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A Brief History of Hysteria

The history of the “medical condition” of hysteria is a long, winding, somewhat convoluted one. In its earliest definitions, hysteria was a term to describe trauma or disease of the uterus (hence the word “hysterectomy” to remove the uterus) – or even to describe a vengeful or mischievous uterus that detached itself from the pelvic region and wandered around the body.

4000 Years Ago, Ancient Egypt:

It’s said that the concept of the wandering womb came about around 4000 years ago in ancient Egypt, although the term “hysteria” wasn’t coined until around 2400 years ago by Hippocrates. Now, in general there was some stuff that Hippocrates got right – indeed he’s considered the father of western medicine. But he had some really interesting and wrong ideas about the uterus.
In old Greek, “hystera” (without the i) referred to the womb, which is where we get terms still used today like “Hysterectomy” – removal of the uterus.

2400 Years Ago, Ancient Greece:

Hippocrates lived around 400 BCE, and wrote / taught about the “wandering womb” – that the uterus was not anchored in place but was like an animal with a mind of its own, traveling around inside the body and wreaking havoc on other tissue and organ systems like a delinquent. All the symptoms caused by the womb’s antics is what they collectively described as hysteria.

The wandering womb was said to cause heart problems, liver problems, respiratory problems, it could cause a host of neurological issues, everything from headaches, to epileptic seizures (known as “Hercules’ Disease”), to unexplained paralysis (which might now be classified as conversion disorder).

Symptoms of hysteria include:

  • Sleeping too much, or too little.
  • Becoming disinterested in past hobbies, or too interested or obsessive in hobbies.
  • Showing apathy or lack of care, or having anxiety, irritability and caring too much.
  • Having high libido, or low libido.
  • Being too quiet and mute, or being too talkative and loud.

I think you get the idea. There was a very narrow range of “acceptable behavior” and if a lady swung too far out of that range on either side, she could be diagnosed with hysteria.

1500-500 Years Ago, Middle Ages in Europe:

In the middle ages, hysteria was tied to sorcery, witchcraft and demon possession and so – naturally – of the treatments was exorcism. Hysteria was a disorder of exclusion – if every other known disease had been ruled out and doctors couldn’t come up with an official diagnosis, then they believed that it was a disease brought about by something “intangible” and “not well understood” and therefore a result of the devil. And of course, since women were thought to have brought about original sin (re: Eve and the serpent), women were thought to be either naturally prone to “evil”, and/or more naïve and impressionable to evil spirits. Exorcism often involved physical and mental torture of the patient, and many women didn’t survive this “treatment”.

150 Years Ago: Victorian Era in Europe:

By the 19th century, at the height of Victorian fashion, hysteria had become a blanket term for emotional, sexual or mental disorders suffered exclusively by women. Some people blamed quintessentially “feminine” objects and garments for the disease (like corsets!) while other people thought that corsets helped prevent hysteria. But honestly, when I first started researching the history of hysteria, I was surprised by how little it was tied to the corset (the real history of corsets and stays are only close to 500 years, while hysteria is 4000 years old, so this is unsurprising).

Hysteria was a particularly popular diagnosis in the 18th and 19th centuries – in fact the 2nd most diagnosed condition after fever. According to author Laura Briggs, one doctor in the 19th century had a 75 page publication listing all the possible symptoms of Hysteria (and said that list was still not exhaustive)! It was estimated that 25% of the female population was affected by hysteria in some form or another. So Hysteria was still this vague, catch-all, umbrella diagnosis that could manifest in any different ways (it had hundreds or thousands of different “faces”) – as long as the patient possessed a uterus. If you, as a lucky owner of a uterus, disturbed the peace in any way, you could be diagnosed with hysteria and hauled away to a sanitarium or insane asylum.

We’ve discussed the many “symptoms” of hysteria, but what were the causes?

Some claimed that hysteria was due to the uterus becoming too dry and light. (Did the uterus become a helium balloon and just float off somewhere else in the body??) So doctors recommended ways to keep the uterus moist and weighted…. Except not really, because another source said that hysteria was caused by too much fluid retention in the pelvic region, specifically because the female was not purging her body of “female sperm”. (!?!!?)

In the 1700 and 1800s they also blamed “bad air” for hysteria, so when a woman “got the vapours” it meant their womb was acting up. You might have heard of smelling salts which were used to rouse fainting women (this worked by creating a sharp inhalation reflex, which was said to oxygenate the body), but the salts also were supposed to help with hysteria. Smelling salts were not pleasant in aroma; they were made with ammonia. Taking in the pungent odors through the nose at the top of the body was thought to repulse the uterus so it would be driven down through the body. Doctors also recommended applying sweet perfumes and scents to the groin to lure the uterus back to its assigned seat, so to speak.

As you can imagine, there was a lot of contradiction and nobody could really agree as to what caused hysteria, what the mechanism is, or how to cure it.

The horrific “treatments” in the name of hysteria:

Smelling salts, while not pleasant to actually smell, was probably one of the ‘preferred’ treatments for mild hysteria. Others recommended spreading dung on the upper lip or in the genitals (which is anything but hygienic).

Hippocrates said that pregnancy could keep the uterus anchored in place and prevent it from wandering – but the caveat, he says, is that the action of childbirth could cause the uterus to act up again and encourage it to wander. So, he seems to have implied that regular relations with one’s husband to keep the patient like constantly impregnated would be the answer.

Rachel Maines, author of “The Technology of the Orgasm”, has written extensively about the “treatment” for hysteria involving what we would now consider sexual abuse. Forced vigorous pelvic massages – manual stimulation administered by the doctor, or this task could be delegated to the nurse or midwife. According to this chapter in her book, when doctors complained that they were getting too tired stimulating the patient or it took too much of their time, that’s when sexual vibrators were developed as a popular substitute.

Lucy’s Added Thought: Even though hysteria is millennia older than the Victorian era, perhaps one of the reasons why it seems to be so intertwined with this era (apart from more literacy and more surviving written documents about the disease during the 1800s), is that there seems to be this connotation that compared to all other times in history, the 18th and 19th centuries in Britain seemed to be the most sexually repressed and these values were said to be spread to other cultures and countries around the world through colonialism during this era.

1885: Sigmund Freud and Male Hysteria:

Sigmund Freud was erroneously blamed for the widespread belief of the wandering womb, when really the theory had existed for millennia. When I looked more into it though, Freud started learning more about Hysteria from Jean-Martin Charcot around at the end of the 19th century, around 1885. Charcot popularized the theory that men could suffer from hysteria as well, especially soldiers. Many of the symptoms Charcot described would later be known as “shell-shock” and then post traumatic stress disorder. Freud put forward the belief that female and male hysteria was basically the same thing, related to anxiety neuroses – which was sort of laying down more framework for what we now know as anxiety disorder, borderline personality disorder, dissociative disorders, and PTSD although that wasn’t what they was called yet.

So in the late 1800s and early 1900s, Freud and Charcot and a few others were working to reclassify many of hysteria’s symptoms into new diagnoses, admittedly a lot of those were also wrong and often harmful and now rejected too – but they did claim that hysteria was a psychological, neurological and emotional disorder presented by survivors of trauma. It was not physical disease reserved only for those who own a uterus, and they promoted hypnotism and talk therapies. Freud even diagnosed himself with hysteria at one point, but there was so much resistance around male hysteria from the rest of the medical community that he flip-flopped and started calling hysteria a “feminine” disease again later on.

Meanwhile there was still a lot of messed up shit happening in the name of “treatment”. It seems that spreading dung on yourself and exorcism had both fallen out of favor by this time (thank goodness), but of course there was still sexual abuse and smelling salts as I had mentioned earlier, they were also injecting things into the uterus, cutting or burning away the genitals with fire or chemicals (Dr John Harvey Kellogg was said to be particularly supportive of female circumcision), using electroconvulsive therapy or shock therapy, among other stomach-churning things. And this was all happening well into the 20th century.

1920 – 1980: The Fall of Hysteria:

Hysteria as a diagnosis plummeted drastically after the 1920s in part due to women’s suffrage, but also a huuuuuge factor was because so many people, men and women, across different countries and cultures, started to present symptoms of PTSD during and after WW1 and WW2 that doctors could no longer deny its association with experience and trauma, and that it had nothing to do with gender. However, hysterical neuroses was still mentioned in the DSM-II in 1968, and was only officially deleted when they came out with the DSM-III in 1980.

 

Like I said before, Hysteria has about 4000 years of history, and it’s a convoluted history. Obviously there were multiple and contradictory hypotheses that existed at the same time about both the cause of Hysteria and the symptoms as a result of the condition, and also there’s a lot of disagreement about the timeline of it and who believed what about it prior to the 1900s. Also it’s worth noting that I am not a historian (I’m trained in modern biology) but I’ve tried to touch on events as fairly as possible in this article and clear up some misconceptions about hysteria.

I’ll post links below if you want further reading on this topic. Comment below and let me know the most absurd thing you’ve heard about hysteria!

 

Links for Hysteria (for further reading):

https://www.jstor.org/stable/30041838

http://www.nytimes.com/books/first/m/maines-technology.html

https://www.ncbi.nlm.nih.gov/pubmed/25273494

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480686/

Did Victorian era doctors use vibrators to treat hysteric female patients with orgasm therapy?