n H dden rom H s ory Rec a m ng he Gay and Lesb an Pas ed M Duberman M V c nus and G Chauncey Jr (New York NAL Books 1989) 45-60 whose hes s deserves cons dera on 163 See Sydenham (n 44) 282-283 164 For med ca heory be ore Sydenham ( e n he per od 1600-1680) advoca ng he pos on ha he pa en may be a c ed w h he one or he o her see G S Rousseau "Towards a Sem o cs o he Nerve The Soc a H s ory o Language n a New Key " n The Soc a H s ory o Language ed Pe er Burke and Roy Por er (Ox ord Po y Press 1991) 76-81 (Append x) some d scuss on o he sub ec s a so ound n P E A Roy "De hypochondr e " Arch ves de Neuro og e 20 (1905) 166-183 165 The hypochondr um was ana om ca y speak ng oca ed w h n he n ercos a cav y ye e d eren a on was made a h s me rom wha can ga her be ween ma e and ema e n ercos a cav es perhaps was one more aspec o Thomas Laqueur s "one sex" heory see Laqueur Mak ng Sex (n 138) n Sex and Reason (Cambr dge Harvard Un vers y Press 1991) R chard Posner sees deep y n o he b o og ca and ega d mens ons o hese d erences bu prac ces a awed me hod by v r ue o gnor ng oca soc oh s or ca prac ces as n he now remo e Res ora on e hos o sexua y 166 See Dewhurs Dr Thomas Sydenham (n 41) and Boss "Seven een h-Cen ury Trans orma on o he Hys er c A ec on" (n 55) 167 For "psyche-o og a" as a neo og sm and or s ngu s c ram ca ons n bo h med c ne and rhe or c a h s me see G S Rousseau "Psycho ogy " n The Fermen o Know edge S ud es n he H s or ography o Sc ence ed G S Rousseau and Roy Por er (Cambr dge Cambr dge Un vers y Press 1980) 167-172 168 See h s mpor an rea se on he gou or g na y pub shed n 1683 as a Trea se on Gou and Dropsy and repr n ed n 1705 Some o Sydenham s deas on gou a so appeared n O he Four Cons u ons (an unda ed manuscr p n he Bod e an L brary Ox ord MS Locke c 19 170-176 ) and n h s Theo og a Ra ona s (wh ch ex s s n our manuscr p vers ons) 169 For Sydenham s med ca prac ce see Dewhurs Dr Thomas Sydenham (n 41) J F Payne A B ography o Dr Thomas Sydenham (London Longman s 1900) L M F P card Thomas Sydenham (D on 1889) oner and co abora or D scuss on o he Locke-Sydenham re a on s ound n Dewhurs Dr Thomas Sydenham (n 41) 39-41 55-56 73-76 164-169 and H s er
170 Locke served as Sydenham s ass s an and amanuens s a er as h s co-prac Thomas W s 1621-1685 Doc or and Sc en s (New York Ha ner 1968)
171 No ev dence nd ca es whe her or no Sydenham read Lepo s on hys er a and Sydenham s mos au hor a ve b ographer (Dewhurs ) s s en on he ma er Boerhaave commen s on he mpor ance o Lepo s s heor es o hys er a n h s 1714 pre ace o Lepo s s se ec observa ons ( Se ec orum observa onum ) For Lepo s and hys er a see Jackson Me ancho a and Depress on (n 80) 172 For Lepo s see Ve h Hys er a 129 he rans a on prov ded here s Ve h s 173 b d 129 174 Sydenham s pub shed med ca works are ew or a s see Dewhurs Dr Thomas Sydenham (n 41) 190 here are even ewer ha surv ve n manuscr p ( b d 190) Commen s on h s s gn cance w h n he h s ory o med c ne are ound n C D Mar n "A Trea se on he Gou " Cr ca Rev ew (March 1759) 281-282 as we as n he 1753 ed on o some o h s works pub shed by John Swan A s udy o h s s y e n he Ep s o ary D sser a on n re a on o he anguage o he me wou d repay he e or and m gh shed ur her gh on h s heory o hys er a 172 For Lepo s see Ve h Hys er a 129 he rans a on prov ded here s Ve h s 173 b d 129 174 Sydenham s pub shed med ca works are ew or a s see Dewhurs Dr Thomas Sydenham (n 41) 190 here are even ewer ha surv ve n manuscr p ( b d 190) Commen s on h s s gn cance w h n he h s ory o med c ne are ound n C D Mar n "A Trea se on he Gou " Cr ca Rev ew (March 1759) 281-282 as we as n he 1753 ed on o some o h s works pub shed by John Swan A s udy o h s s y e n he Ep s o ary D sser a on n re a on o he anguage o he me wou d repay he e or and m gh shed ur her gh on h s heory o hys er a 172 For Lepo s see Ve h Hys er a 129 he rans a on prov ded here s Ve h s 173 b d 129 174 Sydenham s pub shed med ca works are ew or a s see Dewhurs Dr Thomas Sydenham (n 41) 190 here are even ewer ha surv ve n manuscr p ( b d 190) Commen s on h s s gn cance w h n he h s ory o med c ne are ound n C D Mar n "A Trea se on he Gou " Cr ca Rev ew (March 1759) 281-282 as we as n he 1753 ed on o some o h s works pub shed by John Swan A s udy o h s s y e n he Ep s o ary D sser a on n re a on o he anguage o he me wou d repay he e or and m gh shed ur her gh on h s heory o hys er a 175 Ve h Hys er a 140 Sydenham pronounced here c ear y and succ nc y as n every h ng e se he wro e H s ma n po n s are ha hys er a has been m sunders ood n s mos undamen a pr nc p es ( e as he mos rans orma ve o a cond ons) n s a c on among he genders and soc a rank and a er a c on n s phys ca and men a man es a ons 176 s wor h emphas z ng a he cos o be abor ng he obv ous ha a seven een h- and e gh een h-cen ury phys c ans c a med o rea pa en s or he "hys er ca pass on " or he many o her names by wh ch was known There was no h ng unusua abou h s a a The on y d erence was he degree o wh ch he par cu ar phys c an spec a zed n hese cases Doc ors ke W s and Sydenham and a er on Cheyne and Ada r were known as "nerve doc ors " or spec a s s n hys er ca pass ons and pa en s w h hese comp a n s accord ng y ocked o hem 177 Lepo s d d no emphas ze he an ma sp r s bu wro e o "a co ec on o qu d accumu a ed n he h nd par o he head and here co ec ed w h he e ec ha swe s and d s ends he beg nn ngs o he nerves" see Henr Cesbron These pour e doc ora en medec ne H s o re cr que de hys ér ae (Par s Asse n e Houzeau L bra res de a Facu é de Medec ne 1909) who quo es and rans a es h s passage n French Ve h Hys er a 129 The qu d ex s ed w hou regard o gender and h s s prec se y why Lepo s cou d us y a v ew ha women are no na ura y pred sposed o hys er a any more han men Bu Lepo s s v ew was no known n Eng and h s works were never rans a ed n o Eng sh and have ound no ev dence n he wr ngs o Eng sh-speak ng doc ors ha hey were aware o Lepo s s heory 178 For W s s pr mary med ca works bra n heory be e s abou he n er ace o bra n and nervous sys em and v ew o hys er a n he gh o hese bas c heor es see G S Rousseau "Nerves Sp r s and F bres Toward he Or g ns o Sens b y " n S ud es n he E gh een h Cen ury ed R F Br ssenden (Canberra Aus ra an Na ona Un vers y Press 1975) 137-157 or W s and hys er a exc us ve y see Boss "Trans orma on o he Hys er c A ec on" (n 55) 179 The bes rea men o W s s med ca heory s R Frank "Thomas W s and H s C rc e Bra n and M nd n Seven een h-Cen ury Med c ne " n Languages o Psyche ed G S Rousseau (n 13) esp pp 131-141 Frank commen s on W s s mpor an c n ca observa on ha "pos mor ems showed he wombs o hys er ca women o be per ec y norma " (p 134) W s s A ec onum hys er cae (1672) has never been rans a ed n o Eng sh desp e s s a us as one o he mos mpor an neuro og ca works o he ear y modern per od Bu W s s sa en po n abou he e o ogy o hys er a was he b ood-bra n connec on essen a y ha any "derangemen s w h n he b ood were conveyed o he bra n and he nerves and hence he neura ra ec ory o he cond on ra her han any o her ransm ss on The m d- wen e h-cen ury h s or an o phys o ogy Pro essor John Fu on o Ya e Un vers y v ewed W s as a hybr d Eng sh Freud cum phys o og s no ng ha W s s Cerebre ana ome (1664) was one o he "s x corners ones o modern neuro ogy " oge her w h books by H z g Ferr er and Sherr ng on and ha n he sphere o he re a on o he cerebe um and nvo un ary ac on so mpor an o any sc en c or secu ar heory o hys er a " here was e ur her advance a er W s un 1809" see J Fu on Phys o ogy o he Nervous Sys em 2d ed (London Macm an 1943) 463 180 W s h mse had co ned such words as "neuro- og a" and "psyche- og a" bu never used he erm psycho og ca ma ady or hys er a or any o her cond on see Rousseau Fermen o Know edge (n 167) 146-148 181 T Laqueur Mak ng Sex (n 138) 182 The emo ons were undergo ng a parad gma c sh a h s me see G Rosen "Emo on and Sens b y n Ages o Anx e y A Compara ve H s or ca Rev ew " Amer can Journa o Psych a ry 124 (1967) 771-783 L J Ra her "O d and New V ews o he Emo ons and Bod y Changes " C o Med ca 1 (1965) 1-25 or a summary o he r changes n he mora and ph osoph ca rea ms F Hu cheson An Essay on he Na ure and Conduc o he Pass ons (London J Knap on 1730) 183 La ham Works o Thomas Sydenham (n 44) vo 2 85 For a con ras ng cond on o he seden ary e see he e ec s o " he g ass de us on" G Speak "An Odd K nd o Me ancho y Re ec ons on he G ass De us on o Europe (14401680) " H s ory o Psych a ry 1 (1990) 191-206 For hese v o en mood sw ngs and ou burs s o unexpec ed behav or see John Ba The Modern Prac ce o Phys c 2 vo s (London 1760) 2 229 184 See G S Rousseau "Sc ence and he D scovery o he mag na on n En gh ened Eng and " E gh een h-Cen ury S ud es
(1969) 108-135
185 By he m d-e gh een h cen ury he "nervous sys em" had become en renched n med ca heory as we as d agnos s and n ana omy and phys o ogy as we see D Sm h A D sser a on upon he Nervous Sys em o show s n uence upon he Sou (London 1768) A Monro Exper men s on he nervous sys em w h op um and mea ne s c subs ances made ch e y w h he v ew o de erm n ng he na ure and e ec s o an ma e ec r c y (Ed nburgh A Ne & Co or Be & Brad u e 1793) For s deve opmen see E T Car son and M S mpson "Mode s o he Nervous Sys em n E gh een h-Cen ury Psych a ry " Bu e n o he H s ory o Med c ne 43 (1969) 101-115 C Lawrence has s ud ed he cu ura ram ca ons n "The Nervous Sys em and Soc e y n he Sco sh En gh enmen " n Na ura Order H s or ca S ud es o Sc en c En gh enmen ed Barry Barnes and S even Shap n (Bever y H s Ca Sage Pub ca ons 1979) 19-40 or he ear y n ne een h-cen ury v ew see C Be The Nervous Sys em o he Human Body (London 1824 repr n ed 1830) 186 Today v ewed rom our em n s and pro-abor on deo og es he dea wou d be r d cu ed as prepos erous desp e he s rong ves ges o ha rema n everywhere n he c v zed wor d bu v ewed rom he perspec ve o he sc ences o man wh ch re ed so heav y on ana omy and phys o ogy or he r underp nn ngs was easy o make a case or No one shou d h nk hese wo as sub ec s—ana omy and phys o ogy—were ree o he po cs and deo og es ha n ervene n a sc ence 187 See n 182 188 See G S Rousseau "Cu ura H s ory n a New Key Towards a Sem o cs o he Nerve " n n erpre a on and Cu ura H s ory ed J H P ock and A Wear (London Macm an 1991) 25-81 189 The passage appears n La ham Works o Thomas Sydenham (n 44) vo 2 85 190 Be e s abou hys er a were s drawn a mos exc us ve y rom Wes ern mode s and desp e he expans on sm and d scover es o he as cen ury geograph ca nsu a on s charac er s cs see W Fa coner Remarks on he n uence o C ma e S ua on e c on he d spos on and emper o mank nd (London C D y 1781)
served o produce d sease accord ng o c ma c and na ona
191 La ham Works o Thomas Sydenham (n 44) vo 2 85 192 As ear y as 1943 Henry S eger s wro e abou d sease w h n h s ory rom a broad perspec ve and c a med ha here had a ways been an n ma e connec on be ween d sease and ar ( e era ure pa n ng poe ry drama e c ) a v ew ha seems no o have had much n uence on Ve h Had S eger s gazed ur her back han o Charco n h s d scuss on o hys er a he wou d have seen how rue h s n u on was or he seven een h and e gh een h cen ur es see H S eger s C v za on and D sease (n 67) 184-185 191-194 193 For he nervous cons u on by 1900 see J Go ds e n Conso e and C ass y (n 36) and J Oppenhe m " Sha ered Nerves" Doc ors Pa en s and Depress on n V c or an Eng and (Ox ord Ox ord Un vers y Press 1991) 194 La ham Works o Thomas Sydenham (n 44) vo 2 85 195 b d 196 b d vo 2 54 197 b d 194 La ham Works o Thomas Sydenham (n 44) vo 2 85 195 b d 196 b d vo 2 54 197 b d 194 La ham Works o Thomas Sydenham (n 44) vo 2 85 195 b d 196 b d vo 2 54 197 b d 194 La ham Works o Thomas Sydenham (n 44) vo 2 85 195 b d 196 b d vo 2 54 197 b d 198 H ghmore espoused h s heory o hys er a n hree works pr mar y Excerc a ones duae quarum pr or de pass one hys er ca a era de a ec one hypochondr aca (Ams erdam C Comme n 1660) Hys er a (Ox ord A L ch e d and R Dav s 1660) De hys er ca e hypochondr aca pass one Respons o ep s o ar s ad Doc orem W s (London 1670) 199 Quo ed n R chard Hun er and da Maca p ne Three Hundred Years o Psych a ry 1535-1860 (London Ox ord Un vers y Press 1963) See a so Boss Seven een h-Cen ury Trans orma on o he Hys er c A ec on (n 55) s er Thomas W s (n 170) 200 T W s An Essay on he Pa ho ogy o he Bra n (London 1684) 71 201 Be e s abou he e em nacy o men an eda e he Res ora on o course bu he dea acqu red a oge her d eren currency hen For some o he reasons see Trumbach "The B r h o he Queen" (n 162) J Turner "The Schoo o Men L ber ne Tex s n he Subcu ure o Res ora on London" (a a k g ven a UCLA 1989) or a remarkab y de a ed case h s ory o ma e e em nacy o he p aywr gh R chard Cumber and n he e gh een h cen ury see K C Ba ders on ed Thra ana The D ary o Mrs Thra e 1776-1809 2 vo s (Ox ord C arendon Press 1942 rev ed 1951) 2 436-440 202 The erm ca egory as have been us ng n h s chap er shou d no sugges ph osoph ca so much as med ca ca egory D sease was hen unders ood a mos en re y w h n he erms o ca egor es and c ass ca ons as he w de axonom c endenc es o he era had doc ors comp ng and c ass y ng every d sease n erms o s ma or symp oms ana om c presen a ons organ c nvo vemen s and so or h See D Kn gh Order ng he Wor d A H s ory o C ass y ng he Wor d (London Macm an 1980) 203 Bag v he d a cha r o med ca heory n he Co eg o de a Sap enza n Rome hav ng been e ec ed o by Pope C emen X H s book De prax med c na (1699 Eng sh rans 1723) was wr en w h a know edge o Sydenham s heor es He be eved ha hys er a was a men a d sease caused by pass ons o he roub ed m nd n h s sense he s ess accura e and n u ve han Sydenham bu never he ess mpor an For a an hys er a and hypochondr a see Oscar G acch L s er smo e pochondr a avvero ma o nervosa G ud z s oc n c -soc a (M an 1875) 204 See B Mandev e A Trea se o he Hypochondr ack and Hys er ck Pass ons (London 1711 repr n ed 1715 3d ed 1730) 205 W s s ana om ca "exp os ons" are d scussed by R G Frank "Thomas W s and H s C rc e Bra n and M nd n Seven een h-Cen ury Med c ne " n The Languages o Psyche ed Rousseau (n 13) 107-147 Sacks M gra ne (n 7) 26-27 or W s s rhe or c and anguage see D Dav e Sc ence and L era ure 1700-1740 (London Sheed & Ward 1964) 206 For hese sh s n know edge a arge see Thomas S Kuhn The S ruc ure o he Sc en Rousseau and Por er (n 167) 11-55
c Revo u on (Ch cago Un vers y o Ch cago Press 1970 rev ed ) Rom Harré "Ph osophy and deas Know edge " n Fermen o Know edge ed
207 Even Ve h s survey n Hys er a makes h s ac abundan y c ear does n J Wr gh "Hys er a and Mechan ca Man " Journa H s ory o deas 41 (1980) 233-247 and or numbers
208 The ev dence or en renchmen s prov ded n he rema n ng por on o h s chap er and rema ns a cen ra heme o h s essay as o med ca h s or ans such as A Luyend k 209 For some o he ev dence o he oppos e v ew see P Ho mann La emme dans a pensée des Lum éres (Par s Ophrys 1977) H
Women and Work
210 So much has now been wr en abou h s re a ve y sma group ha one hard y knows where o d rec he cur ous reader a good p ace s J Todd S gn o Ange ca Women Wr ng and F c on 1660-1800 (London V rago 1988) and or one case h s ory wr en n dep h R Perry The Ce ebra ed Mary As e An Ear y Eng sh Fem n s (Ch cago Un vers y o Ch cago Press 1986) 211 A horough ngu s c s udy o hese words ("sp een " "vapors " "hys er cs") recons ruc ed n he r oca con ex s wou d revea shades o d erence bu here are an equa number o examp es o over ap and n erchangeab y see a so sec on X For he w ch r a s see K Thomas Re g on and he Dec ne o Mag c (Harmondswor h M dd esex Pengu n 1973) or he amous 1736 case o he w ch o Endor B S ock The Ho y and he Demon c (Pr nce on N J Pr nce on Un vers y Press 1983) A Trea se o Vapours or Hys er ck F s (London J Johnson 1707) 91
212 John Purce
213 Radc e had a arge and es ab shed prac ce o wea hy ar s ocra c c en s many o whom su ered rom hys er a bu he wro e apo hecary Edward S ro her see J Radc e Pharmacopoe a Radc eana (London 1716)
e h s amed reper o re o remed es con nued o be pub shed dur ng and a er h s
e me and was ed ed by
214 A good d scuss on o he scene s ound n John Sena "Be nda s Hys er a The Med ca Con ex o The Rape o he Lock " E gh een h-Cen ury L e 5 no 4 (1979) 29-42 ed The Tw ckenham Ed on o he Works o A exander Pope (New Haven Conn Ya e Un vers y Press) 234
215 J Bu
216 For he pos -Popean conography o Be nda as hys er c see C Tracy The Rape Observ d (Toron o Un vers y o Toron o Press 1974) 81 espec a y D Guern er s us ra on o Be nda swoon ng 217 An n eres ng pharmaceu ca s udy cou d be wr en comp ng hese remed es n he e gh een h cen ury For examp e he Gen emen s Magaz ne regu ar y pr n ed "rece p s" or ema e hys er a and "ma e oves ckness" see he June 1733 ssue p 321 prescr b ng he y ng o a woman s head n a noose nex o a cr cke a eged y s ung by he no se Domes c vade mecums such as W Buchan Domes c Med c ne (London 1776) and s andard pharmacope as such as J Qu ncy The D spensa ory o he Roya Co ege o Phys c ans (London 1721 many ed ons) a so prescr bed Hys er a was a v r ua ndus ry or apo hecar es or he en re per od espec a y n cord a s o preven m scarry ng 218 For he a - mpor an a romechan sm o he per od a arge see T M Brown "From Mechan sm o V a sm n E gh een h-Cen ury Eng sh Phys o ogy " Journa o he H s ory o B o ogy 7 (1974) 179-216 Rousseau "Nerves Sp r s and F bres" (n 178) G Bow es "Phys ca Human and D v ne A rac on n he L e and Though o George Cheyne " Anna s o Sc ence 41 (1974) 473-488 H Me zger A rac on Un verse e e Re g on Na ure e chez que ques Commen a eurs Ang a s de New on (Par s N ze 1938) more recen y or a romechan sm n he work o Dr Cheyne see G S Rousseau Med c ne and M enar an sm mmor a Doc or Cheyne " n Herme c sm and he Rena ssance n e ec ua H s ory and he Occu n Ear y Modem Europe ed ngr d Merke and A en Debus (Wash ng on D C Fo ger Shakespeare L brary 1988) 192-230 and or he ro es o rhe or c and anguage n Cheyne s wr ngs see Rousseau "Language o he Nerves " n Soc a H s ory o Language ed Burke and Por er (n 42) cons der Cheyne s Essay o he True Na ure and Due Me hod o Trea ng he Gou (London G S rahan 1722) among h s mos mpor an works or ay hg ou h s heory o a romechan sm and pos New on an app ca on 219 The Du ch were mpor an n he deve opmen o a mechan ca heory o hys er a he grea and n uen a Dr Boerhaave h mse hav ng den ed hys er a as he mos ba ng o a ema e ma ad es Boerhaave s wr ngs se hys er a on a rm mechan ca bas s on he con nen or h s heory o hys er a and s adop on by h s o owers espec a y An on de Haen n Ho and Gerard van Sw e en n Aus r a and Rober Why n Sco and see A M Luyend k "He hys er e-begr p n de 18de eeuw " n Ongerege d zenuw even ed L de Goe (U rech NcGv 189) 30-41 a vo ume r ch n he b b ography o hys er a and dea ng exc us ve y w h he modern h s ory o ema e u er ne ma ad es Luyend k s r gh o c a m ha hroughou he e gh een h cen ury every aspec o " he s ck woman" was sexua y charged and sexua y m na see A M Luyend k "De Z eke Vrouw n de Ach ende Eeuw " Na uurkund ge Voordrach en 66 (1988) 129-136 220 See Rousseau on Cheyne ("Med c ne and M nar an sm " n 218) By 1750 hys er a had become "na ona zed" ( e Du ch hys er a Sco sh hys er a e c ) and a s udy o
s na ona s c d osyncras es wou d make or asc na ng read ng
221 und d h s psycho og z ng and cu ura de erm na on neg ec ed h s pr mary po n abou hys er a as a d sease o m a on (see n 44) and rep aced w h a rad ca ana om z ng and mechan z ng o he nervous sys em capab e o accoun ng or r ses and a s o hys er a n bo h genders ndeed a er Sydenham he heory o m a on v r ua y wen under nd ng no p ace n Cheyne s sys em where he word never appears may be more han co nc den a ha Sydenham an hys er a as a d sease o m a on dec nes concom an y w h he arger aes he c and ph osoph ca heory o m a on n he same per od see F Boyd M mes s The Dec ne o a Doc r ne (Cambr dge Mass Harvard Un vers y Press 1973) 222 For Rob nson see A New Sys em o he Sp een (London 1729) quo ed n R chard Hun er and da Maca p ne Three Hundred Years o Psych a ry (n 199) K bansky e a (n 80) 291-294 T H Jobe "Med ca Theor es o Me ancho a n he Seven een h and Ear y E gh een h Cen ur es " C o Med ca 19 (1976) 217-231
Sa urn and Me ancho y (n 12) Jackson Me ancho a and Depress on
223 G Cheyne The Eng sh Ma ady or a Trea se o Nervous D seases o A K nds (London S rahan & Leake 1733) 184 see a so O Dough y "The Eng sh Ma ady o he E gh een h Cen ury " Rev ew o Eng sh S ud es 2 (1926) 257-269 E F scher-Homberger "On he Med ca H s ory o he Doc r ne o he mag na on " Psycho og ca Med c ne 4 (1979) 619-628 wh ch d scusses he med ca za on o he mag na on n re a on o he hys er c a ec on and mos mpor an R Por er "The Rage o Par y A G or ous Revo u on n Eng sh Psych a ry " Med ca H s ory 27 (1983) 35-50 224 Cheyne Eng sh Ma ady 14 Samue R chardson he nove s and pr n er had pr n ed he book or h s r end and c a med ha Cheyne chose he e ("Eng sh") because he he d he squa or and po u ed a r respons b e or London s be ng " he grea es mos capac ous c ose and popu ous C y o he G obe"—and a so ca ed he " Eng sh ma ady" because hys er a was so ca ed n der s on by con nen a wr ers ( Eng sh Ma ady 55 C F Mu e ed The Le ers o Doc or George Cheyne o Samue R chardson 1733-1743 Co umb a Un vers y o M ssour Press 1943 15 ) 225 R James A Med c na D c onary nc ud ng Phys cs Surgery Ana omy Chem s ry and Bo any n A The r Branches Toge her w h a H s ory o Drugs
(London T Osborne 1743-1745) ar c e en
ed "hys er a "
226 Cur ous y no sys ema c s udy has been under aken desp e he arge amoun o recen em n s scho arsh p n he e d o e gh een h-cen ury s ud es awa s s av d s uden or whom he sheer amoun o ma er a be ween 1700 and 1800 w make or a e d day o scho arsh p Some ma er a or he n ne een h cen ury s ound n Y R pa La ronde des o es Femme o e e en ermemen au X Xe s ec e (Par s Aub er 1986) Mü er who became a ead ng an hropo og s n Germany wro e h s med ca hes s a he Un vers y o Par s n 1813 on " e spasme e a ec on vaporeuse" as a e as he 1840s some French doc ors s cons dered "sp een" a va d ca egory o he hys er a-hypochondr a syndrome see D Mon a egry Hypochondr e-sp een ou névroses r sp anchn ques Observa ons re a ve à ces ma ad es e eur ra emen rad ca (Par s 1841) and hys er a see Chr s opher Fox ed Psycho ogy and L era ure n he E gh een h Cen ury (New York AMS Press 1988) 236—237
227 For Sw
228 M DePor e N gh mares and Hobbyhorses Sw
S erne and Augus an deas o Madness (San Mar no Ca
Hun ng on L brary Press 1974) 125
229 For ev dence o he ngu s c con us on n he pr mary med ca era ure see W S uke ey O he Sp een (London 1723) J M dr Observa ons on he Sp een and Vapours Con a n ng Remarkab e Cases o Persons o bo h Sexes and a Ranks rom he asp r ng D rec ors o he Humb e Bubb er who have been m serab y a c ed w h hese Me ancho y D sorders s nce he Fa o he Sou h-sea and o her pub ck S ocks w h he proper Me hod or he r Recovery accord ng o he new and uncommon C rcums ances o each Case (London 1720) J Rau n Tra é des a ec ons vaporeuses du sexe (Par s 1758) There s a so a w de era ure o sp een and vapors as n Ma hew Green The Sp een and O her Poems w ha Pre a ory Essay by John A k n M D (London Cade 1796) For compar son o h s ear y e gh een h-cen ury ou break o sp een w h ou burs s n Amer ca a he end o he n ne een h cen ury see T Lu z Amer can Nervousness 1903 An Anecdo a H s ory ( haca N Y Corne Un vers y Press 1991) a s udy o he "neuras hen a p ague" o 1903 ha gave r se o hundreds o cures and po ons M dr wondered cer a n ypes o "sp een" appeared n par cu ar ypes o wars and no o hers Trea se o Vapours (n 212) some d scuss on o hese ma ers s ound n O Temk n The Fa ng S ckness (Ba more Johns Hopk ns Un vers y Press 1974)
230 See Purce
231 For he ex ens veness o h s New on an sm n med ca heory see N Rob nson M D A new heory o phys ck and d seases ounded on he pr nc p es o he New on an ph osophy (London 1725) w h much emphas s on hys er a n heo ogy and cosm c hough J Cra g Theo og a Ma hema ca (London 1699) more genera y Pr gog ne Order Ou o Chaos Man s New D a ogue w h Na ure (New York Ban am Books 1984) James Thomson he poe and au hor o The Seasons he mos w de y read Eng sh poem o he e gh een h cen ury a so re ec s h s pervas veness see A D McK op The Background o Thomson s Seasons (M nneapo s Un vers y o M nneso a Press 1942) For New on an sm and he popu ar mag na on M H N co son New on Demands he Muse (Pr nce on N J Pr nce on Un vers y Press 1946) 232 Roy Por er has chron c ed aspec s o h s deve opmen n M nd-Forged Manac es A H s ory o Madness n Eng and rom he Res ora on o he Regency (London Pengu n 1987) see a so or madness n h s per od and s re a on o curren sc en c movemen s V Sku ans Eng sh Madness deas on nsan y 1580-1890 (London Rou edge 1979) M Foucau Madness and C v za on A H s ory o nsan y n he Age o Reason (New York Pan heon Books 1965) 120-132 Dr Char es Perry a mechan s and con emporary o Cheyne Rob nson and Purce makes percep ve po n s abou madness n re a on o hys er a n h s rea se On he Causes and Na ure o Madness (London 1723) 233 For he human ar an sm o madness see D We ner "M nd and Body n he C n c Ph ppe P ne A exander Cr ch on Dom n que Esqu ro and he B r h o Psych a ry " n Rousseau Languages o Psyche (n 13) 332-340 234 See Rousseau "Med c ne and M enar an sm" (n 218) 235 G Cheyne quo ed n L Feder Madness n L era ure (Pr nce on N J Pr nce on Un vers y Press 1980) 170 Cheyne s prose abounds w h we rd syn ax ungramma ca cons ruc ons and neo og sms " an as ca " ra her han he s mp er word s range s us he sor o word ound n h s vocabu ary 236 The Eng sh Ma ady (1733) 353 237 b d 354 236 The Eng sh Ma ady (1733) 353 237 b d 354 238 S r R chard B ackmore A Trea se o he Sp een and Vapours (London 1725) 320 n a ra her s m ar prose W am Buchan n h s Domes c Med c ne (Ed nburgh 1769) 561 d scuss ng "hys er c and hypochondr aca a ec ons " no ed ha hese nervous d sorders were "d seases wh ch nobody chuses o own " s mpor an o ns s on he yok ng o hys er a and hypochondr a ever s nce Sydenham undercu (excep n name) hys er a as a gendered d sease B ackmore argued rom he perspec ve o one who had ved hrough he revo u on n nomenc a ure as we as gender "Mos Phys c ans have ooked upon Hys er c A ec ons as a d s nc D sease rom Hypochondr aca and here ore have rea ed some o hem under d eren Heads bu hough n Con orm y o ha Cus om do he same ye ake hem o be he same Ma ady " B ackmore adm ed ha women su ered worse he Reason o wh ch s a more vo a e d ss pab e s c and weak Cons u on o he Sp r s and a more so ender and de ca e Tex ure o he Nerves " Ye he ns s ed " h s proves no D erence n he r Na ure and essen a Proper es bu on y a h gher or ower Degree o he Symp oms common o bo h " Th s more "de ca e Tex ure o he Nerves" was he u crum on wh ch he heory o nervous d seases nc ud ng hys er a was o be pegged or he nex cen ury and rema ns a cruc a deve opmen n he h s ory o med c ne n he En gh enmen For some o s cu ura resonances see Rousseau "Cu ura H s ory n a New Key " n n erpre a on and Cu ura H s ory ed P ock and Wear (n 188) 25-81 239 B ackmore Trea se o he Sp een and Vapours (n 238) 319 s mpor an o re era e Sydenham s cons s en use o h s nomenc a ure or ma es wh ch e under h s gender co apse o he d sease and wh ch was genera y adop ed by h s s uden s and o owers n o he me o B ackmore and Rob nson men were a ways "hypochondr aca " wh e women rema ned "hys er ca " and no amoun o ana om ca s m ude be ween he genders cou d accoun or he ngu s d spar y or some d scuss on see E F scher-Homberger "Hypochondr as s o he E gh een h Cen ury—Neuros s o he Presen Cen ury " Bu e n o he H s ory o Med c ne 46 (1972) 391-401 240 N cho as Rob nson A new sys em o he sp een vapours and hypochondr ack me ancho y where n a cause and cure o me ancho y madness and unacy (London 1729) 144
he decays o he nerves and ownesses o he sp r s are mechan ca y accoun ed or To wh ch s sub o ned a d scourse upon he na ure
241 b d 345 More genera y or h s "phys o og ca psycho ogy" see DePor e N gh mares and Hobbyhorses (n 228) Ra her "O d and New V ews o he Emo ons and Bod y Changes" (n 182) Jobe "Me ancho a n he Seven een h and E gh een h Cen ur es" (n 222) 240 N cho as Rob nson A new sys em o he sp een vapours and hypochondr ack me ancho y where n a cause and cure o me ancho y madness and unacy (London 1729) 144
he decays o he nerves and ownesses o he sp r s are mechan ca y accoun ed or To wh ch s sub o ned a d scourse upon he na ure
241 b d 345 More genera y or h s "phys o og ca psycho ogy" see DePor e N gh mares and Hobbyhorses (n 228) Ra her "O d and New V ews o he Emo ons and Bod y Changes" (n 182) Jobe "Me ancho a n he Seven een h and E gh een h Cen ur es" (n 222) 242 Look ng ahead hese ac ors w coa esce a er on n he cen ury n he wor d o Ada r Heberden Cu en—Cheyne s o owers For he med ca pro ess on n he e gh een h cen ury n re a on o he deve opmen o o her pro ess ons see Geo rey S Ho mes The Pro ess ons and Soc a Change n Eng and 1680-1730 (Ox ord Ox ord Un vers y Press 1981) and dem Augus an Eng and Pro ess ons S a e and Soc e y 1680-1730 (London A en & Unw n 1982) 243 For he ro e o quacks n h s m eu see R Por er Hea h or Sa e Quackery n Eng and 1650-1850 (Manches er Manches er Un vers y Press 1989) and "Fema e Quacks n he Consumer Soc e y " The H s ory o Nurs ng Soc e y Journa 3 (1990) 1-25 244 Ve h Hys er a 155 245 e he essen a y an -v a s c pr nc p e ha a s bra n and body no h ng m nd Twen e h-cen ury sc ence has spe ed he dea h kne o sc en c v a sm desp e s many ves ges n he b o og ca and neuro og ca rea ms For he an -v a s c s ra ns and wha am ca ng he r umph o he neurophys o og ca approach o con emporary wen e h-cen ury sc ence see J D Sp ane The Doc r ne o he Nerves Chap ers n he H s ory o Neuro ogy (Ox ord New York Ox ord Un vers y Press 1981) W R ese A H s ory o Neuro ogy (New York MD Pub ca ons 1959) or he ngu s c mp ca ons M Jeannerod The Bra n Mach ne The Deve opmen o Neurophys o og ca Though (Cambr dge Mass Harvard Un vers y Press 1985) H A Wh aker On he Represen a on o Language n he Human Bra n Prob ems n he Neuro ogy o Language (Los Ange es UCLA Work ng Papers n L ngu s cs 1969) 246 Cheyne Eng sh Ma ady 271 247 For nymphoman a see n 74 248 The an ma sp r s con nued o prove roub esome or exper men ers and heor s s un he m dd e o he e gh een h cen ury or h s comp ca ed chap er n he h s ory o sc ence and med c ne see E C arke "The Doc r ne o he Ho ow Nerve n he Seven een h and E gh een h Cen ur es " n Med c ne Sc ence and Cu ure H s or ca Essays n Honor o Owse Temk n ed L G S evenson and Rober P Mu hau (Ba more Johns Hopk ns Un vers y Press 1968) 123-141 or s ngu s c represen a ons and d verse me aphor ca uses Rousseau "D scovery o he mag na on" (n 184) he n erchanges be ween he rhe or ca and emp r ca (or sc en c) doma ns here wou d make a asc na ng s udy ha has no been under aken on a broad canvas 249 See Laqueur Mak ng Sex (n 138) Feher H s ory o he Human Body (n 125) 250 Cheyne Eng sh Ma ady
(pre ace)
251 For n gh mares and hys er a see A M Luyend k-E shou "Mechan sm con ra v a sme De schoo van Herman Boerhaave en de beg nse en van he even " T Gesch Geneesk Na uurw W sk Techn 5 (1982) 16-26 dem "O Masks and M s" (n 82) and more genera y Cas e "Phan asmagor a" (n 82) 252 Two genera ons a er Pope Hannah Webs er Fos er (1759-1840) hough ha he nerves o he coque e d s ngu shed her rom o her ypes see The coque e or The h s ory o E za Whar on Reproduced rom he or g na ed on o 1797 (New York Co umb a Un vers y Press 1939) as d d Dav d Garr ck n h s p ay o he same name bu a cen ury ear er here was no such no on n Ph ppe Qu nau s La mére coque e (wr en as Sydenham was compos ng h s essay on hys er a) or n he S a e Poems on cour coque es wr en dur ng Sw s per od Rena ssance Se - ash on ng From More o Shakespeare (Ch cago Un vers y o Ch cago Press 1980) whose use o se - ash on ng mus be cred ed
253 S Greenb a
254 P M Spacks The Fema e mag na on (London Me huen 1976) dem mag n ng a Se Au ob ography and Nove n E gh een h-Cen ury Eng and (London Rou edge 1976) K O Lyons The nven on o he Se (Carbonda e Sou hern no s Un vers y Press 1978) J Mu an Sen men and Soc ab y (Ox ord Ox ord Un vers y Press 1988) and erary cr c sm dea ng w h he era ure o sens b y c d mens on n m d-e gh een h cen ury see Ha er s phys o og ca revo u on or he popu ar cu s see an anonymous "Descan on Sens b y " London Magaz ne (May 1776) Bredvo d The Na ura H s ory o Sens b y (De ro Wayne S a e Un vers y Press 1962)
255 G S Rousseau "Nerves Sp r s and F bres" (n 178) or he sc en or he erary d mens on Hags rum Sex and Sens b y (n 155) and L
256 r ed o documen h s po n abou he sem o ogy o d sease hen n " Sow ng he W nd and Reap ng he Wh r w nd Aspec s o Change n E gh een h-Cen ury Med c ne " n S ud es n Change and Revo u on Aspec s o Eng sh n e ec ua H s ory 1640-1800 ed Pau J Korsh n (London Scho ar Press 1972) 129-159 257 The new code s no ev den n John P ay ord s seven een h-cen ury rea ses bu beg ns o be apparen n he drama (Wycher y s Love n a Wood ) and n rea ses by danc ng mas ers wr en a er ca 1740 258 Th s comp ex and arge y nonverba code rema ns o be dec phered
s some h ng as ye no unders ood abou he Augus an "se - ash on ng" ( o nvoke Greenb a s ne erm) o he nerves
259 The new ro e o consump on o every ype canno be m n m zed n h s per od see N J McKendr ck e a The B r h o Consumer Soc e y The Commerc a za on o E gh een h-Cen ury Eng and (London Europa Pub ca ons L m ed 1982) J Brewer The S news o Power War Money and he Eng sh S a e 1688-1783 (Cambr dge Mass Harvard Un vers y Press 1990) or he reac on M Ca dwe The Las Crusade The War on Consump on (New York A heneum Pub shers 1988) or he med ca d agnos s and s econom c mp ca ons see such con emporary med ca works as C Benne Trea se o Consump ons (London 1720) or dr nk and s re a on o nervous sens b y compare T Tro er An Essay Med ca Ph osoph ca and Chem ca on Drunkenness (London Longmans 1804) 260 r ed o exp a n he cha n o reasons rom med ca and ph osoph ca sur ace o he En gh enmen cu s o sens b y
o soc a and popu ar n "Nerves Sp r s and F bres" (n 178) and "Cu ura H s ory n a New Key" (n 188) bu much work rema ns o be done— have bare y scra ched he
261 See M Foucau Madness and C v za on A H s ory o nsan y n he Age o Reason (New York Pan heon Books 1965) 132 My own hough has been n uenced as much on he sem o c doma n by Tzve an Todorov n The Conques o Amer ca The Ques on o he O her Trans a ed rom he French by R chard Howard (New York Harper & Row 1985) The Fa o Pub c Man (New York A red A Knop 1979)
262 R chard Senne
263 cou d no have e eva ed sens b y and he cond ons (hys er a) ha depended on w hou a pr or heory o he "sc ences o man " There are ne s ud es o h s sub ec bu hey usua y om he med ca d mens on en re y or he bes see Serg o Morav a F oso a e sc enze umane ne e a de um (F orence Sanson 1982) The po n needs o be re a ed o he deve opmen o he sc ence o man Morav a saw much bu d d no make he mpor an connec ons he saw narrow y on y he new sc ence o man bu no s mp ca on or se - ash on ng 264 Even Pe er Gay had made h s sem na po n abou Ha er n he open ng pages o The En gh enmen An n erpre a on 2 vo s (New York A red A Knop 1966-69) 1 30 n "The Sp r o he Age" and "The Recovery o Nerve " as d d Henry S ee e Commager n The Emp re o Reason (New York Anchor Doub eday 1977) 8-10 n he amous paean o Ha er who " ook a know edge or h s prov nce" (p 8) and who " n he bread h and dep h o h s know edge was perhaps un que (p 10) However Ha er s shrewd us on o a med ca and erary anguage o sexua sens b y ( sens b ä ) has been ess we unders ood by h s or ans orever ben on mere y assess ng h s con r bu on o he h s ory o European sc ence he Sw ss En gh enmen or he n e ec ua deve opmen o Gö ngen 265 E sewhere have r ed o make he argumen ha he med ca and sc en c revo u ons o he En gh enmen have s no been n egra ed n o he cu ure a arge nor n o he deve op ng med ca pro ess on Go ds e n s Conso e and C ass y (n 36) s an exemp ary book or h s ype o work carr ed ou or he nex cen ury For he egacy o he "nervous revo u on" n med c ne n he nex cen ury see a so Oppenhe m " Sha ered Nerves " (n 193) 266 See Rousseau Languages o Psyche (n 13) 267 Mechan ca ph osophy had been app ed o every o her doma n nc ud ng pa n ng d e hea h governmen so why no o manners? For a s o app ca ons see Rousseau "Language o he Nerves" (n 42) 60-61 or an examp e n mus c R Browne Med c na mus ca Or a Mechan ca Essay on he E ec s o S ng ng Mus ck and Danc ng on Human Bod es (London 1729) As a e as 1757 manners are s be ng descr bed n mechan ca me aphors see J Brown An Es ma e o he Manners and Pr nc p es o he T mes (London L Dav s & C Reymers 1757) 268 W am Heberden Med ca Commen ar es (London T Payne 1802) 227 269 b d 235 Heberden d d ns s however ha " he r orce w be very d eren accord ng o he pa en s choos ng o ndu ge and g ve way o hem " 268 W am Heberden Med ca Commen ar es (London T Payne 1802) 227 269 b d 235 Heberden d d ns s however ha " he r orce w be very d eren accord ng o he pa en s choos ng o ndu ge and g ve way o hem " 270 The ro e o med ca schoo s was a so grea n h s see sec on X 271 See F J McLynn Cr me and Pun shmen n E gh een h-Cen ury Eng and (London Rou edge 1989) 272 For he ev dence see Wr gh "Hys er a and Mechan ca Man" (n 208) Servan s o en aped hese a ec a ons o sp een and vapors o o her servan s bu rare y wou d hey do so w h he r m s resses who usua y saw hrough he pre ense n Gay s The Beggar s Opera Lucy exp a ns her unaccep ab e behav or o he r va rous Po y n erms o he vapors bu w hou reca ng ( she ever knew ) ha "A ec a on" had been one o he handma dens n Pope s "Cave o Sp een" n The Rape o he Lock 273 For h s e and works see Rousseau "Cu ura H s ory n a New Key" (n 188) Ph p Gosse Dr V per The Queru ous L e o Ph p Th cknesse (London Casse 1952) A Brunschw g En gh enmen and Roman c sm n E gh een h-Cen ury Pruss a (Ch cago Un vers y o Ch cago Press 1974) For Why see R K French Rober Why he Sou and Med c ne (London We come ns u e or he H s ory o Med c ne 1969) 274 James Mak r ck Ada r Essays on Fash onab e D seases (N P 1786) 4-7 275 The phrase s usua y quo ed rom An Ep s e o Dr Arbu hno ne 132 see a so Mar or e Hope N co son and G S Rousseau Th s Long D sease My L e A exander Pope and he Sc ences (Pr nce on N J Pr nce on Un vers y Press 1968) Bu Pope had used ear er n a e er o Aaron H March 14 1731 ( Correspondence 182) commen ng on h s chron c n rm es wh ch he hough had pred sposed h s "man y emperamen " o cer a n "so er ac v es " 276 For P ne and hys er a see D We ner "M nd and Body n he C n c " n Rousseau The Languages o Psyche (n 13) 391-395 277 For a s o many o hese med ca d sser a ons see G S Rousseau "D scourses o he Nerve " n L era ure and Sc ence as Modes o Express on ed F Amr ne (Dordrech K uwer Academ c Pub shers 1989) 56-60 278 M M ca e "A Rev ew Essay o Ma e Hys er a " Med ca H s ory (1988) 279 For some examp es see Boss "Trans orma on o he Hys er c A ec on" (n 55) 280 B ograph ca ma er a s ound n Thomas Gu do The L ves and Charac ers o he Phys c ans o Ba h (London 1676-77 repr n o 1724-25 s ed on re erred o here) and Some Par cu ars o he Au hor s Edward Jorden s D scourse o Na ura Ba hes and M nera Wa ers (London 1669 3d ed ) Gu do ded ca ed h s books o Map e and n 1694 saw hrough he press Map e s rea se on he e ec s o ba h ng
e Gu do
L e n Gu do s ed o
L ves and Charac ers o Phys c ans o Ba h 128-142 Subsequen passages are ound on hese pages
281 Gu do
282 Throughou my read ng wondered Gu do had read Sydenham on hys er a bu have been unab e o make a case or or aga ns The arger po n however s ha one wou d no have o read a par cu ar ex o know and even espouse he undamen a aspec s o he parad gm 283 E sewhere sha demons ra e ha e em nacy and sodomy
was h s parad gm ha n ormed n par
284 For examp e G deon s F eece or he S eur de Fr sk An Hero c Poem
heore ca exp ana ons o a -ma e r endsh p (on grounds ha sens v y grav a ed o ke sens v y) and ha became he subs ra um o a er d scuss ons abou
by Ph o-Musus a Fr end o he Muses (London 1684)
285 Ph ppe Hecque Le na ura sme des convu s ons dans es ma ad es de ép -dém e convu s onna re (So eure 1733) H e Schwar z The French Prophe s The H s ory o a M enar an Group n E gh een h-Cen ury Eng and (Berke ey Los Ange es London Un vers y o Ca orn a Press 1980) dem Knaves Foo s Madmen and ha Sub e E uv um A S udy o he Oppos on o he French Prophe s n Eng and 1706-1710 (Ga nesv e Un vers y Presses o F or da 1978) The Eng sh Eccen r cs (Bos on Hough on M
286 Ed h S we
n Co 1933)
287 Hugh Farmer An Essay on he Demon acs o he New Tes amen (London G Rob nson 1775) For Farmer s n eres n m rac es demons sp r s and hys er cs as we as h s med ca case h s ory and e see M chae Dodson Memo rs o he L e and Wr ngs o he La e Reverend and Learned Hugh Farmer (London Longman & Rees 1804) Th s work d ers rom phys c an R chard Mead s Trea se concern ng he n uence o he Sun and he Moon upon Human Bod es and he D seases Thereby Produced (London 1748) n Mead ma e hys er a s exp a ned accord ng o ex erna phenomena ( or examp e moon waves des) ac ng hrough Har eyan v bra ons and magne sm upon he human Nerves and hen he mag na on n h s sense Mead ke Farmer d eren hough he r pro ess ons were shou d bo h be cons dered k ndred n he m ndse o coun er-nerve For coun er-nerve see Rousseau "Cu ura H s ory n a New Key" (n 188) 70-75 and R chard Kuhn The Demon o Noon de Ennu n Wes ern L era ure (Pr nce on N J Pr nce on Un vers y Press 1976) 288 Lone ness was an e emen o he r a ena on as secure y as any o her ac ors as has been no ced by John S er n h s L erary Lone ness n M d-E gh een h-Cen ury Eng and ( haca and London Corne Un vers y Press 1982) 289 For a very m ed s udy n one hosp a dur ng he 1780s see G B R sse "Hys er a a he Ed nburgh n rmary The Cons ruc on and Trea men o a D sease 1770-1800 " Med ca H s ory 32 (1988) 1-22 R sse has sugges ed ha he organ c d agnos s ra her han any remo e y psychogen c e o ogy enhanced he beds de d scourse shared be ween hese Ed nburgh pro essors and he r pup s Men were no aken n a Ed nburgh bu hey were n Par s and V enna H ghborn and ow ema e and ma e a were rea ed and even ua y adm ed w hou regard o gender 290 The Adven ures o Tom Jones a Found ng (1749) Bk XV Smo e a phys c an-nove s who knew med ca heory more n ma e y han F e d ng por rays many more hys er cs ma e as we as ema e espec a y n h s "psych a r c nove " The Adven ures o S r Launce o Greaves (1762) Kar M er be eves ha Greaves s "weakness o he nerves " he ma ady h s quack doc or ass gns s a oreshadow ng o modern a mos Becke an "nervousness " and he more nervous peop e here are he more we may need sp ng mages a comedy o hur " See h s provoca ve chap er en ed "Andan e Capr cc oso " n h s Au hors (Ox ord C arendon Press 1989) 291 B env e Nymphoman a (n 74) Works had been wr en be ore 1775 on he behav or or ac v y we wou d now anachron s ca y ca nymphoman a bu B env e was he rs o wr e an en re rea se us ng he word and concep 292 G M er ed Le ers o Edward Jenner (Ba more Johns Hopk ns Un vers y Press 1983) 293 Th s ac sur aces repea ed y n he s udy o ema e ma ad es n Barbara Duden The Woman benea h he Sk n A Doc or s Pa en s n E gh een h-Cen ury Germany (Cambr dge Mass Harvard Un vers y Press 1991) he b b ograph ca ev dence see J Sena A B b ography o Me ancho y (London Ne her Press 1970) and Rousseau "Cu ura H s ory n a
294 Those who h nk "hordes" s excess ve o descr be he pro era on o hys er a heory shou d consu New Key" (n 188) 76-81 wh ch are hemse ves bu he p o he ceberg
295 R chard Hun er and da Maca p ne Hun er Three Hundred Years o Psych a ry (n 41) W am Ba e A Trea se on Madness (London Dawsons 1962) W am Per ec Cases o nsan y W am Parge er Observa ons on Man aca D sorders (Read ng 1792 repr n London Rou edge 1989)
Hypochondr aca A ec on
(London 1781)
296 The c ass c works rema n K aus Doerner s Madmen and he Bourgeo s e (Ox ord Bas B ackwor h 1981 or g na y pub shed n German n 1969) wh ch appeared be ore Foucau s ns gh u B r h o he C n c An Archaeo ogy o Med ca Percep on (New York V n age Books 1973) 297 C ed above a he end o Sec on X 298 For some o he ev dence re a ed o rank and c ass n Ed nburgh see R sse "Hys er a a he Ed nburgh n rmary" (n 289) 299 And ye h s oppos on rema ns one o he mos pers s en con ras s n he h s ory o hys er a n he ear y modern per od surveyed n h s chap er as worked my way hrough he mass ve amoun s o ma er a ava ab e rom over wo cen ur es (1600-1800) was s ruck o wha mass ve degree he body-m nd mode kep re y ng se n he d scourses o hys er a 300 See Andrew W son Med ca Researches Be ng an nqu ry n o he na ure and or g n o hys er cs n he ema e cons u on and n o he d s nc on be ween ha d sease and hypochondr ac or nervous d sorders (London C Nourse 1776) and W am Row ey A rea se on ema e nervous hys er ca hypochondr ac a b ous convu s ve d sease apop exy & pa sy w h hough s on madness & su c de e c (London C Nourse 1788) 301 The po n abou Cu en and axonomy n med ca heory has been we made by C Lawrence "Nervous Sys em and Soc e y" (n 185) See a so John Thomson An Accoun o he L e Lec ures and Wr ngs o W am Cu en 2 vo s (Ed nburgh W am B ackwood & Sons 1859) Wordswor h and he En gh enmen Na ure Man and Soc e y n he Exper men a Poe ry (New Haven Conn Ya e Un vers y Press 1989) 175
302 See A an Bewe
303 K Cave ed The D ary o Joseph Far ng on 16 vo s (New Haven Conn Ya e Un vers y Press 1982- ) 10 3705 304 Tra é des A ec ons Vaporeuses de deux sexes ou Ma ad es Nerveuses vu ga remen appe és de ner s (Par s mpr mer e Roya e 1782) 305 W Fa coner A D sser a on on he n uence o he Pass ons upon D sorders o he Body (London C D y 1788) 306 London R v ng on 1800 307 Ba h R Cru we
1800
308 John Has am Observa ons on nsan y (London R v ng on 1798) re ssued n 1809 as Observa ons on Madness & Me ancho y nc ud ng prac ca remarks on hose d seases oge her w h cases and an accoun o he morb d appearances o d ssec on dem us ra ons o Madness (London Rou edge 1810) 309 See n 1 above For madness rom Rena ssance o En gh enmen more genera y see Ana omy o Madness ed Bynum Por er and Shepherd 310 See sec on X
and n 273
311 s no acc den a or examp e ha Ba e s Trea se on Madness (1757) appeared on y a ew years a er he appearance o Ju en O ray de La Me r e s sem na announcemen o ma er a sm see h s Man a mach ne Where n he severa sys ems o ph osophers n respec o he sou o man are exam ned Trans a ed rom he French o Mons de La Me r e (London G Sm h 1750) and E Ca o La ph osoph e de a v e au XV e s èc e é ud ee chez Fon ene e Mon esqu eu Mauper u s La Me r e D dero d Ho bach L nné (Par s M R v ère 1965) A so as a para e here are he nonmed ca wr ngs o women o he per od who a so re a n mys ery as an essence o he hen modern secu ar zed woman 312 P ne s vers ons o hys er a have no been s ud ed n any de a
bu see nn 233 and 276
313 The m a ve aspec ex ends o course beyond he heory o hys er a For d eren approaches o see Mark Johnson The Body n he M nd The Bod y Bas s o Mean ng mag na on and Reason (Ch cago Un vers y o Ch cago Press 1987) and Barbara S a ord Body Cr c sm mag ng he Unseen n En gh enmen Ar and Med c ne (Cambr dge Mass M T Press 1991) 314 a cs m ne see Mary Jacobus Read ng Woman Essays n Fem n s Cr c sm (New York Co umb a Un vers y Press 2986) 201 and Mary Jacobus Eve yn Fox Ke er and Sa y Shu ewor h eds Body Po cs Women n he D scourses o Sc ence (London Rou edge 1990) 315 See n 300 and or Cu en and neuros s J M Lopez P ñero H s or ca Or g ns o he Concep o Neuros s (Cambr dge Cambr dge Un vers y Press 1983) Echoes o Rober James s Med c na D c onary (2 vo s London 1745 ) ar c e on "Hys er a" are ound n Cu en s works 316 A recen soc a cr c has no ed ha he ma n reason wen e h-cen ury homosexua s bu d up he r musc es n gyms s he r m sogyn s con emp o weak " nner spaces"—a ma er a s hypo hes s a eas 317 There are undamen a ways n wh ch he h s ory o hys er a resemb es ha o gender and sex se and s wrong o be eve ha hys er a res des n a c ass en re y apar rom hese For he soc a cons ruc on o a o hese see Pe er Wr gh and Andrew Treacher Wr gh eds The Prob em o Med ca Know edge Exam n ng he Soc a Cons ruc on o Med c ne (Ed nburgh Ed nburgh Un vers y Press 1982) Cyn h a Eag e Russe Sexua Sc ence The V c or an Cons ruc on o Womanhood (Cambr dge Mass Harvard Un vers y Press 1989) Ce a K z nger The Soc a Cons ruc on o Lesb an sm (London Sage Pub ca ons 1987) Dav d F Greenberg The Cons ruc on o Homosexua y (Ch cago Un vers y o Ch cago Press 1989) Thomas Laqueur "Onan sm Soc ab y and mag na on Med c ne and F c on n he E gh een h and Ear y N ne een h Cen ury " a a k de vered a he Un vers y o Ca orn a Berke ey 1991 318 R B Car er On he Pa ho ogy and Trea men o Hys er a (London John Church
1853)
319 Ve h Hys er a 221-228 For h s v ew n ano her key see L Cher ok and R de Sausurre Cher ok The Therapeu c Revo u on From Mesmer o Freud (New York Brunner Maze 1979) bu or sounder approaches o he Mesmer c phenomenon see V Burane The W zard rom V enna Franz Mesmer and he Or g ns o Hypno sm (London Rou edge 1976) R Darn on Mesmer sm and he End o he En gh enmen n France (Cambr dge Mass Harvard Un vers y Press 1968) 320 For Mesmer s New on an sm see R Coo er "The H s ory o Mesmer sm n Eng and " n Mesmer und d e Gesch ch e des Mesmer smus ed H Scho (S u gar Franz S e ner 1985) 152-162 321 Some have seen he ev dence o hese m sogyn s c ou burs s n he deba es abou ema e reproduc v y see P erre Darmon The My h o Procrea on n he Baroque Per od (London Rou edge 1982) Damn ng he nnocen A H s ory o Persecu on n Pre-Revo u onary France (New York V k ng Press 1986) 322
owe he phrase o Dav d Morr s see D Morr s "The Marqu s o Sade and he D scourses o Pa n L era ure and Med c ne a he Revo u on " n The Languages o Psyche ed Rousseau (n 13) 291-331
323 Roy Por er prov des he scho arsh p bu see a so G D d -Huberman nven on de Hys er e Charco e
conograph e Pho ograph que (Par s Macu a 1982)
324 F Kap an D ckens and Mesmer sm The H dden Spr ngs o F c on (Pr nce on N J Pr nce on Un vers y Press 1975)
Three— The Body and the Mind, The Doctor and the Patient: Negotiating Hysteria 1 See H O Lancas er Expec a ons o L e A S udy o he Demography S a s cs and H s ory o Wor d Mor a y (New York Spr nger Ver ag 1990) James C R ey S ckness Recovery and Dea h A H s ory and Forecas o Hea h (London Macm an 1989) A ex Mercer D sease Mor a y and Popu a on n Trans on Ep dem o og ca -demograph c Change n Eng and s nce he E gh een h Cen ury as Par o a G oba Phenomenon (London Le ces er Un vers y Press a d v s on o P n er Pub shers 1990) Roder ck F oud Kenne h Wach er and Annabe Gregory He gh Hea h and H s ory Nu r ona S a us n he Un ed K ngdom 1750-1980 (Cambr dge Cambr dge Un vers y Press 1990) Mark Na han Cohen Hea h and he R se o C v za on (New Haven Conn Ya e Un vers y Press 1989) P agues and Peop es (Ox ord Bas B ackwe
2 W H McNe
1976) A Crosby Eco og ca mper a sm (Cambr dge Cambr dge Un vers y Press 1986)
3 Mary K bourne Ma oss an Po sons o he Pas Mo ds Ep dem cs and H s ory (New Haven Conn Ya e Un vers y Press 1989) s c a med ha some o Freud s "hys er ca " pa en s n rea y su ered rom organ c d sorders ha Freud n h s zea or psychodynam c exp ana ons om ed o nves ga e See E M Thorn on Hypno sm Hys er a and Ep epsy An Hys er ca Syn hes s (London He nemann 1976) L ndsay C Hurs "Wha Was Wrong w h Anna O " Journa o he Roya Soc e y o Med c ne 75 (1982) 129-131 and he d scuss on n Mark M ca e "Hys er a and s H s or ography A Rev ew o Pas and Presen Wr ngs " H s ory o Sc ence 27 (1989) 223-261 esp p 45 4 The ssues o sh ng med ca erm no ogy are we d scussed n J H D rckx The Language o Med c ne Soc o ogy News 9 (1983) 21-28
s Evo u on S ruc ure and Dynam cs (New York Praeger Pub shers 1983) see a so Roy Por er "The Doc or and he Word " Med ca
5 James Longr gg "P ague o A hens " H s ory o Sc ence 18 (1980) 209-225 6 Such ma ers ead o course o ques ons as o he mean ng o he erm d sease se see W R esse The Concep on o D sease s H s ory s Vers ons and s Na ure (New York Ph osoph ca L brary 1953) G R sse "Hea h and D sease H s ory o he Concep s " n W T Re ch ed Encyc oped a o B oe h cs 2 vo s (New York Free Press 1978) 579-585 O Temk n "Hea h and D sease " D c onary o he H s ory o deas 2 (1973) 395-407 7 On cho era see Margare Pe ng Cho era Fever and Eng sh Med c ne 1825-1865 (Ox ord Ox ord Un vers y Press 1978) 8 See A an Krohn Hys er a The E us ve Neuros s appear ng n Psycho og ca ssues nos 45 46 (New York n erna ona Un vers es Press 1978) These prob ems are n e gen y addressed or a comparab y e us ve cond on as hma n J Gabbay "As hma A acked? Tac cs or he Recons ruc on o a D sease Concep " n The Prob em o Med ca Know edge ed P Wr gh and A Treacher (Ed nburgh Ed nburgh Un vers y Press 1982) 23-48 Modern psych a r s s are hemse ves unsure o he curren va d y o he hys er a d agnos s See or examp e severa o he con r bu ons n A ec Roy ed Hys er a (Ch ches er John W ey & Sons 1982) espec a y Henr Ey "Hys er a H s ory and Ana ys s o he Concep " 3-19 René Ma or "The Revo u on o Hys er a " n erna ona Journa o Psycho-Ana ys s 15 (1974) 385-392 D W Abse Hys er a and Re a ed Men a D sorders (Br s o Wr gh 1987) E M R Cr ch ey and H E Can or Charco s Hys er a Rena ssan " Br sh Med ca Journa 289 (22-29 December 1984) 1785-1788 Haro d Merskey "Hys er a The H s ory o an dea " Canad an Journa o Psych a ry 28 (1983) 428-433 dem "The mpor ance o Hys er a " Br sh Journa o Psych a ry 149 (1986) 23-28 For nva uab e re ec ons on he re a ons be ween modern h nk ng h s or ograph ca rends and he h s ory o hys er a see M ca e "Hys er a and s H s or ography" (par 1) 223-261 dem "Hys er a and s H s or ography" (par 2) 319350 dem "Hys er a and s H s or ography The Fu ure Perspec ve " H s ory o Psych a ry 1 (1990) 33-124 9
be eve E a ne Showa er s chap 4 embod es hese goa s deve oped deas o d seases o he womb and d seases o ove see Dan e e Jacquar and C aude Thomasse Sexua y and Med c ne n he M dd e Ages (Cambr dge Po y Press 1989)
10 Though
11 From he h gh ser ous— or ns ance F C Skey Hys er a (London Longman 1867)— o he h gh y s gma z ng Rober Thorn on The Hys er ca Woman Tr a s Tears Tr cks and Tan rums (Ch cago Donohue & Hennebury 1893) 12 For he represen a ons o hys er a and o her exemp ary d seases n ar and he med a see E a ne Showa er s and Sander G man s chap ers See a so S Son ag ness as Me aphor (New York Farrar S raus & G roux 1978) dem A DS and s Me aphors (London A en Lane 1988) Sander G man D erence and Pa ho ogy ( haca and London Corne Un vers y Press 1985) dem D sease and Represen a on mages o ness rom Madness o A ds ( haca N Y Corne Un vers y Press 1988) dem Seek ng he nsane A Cu ura H s ory o Madness and Ar n he Wes ern Wor d (New York W ey 1982) 13 an Dowb gg n "The Pro ess ona Soc opo ca and Cu ura D mens ons o Psych a r c Theory n France 1840-1900 " Ph D d sser a on Un vers y o Roches er 1986 dem "French Psych a r c A udes oward he Dangers Posed by he nsane ca 1870 " n Research n Law Dev ance and Soc a Con ro ed Andrew Scu and S even Sp zer vo 9 (Greenw ch Conn JA Press 1988) 87-111 Jan Go ds e n "The Hys er a D agnos s and he Po cs o An -c er ca sm n La e N ne een h Cen ury France " Journa o Modern H s ory 54 (1982) 209-239 J Gu a s Cr mes o Pass on (Cambr dge Po y Press 1989) Ru h Harr s "Me odrama Hys er a and Fem n ne Cr mes o Pass on n he F n-de-S èc e " H s ory Workshop 25 (1988) 31-63 Rober Nye The Or g ns o Crowd Psycho ogy Gus ave LeBon and he Cr s s o Mass Democracy n he Th rd Repub c (London Sage 1975) Dan e P ck Faces o Degenera on Aspec s o a European D sorder c 1848-1918 (Cambr dge and New York Cambr dge Un vers y Press 1989) Yann ck R pa Women and Madness The ncarcera on o Women n N ne een h Cen ury France (Cambr dge Po y Press 1990) S Moscov c L Age des ou es Un Tra é h s or que de Psycho og e des masses (Par s Fayard 1981) 14 On Ada Byron see D S e n Ada A L e and Legacy (Cambr dge Mass M T Press 1985) or a para e case see Roger Coo er "D cho omy and Den a Mesmer sm Med c ne and Harr e Mar neau " n Sc ence and Sens b y Gender and Sc en c Enqu ry 1780-1945 ed Mar na Ben am n (Ox ord Bas B ackwe 1991) 144-173 genera y on pa en s accoun s o he r own cond ons see Doro hy Por er and Roy Por er Pa en s Progress Doc ors and Doc or ng n E gh een hCen ury Eng and (Cambr dge Po y Press 1989) dem n S ckness and n Hea h The Br sh Exper ence 1650-1850 (London Four h Es a e 1988) 15 Mark M ca e "Charco and he dea o Hys er a n he Ma e A S udy o Gender Men a Sc ence and Med ca D agnos cs n La e N ne een h Cen ury France " Med ca H s ory 34 (1990) 363-411 16 A so d scussed n Mark M ca e "D agnos c D scr m na ons Jean-Mar n Charco and he N ne een h Cen ury dea o Mascu ne Hys er ca Neuros s " Ph D hes s Ya e Un vers y 1987 17 Edward Shor er "Para ys s The R se and Fa o a Hys er ca Symp om " Journa o Soc a H s ory 19 (1986) 549-582 and more u y h s From Para ys s o Fa gue A H s ory o Psychosoma c 1992) 18 Rober B Car er On he Pa ho ogy and Trea men o Hys er a (London John Church
ness n he Modern Era (New York Free Press
1853)
19 Edward Shor er "Pr va e C n cs n Cen ra Europe 1850-1933 " Soc a H s ory o Med c ne 3 2 (1990) 159-196 dem "Women and Jews n a Pr va e Nervous C n c n La e N ne een h Cen ury V enna " Med ca H s ory 33 (1989) 149-183 Anne D gby Madness Mora y and Med c ne A S udy o he York Re rea 1796-1914 (Cambr dge Cambr dge Un vers y Press 1985) 217 287 Char o e Mackenz e "A Fam y Asy um A H s ory o he Pr va e Madhouse a T cehurs n Sussex 17921917 " Ph D d sser a on Un vers y o London 1987 Trevor Turner "A D agnos c Ana ys s o he Casebooks o T cehurs Asy um 1845-1890 " M D Un vers y o London 1990 20 Suzanne Po r er "The We r-M che Res Cure Doc ors and Pa en s " Women s S ud es 10 (1983) 15-40 R D Wa er S We r M che MD Neuro og s A Med ca B ography (Spr ng e d Thomas 1970) Jane Browne "Spas and Sens b es Darw n a Ma vern " n The Med ca H s ory o Wa ers and Spas ed Roy Por er (London We come ns u e Med ca H s ory Supp emen 10 1990) 102-113 Susan E Cay e Wash and Be Hea ed The Wa er-Cure Movemen and Women s Hea h (Ph ade ph a Temp e Un vers y Press 1987) 21 Edward Shor er "Man a Hys er a and Gender n Lower Aus r a 1891-1905 " H s ory o Psych a ry 1 (1990) 3-31 Franc s Gos ng Be ore Freud Neuras hen a and he Amer can Med ca Commun y 187o-1910 (Urbana Un vers y o Press 1987)
no s
22 W am J McGra h Freud s D scovery o Psychoana ys s The Po cs o Hys er a ( haca N Y Corne Un vers y Press 1986) John Forres er The Seduc ons o Psychoana ys s Freud Lacan and Derr da (Cambr dge Cambr dge Un vers y Press 1990) C Bernhe mer and C are Kahane eds n Dora s Case Freud Hys er a and Fem n sm (New York Co umb a Un vers y Press 1985) ness Behav our " Journa o Chron c D sease 15 (1962) 189-194
23 D Mechan c "The Concep o
24 For exce en cross-cu ura compara ve accoun s see A K e nman Pa en s and Hea ers n he Con ex o Cu ure An Exp ora on o he Border ne be ween An hropo ogy Med c ne and Psych a ry (Berke ey Los Ange es London Un vers y o Ca orn a Press 1980) dem Soc a Or g ns o D s ress and D sease Depress on Neuras hen a and Pa n n Modern Ch na (New Haven Conn Ya e Un vers y Press 1986) dem and B Good eds Cu ure and Depress on S ud es n he An hropo ogy and Cross-Cu ura Psych a ry o A ec and D sorder (Berke ey Los Ange es London Un vers y o Ca orn a Press 1985) 25 For some accoun s o hese pressures V c or an dea s exer ed see Wa er Hough on Jr The V c or an Frame o M nd (New Haven Conn Ya e Un vers y Press 1957) Er c S gswor h ed n Search o V c or an Va ues (Manches er Manches er Un vers y Press 1988) Mar n W ener Recons ruc ng he Cr m na Cu ure Law and Po cy n Eng and 1830-1914 (Cambr dge Cambr dge Un vers y Press 1991) For ur her ns ances see H Mar neau L e n he S ck-Room Essays by an nva d 2d ed (London Moxon 1854) dem Au ob ography 2 vo s (London V rago 1983 1s ed 1877) 26 Among he mass o exce en recen em n s scho arsh p see or ns ance Joan Jacobs Brumberg Fas ng G r s The Emergence o Anorex a Nervosa as a Modern D sease (Cambr dge Mass Harvard Un vers y Press 1989) Lynne Nead My hs o Sexua y Represen a ons o Women n V c or an Br a n (Ox ord Bas B ackwe 1988) Cyn h a Eag e Russe Sexua Sc ence The V c or an Cons ruc on o Womanhood (Cambr dge Mass Harvard Un vers y Press 1989) 27 Shor er "Para ys s" E a ne Showa er The Fema e Ma ady Women Madness and Eng sh Cu ure 1830-1980 (London V rago 1987) and see op c (re 17) Aga ns em n s s who c a m ha hys er a s an e ec ve orm o rebe on Showa er e ec ve y coun erargues or he se -v c m za on hes s See a so Ann Da y Why Women Fa (London W dwood House 1979) dem The Morb d S reak (London W dwood House 1978) For she shock see Mar n S one "She shock " n Ana omy o Madness ed W F Bynum Roy Por er and M chae Shepherd vo 2 (London Rou edge 1985) 242-271 Edward M Brown "Be ween Coward ce and nsan y She Shock and he Leg ma on o he Neuroses n Grea Br a n " Sc ence Techno ogy and he M ary 12 (1988) 323-345 28 G man D sease and Represen a on va uab y nd ca es he soc ocu ura ac ors beh nd so many represen a ons o
ness
29 On Br que s syndrome see Maur ce Dong er "Br que and Br que s Syndrome V ewed rom France " Canad an Journa o Psych a ry 28 (Oc ober 1983) 422-427 See a so J Bab nsk and J Fromen Hys er a or P h a sm and Re ex Nervous D sorders n he Neuro ogy o War (London Un vers y o London Press 1918) 30 Haro d Merskey "Hys er a The H s ory o an dea " Canad an Journa o Psych a ry 28 (1983) 428-433 dem " mpor ance o Hys er a " 31 And see a so He en K ng "From Par henos o Gyne The Dynam cs o Ca egory" (Ph D Un vers y o London 1985) and James Pa s E Rossopou os and L -C Tr arkou "The H ppocra c Concep o Hys er a A Trans a on o he Or g na Tex s " n egra ve Psych a ry 3 (1985) 226-228 Compare A Rousse e Porne a On Des re and he Body n An qu y (Ox ord Bas B ackwe 1988) mes ) Quo ed n E Tr a H s o re de Hys ér e (Par s Seghers 1986) 272
32 (Hys er a has a ways ex s ed n a p aces and n a
33 J -M Charco and P R cher Les Démon aques dans ar (Par s De ahaye and Lecrosn er 1887) J Carroy-Th rard "Possess on Ex ase Hys ér e au X X s èc e " Psychana yse a Un vers é (1980) 499-515 dem Le Ma de Morz ne De a Possess on a hys ér e (Par s So n 1981) see a so J Dev n The Supers ous M nd French Peasan s and he Superna ura n he N ne een h Cen ury (London Ox ord Un vers y Press 1987) Jan Go ds e n Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1987) dem "The Hys er a D agnos s and he Po cs o An c er ca sm n La e N ne een h Cen ury France " Journa o Modern H s ory 54 (1982) 209-239 Ca her ne-Laurence Ma re Les Posedées de Morz ne 1857-1873 (Lyons Presses Un vers a res de Lyons 1981) G H G aser "Ep epsy Hys er a and Possess on A H s or ca Essay " Journa o Nervous and Men a D sease 166 (1978) 268-274 on he under y ng med ca po cs see Jack D E s The Phys c an-Leg s a ors o France Med c ne and Po cs n he Ear y Th rd Repub c 1870-1914 (Cambr dge Cambr dge Un vers y Press 1990) Bernard Bra s "The Mak ng o a Famous N ne een h Cen ury Neuro og s Jean-Mar n Charco (1825-1893) " M Ph hes s Un vers y Co ege London 1990 34 The ounda ona ex or h s read ng s G Z boorg The Med ca Man and he W ch Dur ng he Rena ssance (Ba more Johns Hopk ns Un vers y Press 1935) and more genera y dem A H s ory o Med ca Psycho ogy (New York Nor on 1947) The se -va da ng aspec s o h s p oy have been exp ored by T Szasz The My h o Men a ness (New York Pa ad n 1961) 35 See he d scuss on n M ca e "Hys er a and s H s or ography " 226 36 Ve h Hys er a The H s ory o a D sease (Ch cago Un vers y o Ch cago Press 1965) Ve h s book s assessed n Haro d Merskey "Hys er a The H s ory o a D sease za Ve h " Br sh Journa o Psych a ry 147 (1985) 576-579 and n M ca e "Hys er a and s H s or ography " 223-261 E a ne Showa er o ers n chap 4 a more sympa he c appra sa o Ve h and her work n con ex o he deo og ca cons ra n s shap ng her s ance a abundan y c ear rom Ve h s au ob ography Can You Hear he C app ng o One Hand ? (Berke ey Los Ange es London Un vers y o Ca orn a Press 1988) The o ow ng pages shou d be read a ongs de E a ne Showa er s more persona assessmen o Ve h be ow wh ch sympa he ca y and conv nc ng y recons ruc s Ve h s s udy rom a b ograph ca v ewpo n The a m o my d scuss on s ra her d eren s o show he nbu h s or ograph ca b ases resu ng rom uncr ca y accep ed Freud an perspec ves 37 Th s charac er za on o he M dd e Ages s revea ed as comp e e car ca ure n He en K ng s essay n chap 1 and n Jacquar and Thomasse s Sexua y and Med c ne n he M dd e Ages 173 38 Ve h Hys er a 156 157 183 39 J Breuer and S Freud S ud es on Hys er a
n The S andard Ed on o he Comp e e Works o S gmund Freud ed J S rachey e a
vo 3 (London Hogar h Press 1959) 86
40 Ve h Hys er a v 41 b d 199 40 Ve h Hys er a v 41 b d 199 42 Car er Pa ho ogy and Trea men o Hys er a A Kane and E Car son "A D eren Drummer Rober B Car er on N ne een h Cen ury Hys er a " Bu e n o he New York Academy o Med c ne 58 (1982) 519-534 43 For a samp e see Bernhe mer and Kahane n Dora s Case J Ga op The Daugh er s Seduc on Fem n sm and Psychoana ys s ( haca N Y Corne Un vers y Press 1982) D anne Hun er "Hys er a Psychoana ys s and Fem n sm The Case o Anna O " Fem n s S ud es 9 (1983) 464-488 Showa er Fema e Ma ady J M Masson The Assau on Tru h Freud s Suppress on o he Seduc on Theory (London Faber 1984 Harmondswor h M dd esex Pengu n 1985) dem A Dark Sc ence Women Sexua y and Psych a ry n he N ne een h Cen ury (New York Farrar S raus & G roux 1986) M Rosenbaum and M Muro eds Anna O Four een Con emporary Re n erpre a ons (New York Free Press 1984) For Freud and he w ch-hun ers see J M Masson ed The Comp e e Le ers o S gmund Freud o W he m F ess 1887-1904 (Cambr dge Mass Harvard Un vers y Press 1986) 225 44 Ve h Hys er a v 45 Ve h do es ou dozens o acco ades and br ckba s See or ns ance he udgmen on Paré ha h s "re urn o he anc en v ews on hys er a hough seem ng y a regress on was ac ua y a sc en c advance" Ve h Hys er a 116 or he v ew ha Jorden showed "ex raord nary percep veness" because he recogn zed he ro e o men a pass ons (123) kew se he "surpr s ng y con emporary over ones" o Bur on s "b un asser on o he ev s o en orced sexua abs nence" (127) 46 Szasz My h o Men a
ness
Szasz s po n s we
aken he shor com ng o h s v ew however s ha he has no h ng o say abou pre-Freud an accoun s o hys er a
47 b d a so re evan are dem The Manu ac ure o Madness (New York De Pub sh ng Co 1970) 46 Szasz My h o Men a
ness
Szasz s po n s we
aken he shor com ng o h s v ew however s ha he has no h ng o say abou pre-Freud an accoun s o hys er a
47 b d a so re evan are dem The Manu ac ure o Madness (New York De Pub sh ng Co 1970) 48 Szasz My h o Men a
ness 100
49 b d 65 48 Szasz My h o Men a
ness 100
49 b d 65 50 E Ge ner The Psychoana y c Movemen (London Pa ad n 1985) A C Mac n yre The Unconsc ous (London Rou edge 1958) 51 For such psycho og ca p c or a za on see Graham R chards On Psycho og ca Language (London Rou edge 1989) 52 Szasz My h o Men a
ness 19 For ns ance he hys er c behaves n a woman y way (be ng u ra weak) o avo d u
ng woman y unc ons (e g hav ng sex hav ng bab es keep ng house)
ness 19 For ns ance he hys er c behaves n a woman y way (be ng u ra weak) o avo d u
ng woman y unc ons (e g hav ng sex hav ng bab es keep ng house)
53 b d 52 Szasz My h o Men a 53 b d 54 The r g d y arb rar ness and ah s or c y o Szasz s v ew o d sease are we ana yzed n Pe er Sedgw ck Psychopo cs (London P u o Press New York Harper & Row 1982) 55 M ca e "Hys er a and s H s or ography " (par 1) 223-261 (par 2) 319-350 56 Po n s we made n Ludm a Jordanova Sexua V s ons mages o Gender n Sc ence and Med c ne be ween he E gh een h and Twen e h Cen ur es (Heme Hemps ead Harves er Whea shea 1989) 57 See an Hack ng The Tam ng o Chance (Cambr dge Cambr dge Un vers y Press 1990) G Cangu hem On he Norma and he Pa ho og ca (Dordrech D Re de 1978) 58 J Go ds e n "The Hys er a D agnos s and he Po cs o An c er ca sm n La e N ne een h Cen ury France " Journa o Modern H s ory 54 (1982) 209-239 59 For c ass c comp a n s abou he asc en c y o Freud see K R Popper The Open Soc e y and s Enem es (Pr nce on N J Pr nce on Un vers y Press 1971) H J Eysenck The Dec ne and Fa o he Freud an Emp re (Harmondswor h V k ng 1985) E Ge ner The Psychoana y c Movemen (London Pa ad n 1985) 60 Exce en and con ras ng d scuss ons are o ered n F Su oway Freud B o og s o he M nd (New York Bas c Books 1979) W am J McGra h Freud s D scovery o Psychoana ys s The Po cs o Hys er a ( haca N Y Corne Un vers y Press 1986) sabe F Kn gh "Freud s Pro ec A Theory or S ud es on Hys er a " Journa o he H s ory o he Behav ora Sc ences 20 (1984) 340-358 B B Rub ns e n "Freud s Ear y Theor es o Hys er a " n Phys cs Ph osophy and Psychoana ys s Essays n Honor o Ado Grünbaum ed R S Cohen and L Laudan (Dordrech D Re de 1983) 169-190 61 Hannah Decker Freud n Germany Revo u on and Reac on n Sc ence 1883-1907 (New York Un vers y Press n erna ona 1977) 62 See S Marcus Freud and he Cu ure o Psychoana ys s (Bos on A en & Unw n 1984) 63 H T E enberger The D scovery o he Unconsc ous (London A en Lane 1970) L L Why e The Unconsc ous Be ore Freud (New York Doub eday 1962) 64 See M Foucau D sc p ne and Pun sh (Harmondswor h Pengu n 1979) Theodor T Adorno and Max Horkhe mer D a ec c o En gh enmen (New York Herder & Herder 1972) N E as The C v z ng Process (Ox ord Bas B ackwe 1983) and d scuss on n Dor nda Ou ram The Body and he French Revo u on Sex C ass and Po ca Cu ure (New Haven and London Ya e Un vers y Press 1989) and Roy Por er "Body Po cs Approaches o he Cu ura H s ory o he Body " n New Perspec ves on H s or ca Wr ngs ed P Burke (Cambr dge Po y Press 1991) 65 For h s or es o m nd body doc r nes see J Yo on Th nk ng Ma er Ma er a sm n E gh een h Cen ury Br a n (M nneapo s Un vers y o M nneso a Press 1983) G S Rousseau and Roy Por er " n roduc on Toward a Na ura H s ory o M nd and Body " n The Languages o Psyche M nd and Body n En gh enmen Though ed G S Rousseau (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1990) 3-44 B S Turner The Body and Soc e y Exp ora ons n Soc a Theory (Ox ord and New York Bas B ackwe 1984) Cr ques o m nd body dua sm are o ered n F Barker The Tremu ous Pr va e Body (London Me huen 1984) M Berman The Re-enchan men o he Wor d ( haca N Y Corne Un vers y Press 1981) For he B akean quo a on see Roy Por er M nd Forg d Manac es A H s ory o Madness rom he Res ora on o he Regency (London A h one 1987) y o re g on n N sb s er Freud An n roduc on o H S L e and Work (Cambr dge Po y Press 1985) see a so Norman O Brown L e and Aga ns Dea h The Psychoana y ca Mean ng o H s ory
66 There s a hos e accoun o Freud s hos (London Rou edge & Kegan Pau 1957)
67 Hence or hodox Freud an sm s d sm ssa o W he m F ess s or W he m Re ch s b o og sm 68 Pe er Gay Freud A L e or Our T me (London Den 1988) The non-be ever n psychoana ys s m gh observe ha Freud subs u ed he psychoana y c pr es hood or he Chr s an 69 P La n En ra go M nd and Body (London Harv 1955) or a good accoun o med c ne s me aphys cs see Les er S K ng The Ph osophy o Med c ne The Ear y E gh een h Cen ury (Cambr dge Mass Harvard Un vers y Press 1978) On he Pro ec see sabe Kn gh "Freud s Pro ec A Theory or S ud es on Hys er a " Journa o he H s ory o he Behav ora Sc ences 20 (1984) 340-358 70 E L Gr ggs ed Co ec ed Le ers o Samue Tay or Co er dge 1 (Ox ord C arendon Press 1956) 256 Co er dge o Char es L oyd Sr 14 November 1796 or d scuss on see Roy Por er "Bare y Touch ng A Soc a Perspec ve on M nd and Body " n Languages o Psyche ed Rousseau 45-80 71 Szasz My h o Men a 72 F Bo om ey A
ness 80
udes o he Body n Wes ern Chr s endom (London Lepus Books 1979) Pe er Brown The Body and Soc e y Men Women and Sexua Renunc a on n Ear y Chr s an y (New York Co umb a Un vers y Press 1988)
73 O course here s a so a ong h s ory o a emp s rom bo h s des o deny he o her e g Berke eyan mma er a sm or he k nd o dogma c med ca ma er a sm deve oped rom he me o La Me r e ry ng o prove ha consc ousness s e her a comp e e de us on or a mos ep phenomena See Roy Por er "Med c ne n he En gh enmen " n nven ng Human Sc ence ed C Fox and R Por er (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1994) The po n s as go on o show ha such argumen s have arge y rema ned marg na ra her han ma ns ream 74 M C ark " Morb d n rospec on Unsoundness o M nd and Br sh Psycho og ca Med c ne c 1830-1900 " n Ana omy o Madness ed W F Bynum Roy Por er and M chae Shepherd Vo (London Rou edge 1988) 71-101 dem "The Re ec on o Psycho og ca Approaches o Men a D sorder n La e N ne een h Cen ury Br sh Psych a ry " n Madhouses Mad-Doc ors and Madmen ed A Scu (London A h one 1981) 271-312 W F Bynum "The Nervous Pa en n E gh een h and N ne een h Cen ury Br a n The Psych a r c Or g ns o Br sh Neuro ogy " n Ana omy o Madness ed Bynum Por er and Shepherd Vo (London Tav s ock 1985) 89-102 more genera y see B Ha ey The Hea hy Body and V c or an Cu ure (Cambr dge Mass Harvard Un vers y Press 1978) Mar n W ener Recons ruc ng he Cr m na Cu ure Law and Po cy n Eng and 1830-1914 (Cambr dge Cambr dge Un vers y Press 1991) 168 Char es E Rosenberg "Body and M nd n N ne een h-Cen ury Med c ne Some C n ca Or g ns o he Neuros s Con roversy " Bu e n o he H s ory o Med c ne 63 (1989) 185-197 75 M H N co son and G S Rousseau "B shop Berke ey and Tar Wa er " n The Augus an M eu Essays Presen ed o Lou s A Landa ed H K M er (Ox ord C arendon Press 1970) 102-137 Mar na Ben am n "Med c ne Mora y and he Po cs o Berke ey s Tar-Wa er " n The Med ca En gh enmen o he E gh een h Cen ury ed Andrew Cunn ngham and Roger French (Cambr dge Cambr dge Un vers y Press 1990) 165-193 76 The very comp ex n erp ay o m nd and body n med ca herapeu cs s sp end d y brough ou n Rosenberg "Body and M nd n N ne een h-Cen ury Med c ne " 185-197 77 Thomas W s Essay o he Pa ho ogy o he Bra n (1684) 69 quo ed by Ve h Hys er a 134 78 W Buchan Domes c Med c ne or a Trea se on he Preven on and Cure o D seases by Reg men and S mp e Med c nes (Ed nburgh Bayou Au d & Sme e 1769) 561 79 The d scuss on n "Bourgeo s Hys er a and he Carn va esque " by Pe er S a ybrass and A on Wh e n The Po cs and Poe cs o Transgress on (London Me huen 1986) 171-190 s h gh y re evan They argue ha c v za on s need o repress he carn va esque produced a re urn o he repressed n hys er a Thus hys er a was a mockery o o c a m nd body re a ons 80 See Rousseau and Por er " n roduc on " n Languages o Psyche ed Rousseau 3-44 81 Fem n s h s or ans have p aus b y argued ha a e n ne een h-cen ury ema e hys er cs such as "Anna O" or Char o e Perk ns G man possessed be er ns gh n o he r cond on han he doc ors who rea ed hem See above n 43 and Mary A H Char o e Perk ns G man The Mak ng o a Rad ca Fem n s 1860-1896 (Ph ade ph a Temp e Un vers y Press 1980) 82 For hys er a n he me gh see Ru h Harr s "Me odrama Hys er a and Fem n ne Cr mes o Pass on n he F n-de-S èc e " H s ory Workshop 25 (Spr ng 1988) 31-63 dem "Murder under Hypnos s n he Case o Gabr e e Bompard Psych a ry n he Cour room n Be e Epoque France " n Ana omy o Madness ed Bynum Por er and Shepherd Vo 197-241 J Gu a s Cr mes o Pass on (Cambr dge Po y Press 1989) G D d -Huberman nven on de Hys ér e Charco e conograph e Pho ograph que (Par s Macu a 1982) 83 Car er Pa ho ogy and Trea men o Hys er a 159 On mass hys er a see Moscov c Age des Fou es Rober Nye Cr me Madness and Po cs n Modern France (Pr nce on N J Pr nce on Un vers y Press 1984) 84 E o S a er "Wha s Hys er a?" n Hys er a ed A Roy (Ch ches er John W ey 1982) 37-40 esp p 40 85 Berman Re-enchan men o he Wor d and c ass ca y Theodor T Adorno and Max Horkhe mer D a ec c o En gh enmen (New York Herder & Herder 1972) For a more ba anced v ew o Descar es s mpac see T Brown "Descar es Dua sm and Psychosoma c Med c ne " n Ana omy o Madness ed Bynum Por er and Shepherd 2 40-62 R B Car er Descar es s Med ca Ph osophy (Ba more Johns Hopk ns Un vers y Press 1983) 86 Here see John Mu an "Hypochondr a and Hys er a Sens b y and he Phys c ans " The E gh een h Cen ury Theory and n erpre a on 25 (1984) 141-174 H Mayer Ou s ders A S udy n L e and Le ers (Cambr dge Mass M T Press 1984) 87 P M Spacks The Fema e mag na on (New York Knop 1975) dem mag n ng a Se Au ob ography and Nove n E gh een h Cen ury Eng and (Cambr dge Mass Harvard Un vers y Press 1976) K O Lyons The nven on o he Se (Carbonda e Sou hern no s Un vers y Press London Fe er & S mons 1978) Jane Todd Sens b y An n roduc on (London Me huen 1986) and or nerves see espec a y G S Rousseau "The Language o he Nerves A Chap er n Soc a and L ngu s c H s ory " n Language Se and Soc e y The Soc a H s ory o Language ed P Burke and R Por er (Cambr dge Po y Press 1991) 213-275 and Roy Por er " Express ng Yourse The Language o S ckness n Georg an Eng and " n Language Se and Soc e y ed Burke and Por er 276-299 88 B Fau kner Observa ons on he Genera and mproper Trea men o nsan y (London H Reyne 1789) p 1 Fau kner added ha had "g ven b r h o end ess con ec ure and perpe ua error " See a so W Fa coner A D sser a on on he n uence o he Pass ons Upon D sorders o he Body (London C D y 1788) J Haygar h O he mag na on as a Cause and as a Cure o D sorders o he Body (Ba h Cade & Dav es 1800) 89 N cho as Jewson "The D sappearance o he S ck Man rom Med ca Cosmo ogy 1770-1870 " Soc o ogy 10 (1976) 225-244 dem "Med ca Know edge and he Pa ronage Sys em n E gh een h Cen ury Eng and " Soc o ogy 8 (1974) 369-385 D Por er and R Por er Pa en s Progress 90 W am Heberden Med ca Commen ar es (London T Payne 1802) 227 91 b d 225 92 b d 235 Heberden d d ns s however ha " he r orce w be very d eren accord ng o he pa en s choos ng o ndu ge and g ve way o hem " 90 W am Heberden Med ca Commen ar es (London T Payne 1802) 227 91 b d 225 92 b d 235 Heberden d d ns s however ha " he r orce w be very d eren accord ng o he pa en s choos ng o ndu ge and g ve way o hem " 90 W am Heberden Med ca Commen ar es (London T Payne 1802) 227 91 b d 225 92 b d 235 Heberden d d ns s however ha " he r orce w be very d eren accord ng o he pa en s choos ng o ndu ge and g ve way o hem " 93 S r R chard B ackmore A Trea se o he Sp een and Vapours or Hypochondr aca and Hys er ca A ec ons (London Pember on 1725) quo ed n R chard Hun er and da Maca p ne Three Hundred Years o Psych a ry 1535-1860 (London Ox ord Un vers y Press 1963) 320 94 Barbara S cherman "The Uses o a D agnos s Doc ors Pa en s and Neuras hen a " Journa o he H s ory o Med c ne and A ed Sc ences 32 (1977) 33-54 95 See W F Bynum "Ra ona es or Therapy n Br sh Psych a ry 1780-1835 " Med ca H s ory 18 (1974) 327-334 dem "The Nervous Pa en n E gh een h and N ne een h Cen ury Eng and The Psych a r c Or g ns o Br sh Neuro ogy " n Ana omy o Madness ed Bynum Por er and Shepherd 1 89-102 Bonn e E en B us e n " A Ho ow Square o Psycho og ca Sc ence Amer can Neuro og s s and Psych a r s s n Con c " n Madhouses Mad-doc ors and Madmen ed A Scu (London A h one 1981) 241-270 M C ark " Morb d n rospec on Unsoundness o M nd and Br sh Psycho og ca Med c ne c 1830-1900 " n Ana omy o Madness ed Bynum Por er and Shepherd 3 71-101 M C ark "The Re ec on o Psycho og ca Approaches o Men a D sorder n La e N ne een h Cen ury Br sh Psych a ry n Madhouses Mad-Doc ors and Madmen ed Scu 271-312 For T sso see An o ne e Emch-Dér az Towards a Soc a Concep on o Hea h n he Second Ha o he E gh een h Cen ury T sso (1728-1797) and he New Preoccupa on w h Hea h and We -Be ng (Ann Arbor M ch Un vers y M cro ms n erna ona 1984) 96 Quo ed n Andrew Scu
Men a D sorder Soc a D sorder (Berke ey Los Ange es London Un vers y o Ca orn a Press 1989) 275
97 Gos ng Be ore Freud O course was women who d spropor ona e y underwen he res -cure hys er a rea men s me ed ou n hese c n cs Some such as Char o e Perk ns G man who was rea ed by S as We r M che and V rg n a Woo rebe ed aga ns wha hey cons dered o be demean ng and coun erproduc ve herapeu cs E sewhere n h s book E a ne Showa er exp a ns he power u soc a cu ura and med ca orces ha par cu ar y exposed women o such rea men s See H Char o e Perk ns G man Suzanne Po r er "The We r-M che Res Cure Doc ors and Pa en s " Women s S ud es 10 (1983) 15-40 R D Wa er S We r M che MD Neuro og s A Med ca B ography (Spr ng e d Thomas 1970) 98 Gos ng Be ore Freud A Rab nbach "The Body w hou Fa gue A N ne een h Cen ury U op a " n Po ca Symbo sm n Modern Europe Essays n Honor o George L Mosse ed S Drescher D Sabean and A Shar n (London Transac on Books 1982) 42-62 Shor er "Para ys s " 549-582 dem "Man a Hys er a and Gender n Lower Aus r a " 3-32 C ord Beers A M nd Tha Found se (P sburgh Un vers y o P sburgh Press 1981 1908) Norman Da n C ord W Beers Advoca e or he nsane (P sburgh Un vers y o P sburgh Press 1980) George Beard A Prac ca Trea se on Nervous Exhaus on (Neuras hen a ) (1880) dem Amer can Nervousness s Causes and Consequences (New York Pu nam 1881) Char es Rosenberg "The P ace o George M Beard n N ne een h Cen ury Psych a ry " Bu e n o he H s ory o Med c ne 36 (1962) 245-259 S We r M che Doc or and Pa en (Ph ade ph a L pp nco 1888) dem Lec ures on he D seases o he Nervous Sys em Espec a y n Women (Ph ade ph a Lea 1881) dem Doc or and Pa en (Ph ade ph a L pp nco 1888) dem Fa and B ood An Essay on he Trea men o Cer a n Forms o Neuras hen a and Hys er a (Ph ade ph a L pp nco 1877) Kenne h Lev n "S We r M che nves ga ons and ns gh s n o Neuras hen a and Hys er a " Transac ons and S ud es o he Co ege o Phys c ans o Ph ade ph a 38 (1971) 168-173 99 A par cu ar worry o Mauds ey s Trevor Turner "Henry Mauds ey Psych a r s Ph osopher and En repreneur " n Ana omy o Madness ed Bynum Por er and Shepherd 3 151-189 100 For M and Car y e see Barbara T Ga es V c or an Su c de Mad Cr mes and Sad H s or es (Pr nce on N J Pr nce on Un vers y Press 1988) and B Ha ey The Hea hy Body n V c or an Cu ure (Cambr dge Mass Harvard Un vers y Press 1978) John M Robson and Jack S nger eds Au ob ography and L erary Essays by John S uar M (Toron o Un vers y o Toron o Press 1981) Co ec ed Works o John S uar M vo 1 has o en been no ed ha hys er a cases were never prom nen n Eng and Was h s because we -bred young peop e were ra ned aga ns n rospec on and n hab s o hea hy-m nded ou -go ngness? For some suppor or h s v ew see M Jeanne Pe erson Fam y Love and Work n he L ves o V c or an Gen ewomen (B oom ng on nd ana Un vers y Press 1989) 101 Ve h Hys er a 212-220 Ve h proceeds on he Freud an assump on ha such women were su er ng rom sexua rus ra on Bu why shou d we assume h s? For one h ng m gh be argued per con ra ha such pa en s were p eased o go on res cure because o ered an escape rom sexua demands For ano her as Pe er Gay has con ended our v s on o he rus ra ed sex-s arved V c or an women may be my h ca See Car H Deg er "Wha Ough o Be and Wha Was Women s Sexua y n he N ne een h Cen ury " The Amer can H s or ca Rev ew 79 (1974) 1467-1490 P Gay The Bourgeo s Exper ence V c or a o Freud vo 1 The Educa on o he Senses vo 2 The Tender Pass on (New York Ox ord Un vers y Press 1984 and 1986) 102 Bevan Lew s A Tex book o Men a D seases (London Gr n 1889) 143 103 M C ark " Morb d n rospec on Unsoundness o M nd and Br sh Psycho og ca Med c ne c 1830-1900 " n Ana omy o Madness ed Bynum Por er and Shepherd 3 71-101 A N G ber "Mas urba on and nsan y Henry Mauds ey and he deo ogy o Sexua Repress on " A b on 12 (1980) 268-282 For an exemp ary source see D Hack Tuke us ra ons o he n uence o he M nd upon he Body n Hea h and D sease Des gned o E uc da e he Ac on o he mag na on (London Church 1872) 104 Henry Mauds ey Body and M nd (London Macm an & Co 1873) 79-80 105 b d 104 Henry Mauds ey Body and M nd (London Macm an & Co 1873) 79-80 105 b d 106 On Woo see Roger Poo e The Unknown V rg n a Woo (Br gh on Harves er Press 1982) S ephen Tromb ey " A Tha Summer She Was Mad" V rg n a Woo (London Junc on Books 1981) E a ne Showa er The Fema e Ma ady (New York Pan heon 1986) E zabe h Abe V rg n a Woo and he F c ons o Psychoana ys s (Ch cago Un vers y o Ch cago Press 1990) 107 Jean-Mar n Charco Charco he C n c an The Tuesday Lessons Excerp s rom N ne Case Presen a ons on Genera Neuro ogy De vered a he Sa pê r ère Hosp a n 1887-88 York Raven Press 1987)
rans a on and commen ary by Chr s opher G Goe z (New
108 We emphas zed n Mar n W ener Recons ruc ng he Cr m na Cu ure Law and Po cy n Eng and 1830-1914 (Cambr dge Cambr dge Un vers y Press 1991) 40 109 M Praz The Roman c Agony (Ox ord Ox ord Un vers y Press 1933) M Poovey Uneven Deve opmen s The deo og ca Work o Gender n M d-V c or an Eng and (London V rago 1989) 110 Bram D ks ra do s o Pervers y Fan as es o Fem n ne Ev n F n de S èc e Cu ure (Ox ord Ox ord Un vers y Press 1986) 111 Pe erson s Fam y Love and Work n he L ves o V c or an Gen ewomen has warned us no o equa e adv ce or women w h ac ua women s ves rem nd ng us ha many women escaped or coped per ec y happ y w h hese pressures Sexua Sc ence The V c or an Cons ruc on o Womanhood (Cambr dge Mass Harvard Un vers y Press 1989)
112 For women as de ned by V c or an sc ence and soc e y see Cyn h a Eag e Russe
113 See mos recen y Orne a Moscucc The Sc ence o Woman Gynaeco ogy and Gender n Eng and 1800-1929 (Cambr dge Cambr dge Un vers y Press 1990) Londa Sch eb nger The M nd Has No Sex? Women n he Or g ns o Modern Sc ence (Cambr dge Mass Harvard Un vers y Press 1989) Lynne Nead My hs o Sexua y Represen a ons o Women n V c or an Br a n (Ox ord Bas B ackwe 1988) Thomas Laqueur Mak ng Sex Body and Gender rom he Greeks o Freud (Cambr dge Mass Harvard Un vers y Press 1990) 114 There s a d sappo n ng ack o s ud es o he w der soc a s gn cance o he n ne een h-cen ury revo u on n med c ne See however M Jeanne Pe erson The Med ca Pro ess on n M d-V c or an London (Berke ey Los Ange es London Un vers y o Ca orn a Press 1978) A J Youngson The Sc en c Revo u on n V c or an Med c ne (London Croom He m 1979) Th s s ua on w be rec ed by he or hcom ng work by W F Bynum Bas c Sc ence and C n ca Med c ne n N ne een h Cen ury Soc e y (Cambr dge Cambr dge Un vers y Press 1994) M che Foucau The B r h o he C n c rans A M Sher dan Sm h (London Tav s ock 1973) s h gh y sugges ve 115 For he deve opmen o hese pro ess ona spec a es see or ns ance E Lesky The V enna Med ca Schoo o he N ne een h Cen ury (Ba more Johns Hopk ns Un vers y Press 1976) R Mau z Morb d Appearances The Ana omy o Pa ho ogy n he Ear y N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1987) L S Jacyna "Soma c Theor es o M nd and he n eres s o Med c ne n Br a n 1850-1879 " Med ca H s ory 26 (1982) 233-258 E C arke and L S Jacyna N ne een h Cen ury Or g ns o Neurosc en c Concep s (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) A Scu Soc a Order Men a D sorder Ang o-Amer can Psych a ry n H s or ca Perspec ve (London Rou - edge 1989) esp "From Madness o Men a ness Med ca Men as Mora En repreneurs " 118-161 Cons ance M McGovern Mas ers o Madness Soc a Or g ns o he Amer can Psych a r c Pro ess on (Hanover and London Un vers y Press o New Eng and 1985) Moscucc Sc ence o Woman B La our The Pas eur za on o France (Cambr dge Mass Harvard Un vers y Press 1988) um na ng s L F eck Genes s and Deve opmen o a Sc en
116 Jacyna "Soma c Theor es o M nd" B r h o he C n c
117 Foucau
c Fac (Ch cago Un vers y o Ch cago Press 1979)
rans S Sm h D Arms rong The Po ca Ana omy o he Body (Cambr dge Cambr dge Un vers y Press 1983) Cangu hem On he Norma and he Pa ho og ca
118 an Dowb gg n "Degenera on and Hered ar an sm n French Men a Med c ne 1840-1890 Psych a r c Theory as deo og ca Adap a on " n Ana omy o Madness ed Bynum Por er and Shepherd 1 188-232 Nye Cr me Madness and Po cs n Modern France 119 E a ne Showa er and Eng sh Showa er "V c or an Women and Mens rua on " V c or an S ud es 14 (1970) 83-89 Thomas W Laqueur "Orgasm Genera on and he Po cs o Reproduc ve B o ogy " n The Mak ng o he Modern Body ed C Ga agher and T Laqueur (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) 1-41 E Gask ng nves ga ons n o Genera on 1651-1828 (London Hu ch nson 1967) F J Co e Ear y Theor es o Sexua Genera on (Ox ord C arendon Press 1930) 120 On women and d erence see Ludm a Jordanova Sexua V s ons mages o Gender n Sc ence and Med c ne Be ween he E gh een h and Twen e h Cen ur es (Heme Hemps ead Harves er Whea shea 1989) S G man D erence and Pa ho ogy ( haca and London Corne Un vers y Press 1985) 121 On h s pa ho og z ng o ema e sexua y see G J Barker-Ben e d The Horrors o he Ha -Known L e Ma e A udes owards Women and Sexua y n N ne een h Cen ury Amer ca (New York Harper 1976) C Sm h-Rosenberg "The Hys er ca Woman Sex Ro es and Ro e Con c n N ne een h Cen ury Amer ca " Soc a Research 39 (1972) 652-678 C Sm h-Rosenberg and C Rosenberg "The Fema e An ma Med ca and B o og ca V ews o Woman and Her Ro e n N ne een h Cen ury Amer ca " n Women and Hea h n Amer ca H s or ca Read ngs ed J W Leav (Mad son Un vers y o W scons n Press 1984) 1227 Lorna Du n "The Consp cuous Consump ve Woman as an nva d n De amon and L Du n eds The N ne een h Cen ury Woman Her Cu ura and Phys ca Wor d ed S De amon and L Du n (London Croom He m 1978) 26-56 122 The bes accoun o he r se o Br sh gyneco ogy n he n ne een h cen ury s Moscucc Sc ence o Woman H s o re de a sexua é vo 1 La vo on é de savo r (Par s Ga mard 1976) ( rans Rober Hur ey The H s ory o Sexua y n roduc on London A en Lane 1978 )
123 M che Foucau
"Pass on essness An n erpre a on o V c or an Sexua deo ogy " n Women and Hea h n Amer ca H s or ca Read ngs ed J W Leav
124 Nancy F Co
125 D scuss ons o v ews such as h s can be ound n Sm h-Rosenberg and Rosenberg "Fema e An ma " n Women and Hea h n Amer ca ed Leav
(Mad son Un vers y o W scons n Press 1984) 57-69
12-27
126 On ch oros s see K F g o "Ch oros s and Chron c D sease n N ne een h-Cen ury Br a n The Soc a Cons u on o Soma c ness n a Cap a s Soc e y " Soc a H s ory 3 (1978) 167-197 S L Loudon "Ch oros s Anaem a and Anorex a Nervosa " Br sh Med ca Journa (1978) 974-977 Joan J Brumberg "Ch oro c G r s 1870-1920 A H s or ca Perspec ve on Fema e Ado escence " n Women and Hea h n Amer ca ed Leav 186-195 127 On mas urba on see E H Hare "Mas urba ory nsan y The H s ory o an dea " Journa o Men a Sc ence 108 (1962) 1-25 R H MacDona d "The Fr gh u Consequences o Onan sm " Journa o he H s ory o deas 28 (1967) 423-441 J S engers and A Van Neck H s o re d une Grande Peur La Mas urba on (Brusse s Un vers y o Brusse s Press 1984) 128 Hys er a was he m m c d sorder Charco spoke o "neurom mes s " " h s proper y possessed by unc ona d seases o resemb ng organ c ones" he d scussed he prob em o "s mu a on" as a k nd o ar or s own sake" ( ar pour ar ) done "w h he dea o mak ng a sensa on o exc e p y " J -M Charco C n ca Lec ures on D seases o he Nervous Sys em rans T Sav (London New Sydenham Soc e y 1889) 14 Th s has been repr n ed n he Tav s ock C ass cs n he H s ory o Psych a ry ser es (London Rou edge 1990) w h a ne n roduc on by Ru h Harr s 129 See he s r c ures o Car er Car er Pa ho ogy and Trea men o Hys er a (London John Church
1853) 69
130 Mauds ey Body and M nd 62-64 131 John Has am Cons dera ons on he Mora Managemen o nsane Persons (London R Hun er 1817) 4-5 Has am s ressed ha h s was a ma er o exc us ve med ca udgmen pro ess on wou d be unab e o udge "
or "o such c rcums ances hose who are no o he med ca
132 George Man Burrows Commen ar es on nsan y (London Underwood 1828) 146-148 133 b d See Vern Bu ough and Mar ha Vogh "Women Mens rua on and N ne een h Cen ury Med c ne " n Women and Hea h n Amer ca H s or ca Read ngs ed Leav 28-38 J De aney M J Lup on and E To h The Curse A Cu ura H s ory o Mens rua on (New York Du on 1976) For comparab e v ews o hose o Burrows see Thomas Laycock An Essay on Hys er a (Ph ade ph a Haswe 1840) dem A Trea se on he Nervous D seases o Women Compr s ng an nqu ry n o he Na ure Causes and Trea men o Sp na and Hys er ca D sorders (London Longman 1840) dem M nd and Bra n or he Corre a ons o Consc ousness and Organ za on 2 vo s (Ed nburgh Su her and & Knox 1860) A ex Le "Thomas Laycock and he Cerebra Re ex " H s ory o Psych a ry 2 (1991) 385-408 A such wr ers bear ou M chae C ark s po n ha V c or an psych a r s s ooked o organ c causa on M J C ark "The Re ec on o Psycho og ca Approaches o Men a D sorder n La e N ne een h Cen ury Br sh Psych a ry " n Madhouses Mad-Doc ors and Madmen ed Scu 271-312 132 George Man Burrows Commen ar es on nsan y (London Underwood 1828) 146-148 133 b d See Vern Bu ough and Mar ha Vogh "Women Mens rua on and N ne een h Cen ury Med c ne " n Women and Hea h n Amer ca H s or ca Read ngs ed Leav 28-38 J De aney M J Lup on and E To h The Curse A Cu ura H s ory o Mens rua on (New York Du on 1976) For comparab e v ews o hose o Burrows see Thomas Laycock An Essay on Hys er a (Ph ade ph a Haswe 1840) dem A Trea se on he Nervous D seases o Women Compr s ng an nqu ry n o he Na ure Causes and Trea men o Sp na and Hys er ca D sorders (London Longman 1840) dem M nd and Bra n or he Corre a ons o Consc ousness and Organ za on 2 vo s (Ed nburgh Su her and & Knox 1860) A ex Le "Thomas Laycock and he Cerebra Re ex " H s ory o Psych a ry 2 (1991) 385-408 A such wr ers bear ou M chae C ark s po n ha V c or an psych a r s s ooked o organ c causa on M J C ark "The Re ec on o Psycho og ca Approaches o Men a D sorder n La e N ne een h Cen ury Br sh Psych a ry " n Madhouses Mad-Doc ors and Madmen ed Scu 271-312 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 134 Burrows Commen ar es on nsan y 146 135 b d 136 b d 137 b d 147 138 b d 139 b d 140 b d 141 b d 148 142 b d 143 b d 191 144 b d 145 b d 146 b d Never he ess Burrows adm ed ha "occas ona hys er a however n young and suscep b e ema es whose nervous sys ems are a ways h gh y rr ab e may cer a n y occur w hou any such susp c on " 147 A red Maddock On Men a and Nervous D sorders (London S mpk n Marsha & Co 1854) 177 148 b d 147 A red Maddock On Men a and Nervous D sorders (London S mpk n Marsha & Co 1854) 177 148 b d 149 John M ar H n s on nsan y (London Henry Renshaw 1861) 32 150 Mauds ey Body and M nd 79 151 b d 152 b d A N G ber "Mas urba on and nsan y Henry Mauds ey and he deo ogy o Sexua Repress on " A b on 12 (1980) 268-282 Trevor Turner "Henry Mauds ey Psych a r s Ph osopher and En repreneur " n Ana omy o Madness ed Bynum Por er and Shepherd 3 151-189 150 Mauds ey Body and M nd 79 151 b d 152 b d A N G ber "Mas urba on and nsan y Henry Mauds ey and he deo ogy o Sexua Repress on " A b on 12 (1980) 268-282 Trevor Turner "Henry Mauds ey Psych a r s Ph osopher and En repreneur " n Ana omy o Madness ed Bynum Por er and Shepherd 3 151-189 150 Mauds ey Body and M nd 79 151 b d 152 b d A N G ber "Mas urba on and nsan y Henry Mauds ey and he deo ogy o Sexua Repress on " A b on 12 (1980) 268-282 Trevor Turner "Henry Mauds ey Psych a r s Ph osopher and En repreneur " n Ana omy o Madness ed Bynum Por er and Shepherd 3 151-189 153 Henry Mauds ey The Pa ho ogy o M nd (New York App e on 1886) 464 154 Mauds ey Body and M nd 79-80 155 b d On ear er v ews o nymphoman a see G S Rousseau "Nymphoman a B env e and he R se o Ero c Sens b y " n Sexua y n E gh een h-Cen ury Br a n ed P -G Boucé (Manches er Manches er Un vers y Press 1982) 95-120 For ears o sexua y ac ve women see E zabe h Lunbeck " A New Genera on o Women Progress ve Psych a r s s and he Hypersexua Fema e " Fem n s S ud es 13 (1987) 514-543 154 Mauds ey Body and M nd 79-80 155 b d On ear er v ews o nymphoman a see G S Rousseau "Nymphoman a B env e and he R se o Ero c Sens b y " n Sexua y n E gh een h-Cen ury Br a n ed P -G Boucé (Manches er Manches er Un vers y Press 1982) 95-120 For ears o sexua y ac ve women see E zabe h Lunbeck " A New Genera on o Women Progress ve Psych a r s s and he Hypersexua Fema e " Fem n s S ud es 13 (1987) 514-543 156 Ve h Hys er a 197 157 W Gr es nger Men a Pa ho ogy and Therapeu cs rans C Lockhard Rober son and James Ru her ord (London New Sydenham Soc e y 1867) For s m ar v ews expressed by o her German neuro og s s see F Sch er A Moeb us S r p F nde-s èc e Neuropsych a ry and Pau Moeb us (Berke ey Los Ange es London Un vers y o Ca orn a Press 1982) 158 Gr es nger Men a Pa ho ogy and Therapeu cs
rans Rober son and Ru her ord 1 Ve h Hys er a 197
159 Je rey M Masson Aga ns Therapy (London Fon ana 1990) dem A Dark Sc ence Women Sexua y and Psych a ry n he N ne een h Cen ury (New York Farrar S raus and G roux 1986) Moscucc Sc ence o Woman A Scu and D Favreau "A Chance o Cu s a Chance o Cure Sexua Surgery or Psychos s n Three N ne een h Cen ury Soc e es " n Research n Law Dev ance and Soc a Con ro vo 8 ed S Sp zer and A Scu (Greenw ch Conn JA Press 1986) 3-39 A Scu and D Favreau "The C or dec omy Craze " Soc a Research 53 (1986) 243-260 Ann Da y Women under he Kn e A H s ory o Surgery (London Hu ch nson 1991) See saac Baker Brown On he Curab y o Cer a n Forms o nsan y Ep epsy Ca a epsy and Hys er a n Fema es (London Rober Hardw ck 1866) More genera y upon gyneco og ca v o ence see Roger Coo er "D cho omy and Den a Mesmer sm Med c ne and Harr e Mar neau " n Sc ence and Sens b y Gender and Sc en c Enqu ry 1780-1945 ed Mar na Ben am n (Ox ord Bas B ackwe 1991) 144-173 160 See broad y E C arke and L S Jacyna N ne een h Cen ury Or g ns o Neurosc en N ne een h Cen ury Though (Pr nce on N J Pr nce on Un vers y Press 1987)
c Concep s (Berke ey Los Ange es London Un vers y o Ca orn a Press 1987) Anne Harr ng on Med c ne M nd and he Doub e Bra n A S udy n
161 For he new med c ne o he n ne een h-cen ury hosp a see Foucau B r h o he C n c rans S Sm h (London Tav s ock 1973) E H Ackerknech Med c ne a he Par s Hosp a 1794-1848 (Ba more Johns Hopk ns Un vers y Press 1967) L Granshaw and Roy Por er eds The Hosp a n H s ory (London Rou edge 1989) C E Rosenberg The Care o S rangers The R se o Amer ca s Hosp a Sys em (New York Bas c Books 1987) esp he d scuss on n he n roduc on 162 For degenera on sm see Dowb gg n "Degenera on and Hered ar an sm n French Men a Med c ne " n Ana omy o Madness ed Bynum Por er and Shepherd 1 188-232 Nye Cr me Madness and Po cs n Modern France D P ck Faces o Degenera on A European D sorder 1848-1918 (Cambr dge Cambr dge Un vers y Press 1989) J E Chamber n and S L G man Degenera on The Dark S de o Progress (New York Co umb a Un vers y Press 1985) S G man D erence and Pa ho ogy ( haca N Y Corne Un vers y Press 1985) 163 D d -Huberman nven on de Hys ér e For Charco see Pearce Ba ey J -M Charco 1825-1893 H s L e — H s Work (London P man Med ca 1959) A R G Owen Hys er a Hypnos s and Hea ng The Work o J M Charco (London Dobson 1971) 164 S a ybrass and Wh e "Bourgeo s Hys er a and he Carn va esque " n Po cs and Poe cs o Transgress on (London Me huen 1986) 171-190 rom he Hys er a n Modern France ( haca N Y Corne Un vers y Press 1991)
erary v ewpo n qu e he p u s Mar ha Noe Evans F s and S ar s A Genea ogy o
165 Tr a H s o re de hys ér e M ca e "Hys er a and s H s or ography" (par 2) 319-350 For he French a en s rad on see Jan Go ds e n Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1987) 166 Charco C n ca Lec ures
12 See a so Charco Charco he C n c an
rans Sav
rans a on and commen ary by Goe z
167 E W Massey and L C McHenry "Hys eroep epsy n he N ne een h Cen ury Charco and Gowers " Neuro ogy 36 (1986) 65-67 168 Po n s we made n Mark M ca e "D agnos c D scr m na ons Jean Mar n Charco and he N ne een h Cen ury dea o Mascu ne Hys er ca Neuros s " Ph D Ya e Un vers y 1987 dem "Hys er a Ma e Hys er a Fema e Re ec ons on Compara ve Gender Cons ruc on n N ne een h Cen ury France and Br a n " n Sc ence and Sens b y ed Ben am n 200-242 see a so Charco C n ca Lec ures rans Sav 77 169 Charco C n ca Lec ures
rans Sav
131-166
170 b d 77 171 b d 13 For Br que see P erre Br que Tra é C n que e Therapeu que de hys ér e (Par s Ba ère 1859) Maur ce Dong er "Br que and Br que s Syndrome V ewed rom France " Canad an Journa o Psych a ry 28 (1983) 422427 Franço s M Ma "P erre Br que N ne een h-Cen ury Savan w h Twen e h-Cen ury deas " Canad an Journa o Psych a ry 28 (1983) 418-421 dem and Haro d Merskey "Br que s Concep o Hys er a An H s or ca Perspec ve Canad an Journa o Psych a ry 26 (1981) 57-63 dem "Br que s Trea se on Hys er a A Synops s and Commen ary " Arch ves o Genera Psych a ry 37 (1980) 1401-1405 Br que saw hys er a as a neuros s o he bra n 169 Charco C n ca Lec ures
rans Sav
131-166
170 b d 77 171 b d 13 For Br que see P erre Br que Tra é C n que e Therapeu que de hys ér e (Par s Ba ère 1859) Maur ce Dong er "Br que and Br que s Syndrome V ewed rom France " Canad an Journa o Psych a ry 28 (1983) 422427 Franço s M Ma "P erre Br que N ne een h-Cen ury Savan w h Twen e h-Cen ury deas " Canad an Journa o Psych a ry 28 (1983) 418-421 dem and Haro d Merskey "Br que s Concep o Hys er a An H s or ca Perspec ve Canad an Journa o Psych a ry 26 (1981) 57-63 dem "Br que s Trea se on Hys er a A Synops s and Commen ary " Arch ves o Genera Psych a ry 37 (1980) 1401-1405 Br que saw hys er a as a neuros s o he bra n 169 Charco C n ca Lec ures
rans Sav
131-166
170 b d 77 171 b d 13 For Br que see P erre Br que Tra é C n que e Therapeu que de hys ér e (Par s Ba ère 1859) Maur ce Dong er "Br que and Br que s Syndrome V ewed rom France " Canad an Journa o Psych a ry 28 (1983) 422427 Franço s M Ma "P erre Br que N ne een h-Cen ury Savan w h Twen e h-Cen ury deas " Canad an Journa o Psych a ry 28 (1983) 418-421 dem and Haro d Merskey "Br que s Concep o Hys er a An H s or ca Perspec ve Canad an Journa o Psych a ry 26 (1981) 57-63 dem "Br que s Trea se on Hys er a A Synops s and Commen ary " Arch ves o Genera Psych a ry 37 (1980) 1401-1405 Br que saw hys er a as a neuros s o he bra n 172 Charco C n ca Lec ures
rans Sav
13
173 For Bernhe m see H Bernhe m Sugges ve Therapeu cs A Trea se on he Na ure and Uses o Hypno sm (Wes por Conn Assoc a ed Bookse ers 1957) 174 A Harr ng on "Me a s and Magne s n Med c ne Hys er a Hypnos s and Med ca Cu ure n F n-de-S èc e Par s " Psycho og ca Med c ne 28 (1988) 21-38 dem "Hys er a Hypnos s and he Lure o he nv s b e The R se o Neo-Mesmer sm n F n-de-S èc e French Psych a ry " n Ana omy o Madness ed Bynum Por er and Shepherd 3 226-246 Ra her s m ar y Charco d scovered n he case o one ma e hys er c ha when he sk n o he pa en s scro um was p nched he pa en began a hys er ca a ack One s no surpr sed Charco C n ca Lecures rans Sav 239 175 Po n s we made by M ca e "Hys er a and s H s or ography" (par 2) 319-350 176 Charco C n ca Lecures
rans Sav
3
177 b d Charco ra sed he poss b y o "con ag ous m a on" on y o d sm ss 176 Charco C n ca Lecures
rans Sav
7
3
177 b d Charco ra sed he poss b y o "con ag ous m a on" on y o d sm ss
7
178 P Jane The Ma or Symp oms o Hys er a F een Lec ures G ven n he Med ca Schoo o Harvard Un vers y 2d ed (New York Macm an 1929) 179 Charco C n ca Lecures
rans Sav
14
180 For Charco and sex see Em y Ap er Fem n z ng he Fe sh Psychoana ys s and Narra ve Obsess on ( haca N Y and London Corne Un vers y Press 1991) 181 Charco C n ca Lecures
rans Sav
85
182 b d 99 Hered ary d a hes s o ered one cas - ron reason why ma e hys er a ex s ed 181 Charco C n ca Lecures
rans Sav
85
182 b d 99 Hered ary d a hes s o ered one cas - ron reason why ma e hys er a ex s ed 183 A po n we made n Ru h Harr s "Murder under Hypnos s n he Case o Gabr e e Bompard Psych a ry n he Cour room n Be e Epoque France " n Ana omy o Madness ed Bynum Por er and Shepherd 2 197-241 184 See Scu Soc a Order Men a D sorder M che Foucau Madness and C v za on H s ory o nsan y n he Age o Reason rans R chard Howard (New York Random House 1965) A D gby Madness Mora y and Med c ne (Cambr dge Cambr dge Un vers y Press 1985) M Fears "Therapeu c Op m sm and he Trea men o he nsane " n Hea h Care and Hea h Know edge ed R D ngwa (London Croom He m 1977) 66-81 dem "The Mora Trea men o nsan y A S udy n he Soc a Cons ruc on o Human Na ure " Ph D hes s Un vers y o Ed nburgh 1978 185 Ve h Hys er a 202 209 186 Car er Pa ho ogy and Trea men o Hys er a See a so Kane and Car son "A D eren Drummer Rober B Car er " 519-534 E a ne Showa er exam nes Car er s work (see chap 4) rom he v ewpo n o gender 187 Car er Pa ho ogy and Trea men o Hys er a 83 188 b d 189 b d 187 Car er Pa ho ogy and Trea men o Hys er a 83 188 b d 189 b d 187 Car er Pa ho ogy and Trea men o Hys er a 83 188 b d 189 b d "Thomas Laycock and he Cerebra Re ex " H s ory o Psych a ry 2 (1991) 385-408
190 See A ex Le
191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 191 Car er Pa ho ogy and Trea men o Hys er a 17 192 b d 2 193 b d 43 194 b d 195 b d 46 196 b d 197 b d 51 198 b d 56 199 b d 96 200 b d 129 201 b d 67 202 b d 106 203 b d 113 204 b d 111 205 b d 95 206 b d 35 207 b d 26 208 b d 122 209 b d 107 210
wou d be n r gu ng or examp e o exam ne Judge Schreber n h s gh See da Maca p ne and R chard Hun er eds Memo rs o My Nervous
ness by Dan e Pau Schreber (London W am Dawson & Sons 1955)
211 For d scuss on o m nd and body as heor zed w h n he n e ec ua ramework o psychoana ys s see Sander G man s essay (chap 5) and a so h s The Jew sh Body (London Rou edge 1991) wou d o course be des rab e o ex end he d scuss on n he presen essay ur her han he hresho d o psychoana ys s up oward he presen day bu ha wou d be a g gan c under ak ng On hys er a w h n psychoana ys s se he ems c ed n he o ow ng no e o er a he p u way n On he broader deve opmen s and deba es w h n wen e h-cen ury psych a ry see nn 8 and 30 above 212 Mon que Dav d-Ménard Hys er a rom Freud o Lacan Body and Language n Psychoana ys s ( haca N Y Corne Un vers y Press 1989) John Forres er The Seduc ons o Psychoana ys s Freud Lacan and Derr da (Cambr dge Cambr dge Un vers y Press 1990)
Four— Hysteria, Feminism, and Gender 1 Ha Fos er n erv ew w h Mary Ke y n n er m (New York The New Museum o Con emporary Ar 1990) 55 2 Hè éne C xous and Ca her ne C émen The New y Born Woman
rans Be sy W ng (M nneapo s Un vers y o M nneso a Press 1987) 47
A Handbook o U er ne Therapeu cs and o D seases o Women 4 h ed (New York W am Wood 1881) 85
3 Edward T
"Hys er a and Women " Amer can Journa o Psych a ry 139 (May 1982) 546
4 Pau Chodo
5 A Fabre L hys ér e v scéra e — nouveaux ragmen s de c n que méd ca e (Par s A De ahaye & E Lecrosn er 1883) 3 " H s ory o Sc ence 27 (1989) 320
6 Mark S M ca e "Hys er a and s H s or ography A Rev ew o Pas and Presen Wr ngs
7 Gregor o Kohon "Re ec ons on Dora The Case o Hys er a " n erna ona Journa o Psychoana ys s 65 (1984) 73-84 8 Chodo
"Hys er a and Women " 545
9 See P Chodo and H Lyons "Hys er ca Persona y A Re-eva ua on " Psychoana y c Quar er y 34 (1965) 390-405 and Harr e A Lerner "The Hys er ca Persona y A Woman s D sease " n Women and Men a Hea h ed E zabe h Howe and Mar or e Bayes (New York Bas c Books 1981) 196-206 " 319-331 See a so E a ne Showa er The Fema e Ma ady (New York Pan heon Press 1985)
10 For an overv ew and cr que o h s work see Mark S M ca e "Fem n s H s or ography o Hys er a " n "Hys er a and s H s or ography 11 M ca e "Hys er a and s H s or ography
" 331
"Fem n n y Narra ve and Psychoana ys s " n Women The Longes Revo u on (London V rago 1984)
12 See Ju e M che
13 Jane Ga op "Nurse Freud C ass S rugg e n he Fam y " unpub shed paper M am Un vers y 1983 14 C a re Kahane n Dora s Case Freud-Hys er a-Fem n sm ed C a re Kahane and Char es Bernhe mer (New York Co umb a Un vers y Press 1985) 22 "Gender A Use u Ca egory o H s or ca Ana ys s " Amer can H s or ca Rev ew 91 (December 1986) 1053-1075
15 See Joan W Sco
16 J Russe Reyno ds "Hys er a " n A Sys em o Med c ne ed J Russe Reyno ds (London Macm an 1866-1879) 2 307 quo ed n Mark M ca e "Charco and he dea o Hys er a n he Ma e A S udy o Gender Men a Sc ence and Med ca D agnos cs n La e N ne een h-Cen ury France " Med ca H s ory 34 (Oc ober 1990) Con r bu on à é ude de hys ér e chez homme (Par s 1885) 48
17 Em e Ba au
18 D M Berger "Hys er a n Search o he An mus " Comprehens ve Psych a ry 12 (1971) 277 19 W he m Re ch Charac er-Ana ys s 3d ed
rans Theodore P Wo e (New York Farrar S raus & G roux 1949) 189
20 Chodo and Lyons "Hys er ca Persona y " 739 21 Luc en sraë L hys ér que e sexe e e médec n (Par s Masson 1983) 60 197 (my rans a on) 22 b d 60 21 Luc en sraë L hys ér que e sexe e e médec n (Par s Masson 1983) 60 197 (my rans a on) 22 b d 60 23 See Eve yn Fox Ke er Re ec ons on Gender and Sc ence (New Haven Conn Ya e Un vers y Press 1985) Ludm a Jordanova Sexua V s ons mages o Gender n Sc ence and Med c ne be ween he E gh een h and Twen e h Cen ur es (Heme Hemps ead Harves er Whea shea 1989) Em y Mar n The Woman n he Body A Cu ura Ana ys s o Reproduc on (Bos on Beacon Press 1987) and Cyn h a Eag e Russe Sexua Sc ence The V c or an Cons ruc on o Womanhood (Cambr dge Harvard Un vers y Press 1989) 24 Jordanova Sexua V s ons 5 25 E enne Tr a L h s o re de hys ér e (Par s Seghers 1986) 26 Jose Breuer and S gmund Freud "S ud es on Hys er a " S andard Ed on o he Comp e e Psycho og ca Works o S gmund Freud ed J and A S rachey (London The Hogar h Press 1955) 2 240 (herea er c ed as SE) 27 O ve Schre ner e er o Kar Pearson n The Le ers o O ve Schre ner ed R chard R ve (Ox ord Ox ord Un vers y Press 1987) 86 28 Ne Bar e
Who Was Tha Man? (London Serpen s Ta
1989) 46
29 V eda Sku ans Eng sh Madness deas on nsan y 1580-1890 (London Rou edge & Kegan Pau 1978) 81 30 Thomas Sydenham Works o Thomas Sydenham 1848 2 85 quo ed n za Ve h Hys er a The H s ory o a D sease (Ch cago Un vers y o Ch cago Press 1965) 141 31 Jordanova Sexua V s ons 59 32 Jean-Bap s e Louyer-V ermay Recherches h s or ques e méd ca es sur hypochondr e (1802) quo ed n Tr a L h s o re de hys ér e 103 33 M Jeanne Pe erson "Dr Ac on s Enemy Med c ne Sex and Soc e y n V c or an Eng and " V c or an S ud es 29 (Summer 1986) 578 n 29 34 S ephen Hea h The Sexua F x (London Macm an Pub shers 1982) 30 35 Erns von Feuch ers eben The Pr nc p es o Med ca Psycho ogy
n he La e N ne een h Cen ury " Genders 6 (Fa 1989) 110
36 John H Sm h "Abu a Sexua y and D seases o he W 37 George M Beard Amer can Nervousness
rans H E L oyd ed B G Bab ng on (London Sydenham Soc e y 1847) 228
s Causes and Consequences 1881 repr n (New York Arno Press 1972) and Sexua Neuras hen a
s Hyg ene Causes Symp oms and Trea men (New York Trea 1884)
38 Beard Sexua Neuras hen a 204 39 Spencer quo ed n Howard M Fe ns e n "The Use and Abuse o 1981) 230
ness n he James Fam y C rc e " n Ourse ves Our Pas Psycho og ca Approaches o Amer can H s ory ed Rober J Brugger (Ba more Johns Hopk ns Un vers y Press
40 Jan Go ds e n Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (New York Cambr dge Un vers y Press 1987) 336 41 See he case o M De y and he d scuss on n M ca e "Charco and he dea o Hys er a n he Ma e " Sexua Sc ence 116
42 See Russe
43 Beard Sexua Neuras hen a 59 y " Wes m ns er Rev ew n s 1 (1852) 263
44 Herber Spencer "A Theory o Popu a on Deduced rom he Genera Law o An ma Fer
45 Gordon Ha gh George E o A B ography (New York and Ox ord Ox ord Un vers y Press 1968) 118-119 46 F S Gos ng Be ore Freud Neuras hen a and he Amer can Med ca Commun y (Urbana Un vers y o
no s Press 1987) 34
47 b d 47 55 48 b d 47 63 46 F S Gos ng Be ore Freud Neuras hen a and he Amer can Med ca Commun y (Urbana Un vers y o
no s Press 1987) 34
47 b d 47 55 48 b d 47 63 46 F S Gos ng Be ore Freud Neuras hen a and he Amer can Med ca Commun y (Urbana Un vers y o
no s Press 1987) 34
47 b d 47 55 48 b d 47 63 49 See Edward C arke Sex n Educa on (Bos on J R Osgood 1873) and Henry Mauds ey "Sex n M nd and Educa on " For n gh y Rev ew 15 (1874) 466-483 50 Ernes Earnes S We r M che
Nove s and Phys c an (Ph ade ph a Un vers y o Pennsy van a Press 1950) 51
Doc or and Pa en (Ph ade ph a J B L pp nco
51 S as We r M che
1888) 48
52 S We r M che
Lec ures on D seases o he Nervous Sys em Espec a y n Women 2d ed (London J & A Church
53 S We r M che
Wear and Tear H n s or he Overworked 4 h ed (Ph ade ph a J B L pp nco
54 M che
Doc or and Pa en
55 M che
Lec ures on D seases o he Nervous Sys em 14
56 M che
Doc or and Pa en
57 M che
Lec ures on D seases o he Nervous Sys em 76
1885) 15
1872) 38-39
139 48
58 Quo ed n Gos ng Be ore Freud 115 59 See Ann D Wood "The Fash onab e D seases Women s Comp a n s and The r Trea men n N ne een h-Cen ury Amer ca " n C o s Consc ousness Ra sed New Perspec ves on he H s ory o Women ed Mary Har man and Lo s W Banner (New York Harper & Row 1971) 9 G Barker-Ben e d The Horrors o he Ha -Known L e (New York Harper Co ophon 1976) 130 and Suzanne Po r er "The We r M che Res Cure Doc or and Pa en s " Women s S ud es 10 (1983) 15-40 60 G man The L v ng o Char o e Perk ns G man (1935) repr n (New York Arno Press 1972) 96 61 Margare C eaves The Au ob ography o a Neuras hen c (Bos on Gorham 1910) 198 See a so Po r er "We r M che Res Cure " 28-29 and Cons ance M McGovern "Doc ors or Lad es? Women Phys c ans n Psych a r c ns u ons 1872 -1900 " n Women and Hea h n Amer ca ed Jud h Wa ker-Leav (Mad son Un vers y o W scons n Press 1984) 442-443 62 Breuer and Freud "S ud es on Hys er a " SE 2 311 63 Rober Brudene Car er On he Pa ho ogy and Trea men o Hys er a (London John Church
1853) 25 53
64 b d 97-98 63 Rober Brudene Car er On he Pa ho ogy and Trea men o Hys er a (London John Church
1853) 25 53
64 b d 97-98 65 Henry Mauds ey The Pa ho ogy o M nd (London Macm an 1879) 450 66 Char es Merc er San y and nsan y (New York Scr bner & We ord 1890) 213 67 H B Donk n "Hys er a " n D c onary o Psycho og ca Med c ne by D H Tuke (Ph ade ph a P B ak s on 1982) 619-620 68 F C Skey Hys er a 2d ed (London Longmans Greem Reader & Dyer 1867) 77-84 69 Mauds ey Pa ho ogy o M nd 397-398 70 Skey Hys er a 60 71 Rober Thorn on The Hys er ca Woman Tr a s Tears Tr cks and Tan rums (Ch cago Donohue & Hennebery 1893) 72 Ju es Fa re E udes c n ques sur es ma ad es men a es e nerveuses (Par s L bra r e Ba ère e F s 1890) 502 73 Sm h-Rosenberg "The Hys er ca Woman Sex Ro es and Ro e Con c n N ne een h-Cen ury Amer ca " Soc a Research 39 (1972) repr n ed n Sm h-Rosenberg D sorder y Conduc The H s ory o Sexua y
74 M che Foucau
197-216
rans Rober Hur ey (New York V n age 1980) 104
75 b d 121 The H s ory o Sexua y
74 M che Foucau
rans Rober Hur ey (New York V n age 1980) 104
75 b d 121 76 Sm h-Rosenberg D sorder y Conduc
331 n 5
H s ory o Sexua y 112
77 Foucau
78 Sm h-Rosenberg D sorder y Conduc
200
79 Van Deusen "Observa ons on a Form o Nervous Pros ra on " Amer can Journa o nsan y 25 (1869) 447 c ed n Sm h-Rosenberg D sorder y Conduc
332 n 14
80 L sa T ckner The Spec ac e o Women (Ch cago Un vers y o Ch cago Press 1988) 196 81 Sm h-Rosenberg D sorder y Conduc
259-260
82 See Debora S verman "The New Woman Fem n sm and he Decora ve Ar s n F n-de-S èc e France " n Ero c sm and he Body Po c ed Lynn Hun (Ba more Johns Hopk ns Un vers y Press 1991) 144-163 83 W am Barry "The S r ke o a Sex " Quar er y Rev ew 179 (1894) 312 84 an F e cher n roduc on Br sh Poe ry and Prose 1870-1905 (London Ox ord Un vers y Press 1987) xv 85 T ckner Spec ac e o Women 194 86 L n on The G r o he Per od and O her Essays (London Macm an 1883) 87 See Mark S M ca e "The Sa pê r ère n he Age o Charco An ns u ona Perspec ve on Med ca H s ory n he La e N ne een h Cen ury " Journa o Con emporary H s ory 20 (Oc ober 1985) 709 88 Charco "A propos de s x cas d hys ér e chez homme " n J M Charco L Hys ér e ed E Tr a (Tou ouse Pr va 1971) 156 Con r bu on à é ude de hys ér e chez homme 110
89 Ba au
90 Charco "A propos de s x cas d hys ér e chez homme " 157-158 91 M ca e "Charco and he dea o Hys er a n he Ma e " 66 92 See M ca e "The Sa pê r ère n he Age o Charco " 703-731 93 Go ds e n Conso e and C ass y 322 94 C ed n E sabe h Roud nesco La Ba a e de cen ans H s o re de a psychana yse en France (Par s Ramsay 1982) 1 35 95 Quo ed n Ru h Harr s Murders and Madness Med c ne Law and Soc e y n he "F n de S èc e" (Ox ord C arendon Press 1989) 162 96 Quo ed n F e d ng H Garr son n roduc on o he H s ory o Med c ne (Ph ade ph a Saunders 1924) 640 Con r bu on à é ude de hys ér e chez homme
97 Ba au
98 See Roud nesco La Ba a e de cen ans 1 76 99 Gr se da Po ock V s on & D erence Fem n n y Fem n sm and he H s or es o Ar (London Rou edge & Kegan Pau 1988) 189-190 100 On he ar o he Charco am y see Debora S verman Ar Nouveau n F n-de-S èc e France (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1989) 192-193 196 101 S verman " New Woman Fem n sm and he Decora ve Ar s n F n-de-S èc e France " 147-148 102 See Toby Ge and "Med ca Nemes s Par s 1894 Leon Daude s Les Mor co es " Bu e n o he H s ory o Med c ne 60 (1986) 155-176 103 Axe Mun he The S ory o San M che e (London John Murray 1930) 296 104 Zoöph s 7 (November 1887) 110 quo ed n Mary Ann E s on "Women and An -V v sec on n V c or an Eng and 1870-1900 " n V v sec on n H s or ca Perspec ve ed N co aas A Ruphe (London Rou edge & Kegan Pau 1987) 281 105 Go ds e n Conso e and C ass y 375 106 See he accoun s o Augus ne a so ca ed "Lou se" and "X " n D M Bournev e conograph e pho ograph que de a Sa pê r ère Vo Co ege o Phys c ans o Ph ade ph a or ass s ance w h hese ma er a s
(1878) 124-167 and Vo
(1879-80) 187-199
am gra e u o he s a o he L brary o he
107 Lou s Aragon and André Bre on "Le c nquan ena re de hys ér e " La Révo u on surréa s e no 11 (1928) 20 108 See Georges D d -Huberman nven on de Hys ér e Charco e
conograph e Pho ograph que de a Sa pê r ère (Par s Macu a 1982)
109 The cr c D anne Hun er s ac ve n h s group See a so Showa er Fema e Ma ady chap 6 and Cora Hou man Augus ne unpub shed e ev s on p ay London 1989 y oward women doc ors See he commen s o C R "Charco dévo é " n Go ds e n Conso e and C ass y 375
110 A eas one woman however a acked h s hos
111 L hys ér e aux XV e e XV e s èc es (Par s S e nhe 1897) 112 George e Déga Essa sur a cure préven ve de hys ér e ém n ne par édu-ca on (Fe x A can 1898) 29 See a so Jacque ne Carroy "Le nov c a de hys ér e se on George e Déga " Psychana yse Un vers a re 12 (1987) 141-152 113 Mark M ca e "Hys er a Ma e Hys er a Fema e Re ec ons n Compara ve Gender Cons ruc on n N ne een h-Cen ury France and Br a n " n Sc ence and Sens b y Essays n he H s ory o Gender Sc ence and Med c ne n N ne een h-Cen ury Br a n ed Mar na Ben am n (New Brunsw ck N J Ru gers Un vers y Press or hcom ng) 114 See Tr a H s o re de hys ér e 199-204 115 P erre Jane The Ma or Symp oms o Hys er a (New York Macm an 1920) 10-11 116 Freud "Par s Repor " SE 3 10 117 C ed by Ernes Jones The L e and Work o S gmund Freud ed ed and abr dged by L one Tr ng and S even Marcus (New York Bas c Books 1961) 207n 118 Freud "Hys ér e " SE 1 41 52 119 See D anne Hun er "Hys er a Psychoana ys s and Fem n sm The Case o Anna O " Fem n s S ud es 9 (1983) 467-468 120 A s gn can con r bu on o h s work was made by Hun er n her essay "Hys er a Psychoana ys s and Fem n sm " 121 See D ane Pr ce Hernd "The Wr ng Cure Char o e Perk ns G man Anna O and Hys er ca Wr ng " NWSA Journa 1 (1988) 64-68 122 S gmund Freud Dora An Ana ys s o a Case o Hys er a (New York Co ns 1964) See a so n Dora s Case Freud — Hys er a — Fem n sm ed Char es Bernhe mer and C a re Kahane (New York Co umb a Un vers y Press 1985) 123 Je rey Masson Aga ns Therapy (London Fon ana 1990) 101 124 See Susan Ka z "Speak ng Ou aga ns he Ta k ng Cure Unmarr ed Women n Freud s Ear y Case S ud es " Women s S ud es 13 (1987) 297-324 125 Tor Mo "Represen a ons o Pa r archy Sexua y and Ep s emo ogy n Freud s Dora " n n Dora s Case ed Kahane and Bernhe mer 196 126 Breuer and Freud "S ud es on Hys er a " SE 2 254 127 Freud "Remember ng Repea ng and Work ng Through " SE 12 151 128 Freud "The Dynam cs o Trans erence " SE 12 108 129 The Br sh Schoo o Psychoana ys s ed Gregor o Kohon (London Free Assoc a on Books 1986) 386 130 Kur E ss er "The E ec o he S ruc ure o he Ego n Psychoana y c Techn que " J o Amer can Psychoana y c Assoc a on Vo
(1953) 114
131 Dubo s Les psychonévroses e eur ra emen mora (Par s Masson 1904) 14 132 T ckner Spec ac e o Women 203 133 b d 316 n 198 132 T ckner Spec ac e o Women 203 133 b d 316 n 198 134 P Gur aud Hys ér e e o e hys ér que (AMP 1914) n Tr a L h s o re de hys ér e 241 135 C aude Barro s Les révroses rauma ques (Par s Bardas 1988) 20-21 136 "Deux ypes de névroses de guerre " Oeuvres comp è es (Par s Payo 1970) 2 238-252 137 On W H R R vers see he b ography by R chard S oboden W H R R vers (New York Co umb a Un vers y Press 1978) and Showa er Fema e Ma ady chap 7 138 See Char es S Myers She -Shock n France (Cambr dge Cambr dge Un vers y Press 1940) 25 37 66 139 Myers She -Shock n France 83 and W McDouga
An Ou ne o Abnorma Psycho ogy (London Me huen 1926) 2
140 Mar n S one "She shock and he Psycho og s s " n The Ana omy o Madness ed W F Bynum Roy Por er and M chae Shepherd (London Tav s ock 1985) 261 141 Myers She -Shock n France 40 142 Quo ed n Er c Leed No Man s Land Comba and den y n Wor d War (Cambr dge Cambr dge Un vers y Press 1979) 179 War Neuroses and She Shock (London Hodder & S ough on 1919) 171
143 Freder ck W Mo
144 H S ern "Evo u on du prob ème des psychoneuroses de guerre " An-na es méd co-psycho og ques (1947) 2 249-270 145 Jones L e and Work o S gmund Freud 494-495 146 Quo ed n Thomas Sa mon The Care and Trea men o Men a D seases and War Neuroses ("She Shock") n he Br sh Army (New York War Work Comm ee o he Na ona Comm ee or Men a Hyg ene 1917) 40 147 G E o -Sm h and T H Pear She shock and s Lessons 4 h ed (London Longman Green 1919) 32-33 148 R D G esp e The Psycho og ca E ec s o War on C zen and So d er (New York Nor on 1942) 21 quo ed n S one "She shock and he Psycho og s s " 21 149 Cr ch on-M er quo ed n Sa mon Care and Trea men
40
150 Thomas A Ross Lec ures on War Neuros s (Ba more W ams 1941) 78 The Grea War and Modern Memory (New York Ox ord Un vers y Press 1975) 22-29
151 Pau Fusse
152 Kar Abraham n Psycho-ana ys s and he War Neuroses ed Sándor Ferencz (London n erna ona Psycho-ana y ca Press 1921) 24 153 See The Lance
25 December 1915 15 January 1916 22 January 1916 and 19 February 1916
154 P S Lynch "The Exp o a on o Courage " M Ph
hes s Un vers y o London 1977
155 S one "She shock and he Psycho og s s " 261 263 The Grea War and Modern Memory 273-274
156 Fusse
157 S one "She shock and he Psycho og s s " 262 158 S one "She shock and he Psycho og s s " 245 159 W H R R vers ns nc and he Unconsc ous (Cambr dge Cambr dge Un vers y Press 1922) 252 160 R vers "Psycho-Therapeu cs " n Encyc oped a o Re g on and E h cs ed James Has ngs 13 vo s (Ed nburgh T & T C ark 1918) 10 440 161 See or examp e he case s udy o a c aus rophob c o cer who s ammered n R vers ns nc and he Unconsc ous 162 R vers ns nc and he Unconsc ous 133 135 136 163 Edward Shor er "Man a Hys er a and Gender n Lower Aus r a 1891-1905 " H s ory o Psych a ry 1 (1990) 4 See a so Shor er "Para ys s The R se and Fa o a Hys er ca Symp om " Journa o Soc a H s ory 19 (1986) 549-582 164 n erv ew w h Mon que Dav d-Ménard n Women Ana yze Women ed E a ne Ho man Baruch and Luc enne J Serrano (New York New York Un vers y Press 1988) 54-55 165 Dav d-Ménard n Women Ana yze Women ed Baruch and Serrano 54 166 E zabe h Ze ze The Capac y or Emo ona Grow h (New York n erna ona Un vers es Press 1970) 14 167 b d 236-238 168 b d 245 166 E zabe h Ze ze The Capac y or Emo ona Grow h (New York n erna ona Un vers es Press 1970) 14 167 b d 236-238 168 b d 245 166 E zabe h Ze ze The Capac y or Emo ona Grow h (New York n erna ona Un vers es Press 1970) 14 167 b d 236-238 168 b d 245 169 Baruch and Serrano Women Ana yze Women 55 170 b d 49 169 Baruch and Serrano Women Ana yze Women 55 170 b d 49 171 M ca e "Hys er a and s H s or ography 172
" 227
za Ve h Can You Hear he C app ng o One Hand? Learn ng o L ve w h a S roke (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1989) 94 173 b d 274
172
za Ve h Can You Hear he C app ng o One Hand? Learn ng o L ve w h a S roke (Berke ey Los Ange es Ox ord Un vers y o Ca orn a Press 1989) 94 173 b d 274
174 M ca e "Hys er a and s H s or ography
" 319
175 Ve h Hys er a v 176 See or examp e Caro F Kar son The Dev n he Shape o a Woman W chcra
n Co on a New Eng and (New York V n age Books 1989)
177 Ve h Hys er a 208 210 178 b d 209 177 Ve h Hys er a 208 210 178 b d 209 179 Joan W Sco
"Amer can Women H s or ans 1884-1984 " n Gender and he Po cs o H s ory (New York Co umb a Un vers y Press 1988) 186
180 Nancy J Chodorow Fem n sm and Psychoana y c Theory (New Haven Conn Ya e Un vers y Press 1989) 215 219 181 Kahane n Dora s Case 31 182 Mary Jacobus Read ng Woman Essays n Fem n s Cr c sm (New York Co umb a Un vers y Press 1986) 200 183 Hé ène C xous "The Laugh o he Medusa " n New French Fem n sms ed E a ne Marks and sabe e de Cour vron (Amhers Un vers y o Massachuse s Press 1980) 257 184 C xous and C emen New y-Born Woman 154 185 b d 5 9 15 157 184 C xous and C emen New y-Born Woman 154 185 b d 5 9 15 157 186 On hys er ca narra ve see Made on Sprengne her "En orc ng Oed pus Freud and Dora " n n Dora s Case ed Kahane and Bernhe mer 267-271 187 Tor Mo Fem n s Theory and S mone de Beauvo r (London Bas B ackwe Pub sher 1990) 82 188 L sa K Gorn ck "Deve op ng a New Narra ve The Woman Therap s and he Ma e Pa en " n Psychoana ys s and Women Con emporary Reappra sa s ed Jud h L A per (H sda e N J Ana y c Press 1986) 257-286 189 Gorn ck "Deve op ng a New Narra ve " 258 190 Hernd "Wr ng Cure " 53-54 Women The Longes Revo u on Essays n Fem n sm L era ure and Psychoana ys s (London V rago 1984) 117
191 M che
192 Quo ed n E sabe h Roud nesco H s o re de a psychana yse en France
82-83
193 Anne S evenson "The Hys er ca Women s Movemen " T mes L erary Supp emen (9 Sep ember 1983) 961 There are n eres ng correspondences be ween Sy v a P a h s mos amous poem "Daddy " and he case o Anna O a hough h s ex ua connec on s no a a he k nd o hys er ca para e S evenson had n m nd 194 "The S orm ng o S Pa s " New York T mes (12 December 1989) Sec A 24 195 Lena W ams "Psycho herapy Ga n ng Favor among B acks " New York T mes (22 November 1989) Sec
1
196 Quo ed n Arno d Rampersad "Psycho ogy and A ro-Amer can B ography " The Ya e Rev ew (1989) 7 197 Hun er "Hys er a Psychoana ys s and Fem n sm " 485 198 Tr a L h s o re de hys ér e 274 199 Ph p R S avney Perspec ves on "Hys er a" (Ba more Johns Hopk ns Un vers y Press 1990) 190
Five— The Image of the Hysteric 1 Howard W Te son "Une eçon du Doc eur Charco à a Sa pê r ère " Journa o he H s ory o Med c ne 35 (1980) 58 To con ex ua ze h s mage see he d scuss on by Anne Harr ng on Med c ne M nd and he Doub e Bra n A S udy n N ne een h-Cen ury Though (Pr nce on N J Pr nce on Un vers y Press 1987) 266-170 On he h s or ography o hys er a see Mark S M ca e "Hys er a and s H s or ography " H s ory o Sc ence 27 (1989) 223-261 319-351 See a so he work on he ear y h s ory o hys er a by za Ve h Hys er a The H s ory o a D sease (Ch cago and London Un vers y o Ch cago Press 1965) H Merskey "Hys er a The H s ory o an dea " Canad an Journa o Psych a ry 28 (1983) 428-433 as we as h s "The mpor ance o Hys er a Br sh Journa o Psych a ry 149 (1986) 23-28 Annemar e Le bbrand and Werner Le bbrand "D e kopern -kan sche Wendung des Hys er ebegr es be Parace sus " Parace sus Werk und W rkung Fes gabe ür Kur Go dammer zum 60 Gebur s ag ed Sepp Domand (V enna Verband der W ssenscha chen Gese scha en Ös erre chs 1975) He mu -Johannes Loren z "S mu er ob cuer E n Hys er erezep des Pseudo-Apu e us " Sudho s Arch v 38 (1954) 20-28 Umber o de Mar n "L s er smo De ppocra e a Charco " Pag ne d s or a de a med c na 12 6 (1968) 42-49 John Mu an "Hypochondr a and Hys er a Sens b y and he Phys c ans " E gh een h Cen ury 25 (1983) 141-173 John R Wr gh "Hys er a and Mechan ca Man " Journa o he H s ory o deas 41 (1980) 233-247 Ph p R S avney Perspec ves on "Hys er a " (Ba more Johns Hopk ns Un vers y Press 1990) 2 J -M Charco Lec ures on he D sease o he Nervous Sys em de vered a La Sa pêr ère
rans George S gerson (London New Sydenham Soc e y 1877) 271
3 Among he gures are Charco bes de he pa en (B anche W man?) Joseph Bab nsk n back o her hen gh o e rom he back o he p c ure are Pro V Corn unknown Pro M Debove Pro Ma h as-Duva A Londe ( he head o he pho ograph c serv ce) Pro Jo roy (w h h s head n h s hand) second row rom he r gh are Dr Gu non Dr R bo ( n he oreground) Dr Ju es C aré e Dr Naque Dr D -M Bournev e Pro E Br ssaud Pro P erre-Mar e Dr Georges G es de a Toure e Dr Ferré and Dr Pau R cher (w h a penc n h s hand) 4 Oscar W de "The Decay o Ly ng " n The Sou o Man under Soc a sm and O her Essays ed Ph p Re
(New York Harper and Row 1970) 72
5 am aware ha var ous names were used or he var ous processes deve oped and ha "pho ography" was bu one o hem sha use a o hese erms (or a eas "pho ograph" and "Daguerreo ype") n erchangeab y as am more n eres ed n he reac on o he ob ec han he means by wh ch he ob ec was produced On he nam ng o he "pho ograph" see Wo gang Ba er Que en-dars e ungen zur Gesch ch e der Fo ograph e (Le pz g Fo ok nover ag 1965) 119-120 On he cen ra y o he pho ograph n he h s ory o med ca represen a on n he a e n ne een h cen ury see Rena a Taureck D e Bedeu ung der Pho ograph e ür d e med z n sche Abb dung m 19 Jahrhunder (Co ogne Arbe en der Forschungss e e des ns u s ür Gesch ch e der Med z n 1980) 6 On he prob em o he re a onsh p be ween he sh n he symp oma c s ruc ure o hys er a and he na ure o he percep on o h s d sease en y see Annemar e Le bbrand and Werner Le bbrand "Ges a wande med z n scher Begr e am Be sp e der Hys er e und der Pervers on " Med z n sche K n k 69 (1974) 761-765 Rober Sa ow "Where Has A he Hys er a Gone?" Psychoana y c Rev ew 66 (1979-80) 463-480 and he exchange o e ers under he e "Why No Cases o Hys er ca Psychos s?" n he Amer can Journa o Psych a ry 143 (1986) 1070-1071 My hes s s a var ance w h he v ew o Caro Sm h-Rosenberg "The Hys er ca Woman Sex Ro es n N ne een h-Cen ury Amer ca " Soc a Research 39 (1972) 652-678 as be eve ha he ro e o med ca sc ence n shap ng he " dea" o he hys er c s cer a n y o equa mpor ance o he represen a on o he ass gned soc a ro es o he pa en See a so Edward Shor er "Para ys s The R se and Fa o a Hys er ca Symp om " Journa o Soc a H s ory 19 (1986) 549-582 S Mouch y Sma Concep o Hys er a H s ory and Reeva ua on " New York S a e Journa o Med c ne 69 (1969) 1866-1872 7 Th s p a e s reproduced n E enne Tr a H s o re de hys ér e (Par s Seghers 1986) The p c ure s o be ound n he Musée de Re ms co ec on Roger-V o e 8 J -B Luys conograph e pho ograph ques des cen res nerveux (Par s Ba ère 1873) 9 See Sander L G man See ng he nsane (New York John W ey & Sons 1982) or he broader con ex o he mage o he hys er c 10 J -B Luys Les émo on chez su e en é a d hypno sme (Par s Ba ère 1887) The pho ograph c mages o h s pa en s a he Sa pê r ère are reproduced n he exh b on ca a ogue by Jacque ne Sono e ed J M Charco e s èc e (Chape e de a Sa pê r ère 2-18 u n 1982 ) 33 (p a e 74)
hys er e au x xe
11 Luys Les émo ons chez es su e s 12 G man See ng he nsane 83 13 Lou s Ba a e "Deux Cas d Anorex e Hys ér que " Nouve e conograph e de a Sa pê r ère 5 (1892) 276-278 (p a e oppos e p 277) 14 Ar hur Gamgee "An Accoun o a Demons ra on on he Phenomena o Hys ero-ep epsy " Br sh Med ca Journa 2 (1878) 544-548 C ed by E M Thorn on Hypno sm Hys er a and Ep epsy An H s or ca Syn hes s (London W am He nemann 1976) 144 15 A hographed p a e based on a pho ograph represen ng he ype o pa en descr bed s o be ound n he mage rom Pau Regnard Les ma ad es ép dém ques de espr Sorce er e magné srae morph n sme dé re des grandeurs (Par s E P on Nourr e C e 1887) 359 O her such evoca ons o hys er ca symp oms us ng he un ng ork are represen ed by he d sembod ed hand o he phys c an and he ace o he pa en See Pau R cher "Gon emen du cou chez un hys ér que " Nouve e conograph e de a Sa pê r ère 2 (1889) 17-20 (p a e 34) See a so he pho ograph o a s m ar pa en aken rom he conograph e de a Sa pê r ère reproduced n he exh b on ca a ogue by Sono e J M Charco e hys er e au x xe s èc e 36 16 n h s con ex see Es her F scher-Homburger Krankhe Frau und andere Arbe en zur Med z ngesch ch e der Frau (Bern Hans Huber 1979) Wendy M ch nson "Hys er a and nsan y n Women A N ne een h-Cen ury Canad an Perspec ve " Journa o Canad an S ud es 21 (1980) 87-104 Reg na Schaps Hys er e und We b chke W ssenscha über d e Frau (Frank ur Ma n and New York Campus Ver ag 1982) 17 Charco Lec ures on he D sease o he Nervous Sys em pp 230 and 264 18 Purves S ewar "Two Lec ures on he D agnos s o Hys er a " The Prac
oner 72 (1903) 457
19 See he rev ew o he rs vo ume o he conograph e pho ograph que de a Sa pê r ère n Progrès méd ca 7 (1879) 331 On he genera background o hese concep s see Léon Cher ok "Hys er a Hypnos s Psychopa ho ogy " Journa o Nervous and Men a D sease 161 (1975) 367-378 Maur ce Dong er "Br que and Br que s Syndrome V ewed rom France " Canad an Journa o Psych a ry 28 (1983) 422-427 Franço s M Ma "P erre Br que N ne een h Cen ury Savan w h Twen e h Cen ury deas " Canad an Journa o Psych a ry 28 (1983) 418-421 Jean-Jacques Gob o Ex ase hys ér e possess on Les héor es d A exandre Ber rand " Roman sme 24 (1979) 53-59 E Gordon "The Deve opmen o Hys er a as a Psych a r c Concep " Comprehens ve Psych a ry 25 (1984) 532-537 Les on L Havens "Charco and Hys er a " Journa o Nervous and Men a D sease 141 (1965) 505-516 20 On he prob em o he me aphor o he "germ heory" and s ro e n he evo u on o he dep c on o he hys er c see K Code Car er "Germ Theory Hys er a and Freud s Ear y Work n Psychopa ho ogy " Med ca H s ory 24 (1980) 259-274 21 Georges Cangu hem The Norma and he Pa ho og ca
rans Caro yn R Fawce (New York Zone 1989) 40
22 See he deve opmen o he rede n on o hys er a rom he 1952 DSM d scuss ons o "psychoneuro c d sorders" ( D agnos c and S a s ca Manua Men a D sorders Wash ng on D C Amer can Psych a r c Assoc a on 1952 31-35) o he d scuss on o he represen a on o he hys er c n DSM- -R ( D agnos c and S a s ca Manua o Men a D sorders 3d ed rev sed Wash ng on D C Amer can Psych a r c Assoc a on 1987 205-207 257-259 269-277 318-320 348-349) 23 Fr edr ch N e zsche The W
o Power
rans Wa er Kau mann and R J Ho ngda e (New York V n age 1968) 33
24 Sander L G man ed The Face o Madness Hugh W D amond and he Or g n o Psych a r c Pho ography (New York Brunner Maze 1976) 21 25 G man Face o Madness 23 26 b d 10 25 G man Face o Madness 23 26 b d 10 27 am d scoun ng a presen he recen work on he phys o ogy o s ress and anx e y wh ch may however prov de a u ure bas s or an unders and ng o he psycho og ca "s ar e e ec " o nnova ve ar The ncorpora on o new exper ences and he r ar cu a on n erms o ex s ng mode s o percep on may be our means o dea ng w h such s ress See Je rey A Gray The Neurophys o ogy o Anx e y An nqu ry n o he Func ons o he Sep o-H ppocampa Sys em (New York C arendon Press 1982) 28 George S Layne "K rkbr de-Langenhe m Co ec on Ear y Use o Pho ography n Psych a r c Trea men n Ph ade ph a " The Pennsy van a Magaz ne o H s ory and B ography 55 (1981) 182-202 29 Be y M er ed E zabe h Barre
o M ss M ord The Unpub shed Le ers o E zabe h Barre Brown ng o Mary Russe M ord (New Haven Conn Ya e Un vers y Press 1954) 208-209
30 C ed by Hermann G aser ed The German M nd o he N ne een h Cen ury (New York Con nuum 1981) 16 31 Edgar A an Poe "The Daguerreo ype " repr n ed n C ass c Essays on Pho ography ed A an Trach enberg (New Haven Conn Lee e s s and Books 1980) 37-38 32 Sander L G man "He ne s Pho ographs " Hebrew Un vers y S ud es n L era ure and Ar 13 (1985) 293-350 33 On he background or Freud and hys er a see K Code Car er " n an e Hys er a and n an e Sexua y n La e N ne een h-Cen ury German-Language Med ca L era ure " Med ca H s ory 27 (1983) 186-196 sabe F Kn gh "Freud s Pro ec A Theory or S ud es on Hys er a " Journa o he H s ory o he Behav ora Sc ences 20 (1984) 340-358 Russe Meares e a "Whose Hys er a Br que s Jane s or Freud s " Aus ra an and New Zea and Journa o Psych a ry 19 (1985) 256-263 Jean G Sch mek "Fac and Fan asy n he Seduc on Theory A H s or ca Rev ew " Journa o he Amer can Psychoana y c Assoc a on 35 (1987) 937-965 Ernes S Wo Ar s c Aspec s o Freud s The Ae o ogy o Hys er a " Psychoana y c S ud es o he Ch d 26 (1971) 535-554 Mon que Dav d-Ménard Hys er a rom Freud o Lacan rans Ca her ne Por er ( haca N Y Corne Un vers y Press 1989) 34 George D d -Huberman nven on de hys ér e Charco e
conograph e pho ograph que de a Sa pê r ère (Par s Macu a 1982)
35 Th s genera d scuss on s roo ed n he work (and mages) n Rober Darn on Mesmer sm and he End o he En gh enmen n France (Cambr dge Mass Harvard Un vers y Press 1968) A h s mages are rom he B b o héque na ona e cab ne o pr n s E R L Par s 36 Darn on Mesmer sm and he End o he En gh enmen
53
37 b d 63 36 Darn on Mesmer sm and he End o he En gh enmen
53
37 b d 63 38 Reproduced n Tr a H s o re de hys ér e From he B b o héque na on-a e cab ne o pr n s E R L Par s 39 As n Pau R cher s reproduc on o an engrav ng o " a phase d mmob é ou é an sme " n h s É udes c n ques sur a grande hys ér e ou hys éro-ép eps e (Par s De ahaye & Lecrosn er 1881) P a e reproduced n D d -Huberman nven on de hys ér e 121 40 S r Char es Be s Essays on he Ana omy and Ph osophy o Express on (London John Murray 1824) 101 P a e s on he same page On Be s mage see K aus Knech Char es Be Forschungs e e des ns u s ür Gesch ch e der Med z n 1978) 121
The Ana omy o Express on (1806) (Co ogne Arbe en der
41 On he background o he h s ory o hys er a n he con ex see Urs Boschung "A brech von Ha er a s Arz Zur Gesch ch e des E x r ac dum Ha er " Gesnerus 34 (1977) 267-293 Je rey M N Boss "The Seven een h-Cen ury Trans orma on o he Hys er c A ec on and Sydenham s Bacon an Med c ne " Psycho og ca Med c ne 9 (1979) 221-234 Wa er Russe Barow Bra n "The Concep o Hys er a n he T me o W am Harvey " Proceed ngs o he Roya Soc e y o Med c ne 56 (1963) 317-324 D eren a D agnos s A Manua o he Compara ve Seme o ogy o he More mpor an D seases (Ph ade ph a D G Br n on 1887) 134-135
42 F de Hav and Ha
43 See he d scuss on o he hosp a and s pa en s n Jean-Mar n Charco Hosp ce de a Sa pê r ère (Par s Aux bureau du progrès méd ca 1892-1893) 44 On Jackson see Oswe Temk n The Fa ng S ckness A H s ory o Ep epsy rom he Greeks o he Beg nn ngs o Modern Neuro ogy (Ba more Johns Hopk ns Un vers y Press 1972 ) 305-316 347-350 45 S gmund Freud S andard Ed on o he Comp e e Psycho og ca Works o S gmund Freud ed and rans J S rachey A Freud A S rachey and A Tyson 24 vo s (London Hogar h 1955-1974) 1 58 (Herea er c ed as SE ) On he background see Henr E enberger The D scovery o he Unconsc ous The H s ory and Evo u on o Dynam c Psych a ry (New York Bas c Books 1970) 46 Freud SE 9 234 47 The C n ca D ary o Sándor Ferencz
ed Jud h Dupon (Cambr dge Harvard Un vers y Press 1985) 63
48 Ar hur F Hurs "War Con rac ures—Loca zed Te anus A Re ex D sorder or Hys er a?" Sea e Hayne Neuro og ca S ud es 1 (1918) 43-52 Hurs s co ec ed papers on hys er a appeared as The Croon an Lec ures on he Psycho ogy o he Spec a Senses and The r Func ona D sorders (London Henry Frowde Hodder & S ough on 1920) w h 29 p a es some aken rom Charco 49 Joseph Bab nsk and Ju es Fromen Hys ér e-p h a sme e roub es nerveux d ordre ré exe en neuro og e de guerre (Par s Masson e C e 1917) 50 E a ne Showa er The Fema e Ma ady Women Madness and Eng sh Cu ure 1830-1980 (New York Pan heon Books 1985) 189-194 51 Les Démon aques dans ar (Par s Adr en De ahaye e Ém e Lecrosn er 1887) The a er expanded vers on o h s s udy Les d ormes e es ma ades dans ar (Par s Lecrosn er e Babé 1889) a emp s o para e a v sua mages o "d erence " See a so Lou s Lang e Une possess on au XV e s êc e É ude med ca e de a v e e de hys ér e de N co Obry D e N co e de Verv ns 1566 (Re ms Ma o -Bra ne 1910) and Henr Ey " n roduc on a é ude ac ue e de hys ér e " Revue du prac c en 14 (1964) 1417-1431 52 A de a ed accoun o he s ages o hys er a ha are documen ed n he h s or ca s udy can be ound n J -M Charco "Lemon d ouver ure " Progrès méd- ca 10 (1882) here 336 The mos de a ed v sua represen a on o he s ages s o be ound n R cher É udes c n ques sur a grande hys ér e 53 Compare Jan Go ds e n Conso e and C ass y The French Psych a r c Pro ess on n he N ne een h Cen ury (Cambr dge Cambr dge Un vers y Press 1987) esp her chap er "Hys er a An c er ca Po cs and he V ew beyond he Asy um " 322377 54 The p a es are ound on p 99 ower and p 100 ower 55 The p a e s ound on p 94 upper 56 Lou s Bas e Carré de Mon geron La ver é des m rac es operas par n ercess on de M de Pâr s e au res appe ans demon rée con re M L archevêque de Sens
3 vo s (Co ogne Chez es bra res de a Campagn e 1745-47)
The Mon geron p a es reproduced by Regnard (see n 15) are on he o ow ng unnumbered pages Re nard vo 1
Mon geron vo 1
Regnard vo 2
113
Fron sp ece
120 123
Pr or o p 1 o he " Demons ra on"
127 129
Pr or o p 1 o he "
133 134
Pr or o p 1 o he " V Demons ra on"
141 143
Pr or o p 1 o he "V Demons ra on"
149 151
Pr or o p 1 o he "V Demons ra on"
Demons ra on"
Mon geron vo 2
169 176
Pr or o p 1 o he "M rac e operé sur Mar e Jeanne Fourcroy"
161 163
Pr or o p 1 o "p eces us sur Ca her ne B go "
172
Pr or o p 1 o "Re a on du m rac e sur au eur"
ca ves
See a so he essay by Georges G es de a Toure e "Le Se n Hys ér que " Nouve e conograph e de a Sa pê r ère 8 (1895) 107-121 or he ur her use o mages rom h s source 57 See he second ed on o Ph ppe P ne Tra é méd co-ph osoph que sur a éna on men a e ou a man e (Par s Brosson 1809) 268 See a so Theodore Ze d n "The Con c o Mora es Con ess on S n and P easure n he N ne een h Cen ury " n Con c s n French Soc e y An c er ca sm Educa on and Mora s n he N ne een h Cen ury ed Theodore Ze d n (London A en & Unw n 1970) 22-30 58 Th s assoc a on o orms o "ex ravagan " and "v s b e" re g ons may we be a reac on o he charge odged aga ns he schoo o Charco ha Par s See Go ds e n Conso e and C ass y 364 59 Regnard Les ma ad es ép dém ques de espr
was "Jew sh" as
advoca ed he a c za on o he nurs ng s a a he ma or psych a r c hosp a s n
95
60 Dés re-Mag o re Bournev e and Pau Regnard conograph e pho ograph que de a Sa pê r ère (serv ce de M Charco ) (Par s Progrès méd ca 1877-80) 3 vo s vo 2 P a es are reproduced n D d -Huberman nven on de hys ér e 139-145 61 The dea o rac ng a near h s ory o hys er a hrough exam n ng he h s ory o re g on s no so e y a "French" rad on W am A Hammond documen s he deve opmen o hys er a rom he re g ous man es a on n he m dd e ages (sa n s as we as w ches) hrough he " as ng g r s" o he a e n ne een h cen ury and he r se o a med ca zed hys er a n h s Sp r ua sm and O her Causes and Cond ons o Nervous Derangemen (New York G P Pu nam s Sons 1876) here p 122 Th s s c ear y par o wha seems o be a "French" rad on—a eas as man es ed n Charco and h s n uence on he Sa pê r ère s nce Hammond s v sua sources are pr mar y rom he Sa pê r ère 62 Jean He z "Un possédée de Rubens " Nouve e conograph e de a Sa pê- r ère 14 (1901) 274-276 Henry Me ge "Documen s comp émén ares sur es possédés dans ar " Nouve e conograph e de a Sa pé r ére 16 (1903) 319-320 411412 63 Eugen Ho änder D e Med z n n der k ass schen Ma ere (S u gar Enke 1923) 64 Jean Rousse o ed Med c ne n Ar A Cu ura H s ory (New York McGraw-H
1967)
65 Andrew D ckson Wh e A H s ory o he War are o Sc ence w h Theo ogy n Chr s endom (New York D App e on 1896) 66 Regnard Ma ad es ép dém ques de espr 67 Bournev e and Regnard conograph e pho ograph que de a Sa pê r ère 68 Pau Regnard and M H Johnson P anches mura es d ana om e e de phys o og e (Par s De agrave 1885) 69 Abraham Pa ngh A geruck Mom-Aans gh der Tooverye Daar n he bedrogh der gewaande Toverye naak on deck en em gezone Redenen en exemp en dezer Eeuwe aangewezen wor (Ams erdam Andr es van Damme 1725) The p a es rom Regnard are o be ound n he or g na as o ows Regnard p 19 = Pa ngh p 50 16 = 250 17 = 268 21 = 270 18 (bo h) = 284 (bo h) 20 = 298 (Or g na n he Corne Un vers y W chcra co ec on BF 1565 P16 1725 ) 70 On he genera h s ory o ep epsy see Temk n Fa ng S ckness 71 On he h s ory o "hys ero-ep epsy" see Thorn on Hypno sm Hys er a and Ep epsy and U H Pe ers "Hys eroep eps e D e Komb na on von ep ep schen und hys er schen An ä en " For schr e der Neuro og e Psych a r e und hrer Grenzgeb e e 46 (1978) 430-439 72 Cesare Lombroso Cr m na Man (New York G P Pu nam s Sons 1911) 62 See he p a e accompany ng summary o Lombroso s v ews on p 62 73 As n M Gonza ez Echeverr a On Ep epsy Ana omo-Pa ho og ca and C n ca No es (New York W am Wood 1870) n wh ch a o he mages are cys o og ca 74 Char es Féré "No e sur un cas de mé anoderm e récurren e chez un ép ep que apa h que " Nouve e conograph e de a Sa pê r ère 10 N F (1897) 332-339 75
Va obra "Con r bu on a é ude des gangrènes cu anées spon anées chez es su e s hys ér ques " Nouve e conograph e de a Sa pê r ère 21 (1908) 481-505 (p a e oppos e p 484)
76 L P erce C ark "Te ano d Se zures n Ep epsy " Amer can Journa o nsan y 55 (1898-99) 583-593 (p a e oppos e 589) 77 See he mage o he bra n n a case o "Jackson an" ep epsy n Byrom Bramwe S ud es n C n ca Med c ne A Record o Some o he More n eres ng Cases Observed and o Some o he Remarks Made a he Au hor s Ou -pa en C n c n he Ed nburgh Roya n rmary (Ed nburgh London Young J Pen and 1880) p a e oppos e p 322 Such mages even appear n he work genera ed a he Sa pê- r ère as S -F Dan o "Encépha e parenchyma euse m ée de a subs ance gr se avec ép eps e par e e (Jackson enne) comme syndrome c n que " Arch ves de neuro og e 6 (1883) 217-236 w h cy o og ca mages 78 On he m sshapen hands (as a s gn o nher ed capac y or ep epsy) see F Raymond and P erre Jane "Ma orma ons des ma ns en p nces de humard " Nouve e conograph e de a Sa pê r ère 10 (1897) 369-373 (an ex rac rom he r book Nécroses e dées xes Par s F A can 1898 ) and n he same essay (p a e 41) he p a e "Asyme r e du corps chez une ep ep que " 79 W am A exander The Trea men o Ep epsy (Ed nburgh and London Young J Pen and 1889) 107 80 On ba dness see Char es Féré "La pe ade pos -ép ep que " Nouve e conograph e de a Sa pê r ère 8 (1895) 214-217 (p a e oppos e p 216) 81 Dr Rä uber "E n Fa von per od sch w ederkehrender Haarveränderung be e nem Ep ep ker " V rchows Arch v ür pa ho og sche Ana om e und Phys o og e 97 (1884) 50-83 (p a e no 2) 82 See or examp e A Maber y "Ep epsy A Br e H s or ca Overv ew " A ber a Med ca Bu e n 29 (1964) 65-72 he "An r svor esung" o he pro essor or ped a r cs a he Un vers y o K e H Doose "Aus der Gesch ch e der Ep eps e " Münchener med z n sche Wochenschr 107 (1965) 189-196 anon Anc en A men " MD 19 (1975) 151-160 F L G ö zner "D e Behand ung der Ep eps en n Vergangenhe und Gegenwar " Med z n sche Wochenschr 30 (1976) 123-128 83 J -M Charco and P R cher "No e on Cer a n Fac s o Cerebra Au oma sm Observed n Hys er a dur ng he Ca a ep c Per od o Hypno sm " Journa o Nervous and Men a D sease 10 (1883) 1-13 here p 9 (p a es oppos e p 10) um na onen (Frank ur am Ma n Suhrkamp 1961) 148-184
84 Wa er Ben am n
85 H V Egge ng "D e Le s ungs äh gke phys ognom scher Rekons ruk onsversuche au Grund age des Schäde s " Arch v ür An hropo og e 12 (1913) 44-46 (w h ex ens ve p a es) and Franz S ad mü er "Zur Beur e und der p as schen Rekons ruk onsme hode der Phys ognom e au dem Schäde " Ze schr ür Morpho og e und An hropo og e 22 (1921-22) 227-272 86 Franc s Warner "The S udy o he Face as an ndex o he Bra n " The Br sh Med ca Journa 2 (1882) 314-315 87 James Shaw The Phys ognomy o Men a D sease and Degeneracy (Br s o John Wr gh 1903) p 40 88 G man See ng he nsane 204 89 Hermann He nr ch P oss Das We b n der Na ur- und Vö kerkunde An hropo og sche S ud en 2 vo s (Le pz g T Gr eben 1885) 90 Ar hur F Hurs "Hys er ca Le Fac a Para ys s R gh Fac a Spasm Le P os s S rab smus Aphon a Dysar hr a Para ys s o he Tongue Para ys s o R gh Arm and Bo h Legs and Amb yop a o ow ng Gass ng Rap d y Cured by Persuas on and Re-educa on " Sea e-Hayne Neuro og ca S ud es 1 (1918) 78-80 91 Wa er Baer We d er "Some Ocu ar Man es a ons o Hys er a " n erna ona C n cs 22d ser 2 (1912) 249-261 (p a e
g 5 oppos e p 252)
92 L La es and A Sacerdo e "Un caso d s ndrome s er ca ocu are con s mu az one d emorrag a " Arch vo d An ropo og a Cr m na e Ps ch a ra Med c na ega e e Sc enze A n 47 (1927) 21-47 93 Ju es Luys "Recherches nouve es sur es hém p ég es émo ves " L En-cepha e Journa des Ma ad es Men a es e Nerveuses 1 (1881) 378-398 (p a e 7) 94 E S emer ng "Ueber e nen m Ge s ess örung comp c r en Fa von schwerer Hys er e we cher durch congen a e Anoma ern des Cen ra nervensys em ausgeze chne war " Char é-Anna en 15 (1890) 325-348 (p a e p 349) and Grasse "Des assoc a ons hys éro-organ ques Un cas de sc érose en p aques e hys ér e assoc ées avec au ops e " Nouveau mon pe er méd ca n s Supp 1 (1892) 227-252 (p a e 7) 95 Pau S e ens "Obduc onsbe und be e nem Fa von Hys ero-Ep eps e " Arch v ür Psych a r e und Nervenkrankhe en 35 (1902) 542-546 (p a e 12) 96 C yon Höß n and A A zhe mer "E n Be rag zur K n k und pa ho og schen Ana om e der Wes pha -S rümpe schen Pseudosk erose " Ze schr 97 See Sander L G man Sexua y An
ür d e gesam e Neuro og e und Psych a r e 8 (1911) 183-209 (p a e p 203)
us ra ed H s ory (New York John W ey & Sons 1989) 205-210
98 Dr Mesne "Au ograph sme e S gma es " Revue de hypno sme e de a psycho og e phys o og que 4 (1889-90) 321-335 (p a e 2) 99 Jeanno Hacke "Über e nen schweren Fa von Hys er e " S Pe ersberger Med z n sche Wochenschr
11 (1894) 163-165
100 S We r M che "Hys er ca Rap d Resp ra on W h Cases Pecu ar Form o Rup a Sk n D sease n an Hys er ca Woman " Transac ons o he Co ege o Phys c ans o Ph ade ph a 14 (1892) 228-237 (p a e p 233) See a so Kenne h Lev n "S We r M che nves ga on and ns gh s n o Neuras hen a and Hys er a " Transac ons and S ud es o he Co ege o Phys c ans Ph ade ph a 38 (1971) 168-173 101 S Róna "Über Herpes zos er gangrænosus hys er cus—Kapos " Fes -schr
gew dme Mor z Kapos zum ün undzwanz g ähr ngen Pro essoren Jub äum (V enna and Le pz g W Braumü er 1900) 209-221 (p a e 12)
"A C n ca Lec ure on Hys er ca Sk n Symp oms and Erup ons " The Lance (January 30 1904) 273-278
102 Thomas D Sav
103 Dr Be mann "Über d e Hau a ec onen der Hys er schen und den a yp schen Zos er " Deu sche Ze schr ür Nervenhe kunde 18 (1900) 345-388 Grover W am Wende "Derma s Ves co-Bu osa e Gangrenosa Mu ans " Transac ons o he Amer can Derma o og ca Assoc a on 15 (1901) 29-50 G useppe Ber o n Due cas d gangrena cu anea n soge o s er co " G orna e a ano de e ma a e veneree e de a pe e 60 (1919) 311-322 Rober o Casazza "Su mpor anza d a or ps ch c n derma o og a " Bo en no de a soc e a med co-ch rurg a Pav a 44 (1930) 115-162 104 Dr De S né y "Examen des organes gén aux d une hys ér que " Arch ves de phys o og e norma e e pa ho og que 2d ser 3 (1876) 803-807 dem "Examen des organes gén aux d un hys ér que " Bu e ns de a soc é é ana om que de Par s 4 h ser 1 (1876) 679-684 dem "Examen ana om que des organes gén aux d une hys ér que " Le progrès néd ca 5 (1877) 113-114 105 Jose M Jorge "Coxa g a h s ér ca " Rev s a de a Asoc ac on Med ca Argen na 32 (1920) 18-29 (p a e oppos e p 80) 106 Pau Bercher e "Le concep de o e hys ér que avan Charco " Revue n erna ona d h s o re de a psych a r e 1 (1983) 47-58 107 E ogoro Gu
"Osservaz on C n che " G orna e per Serv re a Progress de a Pa o og a e de a Terapeu ca 2d ser 22 (1847) 229-258 (p a e o ow ng p 258)
108 Pau So er "Con rac ure vo on a re chez un hys ér que " Nouve e conograph e de a Sa pê r ère 4 (1891) 100-106 (p a e oppos e p 106) 109 Georges G es de a Toure e and A Du
"Con r bu on a é ude des roub es roph ques dans hys ér e " Nouve e conograph e de a Sa pê r ère 2 (1889) 251-282
110 Ar hur F Hurs and S H W k nson "Hys er ca Anæs hes a W h Spec a Re erence o he Hys er ca E emen n he Symp oms Ar s ng rom n ur es o he Per phera Nerves " Sea e-Hayne Neuro og ca S ud es 1 (1918-19) 171-184 (p a e 38) Wa er R ese "Zwe Fä e yon hys er schcn Oedem " Arch v ür Psych a r e und Nervenkrankhe en 56 (1916) 228-234 (p a es 3-4) 111 S ewar "Two Lec ures on he D agnos s o Hys er a " 457-471 657-665 (p a e 17) 112 V or o Code upp "Sopra un caso d grande s er smo masch e a ach d s ero ep essa cessa per sugges one " R v s a sper men a e d ren a r a e med c na ega e de e a enaz on men a 13 (1887-88) 414-424 See a so M Carr eu "Syndrome Vaso-Mo eur dans Hys ér e " Mon pe er méd ca e ser 2A 1 (1892) 544-553 566-572 583-589 Lu g Abbamond "Su d un caso d s er smo mash e " Anna d med c na nava e 1 (1895) 185-204 D Ferr er "Hém p- ég e e mu sme hys ér ques " Congres rança s de méd c ne 3 (1896-97) 370-375 Mo a Rezende Re exes na h s er a " Arqu vas bras eros de med c na 16 (1926) 53-74 113 Henr Lamarque and Ém e B o "Sur un cas d hys éro rauma sme chez homme " Bu e ns de a soc é é d ana om e e de phys o og e norma es e pa ho og ques de bordeaux 9 (1888) 242-257 (p a e w h gs 6 and 8) 114 Georges G es de a Toure e "L A 115 Byrom Bramwe
ude e a marche dans hem p ég e hys ér que " Nouve e conograph e de a Sa pêr ère 1 (1888) 1-12 (p a es oppos e p 8 and p 11)
"C n ca Lec ure on a Case o Hys er ca Con rac ure " Ed nburgh Med ca Journa
n s 1 (1897) 128-138 (p a e v)
116 A S e nd er "On Hys er ca Con rac ures " n erna ona C n cs 4 h ser 45 (1935) 221-229 ( g 2 oppos e p 222) 117 Pe er Dav dson "Unusua Cases a he n rmary or Ch dren " L verpoo Med co-Ch rurg ca Journa 35 (1915) 297-308 (p a e 4) 118 Pr nce P Barker "The D agnos s and Trea men o Hys er ca Para ys s " Un ed S a es Ve eran s Bureau Med ca Bu e n 6 (1930) 663-670 ( hree p a es o ow ng p 670) 119 See or examp e he v sua represen a on o he unconsc ous n he essay by L Lauren "De é a men a des hys ér ques " Arch ves c n que de Bordeaux 1 (1892) 416-433 (p a e oppos e p 430) 120 As n he mage o psych c orces n H N sh "Ma e Hys er a Cured by Sugges on" ( n Japanese) Chuga
Sh npo 405 (1897) 5-9 406 (1897) 11-16 ( mage on p 9)
121 See he eva ua on o opera ons on he hear ng o he hys er c n K Rudo phy "Ohropera onen be Hys er schen " Ze schr
ür Ohrenhe kunde und ür d e Krankhe en der Lu wege 44 (1903) 209-221 (p a e 17 oppos e p 220)
122 Th s s he "my h" ha Frank Su oway ( Freud B o og s o he M nd New York Bas c 1979 P 592) w shes o den y as "My h One " he pr ma my h n Freud s a s ca on o h s own h s ory asc na ng ns gh s n o Freud s unders and ng o h s own career and prov de he ma er a or n erpre a on no censure
s c ear ha h s (and he o her my hs") are
123 Freud SE 20 15 124 n h s con ex see John Marsha Townsend "S ereo ypes o Men a ness A Compar son w h E hn c S ereo ypes " Cu ure Med c ne and Psych a ry 3 (1979) 205-229 See M J Gu mann Über den heu gen S and der Rasse- und Krankhe s rage der Juden (München Rudo ph Mü er & S e n cke 1920) and He nr ch S nger A geme ne und spez e e Krankhe s ehre der Juden (Le pz g Benno Konegen 1904) For a more modern ana ys s o he "my hs" and "rea es" o he d seases a r bu ed o he Jews see R chard M Goodman Gene c D sorders among he Jew sh Peop e (Ba more Johns Hopk ns Un vers y Press 1979) 125 Maur ce F shberg The Jews A S udy o Race and Env ronmen (New York Wa er Sco 1911) 6 Compare h s s a emen n The Jew sh Encyc oped a 12 vo s (New York Funk & Wagna s 1904) s v "Nervous D seases " 9 225-227 here p 225 "Some phys c ans o arge exper ence among Jews have even gone so ar as o s a e ha mos o hem are neuras hen c and hys er ca " 126 F shberg "Nervous D seases " 9 225 127 b d 128 b d 126 F shberg "Nervous D seases " 9 225 127 b d 128 b d 126 F shberg "Nervous D seases " 9 225 127 b d 128 b d 129 F shberg The Jews 324-325 130 "La popu a on sraé e ourn à e e seu e presque ou e con ngen des hys ér ques mâdes " Fu gence Raymond L É ude des Ma ad es du Sys ème Nerveux en Russ e (Par s O Do n 1889) 71 131 As quo ed or examp e n Hugo Hoppe Krankhe en und S erb chke be Juden und N ch uden (Ber n S Ca vary & Co 1903) 26 132 Pro oko e der W ener Psychoana y schen Vere n gung ed Herman Nunberg and Erns Federn 4 vo s (Frank ur am Ma n F scher 1976-81) 2 40 rans a on rom M nu es o he V enna Psychoana y c Soc e y (New York n erna ona Un vers es Press 1962-75) 2 44 133 J -M Charco Leçons du mard a a Sa pê r ère 2 vo s (Par s Progrès méd ca 1889) 2 347-353 See he rans a on o he Po k n sche Vor räge von Pro J M Charco Deu cke 1892-95) 2 299-304 134 H S rauss "Erkrankungen durch A koho und Syph s be den Juden " Ze schr
rans M Nunberg 4 vo s
rans S gmund Freud vo 1 and Max Kahane vo 2 (Le pz g
ür Demograph e und S a s k der Juden 4 N F (1927) 33-39 char on P 35
135 Mor z Bened k D e See enkunde des Menschen a s re ne Er ahrungsw ssenscha (Le pz g O R Re s and 1895) 186-187 223-226 136 Cec F Bead es "The nsane Jew " Journa o Men a Sc ence 46 (1900) 736 137 Frank G Hyde "No es on he Hebrew nsane " Amer can Journa o nsan y 58 (1901-1902) 470 138 W am Thackeray Works 10 vo s (New York n erna ona Book Co n d ) 10 16-28 here p 17 139 C ed (w h pho ograph) n Joseph Jacobs S ud es n Jew sh S a s cs (London D Nu
1891) x
140 Rober Bur on The Ana omy o Me ancho y ed Ho brook Jackson (New York V n age 1977) 211-212 e N Sa aman M D "Hered y and he Jew " Eugen cs Rev ew 3 (1912) 190
141 Redc
142 Gu mann Über den heu gen S and 17 143 Freud SE 5 649 4 293 4 139 5 494 144 Henry Me ge E ude sur cer a ns néuropa hes voyageurs Le u -erran a a Sa pê r ère (Par s L Ba a e 1893) On Me ge and h s ex see Jan Go ds e n "The Wander ng Jew and he Prob em o Psych a r c An -Sem sm n F n-de-S èc e France " Journa o Con emporary H s ory 20 (1985) 521-552 145 R chard Andree Zur Vo kskunde der Juden (Le pz g Ve hagen & K as ng 1881) 24-25 c ed by Maur ce F shberg "Ma er a s or he Phys ca An hropo ogy o he Eas ern European Jew " Memo res o he Amer can An hropo og ca Assoc a on 1 (1905-1907) 6-7 146 Bead es " nsane Jew " 732 147 F shberg The Jews 349 148 See L Cher ok "On Ob ec v y n he H s ory o Psycho herapy The Dawn o Dynam c Psycho ogy (S gmund Freud J M Charco ) " Journa o Nervous and Men a D seases 153 (1971) 71-80 as we as Char es Cou s on G sp e The Edge o Ob ec v y An Essay n he H s ory o Sc en c deas (Pr nce on N J Pr nce on Un vers y Press 1960) 149 George Herber Mead Movemen s o Though n he N ne een h Cen ury (Ch cago Un vers y o Ch cago Press 1936) 176 150 Freud SE 1 17 151 Toby Ge and " Mon Cher Doc eur Freud Charco s Unpub shed Correspondence o Freud 1888-1893 " Bu e n o he H s ory o Med c ne 62 (1988) 563-588 here p 571 152 Freud SE 26 29-43 Wh e h s paper was pub shed on y n 1893
was concep ua zed
no wr en be ore Freud e Par s n 1886
153 Toby Ge and "Charco s Response o Freud s Rebe on " Journa o he H s ory o deas 50 (1989) 293-307 154 See he d scuss on n my D erence and Pa ho ogy S ereo ypes o Sexua y Race and Madness ( haca N Y Corne Un vers y Press 1985) 15o-162 See a so Yves Cheva er "Freud e de France 37 (1985) 45-50
an sem sme— a ous e " Am é udéo-chre enne
155 Wes ey G Morgan "Freud s L hograph o Charco A H s or ca No e " Bu e n o he H s ory o Med c ne 63 (1989) 268-272 156 Freud SE 1 98 157 See or examp e George Freder ck Dr nka The B r h o Neuros s My h Ma ady and he V c or ans (New York S mon & Schus er 1984) 108-122 See a so Es her F scher-Homburger D e rauma sche Neurose Vom soma schen zum soz a en Le den (Bern Hans Huber 1975) 158 S r C ord A bu
"Nervous D sease and Modern L e " Con emporary Rev ew 67 (1895) 214-215
159 C E Brown-Séquard "On he Hered ary Transm ss on o E ec s o Cer a n n ur es o he Nervous Sys em " The Lance (January 2 1875) 7-8 160 As n John Er c Er chsen On Concuss on o he Sp ne Nervous Shock and O her Obscure n ur es o he Nervous Sys em n he r C n ca and Med co-Lega Aspec s (New York W am Wood 1886) 2 or n Hans Schmaus "Zur Casu s k und pa ho og schen Ana om e der Rückenmarkserschü erung " Arch v ür k n sche Ch rurg e 42 (1891) 112-122 w h p a es 161 Compare O o B nswanger Hys er e (V enna Deu cke 1904) 82 162 R chard von Kra -Eb ng Psychopa h a Sexua s A Med co-Forens c S udy red ed 163 Augus Fore The Sexua Ques on A Sc en
rans Harry E Wedeck (New York Pu nam 1965) 24
c Psycho og ca Hyg en c and Soc o og ca S udy
164 R chard von Kra -Eb ng Tex -Book o nsan y
rans D F Marsha (New York Phys c ans & Surgeons Book Co 1925) 331-332
rans Char es G ber Chaddock (Ph ade ph a F A Dav s 1904) 143
165 Mar n Eng änder D e au a end häu gen Krankhe sersche nungen der ü-d schen Rasse (V enna J L Po ak 1902) 12 166 G man D erence and Pa ho ogy 182-184 167 The d scuss on o h s case s documen ed n Char es Bernhe mer and C a re Kahane eds n Dora s Case Freud—Hys er a—Fem n sm (New York Co umb a Un vers y Press 1985) See a so D anne Hun er "Hys er a Psychoana ys s and Fem n sm The Case o Anna O " Fem n s S ud es 9 (1983) 465-488 Mar a Ramas "Freud s Dora Dora s Hys er a The Nega on o a Woman s Rebe on " Fem n s S ud es 6 (1980) 472-510 Arno d A Rogow "A Fur her Foo no e o Freud s Fragmen o an Ana ys s o a Case o Hys er a " Journa o he Amer can Psychoana y ca Assoc a on 26 (1978) 330-356 Hannah S Decker Freud Dora and V enna 1900 (New York Free Press 1990) 168 Ca her ne C émen and Hé ène C xous La eune née (Par s 10 18 1975) 283 169 Freud SE 2 134 n 2 (added n 1924) 170 See he d scuss on n Rober S W s r ch The Jews o V enna n he Age o Franz Joseph (Ox ord Ox ord Un vers y Press 1989) 483-485 171 Ber ha Pappenhe m (wr ng as P Ber o d) Zur Juden rage n Ga z en (Frank ur am Ma n Knauer 1900) 23 172 Jacques Lacan " n erven on on Trans erence " repr n ed n Bernhe mer and Kahane n Dora s Case 92-105 On he work ng ou o he mp ca ons o h s heme see he essays by Ne Her z "Dora s Secre s Freud s Techn ques" (pp 221242) and Tor Mo "Represen a on o Pa r archy" (pp 181-199) repr n ed n Bernhe mer and Kahane n Dora s Case 173 Freud SE 7 84 174 b d 7 19 175 b d 176 b d 7 21 173 Freud SE 7 84 174 b d 7 19 175 b d 176 b d 7 21 173 Freud SE 7 84 174 b d 7 19 175 b d 176 b d 7 21 173 Freud SE 7 84 174 b d 7 19 175 b d 176 b d 7 21 177 See he d scuss on o he nher ance o d sease n he seven een h chap er o Pao o Man egazza s s udy o he hyg ene o ove n he German rans a on D e Hyg ene der L ebe
rans R Teu scher (Jena Hermann Cos enob e 1877 ) 366
178 Freud SE 7 78 era y s a ng ha d seases such as syph s cancer and madness can merge one n o he o her hrough he power o he nher ed charac er s cs see h s D e Hyg ene der L ebe
179 Man egazza no es h s qu e
rans Teu scher 369
180 Freud SE 7 16-17 181 b d n 2 180 Freud SE 7 16-17 181 b d n 2 182 Joseph Bab nsk "Sur e ré exe cu ané p an a re dans cer a ns a ec ons organ ques du sys ème nerveux cen ra " Comp es rendus hebdomada res des séances de a Soc e é de b o og e (Par s) 48 (1896) 207-208 183 On he h s ory o h s concep see W Erb "Über das n erm rende H nken und andere nervöse S örungen n Fo ge von Ge ässerkrankungen " Deu sche Ze schr
ür Nervenhe kunde 13 (1898) 1-77
184 P O v er and A Ha pré "C aud ca on n erm en e chez un homme hys ér que a e n de pou s en permanen " La Normand e Méd ca e 11 (1896) 21-28 (p a e on p 23) 185 Freud SE 7 101-102 186 b d 7 102 185 Freud SE 7 101-102 186 b d 7 102 187 Fe x Deu sch "A Foo no e o Freud s Fragmen o an Ana ys s o a Case o Hys er a " repr n ed n Bernhe mer and Kahane n Dora s Case 41 188 Joseph Rohrer Versuch über d e üd schen Bewohnener der ös erre ch schen Monarch e (V enna n p 1804) 26 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 189 Freud SE 7 84 190 b d 191 b d 192 b d 193 b d 7 64 194 b d 7 90 195 b d 7 91 196 S gmund Freud "Some Ear y Unpub shed Le ers " rans
se Sche er n erna ona Journa o Psychoana ys s 50 (1969) 420
197 See my Jew sh Se -Ha red An -Sem sm and he H dden Language o he Jews (Ba more Johns Hopk ns Un vers y Press 1986) 198 C ed by Sau Fr ed änder Kur Gers e n The Amb gu y o Good
rans Char es Fu man (New York A red A Knop 1969) 148-149
199 Mar n Freud "Who Was Freud?" n Jose Fraenke ed The Jews o Aus r a Essays on The r L e H s ory and Des ruc on (London Va en ne M che ns u s 19 (1962) 149-170
1967) 202 See a so Franz Kob er "D e Mu er S gmund Freuds " Bu e n des Leo Baeck
200 Freud SE 7 51 201 b d 7 36 n 1 202 b d 7 62 200 Freud SE 7 51 201 b d 7 36 n 1 202 b d 7 62 200 Freud SE 7 51 201 b d 7 36 n 1 202 b d 7 62 203 On Man egazza see G ovann Landucc Darw n smo a F renze Tra sc enza e deo og a (1860-1900 ) (F orence Leo S O schk 1977) 107-128 204 The au hor zed German ed ons o Man egazza ha Freud and da Bauer cou d have read are D e Phys o og e der L ebe rans Eduard Enge (Jena Hermann Cos enob e 1877) D e Hyg ene der L ebe Cos enob e 1877) An hropo og sch-ku urh s or sche S ud en über d e Gesch ech sverhä n sse des Menschen (Jena Hermann Cos enob e 1891)
rans R Teu scher (Jena Hermann
205 Repr n ed n Bernhe mer and Kahane n Dora s Case 273 206 The re evan passages n he German ed on An hropo og sch-ku urh s- or sche S ud en are on pp 132-137 A Samue Pu nam (New York Eugen cs Pub sh ng Co 1938)
he quo a ons rom Man egazza are rom he Eng sh rans a on Pao o Man egazza The Sexua Re a ons o Mank nd
rans
207 Armand-Lou s-Joseph Béraud É ude de Pa ho og e Comparée Essa sur a pa ho og e des sém es (Bordeaux Pau Cass gno 1897) 55 208 There s no comprehens ve s udy o he German deba es on c rcumc s on See J A kv s "Gesch ch e der C rcumc s on " Janus 30 (1926) 86-104 152-171 209 See he d scuss on by Dr Bamberger "D e Hyg ene der Beschne dung " n D e Hyg ene der Juden m Ansch u b an d e n erna ona e Hyg ene-Auss e ung ed Max Grunwa d (Dresden Ver ag der h s or schen Ab e ung der n erna ona e Hyg ene-Auss e ung 1911) 103-112 (on he Jew sh s de) and W Hammer "Zur Beschne dungs rage " Ze schr ür Bahnärz e 1 (1926) 254 (on he non-Jew sh s de) 210 See or examp e he d scuss on by Em Kohn n he M he ung des Är z- chen Vere nes n W en 3 (1874) 169-172 (on he Jew sh s de) and Dr K e n "D e r ue e C rcumc s on e ne san ä spo ze che Frage " A geme ne Med z n sche Cen ra Ze ung 22 (1853) 368-369 (on he non-Jew sh s de) 211 Max Grunwa d V enna Jew sh Commun es Ser es (Ph ade ph a Jew sh Pub ca on Soc e y o Amer ca 1936) 376 212 See he e er o Sándor Ferencz o 6 Oc ober 1910 n wh ch Freud wro e "S nce F ess s case w h he overcom ng o wh ch you recen y saw me occup ed ha need has been ex ngu shed A par o my homosexua ca hex s has been w hdrawn and made use o o en arge my own ego have succeeded where he parano ac a s " C ed n Erns Jones The L e and Work o S gmund Freud 3 vo s (New York Bas c Books 1955) 2 83 213 See he d scuss on n G man Jew sh Se -Ha red 293-294 214 Ludw k F eck En s ehung und En w ck ung e ner w ssenscha
chen Ta sache (1935 Frank ur am Ma n Suhrkamp 1980)
am ndeb ed o F eck s work or he bas c concep ua s ruc ure presen ed n h s essay
215 Theodor Fr sch Handbuch der Juden rage (Le pz g Hammer 1935) 408 216 Ber ha Pappenhe m w h Sara Rab now sch Zur Lage der üd schen Be-vö kerung n Ga z en Re se-E ndrücke und Vorsch äge zur Besserung der Verhä n sse (Frank ur am Ma n Neuer Frank ur er Ver ag 1904) 46-51 217 Ado ph H er Me n Kamp
rans Ra ph Manhe m (Bos on Hough on M
n Co 1943) 247
218 Compare Edward J Br s ow Pros u on and Pre ud ce The Jew sh F gh aga ns Wh e S avery 1870-1939 (Ox ord C arendon 1982) 219 N Ba aban and A Mo o schek "Progress ve Para yse be den Bevö1-kerungen der Kr m " A geme ne Ze schr 220 H Budu "Be rag zur verg e chenden Rassenpsych a r e " Mona sschr
ür Psych a r e und Neuro og e 37 (1915) 199-204
221 Max S che "D e Para yse der Juden n sexuo og scher Be euch ung " Ze schr
ür Sexua w ssenscha 7 (1919-20) 98-114
222 H S rauss "Erkrankungen durch A koho und Syph s be den Juden " Ze schr 223 Hous on S ewar Chamber a n Founda ons o he N ne een h Cen ury
ür Psych a r e 94 (1931) 373-383
ür Demograph e und S a s k der Juden 4 (1927) 33-39
rans John Lees 2 vo s (London John Lane 1910) 1 388-389
224 Na han B rnbaum "Über Hous on S ewar Chamber a n " n h s Aus-gewäh e Schr en zur üd schen Frage vo 2 (Czernow z Ver ag der Buchhand ung Dr B rnbaum & Dr Kohu 1910) 201 225 Adam G de Gurowsk Amer ca and Europe (New York D App e on 1857) 177 226 Sau K Padover ed and rans The Le ers o Kar Marx (Eng ewood C s N J Pren ce-Ha
1979) 459
227 W W Kopp "Beobach ung an Ha b uden n Ber ner Schu en " Vo k und Rasse 10 (1935) 392 228 M Lerche "Beobach ung deu sch- üd scher Rassenkreuzung an Ber ner Schu en " D e med z n sche We (17 Sep ember 1927) 1222 229 Wer ph osoph e und E h k D e Frage nach den S nn des Lebens a s Grund age e ner Wer ordnung (V enna W Braumü er 1939) 29
CONTRIBUTORS Sander L. Gilman s the Go dw n Sm th Professor of Humane Stud es at Corne Un vers ty and professor of the h story of psych atry at the Corne Med ca Co ege. He s the author or ed tor of over th rty books, the most recent be ng The Jew s Body (1991) and Inscr b ng the Other (1991). He s the author of the bas c study of the v sua stereotyp ng of the menta y , See ng the Insane (1982), as we as the standard study Jew sh Se f-Hatred (1986). Dur ng 1990-1991 he served as the V s t ng H stor ca Scho ar at the Nat ona L brary of Med c ne, Bethesda, Mary and. Helen King s sen or ecturer at St. Kathar ne s Co ege, L verpoo Inst tute of H gher Educat on, and s nterested n the trad t ons of H ppocrat c med c ne n the anc ent wor d. She has wr tten severa art c es about the h story of gyneco ogy and obstetr cs, H ppocrates, and Greek med c ne. Roy Porter s reader n the soc a h story of med c ne at the We come Inst tute for the H story of Med c ne n London and the author of var ous art c es and books dea ng w th the soc a h story of med c ne. H s most recent books nc ude In S ckness and n Hea th and Pat ent s Progress (both w th Dorothy Porter), and M nd Forg d Manac es: Madness n Eng and from the Restorat on to the Regency (1987), wh ch won the Leo Gershoy Pr ze for 1988. G. S. Rousseau s professor of Eng sh and e ghteenth-century stud es at UCLA. He has wr tten or ed ted books about the terature and med c ne, and the terature and sc ence, of ear y Modern Europe, espec a y dur ng the En ghtenment. H s co ected essays were pub shed n
454 three vo umes n 1991 as En ghtenment Borders, En ghtenment Cross ngs , and Per ous En ghtenment . Elaine Showalter , professor of Eng sh at Pr nceton Un vers ty, s a so the current cha r of the Eng sh department and the author of works dea ng w th fem n st thought, V ctor an med ca h story, and terary theory. Most recent y, she has pub shed The New Fem n st Cr t c sm: Essays on Women, L terature, and Theory (1983), The Fema e Ma ady: Women, Madness, and Eng sh Cu ture, 1830-1980 (1985), and Sexua Anarchy: Gender and Cu ture at the F n de S èc e (1991).
455
INDEX A Abraham, Kar , 324 Abraham, N co as, 95 Abr cosoff, G af ra, L hystér e aux XVIIe et XVIIIe S èc es (1897), 313 Abse, D. W., 8 ACT-UP, AIDS act v st group, 334 Ada r, Dr. James Mak ttr ck, 124 , 166 -167 Adams, Franc s, 7 -8 Addams, Jane (1860-1935), Amer can soc a worker and author, 299 Add son, Joseph, 160 Addyman, M. E., 127 , 129 Adorno, Theodor, 237 Adu tery, 317 , 319 Aesthet cs of the face of the hyster c, concept of asymmetry n, 384 Aet us of Am da, 37 -39, 44 , 46 -47 Affectat on (and hyster a), 163 Afr can-Amer cans, d strust of psychotherapy n the 1960s and 1970s, 334 "Ague," the, dur ng ear y modern Eng and, 225 AIDS, x , xv , 106 , 110 , 144 , 175 , 334 -335 A coho sm, 229 A exander, W am, mage of ep ept c faces from The Treatment of Ep epsy , 381 ; use of photography for the study of hyster a, 379 A exander of Tra es, h s twe ve-vo ume Therapeut ca , 46 A exandr a, med ca schoo at, 35 , 45 , 49 A bn a - Abbas a -Ma us , known n Europe as Ho y Abbas, 51 -53; Kam , 55 -56; L ber Pantegn , 55 ; L ber Reg us , 55 A bn Rabban at-Tabar (810-861), F rdaws a h kma (Parad se of W sdom), 50 A butt, S r C fford, Professor of Med c ne at Cambr dge Un vers ty, h s essay pub shed n the Contemporary Rev ew (1895), 417 A ps, the, 296 A zhe mer, A., paper on cerebra p agues, 386 Amer can Revo ut on, the, 92 Amnes a, 322 An ma magnet sm, 184 An ma sp r ts, the, 142 , 145 -148, 150 -151, 158 , 173 , 236 Andree, R chard, c tat on by F shberg about the Jews suscept b ty to hyster a, 412 -415 Anesthes a, 10 Anna O., German fem n st eader, 290 , 315 -316, 318 , 332 , 334 , 419 -420; In the Rummage Store (1890), 316 ; trans at on of Mary Wo stonecraft s V nd ca-
456 t on of the R ghts of Women nto German, 316 ; p ay Woman s R ghts , 316 Apno a, absence of breath, 58 Appet te, 10 , 19 , 52 Aragon, Lou s (1897-), French poet and nove st, v ew about August ne, 312 Aretaeus of Cappadoc a, 35 , 37 -39, 41 , 43 , 55 , 61 , 104 ; "On hyster ke pn x ," 15 ; "Of the Causes and Symptoms of Acute D seases," 38 Ar stophanes p ay Frogs , 32 Ar stot e, 17 , 27 , 30 -31, 33 , 50 Armstrong-Jones, Dr. Robert, 324 Art, ear y med eva re g ous, 367 Art Nouveau, 292 Artem dorus, theor st of dreams, Dream Book , 31 Art ce a , med ca textbook used at Sa erno, 57 -58; vers o ant gua , 58 ; traduct o nova , 58 Aryans, 435 Astronomy, Ga ean, 108 Astruc, Jean, 168 Asy um, the, 249 , 256 , 356 ; reforms of at the turn of the n neteenth century, 261 Athen an c ty states, the, 105 Augustan se f-fash on ng, 158 -165 August ne, pat ent at the Sa pêtr ère hosp ta for f ve years, 311 -313; August ne: B g Hyster a , p ay about August ne staged n 1991 n London, 313 August ne, Sa nt, B shop of H ppo, x Austen, Jane, 134 ; Sense and Sens b ty , 164 ; f ct ona character Mr. Wood-house, 294 ; Mar anne Dashwood, 164 Av cenna, 59
B Bab nsk , Josef, 230 , 265 , 360 -366, 423 Bacon, Roger (c. 1214-1294), 139 Bacter o ogy, 249 Bag v , Georg o, Ita an phys c an, 146 , 151 , 156 , 175 , 245 ; d scuss on of The Pract ce of Phys ck, reduc d to the anc ent Way of Observat ons, conta n ng a ust Para e between the W sdom of the Anc ents and the Hypothes s s of Modern Phys c ans , 148 de Ba ou, Gu aume (1538-1616), 63 Bakht n, M kha , Rabe a s and H s Wor d , 123 Ba n the body, 13 , 22 Bankers, Boston, 294 Barker, Pr nce P., use of Charcot s noso og ca categor es, 393 , 397 ; mages show ng the us on of movement represent ng the hyster c from "The D agnos s and Treatment of Hyster ca Para ys s," 399 -401 Bart, P. B., 4 Bart ett, Ne , study of Oscar W de, 292 Batau t, Em e, 289 , 308 Bath, Eng and, 168 Batta e, Lou s, photograph "Deux Cas d Anorex e Hystér que," 350 Batt e, W am, 175 , 178 -179; Treat se on Madness , 179 Bauer, Ida, the pat ent Freud ca ed Dora, 316 , 332 , 419 -423, 425 -429, 431 -436; the g obus hyster cus she man fested, 420 -421 Bauer, Otto, brother of Ida Bauer, the pat ent Freud ca ed Dora, and one of the founders of the Austr an Soc a st Party, 419 -420 Bauer, Ph p, father of Ida Bauer, the pat ent Freud ca ed Dora, 419 Beard, George M., 245 -246, 295 -296, art c e n Amer can Nervousness , 294 Becker, Gustavus, 168 Bed am, o dest Eng sh nsane asy um, 176 ; Beth ehem, 178 Bed-wett ng, nterpreted by Freud as a sexua metaphor, 423 Beers, C fford, 246 Behav or sm, 234 Be , S r Char es, Essays on the Anatomy and Ph osophy of Express on (1824), 362 , 364 ; mage of op sthotonus, 368 D Benedetto, V., 16 Bened kt, Mor z, the bera -Jew sh neuro og st who was one of Freud s teachers, 406 Ben am n, Wa ter, 95 ; essay on the reproduc b ty of mages n the age of techno ogy, 383 Benz , Ugo (1376-1439), commentar es on the Canon of Av cenna, 59 ; com-
457 mentar es on the Teng of Ga en, 59 ; commentar es on the H ppocrat c Aphor sms , om tt ng books 3 and 7, 59 Béraud, Armand-Lou s-Joseph, d ssertat on dea ng w th c rcumc s on and the Jews, 428 Bergasse, N co as, 360 Berggasse 19, Freud s address, 228 Berke ey, B shop George, 240 Ber n, Germany, 314 Bernhe m, H ppo yte, 258 , 416 Bettmann, Dr., descr pt on of hyster ca gangrene, 389 Bewe , A an, 177 B env e, M. D. T., treat se on nymphoman a, 172 -173 B rnbaum, Nathan, or g nator of the word Z on st , rev ew of Houston Stewart Chamber a n s argument aga nst the pure nature of the Jew sh race, 434 B sexua ty, 288 B ack Death, the, 435 B ackmore, S r R chard, En ghtenment "nerve doctor," 155 , 168 , 244 B ake, W am, 98 , 177 , 185 B ndness, 322 ; and hyster a, 20 B och, Iwan, n neteenth-century sexo og st, 427 B ood, 13 , 18 -19, 24 , 27 , 30 -31, 33 , 53 B ush ng, 163 Boccacc o, G ovann (1313-1375), Ita an poet and nove st, 98 , 134 Bod n, Jean, ph osopher and econom c th nker attached to the court of Henry III, 115 Body, the (see a so Ind v dua parts: Foot, Hand, Sk n, etc.), 99 , 102 , 111 , 113 , 120 , 122 , 147 , 151 , 160 , 164 , 183 , 235 , 238 , 244 , 256 , 260 , 288 , 293 , 335 , 364 , 370 ; Hyster ca body, Ph osoph ca concept of, 95 ; as Metaphys ca category, 95 Body anguage, 161 Boerhaave, Hermann, Dutch phys c an and chem st, 151 , 163 , 168 , 262 Bohem a, hyster a n, 168 Boss, J. M. N., 11 Bournev e, D.-M., advocate of Jean Mart n Charcot s teach ngs, 231 Bovary, Emma, 134 Bradshaw, S r W am, soc ety phys c an n V rg n a Woo f s Mrs. Da oway , 247 Bra n, as the anatom c zone and source of hyster a, 140 , 145 , 151 , 155 , 158 , 252 , 254 -256, 298 , 383 , 385 , 402 ; bra n stem, 232 ; mytho ogy of, 385 Bramwe , Byrom, twent eth-century spec a st on nervous d seases, 392 ; "doctored" photograph of the hyster c from "C n ca Lecture on a Case of Hyster ca Contracture," 396 Brasavo a, Anton o (1500-1555), annotated ed t on of the Aphor sms and ts Ga en c commentary, 59 Breton, André, French poet, nove st, and cr t c, h s v ew about August ne, 312 Breuer, Josef (1842-1925), Austr an phys c an, 180 , 227 , 288 , 292 , 305 , 315 -318, 366 ; Stud es on Hyster a , 291 ; case study of Anna O., 419 Br efe D scourse , 121 Br ght, T mothy, Eng sh phys c an tra ned at Tr n ty Co ege, Cambr dge, 116 Br quet, P erre, 13 , 185 , 258 ; "Br quet s syndrome," 230 Br t sh, the, 161 Br t sh Is es, the, 149 Br t sh L brary, the, 60 Brothe s, managed by Jews, 432 Brou et, André, pa nt ng of Jean-Mart n Charcot at the Sa pêtr ére, 345 , 353 , 356 , 362 , 416 ; nf uence on the h story of hyster a, 346 Brown, Baker, n neteenth-century doctor known for perform ng the pract ce of hysterectomy, ovar ectomy, and c tor dectomy, 255 Brown, John (1735-1788), deve oped the concept of the rr tab ty of the musc es from the work of A brecht yon Ha er, 364 Brown-Séquard, C. E., n neteenth-century neuro og st, 417 , 419 Brown ng, E zabeth Barrett (1806-1861), 357 Brücke, W he m, 238
458 Buchan, W am, popu ar med ca wr ter on domest c med c ne, 241 Bude , H., e ghteen-year ong tud na study among Jews n Eston a dur ng the prewar per od, 433 Burg, V ctor Jean-Mar e, 258 -259 Burghart, C. G., 168 Burrows, George Man, 252 -253 Burton, Robert, 112 , 128 -129; The Anatomy of Me ancho y , 114 , 126 , 129 , 409 Bushmen, 294 Byzant ne Emp re, the, 44 -46, 64
C Cae us Aure anus, 39 , 48 Cambr dge, Eng and, 157 Cambr dge Un vers ty, 127 Cam zards, French prophets, 170 Cancer, 110 , 144 , 352 Cangu hem, Georges, v ew re at ng germ theory to hyster a, 353 Cap ta sm, Amer can, 295 Car y e, Thomas, 246 Carpenter, W. B., 262 Carter, Robert, m d-V ctor an phys c an, 232 -233, 242 , 262 -265, 289 , 301 -227, 302 , 329 ; On the Patho ogy and Treatment of Hyster a (1853), 262 , 300 Casanova de Se nga t, G ovann G acomo (1725-1798), Venet an adventurer and author, an nternat ona gamb er and spy, 163 , 243 Casazza, Roberto, h s survey of hyster ca sk n d seases, 389 Catarrh, n re at on to hyster a, 168 Categor ca mperat ves, and hyster a, 179 -180 Cather ne of S enna, Sa nt, 367 Catho c re g ous exper ence, 367 Catho cs, the, as a re g ous category, 374 Cause, sc ent f c, 99 Ce sus, Au us Corne us, 36 , 39 , 47 Centra Un on of the Decorat ve Arts, the, 310 Cerebra f bers, 254 Cerebra pa sy, 256 Cervantes, M gue de (1547-1616), Span sh nove st, 139 Chadw ck, J., 8 Chamber a n, Houston Stewart, argument aga nst the pure nature of the Jew sh race, 434 Champ er, C aude (f . 1556), 60 Charcot, Jean-Mart n, x , x , 8 , 10 , 93 , 102 , 104 , 176 , 185 , 227 , 235 -236, 238 , 256 -260, 264 , 289 , 295 , 304 -307, 309 -315, 320 , 322 -323, 351 -352, 359 , 362 , 364 -370, 372 , 374 , 377 , 379 , 383 -384, 388 -389, 391 , 402 , 404 , 406 , 411 , 416 -417, 419 , 423 , 427 , 436 ; c n c at the Sa pêtr ére, 307 ; "Dr. Charcot s Hyster a Shows," product on about Char-cot s pat ent August ne performed at Tr n ty Co ege, Connect cut, 313 ; mages of hyster cs, 368 -371; Les Demon ques dans art (1887), 231 , 370 , 372 ; etter to Freud on 23 November 1891, 415 ; noso og ca categor es, 415 ; paper w th Pau R cher pub shed n the Journa of Nervous and Menta D sease , 381 Charcot, Madame, 310 Char es II, 136 Chaucer, Geoffrey (1340-1400), 98 Cheyne, George, Scott sh atromechan st, 124 , 145 , 151 -152, 154 -156, 162 , 165 -167, 170 , 183 -184, 262 ; The Eng sh Ma ady , 148 , 151 -152, 157 -158, 166 ; nervous theory, 232 Ch db rth, 17 , 24 , 287 , 326 Ch na, under the eadersh p of Mao Tse-tung, 228 Ch oros s, 9 Chodoff, Pau , org nator of the term "the hyster ca persona ty d sorder" or DSM-111, 287 Chodorow, Nancy, 330 Cho era, 226 Chr st, Jesus of Nazareth, 35 , 361 , 429 ; st gmata of n Sa nt Petersburg, 388 Chr st an ty, 98 , 105 , 107 , 372 , 429 ; and Med eva Chr stendom, 232 Church, Arch ba d, Ch cago neuro og st, 299 C rcumc s on, 428 , 430 , 432 -436 C v War, the, 297 C v zat on, 102 , 158 ; Eng sh, 123 ; European, 123 ; Western, 94 , 335
459 C xous, Hé ène, v , 286 , 419 ; In Dora s Case , 332 ; "The Laugh of the Medusa," 332 ; The New y-Born Woman (1975), 332 ; Portra t de Dora (1976), 332 C ark, L. P erce, argument that there are tetano d se zures n ep epsy, 377 C ark, M chae , 240 C arke, Edward, 297 C as us, George, 168 C ass mob ty, 161 C ass ca Assoc at on Tr enn a Meet ng, the, 65 C eaves, Dr. Margaret, 300 C ement, Cather ne, debate w th Hé ène C xous n The New y-Born Woman , 332 C eopatra, 120 C n ca Cha r of the Nervous System, 257 C tor s, the, 251 C ouston, Thomas, n neteenth-century Br t sh phys c an, 247 Codes of nervousness, 161 Codes of po teness, 160 -162 Cod ngsby, Lord, character n W am Thackeray s Cod ngsby , conversat on w th Rafae Mendoza, 409 Cogn t on, 143 Co e, Dr. W am (see a so Dr. Thomas, Sydenham), 139 Co er dge, Samue Tay or (1722-1834), Eng sh poet, cr t c, and ph osopher, 239 -240 Co ège de France, 391 Co ns, W am, Eng sh yr c poet and ear y romant c, 170 , 171 Commentar es, Byzant ne, 48 Comte, Auguste, 236 -237 Concept on, 250 Congrès A emand de Méd c ne Internat ona e, 321 Congreve, W am (1670-1729), Eng sh Restorat on dramat st, 160 Consc ousness, 261 Constant ne the Afr can, 55 ; Expos t o Afor sm , 55 ; In H ppocrat s Aphor sm , 57 Constant ne Prophyrogen tus, Byzant ne emperor, 46 Constant nop e, 46 Convu s ons, 15 Coquetry, 157 -158 Cosmo ogy, 98 Cowper, W am ( 1731-1800), Eng sh poet, 170 , 171 , 177 Cra g, Maur ce, n neteenth-century London phys c an, 247 Cra g ockhart Hosp ta , 326 Cr chton-M er, Hugh, ear y twent eth-century m tary doctor, prescr pt on to cure she -shocked m tary off cers, 323 Cr me, 161 Cu en, W am, 166 , 177 , 183 -184, 262 ; F rst L nes of the Pract ce of Phys c , 181 ; theory of hyster a n re at on to neuros s, 181 -184 Cu ture, 169 ; Augustan, 162 ; e ghteenth century, 165 ; Georg an, 162 Cupp es, Thomas, famous En ghtenment doctor, 168 Czech anguage, the, 420
D Daguerre, Lou s Jacques Mandé (1789-1851), French scene pa nter and phys c st, use of photography n treatment of the menta y , 356 Da y Chron c e , 320 Da y M rror , 320 Dan sh, the, 430 Darne , Octap a, hyster ca character n Ro and B ake , 299 Darw n, Char es, Descent of Man , 427 ; reference to by Franc s Warner n The Express on of Emot ons n Men and An ma s , 383 ; study of the nature of express on, 382 Darw n, Erasmus, Eng sh poet and sc ent st, 172 Daudet, Leon, Les Mort co es (1894), 310 Daumer, Georg Fr edr ch, 429 Dav d-Ménard, Mon que, French twent eth-century psychoana yst, 265 , 326 , 328 ; Hyster a from Freud to Lacan (1983), 328 Dav dson, Peter, presentat on of a case of hystero-cata epsy from L verpoo , 392 -393 Deafness, 322 Death, hyster a m staken for, 33 -35, 46 , 51 , 56 , 63
460 Decorum, cu ts of, 155 -165; var egated, 162 Déga, Dr. Georgette, her stud es at the med ca facu ty of Bordeaux, 313 De ty, 119 De er um tremens, 229 Demono ogy, 98 ; ear y modern d agnoses of demon acs, 231 Denmark, hyster a n, 168 Depress on (see a so Sp een, Vapors), 141 Derangement, somat c, 99 Descartes, René, 108 , 117 , 143 ; Cartes an cog to , 237 , 243 ; Cartes an dua sm, 108 , 184 , 234 ; Cartes an onto ogy, 234 ; Cartes an sc ence, x , 95 Deutsch, Fe x, phys c an who treated Ida Bauer after she broke off her ana ys s w th Freud, 423 Dev , the, 117 , 121 , 122 , 131 , 361 D agnost c and Stat st ca Manua , the Eng sh-speak ng wor d s author tat ve psych atr c handbook, 230 D amond, Hugh W., 358 ; the case of "A. D., aged 20," 355 ; ntroduct on of photography nto the treatment of the menta y , 353 ; paper "On the App cat on of Photography to the Phys ognom c and Menta Phenomena of Insan ty," 355 ; portra t of a case of re g ous me ancho y," 354 D ckens, Char es, L tt e Dorr t , 185 D derot, Den s (1713-1784), French ph osopher, 243 D d -Huberman, Georges, study of Jean-Mart n Charcot, 312 D epgen, P., 41 D et, neo-Pythagorean, 176 ; and Thomas Tryon, 176 D gest on, 10 D oc es of Carystos, therapy used for hyster ca pn x , 35 D ogenes Laert us, 34 -35, 63 -64 D sease, 40 , 117 ; H ppocrates theory of, 16 , 27 , 29 -30; h stor ca dent f cat on of, 226 ; mutat on of, 225 -226; taxonomy of, 161 -162 D ssect on, 36 ; as v v sect on, 42 D v ne M nd, the, 237 Doddr dge, Dr. Ph p, 171 Donk n, Dr. Bryan, n neteenth-century Eng sh phys c an, 302 , 305 Donne, John, 136 Dora, the hyster ca pat ent made famous by Freud (see a so Bauer, Ida), x , 228 , 233 , 286 , 316 -319, 331 -333, 430 Dorset, n the West Country, 138 Drama, Jacobean and Restorat on, 135 ; ref ect ng hyster a, 160 Dramat sts, the, 131 Draw ng up of mbs, 10 , 47 Drayton, M chae (1563-1631), Eng sh poet, Po y-O b on , 127 Dream ana ys s, techn que for cur ng hyster a, 315 , 323 Dr nk, 161 DuBo s, W( am) E(dward) B(urghardt), Dusk of Dawn (1940), 334 -335 Dupont, J. C., 168 Duras, Marguer te, xv , 97 , 99 -101, 103 -104, 106 , 124 ; La Dou eur , 104 ; The Ma ady of Death , 104 ; The Rav sh ng of Lo Ste n , 104 Dur ng, R. J., 50 Dykstra, Bram, 248
E Eco e Freud enne, schoo for psychoana ys s n Par s, 328 Eco e Po ytechn que, 295 Eddy, Mary Baker, founder of Chr st an Sc ence, 290 Eder, Dav d, member of ear y twent eth-century group pract c ng Freud an psychotherapy n London, 324 Ed nburgh, 156 ; med ca schoo at, 166 , 168 , 175 , 179 , 181 -182 Educat on, med ca , 64 Educat on of women, 297 -298, 327 Egypt, Greco-Roman nf uences on, 36 , 43 E ss er, Kurt, hypothes s about the d scovery of psychoana ys s, 320 E as, Norbert, 237 E zabethan per od, the, 128 , 136 , 167 , 230 E enberger, Henr , v -v , 5 E ot-Sm th, G., ear y twent eth-century m tary doctor, prescr pt on to cure she -shocked m tary off cers, 323
461 E s, Have ock (1859-1939), Eng sh psycho og st, 297 , 309 , 427 Empedoc es, 33 -34, 52 -53 Emp r c sts, the, 40 , 119 Encyc oped sts, Byzant ne and anc ent, 37 , 41 , 44 -45, 47 -48, 50 , 53 Eng and, 134 , 136 , 142 , 153 , 160 , 167 -168, 182 -184, 293 , 296 -297, 300 , 306 , 321 ; dur ng the En ghtenment, 151 ; ear y modern, 225 Eng and, Tudor Stuart, great sweat and p ague n, 226 Eng sh, the, 254 ; c v zed fe, 153 Eng sh C v War, the, 138 "Eng sh Ma ady," the (see a so Cheyne), 152 -274 pass m Eng sh Restorat on, the, 136 -237, 143 -145, 149 , 160 ; bert n sm dur ng, 144 ; hedon sm dur ng, 144 En ghtenment sc ence (see a so Newton, Newton an sm, and French Revo ut on), 150 -176 Entra go, La n, 238 Ep epsy, 19 , 23 , 37 , 39 ; h story of, 379 ; hyster ca ep epsy, 258 Ergot sm, and mass hyster a, 225 Erotoman a, 272 -173 Esgers, Jan, med ca student of Herman Boerhaave, 168 Esqu ro , J.-E.-D., creator of f rst modern psych atr c at as, 116 , 257 , 349 Etherege, S r George, 1635-1691, Eng sh Restorat on dramat st, 160 Et quette, codes of, 160 Eupor ston , trans ated by Theodorus Pr sc anus, 48 Eur p des, 132 ; H ppo ytus , 104 Europe, 148 -149, 156 , 182 , 226 , 228 , 287 , 305 ; ear y modern, 130 , 134 ; med eva , 227 ; modern cu ture emerg ng around 1700, 136 ; Western, 54 , 114 , 153 European En ghtenment, x , 95 -96, 100 -101, 106 -107, 124 , 132 , 141 , 147 , 149 , 153 , 157 -158, 164 , 171 , 177 , 182 , 227 , 238 , 243 , 247 ; aesthet c theory, 358 ; art, 356 Euseb us of Caesarea (c. 263-339?), Greek h stor an, 429 Eve, 131 Eve na, n the nove by Frances Burney, 163 Exh b t on of the Arts of Women n Par s, 310
F Fabre, Jean Henr (1823-1925), French entomo og st and author, 287 Face, the, 383 Facu té de Par s, the, 307 Fa nt ng, 10 Fa rba rn, W am R. D., 233 Fa coner, W am, 178 Fa ret, Ju es, 302 , 305 Fam y, the, stab ty of, 306 Farmer, Hugh, An Essay on the [ma e] Demon acs of the New Testament, 171 Far ngton, Joseph, Br t sh andscape pa nter, 178 Fau kner, Ben am n, owner and operator of a pr vate madhouse at L tt e Che sea n London, 178 Fear, psychoana yt c ssue of, 326 Febvre, Luc en, 198 Fed kew, Patr c a, "Marguer te Duras: Fem n ne F e d of Hyster a," 101 Fe x, Cass us, f rst-century A.D . Afr can wr ter, 48 Fe at o, 420 , 426 , 430 Fema e unacy, 179 -184 Fema e reproduct ve system, the, 251 , 298 , 329 Fem n n ty, theory of, 287 Fem n sm, 97 , 111 , 286 , 288 , 290 , 305 -306, 329 -331, 333 -335 Féré, Char es, art c e n the Nouve e Iconograph e de a Sa pêtr ére , 377 ; mage show ng sens t ve sk n of the ep ept c, 378 Ferencz , Sándor, d st nct on of Wor d War I hyster ca symptoms, 321 ; c n ca d ary, 365 -366 Fermor, Arabe a, 150 von Feuchters eben, Ernst, n neteenth-century V ennese doctor, 232 , 255 , 293 F e d ng, Henry, Ame a , 264 ; Capta n Booth , 164 ; Tom Jones , 172 F enus, Thomas, Rena ssance med ca theor st, 124
462 F nch, Anne, the Countess of W nche sea, 153 ; The Sp een: A P ndar que Ode by a Lady , 153 F rst Wor d War, the, 229 , 241 F shberg, Maur ce, 412 ; The Jews: A Study of Race and Env ronment (1911), 405 F aubert, Gustave (1821-1880), French nove st, 290 F etcher, Ian, 306 F ess, W he m, 233 , 431 F orence, Ita y, 63 F uss, Em , 425 Food, 161 Fops, 161 van Foreest, P eter, 63 ; Observat onum et curat onum med c na um , Book 29, 62 ; Observat ons, 25 -34, 62 ; scho a , 34 Fore , August, The Sexua Quest on (1905), 418 Foreman, R chard, "Onto og ca -Hyster c Theatre," 137 Forsyth, Dav d, member of ear y twent eth-century group pract c ng Freud an psychotherapy n London, 324 Fortuna, Bona, Treat se on the V at cum , 113 Foucau t, M che , xv , 95 -96, 113 , 162 , 179 , 237 , 250 ; and fema e, 150 -172 pass m; H story of Madness , 250 ; H story of Sexua ty , 303 ; nner spaces, 162 Fracass n , A., 168 France, 136 , 142 , 149 , 162 , 168 , 174 , 183 , 291 , 302 , 306 , 320 ; the fourth Repub c of, 105 Frank n, Ben am n, 361 -362 Fraser, Lawrence, 168 Frau K., w fe of Herr K., 426 -427, 436 Free assoc at on, techn que for cur ng hyster a, 315 , 323 Free w , 131 French, the, 153 ; c v zed fe, 153 French Revo ut on, the, 92 , 181 -183, 184 , 360 , 370 Freud, Ama a, mother of S gmund Freud, 426 Freud, Anna, 327 Freud, Mart n, son of S gmund Freud, 426 Freud, S gmund, v -x, xv -xv , 92 -94, 98 , 102 , 105 , 115 , 124 , 142 , 145 , 156 , 180 , 184 , 227 -228, 231 -234, 236 , 238 , 264 -265, 288 -289, 305 , 314 -319, 323 , 325 , 327 -328, 331 , 333 , 359 , 364 -366, 402 , 404 -405, 412 , 415 -417, 420 , 422 -423, 425 -428, 430 -431; death w sh, 237 ; D fferent a D agnos s of Organ c and Hyster ca Para ys s (1886), 415 ; Dora , 317 , 419 , 436 ; "The Dynam cs of Transference," 318 ; ego, 237 ; free-f oat ng unconsc ous, 118 , 234 , 237 ; Freud an "m nd doctors," 247 ; d, 237 ; Interpretat on of Dreams , 366 , 411 ; etter to Em F uss, 425 ; Oed pa conf cts, 327 ; Oed pa tr ang e, 420 ; paper "On Ma e Hyster a," 314 ; Stud es on Hyster a , 300 , 315 -316, 419 ; pen s envy, 327 ; super ego, 237 ; theory of sexua et o ogy of the neuroses, 320 ; theory of sexua ty, 325 ; trans at on of Charcot s Lecons de Mard , 314 ; use of Charcot s noso og ca category, 419 Fr ngs, Mons gnor Joseph, v ew about be ng Jew sh n the twent eth century, 425 Froment, Ju es, twent eth-century neuro og st, 366 -367 Fuchs, Leonhart (1501-1566), trans ator of 1545 ed t on of Aphor sms , 60 Fum gat on, remedy for anc ent gyneco og ca cond t ons, 20 -21 Furor uter nus (see a so Gyneco ogy, Uterus, Vag na), 112 -145 pass m Fusse , Pau , conc us on that out of Wor d War I there or g nated a new wor d of mytho ogy, 324 ; g ossary of the romant c vocabu ary of Wor d War I, 324
G Gabr e , Georges-Franço s Mar e, unpub shed mage of Eugene Hugo, 349 Ga e, Susan (see a so Wordsworth), 177 Ga en of Pergamum, x , 5 -6, 22 , 25 -28, 35 , 37 -39, 41 -47, 50 -64, 120 ; commentary on H ppocrat c Aphor sms , 55 , 58 -60; De usu resp rat on s , 33 ; mode of the body, 46 ; On the Affected Parts , 26 , 34 , 41 , 53 , 60 ; On the Method of Hea ng the G aucon , 49 , 54 ; Tegn , 57 ; theory of "hyster ca suffocat on," 34 Ga eo, 117
463 Ga op, Jane, 288 Ga ton, Franc s, compos te photography, 402 , 411 ; "compos te" and "component" mages of the Jew, 410 ; photographs of "boys n the Jews Free Schoo , Be Lane," 409 Gamgee, Arthur, Professor of Phys o ogy at Owens Co ege, Manchester, account of Charcot s exper ments w th hypnot sm n the Br t sh Med ca Journa , 349 , 359 Gay, John (1685-1732), Eng sh p aywr ght and poet, 160 , 164 Gay, Peter, 238 Gender, 136 -137, 170 , 172 , 175 , 178 , 182 , 293 , 305 , 367 ; theory of, 228 Gender deo ogy, 330 Gen ta passage, the, 366 Gen ta a, 38 , 43 , 307 -308, 391 , 420 -421, 426 , 431 ; c rcumc sed, 411 ; fema e, 425 ; ma e, 425 Gent eman s Magaz ne , 171 Georget, Et enne, 262 German anguage, 435 German c schoo of neurophys o ogy, the, 236 Germany, 168 , 174 ; a eged weaken ng of by the Jews, 435 Gérôme, Jean Léon (1824-1904), French h stor ca and genre pa nter, 345 Ghost n the mach ne, the, 231 ; onto ogy of, 243 G es de a Tourette, Georges, essay on the schemat c representat on of the hyster c, 391 G man, Char otte Perk ns (1831-1908), Amer can fem n st, reformer, and educator, 186 , 300 ; "The Ye ow Wa paper" (1892), 299 G man, Sander, Jew sh Se f-Hatred , 425 G r s, Roman Catho c, 388 G ss ng, George, character A ma Ro fe n The Wh r poo (1897), 306 G obus hyster cus , cond t on resu t ng when the wander ng womb of a Greek woman becomes odged n her throat, 402 G over, Mary (see a so Edward Jorden), 116 -121 God, 121 , 171 Go d fever, 226 Go dsm th, O ver (1730-1774), Eng sh poet and dramat st, 160 Go dspe ge , Hê éne, Contr but on à étude de hystér e chez es enfants (1888), 313 Gos ng, Franc s, 246 , 296 Gourev tch, D., 24 Gout, n re at on to fem n n ty, 168 ; to hyster a, 168 Grande hystér e , pro onged and e aborate convu s ve se zure, 307 , 312 , 416 ; arcen-cerc e phase , 308 , 345 , 359 , 361 -362, 368 ; the "att tudes pass onne es," 308 , 362 ; the "c own sm" phase, 308 ; the ep epto d phase, 308 Graph c , the Br t sh newspaper, 356 Grasset, J., v ew that cerebra -sp na degeneracy s the source of a hyster a, 385 Graves, Robert, famous she -shock pat ent, 324 Gray, Thomas (1716-1771), Eng sh poet, 170 -171 Great p ague of Athens, 226 ; as descr bed by Thucyd des, 225 "Great sweat" of ear y-Tudor Eng and, 226 Greeks, the, 4 , 14 , 17 , 91 , 97 , 205 , 185 , 232 , 238 , 372 , 374 ; East, 55 , 64 Green, Mon ca, 65 ; On the Method of Hea ng, to G aucon , 43 , 56 Greenb att, Stephen, 158 Greer, Germa ne, The Fema e Eunuch , 126 Gr es nger, W he m, German psych atr st, 254 ; Menta Patho ogy and Therapeut cs , 255 Gross, C. G, 168 Gu dott, Thomas, Eng sh Restorat on phys c an, 168 -170 Gu a n, Georges, Jean-Mart n Charcot s student and b ographer, 309 Gu tt , E ogoro, be ef that hyster a man fests tse f nterna y, 391 ; mage of an hyster ca gut from "Osservaz on C n che," 393 Gurowsk , Adam, Po sh nob e, 434 Gutmann, Ju us Moses, wr t ng on the structure of the Jew sh face, 410
464 Guze, S. B., 4 Gyneco ogy, 249 -251, 260 ; anc ent Greek, 4 , 16 , 17 , 37 , 40 , 41 , 50 ; H ppocrat c, 5 , 9 , 16 -17, 55 , 57 ; Lat n, 54
H van de Haghen, C., med ca student of Hermann Boerhaave, 168 Ha ght, Gordon, 296 Ham et, 95 Hammond, W am, 1876 h story of hyster a, 372 Hand, the hyster ca traumat c para ys s of, and hyster ca hand, 391 Hapsburg Emp re, 420 Hardy, Thomas, character Sue Br dehead n Jude the Obscure (1895), 306 Harr ngton, Anne, 258 Harsnett, Samue , A Dec arat on of Egreg ous Pop she [s c] Impostures. . . Under the Pretence of Cast ng Out Dev s (1603), 127 Harvard Med ca Schoo , 314 Harvey, W am, d scoverer of the c rcu at on of the b ood, 33 , 115 , 117 , 126 , 131 -133 Has am, John, an off c a at Beth ehem for two decades, 178 , 251 Haygarth, John, ate-e ghteenth-century med ca theor st, treat se Of the Imag nat on, as a Cause and as a Cure of D sorders of the Body , 178 Heart, the, 162 Heberden, W am, 263 -264, 244 -245 Hebrew anguage, 425 , 430 Hebrews, the, 8 Hecquet, Ph ppe, French phys c an of the anc en rég me, Le natura sme des convu s ons dans es ma ad es de ép dém e convu s onna re (1733), 170 Hegar, A fred, n neteenth-century phys c an known for the pract ce of hysterectomy and ovar ectomy, 255 He tz, Jean, essays to the Nouve e Iconograph e de a Sa pêtr ére , 372 He mho tz, Hermann (1821-1894), German sc ent st, 238 Herac e des of Pontus, 33 -35, 46 ; Apnous, 35 Heresy, 117 Hernd , D ane, 333 Herodotus, 31 Heroph us of Cha cedon, 36 , 40 Herr, K., 423 , 427 -428 Hervey, Lord, Eng sh po t ca f gure and d ar st, 167 Hes od, 17 H ghmore, Nathan e , 145 , 168 , 262 ; et o ogy from "bad b ood," 140 "H pp and hypp sh," as re ated to hyster a, 167 H ppocrates, the Father of Med c ne, 3 , 16 , 29 , 26 , 33 , 38 , 43 , 63 , 92 , 104 , 106 , 115 , 118 , 153 , 231 , 250 H ppocrat c corpus of wr t ngs, 3 -5, 8 -9, 11 -12, 16 , 18 , 26 , 28 -29, 32 , 36 -38, 41 -42, 48 -50, 55 , 57 , 59 , 64 ; Aphor sms , 5 , 8 , 45 , 47 -48, 50 , 54 , 57 -60; D seases of Women , 7 , 14 -20, 23 , 25 -27, 30 -32, 36 -38, 45 , 48 -50, 54 , 56 ; D seases of Young G r s , 56 ; Generat on , 4 , 6 , 8 , 28 , 30 , 31 ; Nature of the Ch d , 30 -31; Nature of Woman , 14 -15, 22 , 38 ; On the Sacred D sease , 30 ; P aces n man , 30 ; Prognost cs , 57 ; Reg men , 31 H ppocrat c scent therapy, 26 , 38 , 41 , 43 , 44 , 46 -48, 51 -52, 54 , 56 , 61 , 64 H ppocrat c womb, the (see a so Womb), 25 H rschfe d, Magnus, n neteenth-century German sexo og st, 427 H t er, Ado f, d scuss on of syph s n Me n Kampf , 432 , 434 -436 von Höb n, C., and A zhe mer, A., "E n Be trag zur K n k und patho og schen Anatom e der Westpha -Strümpe schen Pseudosk erose," mage of the bra n structure of the hyster c, 388 Hodges, Devon, 129 Hogarth, W am (1697-1764), Eng sh pa nter and engraver, 174 Ho dhe m, Samue , Jew sh rabb and n neteenth-century reform eader, 429 -430 Ho and, 148 , 162 , 168 Ho änder, Eugen, twent eth-century phys c an, h stor an, and art cr t c, 372 Ho ocaust, 104 Homosexua ty, 319 , 326 , 334 ; Ma e, 292 , 304 , 324 , 431
465 "Hôp ta Charcot," the, 307 Horney, Karen (1885-1952), Amer can psych atr st and founder and dean of Amer can Inst tute of Psychoana ys s, 327 Horow tz, Rabb Lazar, sp r tua eader of the orthodox Jew sh commun ty n V enna n the n neteenth century, 430 Howe s, W n fred, 299 Human organ sm, the, 99 Human sts, Erasmus, 123 ; More, 123 ; Petrarch, 123 ; Rena ssance, 123 von Humbo dt, A exander, etter to the Duchess Fr eder ke von Anha t-Dessau, 357 Hume, Dav d, 158 Huna n bn Ishaq a -`Ibad , known to the West as Johann t us, 50 ; Isagoge , 57 Hungar an anguage, 420 Hunt, Le gh, p ay, A Legend of F orence , 63 Hunter, D anne, 316 , 335 ; "Hyster a, Psychoana ys s, and Fem n sm: The Case of Anna O," 101 Hunter, R chard, 175 Hunt ngdon s chorea, 256 Hurst, Arthur F., paper on batt e fat gue (1918), 384 ; study of hyster ca contractures, 366 -367, 370 , 391 Hypnos s, 258 , 307 , 315 , 323 , 349 Hypochondr a, 255 , 293 -294; st gmat zat on of, 294 Hyster a, b sexua ty, 288 ; educat on, 297 -298, 327 ; gender, 286 -287, 289 ; ntrospect on, 246 -247; marr age, 23 , 24 , 56 ; menstruat on, 13 , 251 -253; pass v ty, 297 -299, 314 -317; sex ro es, 302 -303; causes of, stress, 228 -229, 242 -243, 246 , 295 Hyster a, creat v ty n re at on to, 168 -170 Hyster a, d agnos s of, as phys ca , 11 -12, 23 -24, 227 -229, 232 , 236 -237, 239 , 244 , 252 -255, 259 -260; as psycho og ca , 23 , 228 , 232 -233, 233 -234, 236 -239, 247 -248, 261 -265, 288 ; retrospect ve y, 9 , 10 -11, 53 , 227 -229, 231 ; and hypnot sm, 258 ; and magnet sm, 258 -259; and neuro ogy, 255 -260; by women, 287 ; n men (see Ma e hyster a); by H ppocrates, 17 -25 Hyster a d ssenters and (see a so Hyster a; fem n sm and), 171 -175, 334 -335 Hyster a, doub es n, 173 -175 Hyster a, the En ghtenment and, 152 -168; go den age of, 140 -168, espec a y 161 -163, and gout, 168 Hyster a, fa s f cat on of (see a so War neuros s), by women, 62 , 255 , 261 -262, 263 -264, 300 -302, 327 ; by men, 321 -326 Hyster a, fem n sm and (see a so Fem n sm), 306 -306, 316 -317, 320 , 326 -330, 332 -333 Hyster a gender constructs and, 289 , 292 -293, 303 -304, 305 -306, 309 , 319 , 326 , 333 ; and representat ons of hyster a, 309 -310 Hyster a, gender format on and, 140 -178, espec a y 168 -170; 229 , 288 Hyster a, h story of, 4 -5, 8 , 9 -10, 12 , 226 , 229 -230, 231 -236, 287 -288, 303 -304, 313 , 328 -330, 332 -333, 335 ; and anguage, 290 -291; by women, 313 , 328 -330 Hyster a, m tat on as cruc a n, 180 -182 Hyster a, atent, 258 Hyster a, the aw and, 204 Hyster a, ma e (see a so Neurasthas a), 10 -11, 140 -176 pass m, 290 -291, 304 -305, 307 -309; a ternat ve cond t ons and terms for, 235 , 255 , 290 -297, 313 -314, 321 , 326 ; and bond ng among ma es, 168 -170; and fem n ne nervous const tut ons among ma es, 169 , 229 , 289 ; and Freud, 314 -315; and hyster a n women, 13 , 307 , 309 -310, 315 ; and poet c gen us, 168 ; psychogen c exp anat ons for, 164 -166; and temperamenta sens t v ty among ma es, 169 ; and Wor d War I (see a so War Neuros s), 321 ff.; and women ana ysts, 333 Hyster a, mass, 10 ; as symptoms of ergot sm, 225 Hyster a, mock-ep c nove s and, 172 Hyster a, nymphoman a and, 172 -173 Hyster a, organ c resonance and, 185 Hyster a, paradoxes of, 173 -177 Hyster a, pred ctab ty of, 180 -183 Hyster a, psychoana ys s and, 319 -320
466 Hyster a, she shock and (see a so War Neuros s), 323 -324 Hyster a, ster ty n women and, 291 -293, 305 -306 Hyster a, the surrea sts and, 312 -313 Hyster a, taxonomy and, 179 -182 Hyster a, treatment of (see a so Hyster a, ma e; Sexua ntercourse; War Neuros s), 20 -24, 26 , 36 , 37 , 43 -47, 51 -52, 54 , 244 -248, 254 , 300 -302; by women doctors, 41 , 299 -300, 327 , 333 ; by reconstruct on of the pat ent s story (see a so Hyster ca narrat ve), 318 -319, 333 ; compress on of gen ta s, 307 -308; doctor-pat ent re at ons (see a so Fem n sm), 10 -11, 23 , 244 -245, 298 -299; eva uat on of, 35 , 303 , 310 -311, 319 , 327 ; ncurab e, 253 ; terary character st cs of, 317 -318; and marr age, 317 -318; and women s ndependence, 316 -318, 326 -327 Hyster a, work ng-c ass women and, 305 , 320 Hyster a as ze tge st d sease , 9 , 158 -168, 164 -165 Hyster c as performer, 309 -311, 320 ; and catarrh, 168 ; v s b ty of the, 142 -176 pass m Hyster ca pass o , 127 -129 Hyster ca gout, 167 -169 Hyster ca man a, 169 Hyster ca narrat ve, 318 -319, 333 , 335 "Hystér e v r e" term used by Jean-Mart n Charcot to descr be h s concept of ma e hyster a, 309 Hyster ka, mean ng of, 5 -6, 7 -8, 12 -13, 15 , 41 -42 Hyster ke pn x , med ca symptom dent f ed by the H ppocrat cs as "suffocat on of the womb," 5 , 6 , 14 -20, 22 , 29 -32, 35 -36, 38 , 40 -48, 50 -51, 54 , 56 , 58 -59, 61 , 64 , 98 Hystero-ep epsy, 227 , 377 Hysterogen c zone, 307 -308
I Iatromechan sts, 184 Ibn a -Jazzar, 53 -56; K tab Zad a -Musaf r , 52 , 55 Ibn S na (Av cenna), d scuss ons of hyster ca suffocat on n h s Qanum (the Canon ), 52 , 57 , 62 -63 Iconograph e photograph que de a Sa pêtr eére , three-vo ume med ca at as, 374 Idea sm, conf ct w th mater a sm, 238 -241 I ad, the, 30 I ustrated London News , Br t sh newspaper, 356 Imag nary, the, 332 Imag nat on, E zabethan, the, 137 ; Restorat on, the, 137 ; as the source of hyster a, 404 Imag nat on, and d sease, 148 -178 pass m; and hyster a, 163 -165, 404 Ind ans, S oux, 294 Ind v dua sm, n re at on to hyster a, 162 ; and narc ss sm, 162 Inf ammat on of the reproduct ve organs, 179 Inqu s t on, the, 352 Insan ty, 261 Inst nct and the Unconsc ous , 325 Inte ect (see a so Sedentary fe), 160 -162, 261 Introspect on, 246 -247 Isenf amm, J. F., 168 Is am c cu ture, 53 , 64 Israe , Luc en, L hystér que, e sexe, et e médec n , 290 Ita y, hyster a n, 162 , 168
J Jackson, E zabeth, arra gned on charge of bew tch ng the fourteen-year-o d Mary G over, 116 Jackson, John Hugh ngs, d fference be tween Jackson s mode of hyster a and Charcot s mode of hyster a, 417 ; v ew hyster a as a d sso ut on of the h gher funct ons of the nervous system, 365 Jacob, Joseph, 412 ; d scuss on of Ga ton s f nd ng of the abso ute Jew shness of the gaze, 409 -410 Jacobus, Mary, 180 , 332 Jacyna, L. S., 249 James, Dr. Robert, 152 Janet, P erre, French neuro og st, 100 , 112 , 227 , 230 , 259 , 265 , 314 Jansen sts, 370 , 372
467 Jard ne, A ce, Gynes s: Conf gurat ons of Woman and Modern ty , 101 Jenner, Edward, G oucestersh re doctor and sma pox researcher, 173 , 293 Jews, 420 , 422 -423, 425 -426, 428 , 431 -436; c rcumc sed, 431 , 433 ; Eastern, 372 , 382 ; as a h gh r sk group for contract ng the d sease hyster a, 405 -406, 410 -418; as a re g ous category, 374 Jewson, N cho as, 244 Johannes, P atear us, De aegr tud num curat one , 56 Johns Hopk ns Un vers ty, 328 Johnson, Ben, 136 Johnson, Samue , 134 , 163 Jones, Ernest, member of ear y twent eth-century group pract c ng psychotherapy n London, 324 , 327 Jordanova, Ludm a, 291 Jorden, Edward, 112 , 114 , 116 , 118 -124, 126 -127, 129 , 133 , 149 , 232 ; A Br efe D scourse of a D sease Ca ed the Suffocat on of the Mother , 29 , 62 -63, 114 , 117 Jorge, Jose M., "Coxa g a h stér ca," X ray mage from, 292 Joubert, Laurent, the chance or of the Un vers ty of Montpe er, 123 Juda sm, 429 -430 Jud scher Frauenbund, the League of Jew sh Women, 316
K Kahane, C a re, 288 Katz, Susan, v ew about Freud s deo og ca pos t on towards women and men, 318 Ke er, Eve yn Fox, 291 Ke ey, Mary, 286 K erkegaard, Soren, xv K gour, Dorothy, From Commun on to Cann ba sm: Metaphors of Incorporat on , xv K ng, He en, 227 , 231 K e n, the Hungar an Jew who wandered on foot to Par s and was adm tted to the Sa pêtr ére the next day, 406 K e n, Me an e, 327 Kohon, Gregor o, Br t sh hyster ca ana yst, 287 Krafft-Eb ng, R chard, be ef that c v zat on regu ar y br ngs forth degenerate forms of sexua ty, 418 , 427 Kr steva, Ju a, v , 97 , 103 , 111 , 124 Krohn, Dr. A an, 106 , 125 , 165 , 226 , 230 -231
L Lacan, Jacques, xv , 95 , 132 , 333 , 334 , 420 Lady Mary, 167 Lamarque, Henr , and B tot, Em e, 397 ; descr pt on of the schemat c representat on of the hyster c, 391 ; mage of the posture of the schemat c pat ent from "Sur un cas d hystéro-traumat sme chez homme," 395 Langenhe m, W am and Freder ck, use of antern s des for the "mora " treatment of the pat ents n the Ph ade ph a Hosp ta for the Insane, 356 Langhorne, John, Letters on Re g ous Ret rement, Me ancho y, and Enthus asm (London, 1762), 177 Language, 117 , 143 , 290 Laqueur, Thomas, 130 , 250 Lattes, L., work on changes n the qua ty of the hyster c s face, 384 Lat n West, the, 55 , 57 , 64 Laurenz an , Lorenzo (ca. 1450-1502), 59 Lavater, Johann Caspar, h s study of phys ognomy, 383 Lavo s er, Anto ne-Laurent, 362 Lawyers, n New York, 294 Laycock, Thomas, Br t sh psychophys o og st, 262 ; Treat se on the Nervous D seases of Woman , 63 Layne, George S., 356 Lederer, Wo fgang, Gynophob a ou a Peur des Femmes , x Lefkow tz, M. R., 15 Leon ceno, N cco ò (1428-1524), trans ator of the Theodorus Gaza ed t on of the Art ce a , 59 Leontes, 129 ; The W nter s Ta e , 128 Lepo s, Char es, the Ita an phys c an a so known as Car o P so (1563-1633), 139 -140 Lew s, Bevan, m d-V ctor an Br t sh phys c an, 246 Lew s, G., 8 Lew s, I. M., 23
468 Leytonstone, London suburb where Robert Carter pract ced med c ne, 262 L eutaud, Joseph, 124 L en, Ephra m Moses, draw ng of a Jew sh fema e, 408 L nton, E za Lynn, term "the shr ek ng s sterhood," 306 L terary cr t c sm, 143 , 289 L tt e Hans, one of Freud s pat ents, 318 L ttré, Em e, D ct onna re de a angue françra se (1863-1877), 13 -15, 20 -21, 23 , 29 -30 L ver, 19 , 22 , 23 , 32 , 49 L verpoo Med ca H story Soc ety/Soc ety for the H story of Sc ence, the, 65 Locke, John, x , 138 ; Essay Concern ng Human Understand ng , 148 Logos , the, 27 Lombroso, Cesare, 427 ; study of ep ept cs, 377 Londe, A bert, head of the Sa pêtr ére s photograph c serv ce, 350 , 379 London, Eng and, 136 , 138 , 156 , 170 , 182 , 292 London T mes , the, 320 Lord Hervey, target of A exander Pope s sat re n Ep st e to Dr. Arbuthnot , 167 Lote, George, Rabe a s scho ar, 123 Lou s XVI, French k ng (1754-1790), 184 Louyer-V ermay, Jean Bapt ste, French phys c an, 292 Love, 99 , 120 Love s ckness, 112 -114 Love ace, Ada, Byron s daughter, 227 Lus tanus, Amatus, 63 Luys, Dr. J.-B. (1848-1897), author of an ear y photograph c med ca at as, 349 , 385 ; mage of the hyster c s bra n from "Recherches nouve es sur es hém p ég es emot ves," 387 Luys, Georges, brother of Dr. J.-B. Luys, photograph "Esther," 349 Lynch, John, v ew on the exp o tat on of man ness dur ng Wor d War I, 325
M Maca p ne, Ida, 175 Maddock, A fred Beaumont, 253 Madhouses, 171 -178 Madness, 178 -182; theory of, 175 MacDona d, M chae , 125 Mag c, 117 , 125 , 127 Ma e hyster a, see under Hyster a, ma e Ma eus Ma ef carum , the "W tches Hammer," 115 Mandev e, Bernard, Eng sh sat r ca wr ter on econom c and eth ca sub ects, 146 -147, 151 , 154 , 158 , 162 , 168 , 184 , 245 ; The Fab e of the Bees , 145 ; Treat se of the Hypochondr ack and Hyster ck Pass ons , 146 Mann, W. N., 8 Manners, cu ts of, 160 -162 Mannhe mer, Isaac Noah, rabb of the Se tenstettengasse synagogue, 430 Mantegazza, Po o, study of Erthroxy on and ts der vat ve, coca ne, 427 ; tr ogy on ove and sex, F s o og a de amore (1872), Ig ene de amore (1872), and G amor deg uom n (1885), 427 -428, 431 , 433 Mant as, fo ower of Heroph us, 36 Mantua, Countess of, 120 Mao Tse-tung, eader and founder of Ch nese Commun st party, 228 Map et, John, Eng sh Restorat on phys c an, 168 -170 Marce us Emp r cus, Book of Med c nes , 44 Marce us, Marcus C aud us, commentary on D oscor des, Ph otheus, and Pau of Aeg na, 59 Marr age, 23 , 24 Marsden, C. D., 9 Mart a (Marcus Va er us Mart a s) (A.D.C . 40-c. 104), Ep grams , 42 , 62 Mart n, Em y, 291 Mart n du Gard, Roger (1881-1958), French nove st, 309 Mart neau, Harr et, 134 Marx, Kar , descr pt on of h s archr va Ferd nand Lassa e, 435 Marx sm, 419 -420 Masson, Jeffrey, 255 ; v ews about Freud s pat ent Dora, 317 Masturbat on, 317 , 319 , 422 -423, 429 ; ant -masturbat on campa gns, 182 -186; masturbatory d sease, 388
469 Mater a sm, ph osoph es of, 117 , 157 , 180 , 240 Mathemat cs, 150 Matoss an, Mary, 225 , 226 Mauds ey, Henry, ate V ctor an psych atr st, 240 , 247 , 251 , 254 , 297 , 302 ; and mater a sm, 254 Mauds ey Hosp ta , 327 Mau tz, Russe , 249 Mead, George Herbert, remarks about the fundamenta assumpt ons of sc ence, 415 Mechan cs, Newton an, 151 , 163 ; mechan sm, 117 Med ca educat on, 45 -46, 49 Med ca h story, 225 , 226 , 230 ; changes n n neteenth century, 248 -249; emergence of spec a zed f e ds, 249 Med ca schoo s, hyster a and, 168 Med ca theory, 119 , 133 , 165 , 167 , 171 , 174 Med c ne, 64 , 119 , 123 , 129 , 166 , 181 , 236 , 239 -240, 248 -250, 266 , 289 ; Arab c, 44 , 55 -56; Assyr an, 16 ; Baby on an, 16 ; Byzant ne, 47 ; En ghtenment, 146 , 255 ; Ga en c, 54 -56; Georg an, 152 ; H ppocrat c, 3 , 8 , 15 -16, 18 , 24 , 29 , 40 , 49 , 54 , 61 ; mathemat ca , 154 ; mechan ca , 177 ; med eva European, 52 ; n neteenthcentury, 245 , 250 , 253 , 257 , 265 , 269 ; Roman, 24 ; Western, 92 Med eva wor d, the, 64 , 91 , 107 Me ge, Henry, ed tor of the Nouve e Iconograph e de a Sa pêtr ére after 1901, 372 ; d ssertat on of 1893 on the wander ng Jew, 411 ; mage of Moser C., 413 ; mage show ng the phys ognomy and the gaze of "Gott eb M.," 414 ; mage of a wander ng Jew as the mode for the psychopatho ogy of the Eastern Jew, 412 Me ancho y, 293 Mendoza, Rafae , character n W am Thackeray s Cod ngsby , conversat on w th Lord Cod ngsby, 409 Menopause, 18 , 252 Menstrua pa n, 255 Menstruat on, 5 , 10 , 18 , 22 , 27 , 37 , 40 , 42 -43, 50 , 52 , 53 , 57 , 250 -253, 298 , 391 Merc er, Char es, 246 , 302 ; response to Dav d Forsyth s cr t c sm n the Lancet, 324 Merskey, Haro d, 230 Mesmer, Franz Anton (17337-1815), German phys c an respons b e for deve op ng the treatment known as mesmer sm, 104 , 183 -185, 232 , 359 ; portra t of, 362 Mesmer sm, mean ng of, 362 Mesmer sm, treatment of hyster a and, 309 -310 Mesmer st, mage of the, 360 Method sm, 40 , 372 Method sts, the, 370 Mets tsah , Jew sh c rcumc s on r tua , 430 de La Mettr e, Ju an, 240 Meynert, Theodor, 238 ; pub c y expressed skept c sm about Jean-Mart n Charcot s symptomato ogy, 314 M ca e, Mark, xv -xv , 65 , 168 , 235 , 257 , 287 , 309 , 313 , 328 M chae s, Johann Dav d, e ghteenth-century German commentator, 429 M che et, Ju es, n neteenth-century French soc a h stor an, 97 M dd e Ages, the, 96 , 99 , 112 , 118 , 379 ; ate, 97 , 100 M dd esex r ots, the, 182 M dw ves, 41 M , John Stuart, 246 M ar, John, 254 M ett, Kate, 330 M ton, John (1608-1674), 98 , 135 M nd, the, 103 , 113 , 120 , 122 , 156 , 160 , 235 , 237 , 244 , 247 , 383 M nd and body, Cartes an, 162 -168 M sch ng , term from rac a sc ence para e to bastard, 435 -436. M tche , Ju et, 111 , 180 , 288 , 319 , 333 M tche , Dr. S as We r (1829-1914), Amer can phys c an and author, 176 , 245 -246, 297 -298, 300 , 302 -303; art c e n Doctor and Pat ent , 298 ; mage of the u cerated sk n of the hyster c from "Hyster ca Rap d Resp rat on, W th Cases; Pecu ar Form of Rup a Sk n
470 D sease n an Hyster ca Woman," 389 ; Ro and B ake , 299 M tch nson, W., on n neteenth-century Canad an med c ne, 29 Modern sm, 96 Mo , Tor , study about Freud, 318 , 333 Mohe , ro e performed by the c rcumc ser n the Jew sh c rcumc s on r tua mets tah , 430 Monro, Haro d (1879-1932), Eng sh poet, 178 , 184 Montagu, Lady Mary Wort ey, 160 , 167 Monte Cass no, monastery founded c. 529 by St. Bened ct of Nurs a, 55 de Montgeron, Lou s Bas e Carré, account of the Jansen st m rac es, 370 ; La ver té des m rac es operas par ntercess on de M. de Pâr s et autres appe ans demontrée contre M. L archevêque de Sens , 371 Montpe er, 123 Moreau de Tours, Jacques Joseph, 346 , 349 ; 1890 photograph "Hyster cs of the Char té on the Serv ce of Dr. Luys," 348 , 356 , 359 , 362 Morgagn , G ovann Batt sta, Seats and Causes of D seases . . . (Eng sh vers on 1769), 177 Morr s, C. A., Br t sh surgeon dur ng the Boer War, 321 Moscucc , Orne a, 249 , 255 Mott, Freder ck, ear y twent eth-century she -shock treatment theor st, 322 Muhammad bn-Zakar yya ar-Raz (Rhazes), twenty-four vo ume co ect on of works, c tat on of H ppocrat c text D seases of Young G r s , 53 ; K tab a -Haw , 51 ; K tab a -Mansor , 51 Mu t p e sc eros s, 256 Munthe, Axe , n neteenth-century Swed sh doctor, h s descr pt on of Charcot s Tuesday ectures, 311 Musc o, trans ator of Soranus, 39 , 48 Mut sm, 322 Myers, Dr. Char es S., case stud es of amnes a, mpa red v s on, and emot ona d stress among Br t sh so d ers n France, 321 Myst cs, Catho c, 367
N Nap er, R chard, ear y Stuart parson-phys c an, 125 Nat ona Schoo of Agronomy, 374 Naz Germany, 105 Neo og sms for hyster a, 167 Nerve cu ture, 152 -178; n Georg an Eng and, 156 -176 Nerves, the, 161 , 165 , 170 , 172 -173, 175 , 182 , 227 ; nerve doctors, 153 , 157 , 162 , 164 -165, 173 , 175 -176, 179 -180, 182 -184, 245 -246, 289 ; sem ot cs of, 162 Nervous const tut on , term used by Dr. Thomas Sydenham to descr be an mproper y understood sensat on, 142 Nervous d scourse, 166 -168 Nervous organ zat on, 150 -178 pass m; metaphors of, 162 -165 Nervous sens b ty (see a so Sens b ty), 161 -162, 163 Nervous sty e, 166 -167 Nervous system, the, 143 , 146 -147, 150 -151, 154 , 185 , 232 , 252 , 262 , 418 ; centra , 145 ; fema e, 103 ; Newton an f ux ons to, 105 ; sem ot cs of, 140 -175 pass m Nervous tens on, 160 -168, 160 -172 pass m Nether ands, hyster a n, 168 Neurasthen a, nervous d sorder named by George M. Beard def n ng a cond t on of nervous exhaust on, 228 , 245 , 294 -297, 306 ; and "rest cure," 297 -298 Neurob o ogy, 157 Neuro ogy, 249 , 255 -260 Neuros s, 13 The New Testament , 171 Newton, S r Isaac, Ph osoph ae natura s pr nc p a mathemat ca , 148 ; Newton an sm, 151 , 153 Newton an d ssertat ons on hyster a, 167 Newton an matter theory, 184 Newton an revo ut on, 151 -168 Newton an sc ence, x New York T mes , ed tor a on the 1989 Sunday Mass nterrupt on at Sa nt Patr ck s Cathedra , 334 N etzsche, Fr edr ch, xv
471 N e r ver, the, 234 N us, Sa nt, 368 N sh , H., Chuga I Sh npo , chart represent ng the mage of psych c forces n the Japanese ma e hyster c, 403 North Amer ca, 226 , 228 Norw ch, county seat of Norfo k, Eng and, 130 Nouve e Iconograph e de a Sa pêtr ère , 349 -351 Nymphoman a (see a so Hyster a), 172 -173, 254
O Obstetr cs, 249 Oed pa ru e, the, 95 Oed pus comp ex, the, n Freud an psycho ogy, 95 Oed pus Rex , Greek tragedy, 95 O Hara, Scar ett, 329 O ver, P., and Ha pré, A., "C aud cat on nterm ttente chez un homme hystér que atte nt de pou s ent permanen," mage dep ct ng Charcot s d agnost c category of nterm ttent c aud cat on, 424 Onan a crusades, the, 182 -183 Or bas us, 38 , 44 , 46 , 48 , 50 , 54 ; Synops s , 45 Or ent, the, 176 Organ c chem stry, 249 Orgasm, 262 ; fema e, 112 , 130 , 250 , 287 Or g na s n, Chr st an doctr ne of, 131 Or gen (ca. A.D . 185-ca. 254 A.D .), Chr st an theo og an, 35 , 429 Oxford, Eng and, 157 Ovar es, the, 254 , 391 Ovu at on, 250 Owen, W fred, famous she -shock pat ent, 324 Oxford Un vers ty, 138 -139, 170
P Pagan sm, 107 Page, Herbert, In ur es of the Sp ne and Sp na Cord (1883), 417 Pa n, 185 -186; and emot on, 185 -186 Pa ngh, Abraham, mage of the w tch from t Afgeruckt Mom-Aans ght der Tooverye: Daar n bet bedrogh der gewaande Toverye, naakt ontdeckt, en em gezone Redenen en exemp en dezer Eeuwe aangewezen wort (1887), 374 ; study of w tchcraft, 374 Pan c, hyster a and, 164 ; n re at on to cr me, 164 Pappenhe m, Bertha, 290 , 315 , 332 , 419 -420, 432 Parace sus, Aureo us, 123 , 232 Para ys s, 10 , 15 , 322 Paré Ambro se, French phys c an, 115 , 123 Par s, France, 100 , 180 , 295 , 314 , 359 Park nson s d sease, 256 Parma, Ita an c ty, 59 Parry, Ca eb, 262 Parsons, Ta cot, 233 Pasteur, Lou s, deve oper of a germ theory of contag ous d sease, 353 Patho ogy, 176 , 249 Pau of Aeg na, 38 -39, 44 , 46 -47, 49 -50, 54 Pau of Aet us, 51 Pau , Sa nt (d. A.D . 67?), apost e to the Gent es, 429 Pausan as, 34 Pear, T. M., ear y twent eth-century m tary doctor, prescr pt on to cure she -shocked m tary off cers, 323 Pe v c structure, 391 Pen s, as an ma , 28 ; c rcumc sed on a Jew sh man, 425 -426; nfect on by syph s, 434 Per ander of Cor nth, 31 Perk ns, Char otte, n neteenth-century hyster c, 101 Per ey-Guze cr ter a, n psych atry, 9 Perry, Char es, the Levant, 176 -177; On the Causes and Nature of Madness (1723), 176 Persona dent ty (and hyster a d agnos s), 160 -161 Pharmacoep a, 24 Pharoahs, 235 Ph aretus, on pu ses, 57 Ph o (c. 20, B.C .-A.D.C . 50), A exandr an Jew sh ph osopher, 429
472 Ph osophy, 165 , 240 ; mechan ca , 163 ; modern ngu st c, 234 ; natura , 148 Ph otheus, 60 Ph umenos of A exandr a, 45 -46 Phe gm, 19 Photography, and hyster a, h story of, 356 -357; use as a means of psycho-therapy, 355 -356, 358 , 381 , 392 Phys c ans, 99 , 102 , 111 , 114 , 120 , 122 , 124 , 143 , 156 , 240 , 249 , 261 , 296 ; Amer can, 305 ; Arab c, 37 ; e ghteenth-century, 116 , 123 ; En ghtenment, 154 , 155 , 242 , 253 ; London, 170 ; n neteenth-century, 229 ; Rena ssance, 231 -232; V ctor an, 240 , 298 , 300 , 302 Phys ognomy, hyster ca , med ca terature of, 384 Phys o ogy, 112 , 117 , 130 , 141 , 169 ; Cartes an, 108 ; sexua , 99 P nea g and, 108 P ne , Ph ppe (1745-182?), French phys c an and psych atr st, 116 , 168 , 179 -180, 232 , 255 , 257 , 261 -262, 349 -350, 362 , 370 , 384 P tca rne, Arch ba d, professor of med c ne at Leyden and Ed nburgh, 151 P th at sm, suggested a ternate term no ogy for hyster a, 235 P ague, 110 , 225 -226, 435 P ath, Sy v a, 334 P ato, 33 , 35 , 107 , 132 ; P aton sm, 237 , 240 ; T maeus , 25 -28, 42 , 44 ; theory of the womb, 26 , 46 , 52 -53, 118 P atter, Fe x (P atterus), 113 P easure, 99 P nca po on ca, sk n d sease attr buted by Western dermato og sts to the Jews of the East, 379 P ny, the E der, 6 , 34 -35, 63 P utarch, Mora a , 31 Poe, Edgar A an, essays on the daguerreotype, 358 Poets, Romant c, 132 Po teness, cu ts of, 157 -164 Po ock, Gr se da, n neteenth-century art cr t c, 310 Pomme, P erre, French phys c an, a 168 ; treat se on "Hyster ca Affect ons n both Sexes," 178 -179 Pope, A exander, Eng sh poet, 153 , 167 ; The Rape of the Lock , 150 , 158 Port and, Duchess of, 160 Possess on, 23 Pos t v sm, og ca , 233 ; med ca d agnos s and, 236 , 259 -260; Th rd Repub c, 259 Poststructura sm, 234 Praxagoras of Cos, 33 Pregnancy, 19 , 22 , 40 Pr est ey, Joseph, Eng sh rad ca theo og an and sc ent st (1773-1804), 171 Progrès Méd ca , the Sa pêtr ère med ca ourna , 313 Prost tut on, 136 ; nk between the Jew and syph s, 432 Protestant ands, 134 Proteus, sea-god, the son of Oceanus and Tethys, 91 , 100 , 108 , 146 , 166 Psychasthen a, suggested a ternate term no ogy for hyster a, 230 Psyche, 238 ; fema e, 105 , 123 Psych atry, 93 , 138 , 233 , 249 , 259 , 261 , 264 , 289 , 367 ; psych atr c c n cs n Western Europe, 411 ; r se of, 162 Psychoana ys s, v , x , xv , 233 , 235 , 237 -238, 265 , 319 -320, 324 , 328 , 330 ; Freud an, 93 , 104 , 232 , 288 , 316 , 318 ; Lacan an, 287 ; techn que of, 315 ; V ennese schoo s of, 366 Psychoana yt c method, the, 288 Psycho ngu st cs, v Psycho ogy, 169 , 259 -260, Freud an, 23 Psychopatho ogy, 367 , 374 Psychos s, 228 Psychotherapy, 120 , 334 ; Freud an, 324 Purce , Dr. John, se f-professed "nerve doctor," 149 , 153 , 168 Pure Reason, as deve oped n the trad t on of a Chr st an-P aton c d v ne-r ght monarchy, 238 Pybus C ub, the, 65
Q Queen Anne, 149 -150 Queen V ctor a, 63
473 Queensbury Ru es, the, 230 Qu nsey, the streptoccoca nfect on, 225
R Rabe a s, Franço s (c. 1490-1553), 134 ; Gargantua and Pantagrue , 123 ; Ta e of a tub , 152 Radc ffe Co ege, 298 Radc ffe, Dr. John, 149 Ra way sp ne, hyster ca trauma resu t ng from ra way acc dents, 417 -418 Rakes, 161 Rane agh Gardens, the, 100 Raphae , c tat on of by Eugen Ho änder, 372 ; sketch transf gurat on , 368 -369, 374 Rau n, Joseph, descr pt on of ma e hyster a n G af ra Abr cosoff s book L hystér e aux XVIIe et XVIIIe s èc es , 313 Ravenna, f fth/s xth-century Ita an c ty, 57 ; Romanesque mosa cs of, 367 Raymond, Fu gence, French psych atr st who s m squotat on by Maur ce F shberg became the ead ng v ew n German psych atry, 405 ; and Janet, P erre, "Ma format ons des ma ns en `p nces de humard," mage "Asymetr e du corps chez une ep ept que," 380 Rea sm, 109 , 111 , 123 Regnard, Pau , 377 ; mage of a v sua ha uc nat on, 376 ; Les ma ad es ép dém ques de espr t: sorce er e magnét sme, morph n sme, dé re des grandeurs , 373 , 375 ; monograph on the v sua re at onsh p between magnet sm, morph n sm, and madness, 374 ; photographs of August ne from the second vo ume of the Iconograph e de a Sa pêtr ère , 372 Re ch, W he m, 238 , 289 Re , Johann, asy um super ntendent dur ng the n neteenth century, 261 Re n nger, Robert, c a m we construct our understand ng of the wor d from our nterna zed system of va ues, 436 Re g on, h story of, 370 Re g ous enthus asm, 177 Re g ous me ancho y, 162 -175 pass m Rembrandt, (Harmenszoon van R n), trad t on of anatom es, 345 Rena ssance, the, 57 , 91 , 95 -97, 99 , 101 , 106 -108, 112 , 124 , 126 , 129 , 131 -132, 158 , 181 -183, 227 , 239 , 241 , 292 , 374 Report of the Roya Comm ss on on Mesmer sm, 361 -362 Reproduct ve organs, the, 179 , 254 , 297 , 300 Repub c of Letters, the, 160 Resp rat on, 33 , 47 Rest cure for hyster a, 246 -248; for neurasthen a, 297 -298; for she shock, 323 ; fa ure w th men, 299 ; protests aga nst, 299 -300 Rev on, Char es, French phys c an, author of Recherches sur a cause des affect ons hypochrondr aques , 170 Revue de hypnot sme , 388 Revue photograph que des Hôp tax des Pa rs , 349 Reyno ds, John Russe , A System of Med c ne , 289 R chardson, Samue , 170 ; S r Char es Grand son , 152 ; C ar ssa Har owe (1753), 185 R cher, Anto ne, Les Demon ques dans Art (1887), 231 R cher, Pau , co eague of Jean-Mart n Charcot, 345 , 350 , 367 , 377 , 379 , 383 ; Études c n ques sur e grande hystér e ou hystéro-ép eps e , 363 ; "Gonf ement du cou chez un hyster que," 351 R sse, G. B., 10 R vers, W. H. R., ear y twent eth-century Br t sh psycho og st, 325 -326; v ew on Freud s theory of the unconsc ous and the method of psycho-ana ys s founded upon t, 321 ; study of she shock, 325 ; theory of the unconsc ous, 325 Robb, Dr., n neteenth-century phys c an, 3 , 7 -8, 14 , 16 Robert-F eury, Tony, portra t, "P ne Free ng the Insane," 347 ; nf uence of, 345 Rob nson, Dr. N cho as, 151 , 153 , 155 -156, 168 ; "Newton an d ssertat on on hyster a," 167 Romans, the, 4 , 8 , 14 , 36 , 64
474 Romant cs, the, 110 ; Romant c poetry, 177 ; Romant c sm, 248 Róona, S., work cont nued from Mor z Kapos on forms of sk n erupt ons wh ch cou d be abe ed hyster c, 389 Ross, T. A., suggest ons for tra n ng Wor d War I so d ers, 324 Rousseau, Jean Jacques (1712-1778), French ph osopher, 243 Rousse ot, Jean, study of med c ne n art n post Wor d War II era, 372 Row ey, W am, Eng sh phys c an spec a z ng n fema e d seases, author of A treat se on fema e, nervous, hyster ca , hypochondr aca , b ous, convu s ve d sease ; apop exy and pa sy w th thoughts on madness and su c de, etc ., 177 Roy, A ec, 230 ; Hyster a (1982), 10 Roya Co ege, the, 117 Roya Soc ety, the, 146 , 355 Rudo phy, K., "Ohroperat onen be Hyster schen," chart represent ng the operat ons of the German hyster c s hear ng, 404 Russett, Cynth a, 291
S Sade, Donat en A phonse Franço s, comte de (1740-1814), French author known as the marqu s de Sade, 184 Sacerdote, A., work on the changes n qua ty of the hyster c s face, 384 Sad er, John, S cke Woman s Pr vate Look ng-G asse where n Method ca y are hand ed a uter ne affects, or d seases ar s ng from the wombe; enab ng Women to nforme the Phys c an about the cause of the r gr ef e , 131 St. Bartho omew s Hosp ta , 302 Sa nt Patr ck s Cathedra , New York C ty, 334 Sa em w tch-hunt ng tr a s, 100 Sa erno, schoo of, 55 , 56 , 148 Sa mon, Thomas, ear y twent eth-century Br t sh phys c an, 322 Sa pêtr ère hosp ta , 242 , 257 , 259 , 264 , 289 , 302 , 305 , 308 -312, 314 , 345 -346, 349 , 352 , 359 , 365 , 366 -367, 372 , 377 , 383 -384, 406 , 411 , 422 -423 Sartre, Jean Pau (1905-1980), 290 Sassoon, S egfr ed, famous she -shock pat ent, 324 Satan, 98 , 232 ; satan sm, 99 Satow, Roberta, 4 , "Where Has A the Hyster a Gone?" 101 de Sauvages, Bo sser, 262 Savage, S r George, n neteenth-century London phys c an, 247 Sav , Thomas D., study of sk n on hyster ca ch dren, 389 ; mage of the hyster c w th syph s from "A C n ca Lecture on Hyster ca Sk n Symptoms and Erupt ons," 390 Schre ner, O ve (1855-1920), South Afr can author and fem n st, 292 Sc ence, 129 , 232 , 240 , 259 ; En ghtenment, 165 ; n neteenth-century, 176 ; med ca , 231 ; of the body, 236 Sc ent f c revo ut on, the, 239 Scot and, 168 , 174 , 183 Scott, Joan, post-Wor d War II Amer can h stor an, 330 Scr b er ans, the, wr ters co ect ve, 160 de Schwe n tz, George Edmund, Ph ade ph a optha mo og st n the ear y twent eth century, 384 Scu y, D. H., 4 Scu ptured mage of a case of hem p eg a from the teach ng co ect on of the Sa pêtr ère, 385 Sedentary fe (see a so Inte ect), 160 -162 Se f-fu f ment, deve op ng codes of, 160 -161 Sem o ogy of ness, 160 Sem ot cs, med ca , 286 , 362 , Sem tes, the, 227 Sennett, R chard, Amer can soc o og st, 162 Sensat on, 143 Sens b ty, cu ts of, 160 -161 Sergt, M., hyster ca pat ent w th wounds on h s r ght forearm, 367 Sex sm, 329 -331 Sexua et o ogy of the neuroses, 324 Sexua ntercourse, 40 , 42 , 50 , 52 , 62 , 426 ; w th a c rcumc sed pen s, 422 Sexua organs, the, 99 -100, 251 , 297 ; fema e, 112 -114, 134 Sexua pass ons, the, 262
475 Sexua po t cs, and hyster a n the e ghteenth century, 162 Sexua theory, n neteenth century, 249 -250; twent eth-century, 132 -133 Sexua ty, 136 , 163 , 250 , 292 , 327 , 329 , 333 , 427 ; fema e, 93 , 251 , 292 , 303 -304, 335 ; Greek or g ns of term, 329 ; ma e, 171 ; repress on of, 182 -185, 302 -303, 326 Shakespeare, W am, 114 , 123 , 126 -129, 131 , 133 ; Ham et , 95 ; K ng Lear , 121 , 127 -128 Shaman sm, 23 Sharp, Jane, a ma e "quack doctor" n Restorat on Eng and, 132 Shaw, James, study of the concept of asymmetry n the hyster c s face, 384 Shaw, Peter, H s Ma esty George II s Phys c an Extraord nary, The Ref ector: Represent ng Human Affa rs, As They Are: and may be mproved , 163 She shock (see a so War Neuros s), post traumat c symptom f rst exper enced by so d ers after Wor d War I, 229 , 247 , 292 , 304 , 321 , 326 , 367 , 370 She ey, Percy Bysshe (1792-1822), "G nevra," 63 -64 Shorter, Edward, 9 , 29 , 297 -229, 326 Showa ter, E a ne, x , xv , S che , Max, Jew sh phys c an dur ng Wor d War I, 433 S emer ng, E., v ew of cerebra -sp na degeneracy as the source of hyster a, 385 S ger st, Henry, 328 S verman, Debora, comments about the Centra Un on of the Decorat ve Arts program n the 1890s, 310 S mon, Bennett, M nd and Madness n Anc ent Greece , 22 -24 S twe , Dame Ed th, 171 Skae, Dav d, n neteenth-century Br t sh phys c an, 247 Skey, F. C., n neteenth-century Eng sh phys c an, 302 Sk n, hyster ca ; as an mage of the d sease hyster a, 402 ; re at on between the appearance of sk n to the state of the gen ta a, 389 , 391 , 434 Sk nner, Quent n, 142 Sku , the, 383 Sku tans, V eda, h stor an of Eng sh madness, 293 S ater, E ot, 4 , 242 S avney, Ph p, descr pt on of Et enne Tr at s study "Perspect ves on Hyster a," 335 Sma pox, 352 Smart, Chr stopher, 170 , 171 , 177 Sm th, Adam, Scott sh En ghtenment ph osopher, 134 Sm th-Rosenberg, Carro , fem n st h stor an, 302 Smo ett, Tob as: Don Qu xote, the f ct ona character, 172 ; Launce ot Greaves, the f ct ona character, 172 Sneez ng, as treatment for hyster a, 4 -5, 40 , 45 , 56 , 58 , 59 , 60 -61 Snow, C(har es). P(ercy). (1905- ), Eng sh nove st, "two cu tures" d chotomy, 237 Soc ety, 169 ; Western European, 104 , 149 , 175 Sofer, Pressburg Rabb Moses, 430 So er, Pau , case of the contracture of the hand n the ma e hyster c n the fourth vo ume of the Nouve e Iconograph e de a Sa pêtr ère , 391 ; mage of the hand of the ma e hyster c from "Contracture Vo onta re chez un Hystér que," 394 Somat sm, 237 , 239 , 245 Sontag, Susan, xv ; I ness as Metaphor , 110 Soranus, gyneco og ca theor es of, 25 -28, 35 -42, 44 , 47 , 53 -55, 57 , 91 ; Gyneco ogy , 15 , 37 , 53 Sorc ères , ear y twent eth-century French fem n st ourna , 331 Spa n, 148 Speech d sorders, 326 Spencer, Herbert (1820-1903), Eng sh ph osopher, 295 -296; art c e wr tten for the Westm nster Rev ew , 295 Spencer, Johann, e ghteenth-century theo og an, 429 Spenser, Edmund, 98 Sp noza, Baruch, 1632-1677, Dutch ph osopher, 410 Sp r ts, ev , 361 Sp een, the, 231 , 255 , 293 "Start e effect," 358
476 Steffens, Pau , twent eth-century Hamburg phys c an, 385 Ste nd er, A., essay on hyster ca contracture, 392 ; mage of posed hyster c from "On Hyster ca Contractures," 397 Stephen of P sa, 55 Ster ty, hyster a and, 291 -293; neurasthen a, 295 -296 Sterne, Laurence (1713-1768), Br t sh author of Tr stram Shandy , 163 , 170 , 173 , 243 van Steven ck, Lucas, med ca student of Hermann Boerhaave, 168 Stevenson, Anne, her remarks to the controversy concern ng the use of "hyster ca " as a cr t ca term for the poetry of Sy v a P ath, 334 St gma and ness, 175 -178; and gender, 176 -177 Stock, Johann Chr stoph, 168 Stone, Mart n, ear y twent eth-century she -shock scho ar, 325 Strauss, H., "Erkrankungen durch A koho und Syph s be den Juden," chart represent ng the Jew sh hyster c, 407 ; study of the patho ogy of the Jews, 406 , 433 Stress, 228 -229, 242 -243, 246 , 295 Stuart Eng and, 105 Surrea sm, 312 -313 Surrey County Lunat c Asy um, the, 356 Sweat, great, 226 Swedenborg, Emanue (1688-1772), Swed sh sc ent st, ph osopher, and theo og an, 183 -185 Sw ft, Jonathan, 160 , Ta e of a Tub , 152 , 170 Sw tzer and, hyster a n, 168 Sydenham, Dr. Thomas, x , 13 , 93 -94, 98 , 102 -104, 106 , 109 -110, 116 , 124 , 137 -149, 151 -153, 155 , 157 , 162 , 167 -168, 170 , 173 -174, 177 , 180 -181, 185 , 232 , 245 , 258 , 293 ; Ep sto ary D ssertat on , 139 , 141 , 143 Symbo c, the, 332 Syph s, 228 , 229 , 389 , 417 , 421 -423, 428 -435 Szasz, Thomas, 234 -235, 239 , 265 ; The Myth of Menta I ness , 233
T Tabes, 422 Ta bot, Fox, use of photography n treatment of the menta y , 356 Tears (see a so B ush ng), 163 Teeth, gr nd ng as symptom of hyster a, 15 , 19 , 23 Tetanus, 364 , 366 , 368 , 379 Test c es, the, 308 Thackeray, W am, 409 , Cod ngsby , 406 Theodorus Gaza, traduct o nova ed t on of the Art ce a , 58 -59 Theo ogy, 238 , 240 ; Chr st an, 237 Theophanes Nonnos, med ca comp at ons by, 46 Theoph us, on ur nes, 57 Therap sts, H gh V ctor an, 246 Theseus, 104 Th rd Repub c, the, 231 Thorax, the, 241 Throat, the, 241 Thucyd des (c. 460-400 B.C .), Greek h stor an of Athens, descr pt on of the "great p ague" of Athens, 225 T ckner, L sa, study of the Br t sh suffrage movement, 306 T t, Edward, V ctor an phys c an, 286 T maeus of Locr , 25 T mes L terary Supp ement , 334 T ssot, Samue Auguste, Sw ss "ant masturbat on" doctor, 182 , 245 , 262 Tode, Johannes, 168 Trance, 23 Trave to seas de resorts, 164 Tr at, Et enne, 257 , 335 ; H sto re de Hyster e (1986), v , 5 , 9 -10, 29 , 41 -42, 291 Tr n ty Co ege, Hartford, Connect cut, 313 Trota, twe fth-century fema e phys c an, Cum auctor , 56 ; Ut de curt s , 56 Trumbach, Rando ph, 136 Tryon, Thomas, myst c and vegetar an, D scourse of the Causes of Madness , 176 Tubercu os s, 228 Tudor-Stuart Eng and. See Eng and, Tudor-Stuart
477 Tuesday C n c, c n c operated by Jean-Mart n Charcot, 242 , 247 , 260 Tuesday ectures, the, 350 , 415 Tuke, Hack, 265 Tukes, the (W am, Henry, and Samue ), asy um super ntendents dur ng the n neteenth century, 261 Turbayne, C. M., 25 Turner, W am, 168 Tuskegee exper ments, 433
U Uff z Ga ery, Bacch c scene of "dy ng Bacchante," 372 Un ted K ngdom, the, war hosp ta s for menta pat ents, 321 Un ted States, the, 287 , 294 -297, 305 -306, 434 Un vers ty po yc n c, the, 249 Un vers ty of San Franc sco, the, 331 Urban spraw , n re at on to gender arrangements, 154 -166 Uterus, the, 251 , 254 , 292 , 359 , 402 ; uter ne system, the, 252
V Vag na, 251 , 254 ; re at onsh p to the c rcumc sed pen s of a Jew sh man, 425 Van Deusen, E. H., 305 Van Sw eten, Gerard, 262 "Vapours," 119 , 149 -150, 152 -153, 155 , 170 , 255 , 289 , 293 Vascu ar system, the, 252 Vassar Co ege, 298 Ve th, I za, med ca h stor an of hyster a, 104 , 106 , 109 , 115 , 139 , 142 , 157 , 183 , 232 -233, 235 , 237 , 242 , 246 , 255 , 262 , 329 -330; Can You Hear the C app ng of One Hand (1989), 331 ; Hyster a: The H story of a D sease , v , xv , 4 -5, 7 -8, 26 , 93 , 96 , 119 -121, 232 ; Hyster a (1965), 328 -331 Vesa us, Andreas, 63 ; De human corpor s fabr ca (1543), 64 V co, G ovann Batt sta, xv V ctor ans, the, 185 V enna, Austr a, 420 , dur ng the t me of Freud, 144 , 174 , 183 , 315 , 402 , 405 , 427 V enna Genera Hosp ta , 323 V enna Psych atr c Soc ety, the, 314 V enna Psychoana yt c Soc ety, 405 -406 V enna, Un vers ty of, 404 V ennese Jew sh commun ty dur ng the ear y n neteenth-century debate on the abo t on of c rcumc s on, 430 V ennese Soc ety of Phys c ans, 402 V nd c anus, 48 V o ence, 161 V rago, ear y twent eth-century Eng sh pub sh ng company, 331 V rard, P., 168 V rg ns, 123 , 135 V s b ty of the hyster c. see Hyster c V s onar es. See Cam zards, French prophets, B ake, Eng sh yr c poets
W Wack, Mary, 64 , 99 , 113 War fever, 226 War Neuros s, 321 -326 Warner, Franc s, The Express on of Emot ons n Men and An ma s , 383 Warner-Jauregg, Professor Ju us, report for the Austr an comm ss on appo nted to nvest gate the treatment of Wor d War I war neurot cs, 323 We der, Wa ter Baer, mage show ng eyes, and s ght of the hyster c, 386 ; work on hyster ca b ndness, "Some Ocu ar Man festat ons of Hyster a," 384 We r M tche rest cure, the, 323 We come Inst tute for the H story of Med c ne, the, 65 Western med ca mode before 1800, the, 92 Weyer, Johannes, Dutch phys c an, 112 , 14 -116, 122 -127, 149 , 232 WHAM, abort on r ghts group, 334 Wharton, Ed th (Jones) (1862-1937), Amer can nove st, 299 Wh te, Andrew D ckson (1832-1918), study of conf ct between sc ence and theo ogy, 374 Wh te, Hayden, x Whytt, Robert, Scott sh phys c an, 179 -180, 183 -184, 262 ; Observat ons on the nature, causes and cure of those d sorders wh ch have been common y ca ed nervous ,
478 hypochondr ac, or hyster c, to wh ch are pre-f xed some remarks on the sympathy of the nerves , 166 -167; "Proteus and the chame eon," 176 W dows, 123 , 135 W de, Oscar, 292 , 346 W s, Thomas (1621-1675), Eng sh phys c an and anatom st, author ty on bra n and nervous system, 104 , 124 , 138 , 140 -141, 143 , 145 ; 147 , 151 -152, 155 , 158 , 162 , 183 -184, 241 , 262 ; Affect onum quae d cuntur & hypochondr acae patho og a . . . (1672), 140 ; theory of sympathy, 147 W son, N. G., summary on A exandr an med c ne, 45 W t, Restorat on and Scr b er an, 160 W tchcraft, 96 -98, 100 , 104 , 121 , 127 , 132 , 148 , 329 W tches, 98 , 100 -101, 105 , 117 , 124 , 126 , 132 , 149 , 177 , 233 , 352 , 361 , 374 , 377 ; the ate med eva w tch craze, 225 ; w tch-hunts, 265 , 287 , 329 ; w tch tr a s, 242 , 329 ; w tch s c aw, the, 104 -105 W tches, the, ear y women s group, 331 W ttmann, B anche, the "Queen of Hyster cs," 229 , 242 , 309 -310, 345 -346 Womb, the, 11 , 12 , 13 , 14 , 15 , 18 , 19 , 27 , 28 , 36 , 38 , 117 , 119 , 130 -134, 157 , 181 , 232 , 266 , 356 , 404 ; dry womb, 18 -19; movement of, 12 , 14 , 17 , 24 , 25 , 27 , 29 , 30 , 32 , 38 -39, 42 , 46 , 48 , 50 -53, 55 , 64 ; or g n of a d seases, 30 ; P ato s descr pt on of, 25 -28, 104 , 118 , 123 ; suffocat on of, see Hyster ke pn x ; wander ng, 25 -26, 42 , 49 , 54 , 116 , 118 , 121 , 125 , 140 , 335 , 402 , 404 ; womb, as an ma , 25 -26, 28 , 38 -39, 40 -41, 43 -44, 46 , 52 , 56 , 185 ; womb as oven, as hearth, 31 -32 Women, hyster a and. See under Hyster a Women s suffrage, n Eng and, 326 ; n the Un ted States, 326 Woodruff, R. A., 4 Woo f, V rg n a, Mrs. Da oway , 247 Wordsworth, W am (see a so Ga e, Susan), 132 , 153 ; "The Id ot Boy," 177 Wor d War I, 292 , 300 , 321 , 366 , 433 Wr ght, Dr. A mwroth, art c e "On M tant Hyster a," 320
X X-ray med ca ana ys s, 381 , 391
Y Y dd sh, 425 -426
Z Zamp er , Domen ch no (1581-1641), 368 Zetze , E zabeth Rosenberg, Emergency Med ca Serv ce psych atr st dur ng Wor d War II, 330 ; f rst ana yt c paper, "War Neuros s: A C n ca Contr but on," 327 Zev an , G. V., 168 Z boorg, Gregory, med ca h stor an, 231 Z on st , a eged bastard race or g nat ng from sexua se ect v ty, 434 Zoöph st , Eng sh ant v v sect on st ourna , 311 Preferred C tat on: G man, Sander L., He en K ng, Roy Porter, G. S. Rousseau, and E a ne Showa ter Hyster a Beyond Freud. Berke ey: Un vers ty of Ca forn a Press, c1993 1993. http://ark.cd b.org/ark:/13030/ft0p3003d3/
