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Hysteria Beyond Freud
"She's hysterical." For centuries, the term "hysteria" has been used by physicians and laymen to diagnose and dismiss the extreme emotionality and mysterious physical disorders presumed to bedevil others—especially women. How did this medical concept assume its power? What cultural purposes does it serve? Why do different centuries and different circumstances produce different kinds of hysteria?
These are among the questions pursued in this absorbing, erudite reevaluation of the history of hysteria. The widely respected authors draw upon the insights of social and cultural history, rather than Freudian psychoanalysis, to examine the ways in which hysteria has been conceived by doctors and patients, writers and artists, in Europe and North America, from antiquity to the early years of the twentieth century. In so doing, they show that a history of hysteria is a history of how we understand the mind.
This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1993.
These are among the questions pursued in this absorbing, erudite reevaluation of the history of hysteria. The widely respected authors draw upon the insights of social and cultural history, rather than Freudian psychoanalysis, to examine the ways in which hysteria has been conceived by doctors and patients, writers and artists, in Europe and North America, from antiquity to the early years of the twentieth century. In so doing, they show that a history of hysteria is a history of how we understand the mind.
This title is part of UC Press's Voices Revived program, which commemorates University of California Press’s mission to seek out and cultivate the brightest minds and give them voice, reach, and impact. Drawing on a backlist dating to 1893, Voices Revived makes high-quality, peer-reviewed scholarship accessible once again using print-on-demand technology. This title was originally published in 1993.
502 pages, Hardcover
First published December 7, 1993
About the author
Sander L. Gilman
130 books38 followersSander L. Gilman is an American cultural and literary historian. He is known for his contributions to Jewish studies and the history of medicine. He is the author or editor of over ninety books. Gilman's focus is on medicine and the echoes of its rhetoric in social and political discourse.
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November 11, 2023
UCTION—THE DESTINIES OF HYSTERIA
• 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
o 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.
• But even if the medical diagnosis of hysteria has languished, for 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. THESIS
• 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.
• We are sensitive to the differences between 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
Once Upon A Text: Hysteria from Hippocrates by Helen King
• 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."
o Yet recent work on Hippocratic medicine has called into question much of this tradition.
• 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
• 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 . . .
• "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.
• 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
o Hysteria is supposedly the 35th aphorism
o But this is incorrect: the word hysterika occurs in 5.35: "In a woman suffering from hysterika , or having a difficult labor, a sneeze is a good thing."
o HYSTERIKA
Hysterika , he wrote in his commentary on the Aphorisms , could refer to all diseases of the womb 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 .
Since retained menses were thought to be the cause of many female disorders, the expulsive value of a sneeze could often be beneficial.
o 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
• Two obstacles standing in the way of a decision to treat hysteria as a historical constant
o 1. 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
o 2. that an integral part of the definition of hysteria often consists in its supposed ability to mimic symptoms of other diseases.
• The solution here: 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.
• DIAGNOSIS HISTORY
o he 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.
o In a woman, as another Hippocratic 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.
o 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)
o 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
o 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."
o By 19th century, whether or whether not the origin was the womb, hysteria was ROOTED IN THE VERY NATURE OF BEING FEMALE
• Hippocratic Hysteria: the womb and its destinations
o ORGANIC CAUSE: the movement of the womb
o 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.
o 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?
o WOMBINESS
o 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. INTERESTING
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"
"if symptom x, therapy y"
o So there is no name of disease Hysteria but instead “when the womb turns to the head” or the symptoms of pnix, suffocation.
o Defining the female in terms of the male is one way of expressing difference; chronology is another.
o 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
• Plato and Aretaeus: The Wild womb?
o 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
• Stifling and Suffocation: the development of the textual tradition
o 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 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. THESIS
• 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
o 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.
• But even if the medical diagnosis of hysteria has languished, for 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. THESIS
• 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.
• We are sensitive to the differences between 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
Once Upon A Text: Hysteria from Hippocrates by Helen King
• 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."
o Yet recent work on Hippocratic medicine has called into question much of this tradition.
• 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
• 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 . . .
• "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.
• 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
o Hysteria is supposedly the 35th aphorism
o But this is incorrect: the word hysterika occurs in 5.35: "In a woman suffering from hysterika , or having a difficult labor, a sneeze is a good thing."
o HYSTERIKA
Hysterika , he wrote in his commentary on the Aphorisms , could refer to all diseases of the womb 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 .
Since retained menses were thought to be the cause of many female disorders, the expulsive value of a sneeze could often be beneficial.
o 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
• Two obstacles standing in the way of a decision to treat hysteria as a historical constant
o 1. 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
o 2. that an integral part of the definition of hysteria often consists in its supposed ability to mimic symptoms of other diseases.
• The solution here: 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.
• DIAGNOSIS HISTORY
o he 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.
o In a woman, as another Hippocratic 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.
o 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)
o 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
o 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."
o By 19th century, whether or whether not the origin was the womb, hysteria was ROOTED IN THE VERY NATURE OF BEING FEMALE
• Hippocratic Hysteria: the womb and its destinations
o ORGANIC CAUSE: the movement of the womb
o 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.
o 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?
o WOMBINESS
o 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. INTERESTING
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"
"if symptom x, therapy y"
o So there is no name of disease Hysteria but instead “when the womb turns to the head” or the symptoms of pnix, suffocation.
o Defining the female in terms of the male is one way of expressing difference; chronology is another.
o 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
• Plato and Aretaeus: The Wild womb?
o 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
• Stifling and Suffocation: the development of the textual tradition
o 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 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. THESIS
May 2, 2024
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