Constructions of Hysteria
Earl Jackson, Jr.
Since the Egyptians, some condition now known as „hysteria“ has been associated in the medical Imaginary with the uterus. The Egyptians believed the uterus to be a tiny animal in the woman’s body, that tended to wander out of place. This wandering caused the „hysteria.“ If the animal had wandered too low, the cure prescribed was fumigating the vagina and placing fragrances inside it to tempt the animal upward. If the animal had risen too high, fowl-tasting medicines were poured into the subject’s mouth to force the animal downward. The Greek imported this belief from Egypt. Still found in Plato, for example Timeus 91C:
The womb is an animal which longs to generate children. When it remains barren too long after puberty, it is distressed and sorely disturbed, and straying about in the body and cutting off the passages of the breath, it impedes respiration and brings the sufferer into the extremest anguish and provokes all manner of diseases besides.
Sainthood and Stigmata – we will deal with later
What else is woman but a foe to friendship, an inescapable punishment, a necessary evil, a natural temptation, a desirable calamity, a domestic danger, a delectable detriment, an evil of nature, painted with fair colours.
Malleus Maleficarum (1494) – The Hammer of Witches
The Nineteenth Century in France
Psychiatry in the early nineteenth century (1840s) considered hysteria of little interest. But beginning in the 1880s psychiatry was expanding its domain into conditions that „fell short of insanity.“ In the late eighteenth and early nineteenth centuries, hysteria was considered a condition that befell women of the upper classes. Lower class, and working class women, the „women of the people“ were believed to be insufficiently „impressionable“ and of “ too coarse a sensibility to succumb to hysteria. “ Furthermore, the “ muscular exertions of manual labor dulled their nerves and hence protected them against the ravages of the disease. “ But in the mid- to late nineteenth century in France, there is a class shift in the diagnosed cases of hysteria. [Goldstein 218-219]
The Salpêtrière – the public insane asylum for women. 1841-42: 648 women – only 7 (1%) diagnosed as hysterical. 1882-83: 500 women admitted – between 18-20% diagnosed hysterical. Male insane asylum Bicêtre – 1841-42 – none of the inmates diagnosed hysterical; in 1883 -two.
This history is involved with the history of the anti-clerical movements within French – and particularly Parisian municipal history. Until the late nineteenth century, all medical facilities in France were affiiliiated with the Catholic Church. There was a movement to remove the Church’s presence in public medicine.
In 1878 the Ecole municipale des Infirmières opened along the eastern perimeter of the hospital , the first lay medical school in France.
In December 1878 Salpêtrière was purged of all clerical workers. This purge was followed by similar purges of all other French hospitals. The soeurs-infirmieres were replaced by trained and licensed nurses. (Micale 710-711).
J.-M. Charcot (1825-1893).
A neurologist, Charcot served as Director of Salpêtrière (médicin en chef) 1862-1863.
Under his directorship, the asylum expanded immensely in both scientific and teaching facilities. In January 1882 the National Assembly created for Charcot personally a chaire des maladies du système nerveux, first official position in the Paris Faculty of Medicine dedicated to the study of neurological and psychological disorders. Charcot founded the Clinic Charcot, which was affiliated with the Public Assistance Administration. The clinic/asylum supported auxillary medical and scientific services, besides becoming a teaching hospital. By the 1880s the clinic included a museum of pathological anatomy, „a casting room, a photographic studio, . . . an ophthalmological office . . . and a service richly endowed with all the necesary equipment for the practice of electrodiagnostics and electrotherapy.“ [ Charcot qt. Micale, 709]
The new lecture amphitheater held 500 observers. This was where Charcot held weekly Tuesday demonstrations on hypnotized hysterics from the asylum. This is the setting for the famous painting by André Brouillet, Une Leçon clinique à la Salpêtrière.
According to Jean-Martin Charcot there are four stages in a full hysterical attack:
- (1) tonic rigidity
- (2) clonic spasms – grands movements“ – circus-like acrobatics
- (3) attitudes passionelles ,
or vivid physical representations of one or more emotional states, such as terror, hatred, love. The patient moves from being an acrobat to being a mime.
- (4) final delirium – tears, laughter and a return to the real world.
[Charcot, Lectures on the Diseases of the Nervous System . p.305]
Charcot emphasized the visual, spectacular quality of hysterical symptoms. Using the photographic technologies made available to him, Charcot founded the annual publication: Iconographie photographique de la Salpêtrière founded in 1876. A yearbook of the inmates in various poses of &manifesting“ one of more of the above stages of „hysterical attack“.[Goldstein 215]
Sigmund Freud studied and worked with Charcot 1885-1886. But that is another story.