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Hysteria, an [En]gendered Disease

Published onJan 30, 2023
Hysteria, an [En]gendered Disease
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In early modern Europe, specifically the seventeenth and eighteenth centuries in England, hysteria was considered by medical authorities and home medics to be a female-specific epidemic that threatened the established order of society.[1] Hysteria was loosely understood to include “women’s nervous afflictions” that caused patients to act in subversive, uncontrollable, and unreasonably ‘feminine’ ways, which prompted physicians of the time to treat this ‘disorder’ by harshly reimposing gender roles, notably the societal expectation for women to be subdued mothers who controlled their bodily desires and words.[2] Manifesting in the patient through both physical and psychological symptoms, hysteria was commonly referred to as the ‘suffocation of the mother’ due to the choking sensation that was experienced by many women. This choking phenomenon was attributed to the accepted and contested Hippocratic idea that the “womb could move around the body, block the channels of respiration and cause ‘suffocation’, as well as have some effect on the throat”.[3] Looking at primary sources of the early modern period, a pattern of collaboration and tension emerges between physicians and literate women through household medical receipt books. Women often wrote their own recipes to treat hysterical symptoms that would include snippets of advice doctors had been known to give, but they would also craft recipes that rejected a professional physician’s treatment plan if it was painful or generally undesirable. Women’s’ writings are especially relevant when considering that “home-based medicine constituted the bulk of health care in the period”, which would suggest that many women were treating their hysterical symptoms themselves.[4] In the seventeenth and eighteenth centuries in England, women’s and physicians’ understandings of, writings about, and treatments of hysteria indicate that the ‘disease’ was something around which social capital could be accrued and social control could be enacted. This essay will address how physicians were able to gain acclaim in the scientific sphere through pioneering new treatments for hysteria that, in turn, worked to control the physical and social bodies of women. Additionally, “Hysteria: an [En]gendered disease” will show how women confronted these scientific developments through authoring receipt books and managing their own treatments in ways that afforded them autonomy and allowed them to resist subjugation by medical professionals in the domestic sphere.

Top Image: a picture from Dr. John Leake's medical book Bottom Image: a picture from an Dr. John Pechey's medical book

While looking at physician’s manuals and recipe books, hysteria emerges as a social disease with physical and psychological manifestations whose physiological origin was contested but, ultimately, remained the same throughout the eighteenth century. Throughout the early modern period, hysteria was described as a disease whose exact causes and symptoms were unable to be officially determined, though headaches, paralysis, and choking were all common symptoms believed to be caused by uncontrolled, deviant wombs.[5] A medical treatise published at the end of the seventeenth century by John Pechey, a member of the College of Physicians in London, posits that hysteria was nearly impossible to decipher in a patient because it resembled so many other ailments. As he wrote, “[hysteria] proceeds from a weakness and confusion of the Spirits, and is not only very frequent, but also so wonderfully various, that it resembles almost all Diseases Mankind is subject to”.[6] The demographic that physicians warned were the most susceptible to hysteria were unmarried, virgin women and widows whose ‘lighter wombs’ could float to the liver and cause seizures or block respiratory function.[7] Even though a few prominent physicians of the time argued that complications within the nervous system were the major cause of hysteria, the majority of medical practitioners maintained the Galenic view that hysteria was caused by problems with the uterus, especially the retention of menstrual blood and ‘female semen’.[8] Women’s highly emotional nature was implicated as a possible cause of hysteria in the early seventeenth century, and many people began to see hysteria as a form “of love sickness, related to love melancholy”.[9] Introducing a new dimension to the disease in the early modern period, hysteria, which is now understood to be a form of anxiety or depression, was grounded in the female anatomy in order to naturalize the characterization of the entire sex as unruly and in need of subduing. However, because the nature of hysteria was so unknown and highly gendered, physicians were forced to consult women’s medical knowledge and personal experiences in order to understand the nuances of the disease.[10] By focusing their attention on unmarried women and widows, physicians underscored the social fear of women who were not directly subjugated in the domestic sphere through marriage and forced to be subservient to men in every aspect of their lives. This subjugation of masterless women was directly linked to the early modern fear, which increased in fervor from the sixteenth to eighteenth century, regarding single, ‘unruly’ women’s capabilities to upend the established order and gender roles of patriarchal society.[11] Therefore, unmarried women were subject to the pathologizing of their wombs as moveable and destructive and regarded as duplicitous and temperamental in order to legitimize their subjugation. Unsurprisingly, the medical field had been professionalized to exclude women, so the treatment of hysteria by male physicians worked to reinforce the gendered power differential that was the foundation of the patriarchal society.

Through examining early modern medical texts and medical recipe books, the physician’s problem of reconciling the cause of hysteria and providing a succinct diagnosis emerges. However, in many physician’s medical records and writings from the seventeenth and eighteenth centuries, there are multiple listed cases of hysteria, which implies that this was an illness that was commonly treated.[12] Throughout early modern medical texts, especially those belonging to Thomas Sydenham­­—a well-known physician who rejected the idea of the wandering womb and posited that hysteria was neurological—the professional physicians claimed that the symptoms of hysteria were so numerous that diagnoses had to be made from inferring the cause of the illness.[13] However, physicians were quick to credit hysteria with many physical symptoms that the patient had, including the swelling of the stomach. Even though the cause was implied to be more important than the symptoms, physicians in the mid-seventeenth century did not stop giving lengthy descriptions of hysterical symptoms that put the “animal spirits” of the womb into “disorderly motions”.[14] In eighteenth century Britain, there was an increased interest in nervous ailments, physical sensitivity, and feelings as they connected to social and sexual interactions, thus resulting in a ‘culture of sensibility’ that emphasized the connection between the body and mind.[15] This reasoning of hysteria as a result of violent wombs was rebuked in 1777 by John Leake, a member of the Royal College of Physicians. As he argued, “the true cause [of hysteria] seems entirely to arise from too much Irritability, joined to an excess of nervous feeling, which generally prevails at the same time”.[16] However, as mentioned above, the uterus and its ‘humors’ were believed to be the principal cause of hysteria through the eighteenth century. By focusing on the symptoms rather than the causes, physicians could diagnose more women with hysteria and put them on undesirable, often physically violent courses of treatment, which will be discussed later in the paper, that placed them in a state of mental and social submission through reinforcing the belief that women’s intellectual and moral capacities were tied to their ‘animalistic’ wombs and, therefore, they were not equal to those of men.

Image: a picture from Dr. John Leake's medical book that describes the cause of Hysteria

Top Image: a picture of Mary Chantrell's recipe for 'historicall water'Bottom Image: a picture of Johanna Saint John's recipe for the treatment of 'fitts'

Through the analysis of receipt books belonging to early modern women, the practice of writing recipes, especially medical recipes, and making medicines within the household presents as a way in which women exerted autonomy and challenged dominant social structures. In many of these recipe books, women include instructions on how to make medicines that ‘cure’ hysteria, which suggests that women as well as male physicians recognized hysteria as a legitimate ailment.[17] In the 1690s, Mary Chantrell, an English lady, compiled many family and popular recipes into a household recipe book; among these recipes was ‘The reseat of historicall water good against all soarts of vapors”, which instructed the individual creating the medicated water to “Let [the mixture of herbs] steep all night tell the negxt morning put in a pint of spring water then disstill it with a reasonable fire and let it drop upon white sugare candey….”.[18] Including mint, an aromatic herb, within her ‘historicall water’ recipe, Mary Chantrell was following a larger early modern trend of women using household ingredients and herbs, especially rosemary, nutmeg, and cinnamon, to produce many liquid medicines.[19] Mary Chantrell’s collection of medical recipes is indicative of a larger trend of women exchanging recipes within their own social networks while simultaneously collecting and modifying knowledge of ‘commercial medical practitioners’ to suit their personal uses.[20] However, women were careful in the commercial recipes that they included in their receipt books, especially considering that physicians profited from their hysteria and often treated their illnesses in cruel ways.[21] By modifying or rejecting physicians recipes, women inserted themselves into the public medical sphere and confronted commercial recipes and medical speech that depicted them as unruly and unable to engage in effective medical treatment. In her receipt book under a recipe for the treatment of fitts, Johanna Saint John advises the reader to obtain “oyly volatile salt” from “Cashimears the Germane Dr” and mix it with “oake or fennel water”.[22] By instructing women to get ingredients from doctors rather than treatments, Johanna Saint John’s receipt book shows how women often sidestepped professional physicians in order to craft treatments that effectively suited their needs and proved themselves capable of the undertaking of home medicine. In this way, recipe books and home medicine were subtly radical in the ways in which they challenged the legitimacy of the professionalized medical field.

Image: a painting of an old woman performing a bloodletting on a young woman

In the early modern period, the treatment of hysteria was often a collaborative effort between physicians and medically literate women. Recovered documents and recipe books suggest that “doctors and educated women writers traded, embraced, dismissed, and reformulated a plethora of theories ranging from aggressive bloodlettings, diets, and beatings, to exercise, fresh air, and writing cures”.[23] Since physicians in the seventeenth and eighteenth centuries still considered the ‘wandering womb’ the principal cause of hysteria, marriage and pregnancy were the most popular courses of treatment.[24] However, many physicians in the eighteenth century suggested that women utilize exercise as an alternative means to treat their hysteria in order to avoid aggressive or violent treatments.[25] Dr. John Leake wrote, “Hence it may reasonably be concluded, that moderate exercise in a dry, pure air…[is] [one of] the principal remedies to be depended upon in this species of nervous disorders, as they are all known to strengthen the body.”[26] However, exercise regimes being prescribed as gentle courses of treatment was a result of women disregarding medical advice or cutting personal and financial ties with physicians altogether when medical professional chose to enact brutal treatments that trapped women not only in their homes but also inside their own bodies.[27] When hysterical women did chose to treat their ailment at home, they were able to combine their own knowledge with that of the physicians in order to make a more affordable, personalized drug that was often high quality and safe to use.[28] Many of the herbal waters that were prescribed by physicians were able to be made by women at home, but they often substituted herbs in the recipes for favorite ingredients or what they had available in their homes.[29] Even though women were not permitted to engage directly in professionalized medicine, their intimate knowledge of home medicine and their gendered ailment allowed them to have considerable sway over physicians and their medical treatment. In this way, recipe books prepared women to engage indirectly in both the medical profession and the public sphere.

Through seventeenth- and eighteenth-century physician’s and medically literate women’s understandings, writings, and treatments of hysteria, the historical record shows that recipe books and medical guides were physical objects by which both physicians and literate women gained social capital and social control. Practicing informal home medicine and exchanging and collecting medical recipes, some women were able to speak on their own behalf and advocate for better medical treatment that incorporated some of their own recipes and methods. Due to their intense cataloguing and experiments within recipe and cookery books, early modern women breached the barrier between the public and private spheres in order to exert autonomy and be active in the maintenance of their health and well-being.

Bibliography

Chantrell , Mary & Others, Book of Receipts. (London, United Kingdom: Wellcome Library, 1690) (MS1548).

Leake, John, Medical instructions towards the prevention, and cure of Chronic or Slow Diseases peculiar to women: Especially, those proceeding from over-delicacy of Habit called Nervous or Hysterical; from Female Obstructions, Weakness, and inward Decay; a diseased state of the Womb, or critical change of Constitution at particular Periods of Life; in which, their Nature is explained, and their Treatment, by Regimen, and simple Medicines, divested of the Terms of Art, is clearly laid down, for the use of those affected with such Diseases, as well as the Medical Reader. By John Leake, M.D. Member of the Royal College of Physicians, London; and Physician to the Westminster Lying-in Hospital. The second edition. (London: Eighteenth Century Collections Online, Gale, 1777): 1– 454.

Leong, Elaine. “Making Medicines in the Early Modern Household.” Bulletin of the history of medicine 82, no. 1 (2008): 145–168.

Meek, Heather. “Medical Men, Women of Letters, and Treatments for Eighteenth-Century Hysteria.” The Journal of medical humanities 34, no. 1 (March 2013): 1–14.

Merskey, Merskey. “Hysteria, or ‘Suffocation of the Mother.’” Canadian Medical Association journal (CMAJ) 148, no. 3 (February 1, 1993): 399–405.

Natalie Zemon Davis, “Women on Top.” Society and Culture in Early Modern France (1965): 124-151.

Pechey, John, 1655-1716. A General Treatise of the Diseases of Maids, Bigbellied Women, Child-Bed-Women, and Widows Together with the Best Methods of Preventing Or Curing the Same / by J. Pechey (London, Printed for Henry Bonwick, 1696).

Saint John, Johanna, Johanna St. John Her Booke. (London, United Kingdom: Wellcome Library, 1680) (MS4338).

Schleiner, Winfried. “Early Modern Green Sickness and Pre-Freudian Hysteria.” Early science and medicine 14, no. 5 (2009): 661–676.

Wagner, Darren. “Body, Mind and Spirits: The Physiology of Sexuality in the Culture of Sensibility.” Journal for eighteenth-century studies 39, no. 3 (September 2016): 335–358.

Williams, Katherine. “Hysteria in Seventeenth-Century Case Records and Unpublished Manuscripts.” History of psychiatry 1, no. 4 (December 1990): 383–401.

Image Credits:

Webpage Image: Piazzetta, Giovanni Battista (Italian painter and printmaker, 1682-1754). 18th century. Physician and Female Patient and a Border Design. Place: The Morgan Library and Museum, Morgan Library & Museum. Gift of the Samuel H. Kress Foundation, 1961.12:8. https://library-artstor-org.go.libproxy.wakehealth.edu/asset/AWSS35953_35953_39923087.Banner Image: A sick lady addressing her husband, and being nursed by three women. Mezzotint by V. Green after E. Penny, 1774.. Credit: Wellcome Collection. Public Domain MarkLeake Image One: Leake, John. Medical instructions towards the prevention, and cure of Chronic or Slow Diseases peculiar to women: Especially, those proceeding from over-delicacy of Habit called Nervous or Hysterical; from Female Obstructions, Weakness, and inward Decay; a diseased state of the Womb, or critical change of Constitution at particular Periods of Life; in which, their Nature is explained, and their Treatment, by Regimen, and simple Medicines, divested of the Terms of Art, is clearly laid down, for the use of those affected with such Diseases, as well as the Medical Reader. By John Leake, M.D. Member of the Royal College of Physicians, London; and Physician to the Westminster Lying-in Hospital. The second edition. London, [1777]. pg. 1Eighteenth Century Collections Online. Gale. Wake Forest University. 6 Dec. 2020 <http://find.gale.com.go.libproxy.wakehealth.edu/ecco/infomark.do?&source=gale&prodId=ECCO&userGroupName=nclivewfuy&tabID=T001&docId=CW3309323475&type=multipage&contentSet=ECCOArticles&version=1.0&docLevel=FASCIMILE>. Pechey Image One: Pechey, John, 1655-1716. A General Treatise of the Diseases of Maids, Bigbellied Women, Child-Bed-Women, and Widows Together with the Best Methods of Preventing Or Curing the Same / by J. Pechey (London, Printed for Henry Bonwick, 1696): 1. https://www-proquest-com.go.libproxy.wakehealth.edu/docview/2240968317/12575881?accountid=14868Leake Image Two: page 224Mary Chantrell Image: Chantrell , Mary & Others, Book of Receipts. (London, United Kingdom: Wellcome Library, 1690) (MS1548): 57. https://wellcomelibrary.org/item/b19559070#?m=0&cv=59&c=0&s=0&z=0.3432%2C0.0324%2C0.7908%2C0.5374Johanna Saint John Image: Saint John, Johanna, Johanna St. John Her Booke. (London, United Kingdom: Wellcome Library, 1680) (MS4338): 60. https://wellcomelibrary.org/item/b19145032#?c=0&m=0&s=0&cv=61&z=-0.0329%2C0.1545%2C0.6775%2C0.4604Bloodletting Image: Brekelenkam, Quiringh van. c.1660. An Old Woman Bleeding a Young Woman, known as 'The Bloodletting'. Place: Mauritshuis. https://library-artstor-org.go.libproxy.wakehealth.edu/asset/AWSS35953_35953_30940322.

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