Female Hysteria and Hysterical Paroxyxm

September 9, 2022

Historically, women’s health complaints were often diagnosed as “female hysteria” – an umbrella term that implied “it’s all in her head.” The condition was believed to be caused by a “wandering uterus” and/or sexual frustration. Before the medical community came to understand mental health, epilepsy, multiple sclerosis, and other neurological disorders, they combined symptoms to diagnose women with "female hysteria" for thousands of years. Physicians believed female hysteria to be the cause of everything from clinical depression to uncontrollable spasms. Essentially, if anything was wrong with a woman, they blamed her uterus, or her gender. 

In 1600 BC, Ancient Egyptians believed a woman's sudden labile behavior was caused by her uterus either migrating north or south within her body. For the uterus that supposedly migrated upward, they prescribed, "placing malodorous and acrid substances near the woman’s mouth and nostrils," as well as putting scented substances near her genitalia. For those that were suspected to have migrated south, they prescribed the treatment in reverse.

Ancient Greeks called it "uterine melancholy." In an Ancient Greek myth, Melampus, a god, physician and oracle, diagnosed the female virgins in the city of Argos with the malady when they were reluctant to copulate with men in their neighborhood. They were eventually "cured" of their "venomous humors" by having sexual intercourse with younger, more virile men instead.

Hippocrates, Greek physician of the classical period who is considered one of the most outstanding figures in the history of medicine and who inspired every doctor to take an oath to "do no harm," was also the first to describe a woman as "hysterical" owing to the "poisonous stagnant humors" in her uterus caused by an unfulfilling sex life. He believed this was a critical issue for virgins, widows, single, and sterile women. Like the ancient Egyptians, Hippocrates placed the onus on the uterus for migrating around a woman's body and causing anxiety, a sense of asphyxia, trembling, seizures, and decrepitude.

Claudius Galen, considered the greatest physician of his era, a skilled surgeon and acclaimed philosopher, is credited for numerous advances in the fields of anatomy, physiology and healing. He is proclaimed by many historians to have been the most successful medical researcher of antiquity but even he had some confusing ideas on treating “hysterical” women after examining them with a passel of so-called symptoms and documenting his findings. According to his notes from In Hippocratis Librum de Humoribus, the women in question should either be "getting married or repressing stimuli that could excite a young woman."

Soranus, the physician who is regarded as the founder of scientific gynecology and obstetrics, deemed former treatments using fumigation as ineffective. He claimed that "hysterical" women were to be treated with the utmost care, including hot baths and massages. However, he also placed the responsibility for female hysteria on the physical rigors of childbirth and recommended women maintain sexual abstinence and "perpetual virginity."

In the Middle Ages it was common to blame witchcraft and sorcery for nearly every unpleasant situation that came up, which included believing female hysteria was caused by a "demonic presence" in the uterus which needed to be expelled by exorcism. It was thought to be a particularly common issue for older, widowed, and single women.

In Italy, Girolamo Cardano and Giovanni Battista Della Porta resisted the "demonic presence" idea and instead placed the blame on inhaling toxic fumes or drinking polluted water. They also suspected women of ingesting hallucinogens that induced “visions” and “pictures," causing their symptoms. Like most physicians of the time, they also believed a woman's uterus made them weaker and scientifically inferior to men.

Franz Anton Mesmer, 18th century physician, believed it was a bodily fluid which caused fractious behavior seen exclusively in hysterical women and would treat his patients with "mesmerism" — essentially hypnotizing them into believing they had been cured.

Because they were so prone to "swooning," Victorian women were recommended to keep smelling salts in their purses at all times to revive themselves, based on the Hippocratic idea that the acrid scent would lure the uterus down to its proper position. Interestingly, the restrictive corsets most women were wearing at the time were far more likely the cause of their frequent fainting.

In 1859, a physician was noted for claiming that 25% of all women suffered from hysteria. One American doctor cataloged 75 pages of possible symptoms of the condition, and called the list incomplete. According to the document, almost any complaint could fit the diagnosis for female hysteria. Physicians thought that the stresses associated with urbanized life caused modern women to be more susceptible to nervous disorders, and to develop defective reproductive organs.

Sigmund Freud introduced the idea that males could also suffer from hysteria, claiming in his journals to be occasionally afflicted himself, but he also opined that the problem was caused in barren women, which was a popular theory of the time — and that that was evidence of a symptom — their "lack of libidinal evolution."

Women diagnosed with hysteria exhibited a variety of symptoms, including syncope, insomnia, edema, heaviness in abdomen, muscle spasm, shortness of breath, agitation, anorexia, disinterest in sex, and “a tendency to cause trouble”. The history of this diagnosis is controversial because of the wide range of bizarre symptoms and causes, but the condition becomes more shocking when you look at the treatment. 

During this time, female hysteria was widely associated with sexual dissatisfaction and the disorder was extensively discussed in medical literature. For this reason, the patients would undergo weekly “pelvic massages.” During these sessions, a doctor would manually stimulate the female’s genitals, until the patient experienced repeated “hysterical paroxysm” (i.e., orgasms). It is interesting to note that this diagnosis was quite profitable for physicians, since the patients were at no risk of death, but needed ongoing care. 

Pelvic massages were used as a medical treatment on women into the 1900s. Around 1870, doctors worldwide realized that a new electrical invention could help the vaginal massage technique. In many cases, physicians found it difficult to reach hysterical paroxysm. This could have been due to the physician’s lack of manual dexterity or technique. In 1873, the first electromechanical vibrator was developed and used at an asylum in France for the treatment of female hysteria. For decades, these mechanical devices were only available to doctors for the use in pelvic massages. In the 1880s, Dr. J. Mortimer Granville invented the first personal massager in order to achieve the desired response more efficiently.  By the turn of the century, the arrival of electricity in homes brought the vibrator to the consumer market. From the early 1900s, the number of diagnoses of female hysteria sharply declined, and today it is no longer a recognized illness.

But what about the husbands? What did they think about this? Well-bred gentlemen of the era were not taught to tend to their wives’ needs – it was not even understood that women had needs. It was much easier to call for the doctor when a woman exhibited symptoms of hysteria. The doctor could treat the women in their homes and the fainting couch or chaise lounge became fashionable for the women’s comfort during the “treatment”.

Today, many health care providers still believe women’s physical symptoms are exaggerated, imaginary, or stemming from emotional or mental disturbances. Those who present with unexplained neurological complaints may be diagnosed with conversion or somatic symptom disorders. These are the modern terms for female hysteria—the premise being that if modern technology can’t find the cause, then symptoms must be psychological or psychosomatic. Women are up to 10 times more likely to receive the diagnosis than men. 

The American Psychiatric Association kept hysteria in their books as a legitimate disorder until the 1950s, which commonly led to diagnosing other, more serious ailments like epilepsy as a sexual disorder instead. This wasn't amended until more female doctors began to address the issue.

©2022 Guiomar Goransson