MEDICAL MATTERS:Term now seen as a misogynistic anachronism, writes MUIRIS HOUSTON
THE TERM hysteria, when used in a medical sense, is now seen as a misogynistic anachronism. But this wasn’t always the case; female hysteria was a routine diagnosis for many years in Western Europe and in the US. Originally attributed to Hippocrates, hysteria meant “wandering womb” and women with a wide range of symptoms were told they had the condition.
Their complaints ranged from nervousness and insomnia to fluid retention and muscle spasm; such broad symptomatology would now probably trigger suspicion about the appropriateness of a single diagnosis, but in the 19th century the label was a fashionable one.
One of the most “famous” hysterics was 15-year-old Louise Augustine Gleizes, who allegedly had 154 hysterical fits in one day. Her Parisian doctor, Jean-Martin Charcot, put her on show. She was hypnotised to show the various stages of hysteria in packed public lectures: she heard voices, saw (imagined) black rats, and developed abdominal pain before finally losing consciousness.
But hysteria hasn’t gone away – it appears every now and again in response to otherwise inexplicable events. The most recent to attract public attention occurred last October in Leroy, a town in upstate New York. A high school cheerleader woke up from a nap with facial tics, other uncontrollable movements and verbal outbursts. A total of 14 girls and one boy were similarly afflicted by symptoms suggestive of Tourette’s syndrome. However, after extensive medical testing, no explanation could be found other than “mass hysteria”, now carrying the more politically correct title of mass psychogenic illness.
According to experts, the first girl seems to have suffered from some kind of emotional distress, which she expressed through otherwise unrelated physical symptoms. The other victims believed the condition to be communicable and “caught” it. Other famous cases of hysteria include a 1962 episode in a Tanzanian girls’ school in which an epidemic of uncontrollable laughing affected some 95 students. In 1965, there was a mass fainting episode at a school in Blackburn during which 85 girls were hospitalised.
A common thread through all of these incidents of hysteria is the age and sex of those affected. Why is it almost always young teenage girls? Asti Hustvedt, in her book Medical Muses: Hysteria in Nineteenth-Century Paris, says Charcot’s activities and attitudes continue to resonate, albeit in an unhelpful way.
“In many ways we live in a culture that’s far less sexist than Charcot’s was,” the author says, “but when it comes to the idea that the female body is, say, more vulnerable to hormones than the male body – that absolutely continues. As does the idea that anything connected to the entirely natural, biological female reproductive system – pregnancy, childbirth, menstruation, menopause – is a medical issue.”
And she points out that in modern medicine when we are diagnosed with some vague syndrome, it can seem to lack legitimacy or even carry a pejorative label.
Hustvedt touches on a crucial point: the difference between illness and disease. “Illness is what you have on the way to the doctor; disease is what you have on the way home” is a useful aphorism in this context.
Ultimately, what matters most is the patient’s experience of a particular condition, regardless of any medical label. This experience is often driven by cultural factors and it may well be that the Parisian patients might not experience the same symptoms now as they did in the 1800s.
Clearly the 19th-century approach to “female hysteria” does not reflect well on the medical profession. Publicly exhibiting patients for entertainment and the use of “pelvic massage” – the manual stimulation of the victim’s genitals – until the patient experienced “hysterical paroxysm” seem almost barbaric when viewed through a 21st-century prism.
Could our discomfort about these treatments be a reason why hysteria is no longer considered a medical diagnosis? Or does the disappearance of the term simply reflect the cultural changes and scientific advances of modern times?