'Medical Muses': Putting hysteria under the microscope

Hysteria in Nineteenth-Century Paris By Asti Hustvedt

W.W. Norton. 372 pp. $26.95


Reviewed by Joelle Farrell
Asti Hustvedt, an editor and translator in New York City, was first drawn to the subject of hysteria while working on her doctorate in French at New York University. She aimed to write a "nonhysterical book about hysteria," a condition that, at least in part, was "an illness of being a woman in an era that strictly limited female roles."Her book, Medical Muses, examines the lives of three women diagnosed with hysteria who, through the work of a famous French neurologist, Jean-Martin Charcot, became medical celebrities.

Hustvedt's focus on the three women - Blanche, Augustine, and Geneviève - gives a face to her story of a condition that the medical community no longer recognizes.

Her thorough research and elegant writing bring the women to life and prevent the story from getting bogged down in social and medical questions about hysteria itself.

All three women came from impoverished families and suffered abuse and neglect that seemed to provoke some of their early hysterical outbursts. They ended up at the famous Salpêtrière Hospital, a massive institution that housed women suffering from mental and physical ailments, as well as some women who were simply poor or elderly.

Doctors diagnosed hysteria in women who suffered from a variety of symptoms that resembled conditions ranging from depression and anxiety to schizophrenia or epilepsy. But doctors also linked seemingly normal behavior to the illness, as was the case with Augustine, then 14, who had a rebellious streak and liked to look pretty.

"Everything in her . . . announced the hysteric," one doctor wrote about Augustine. "The care that she takes in her toilette; the styling of her hair, the ribbons she likes to adorn herself with."

Charcot believed that hysteria was an illness linked to brain anatomy, and he looked in vain for lesions in the cadavers of women who had suffered from the illness. He used the three women to prove his hypothesis that hysterics would present certain poses under hypnosis - that despite the array of symptoms, a common thread linked them.Hustvedt is unflinching in her descriptions of the treatment the women received at the Salpêtrière Hospital, then one of the most respected in the world. Ovary compressors were used to stop hysterical fits - the device worked like a vise grip to put pressure on an ovary. Doctors, fascinated by the apparent skin sensitivity displayed by some hysterics, would scrawl words, even their own names, onto a patient's skin. Needles were stuck through the arms of hysterics, who allegedly did not feel pain and would not bleed from the wounds.We can cut them, prick them and burn them and they feel nothing," a student of Charcot wrote, as quoted in Hustvedt's book. "Even better, these completely numb spots are so poorly irrigated that when we wound them, there is not a drop of blood."

It was Charcot's work with hypnotism that made the women famous. Under hypnosis, Charcot believed he could provoke symptoms of hysteria. His lectures took on a theatrical quality, as students, authors, and artists packed halls to see Charcot and his strange muses.

Under hypnosis, the women would strike odd poses and act on suggestions made by doctors, acting out skits for a rapt audience. They convinced the women that snakes were at their feet or that they were soldiers in a war. They would put the women into a catatonic state and mold them like wax sculptures into unnatural positions.

While Charcot's tricks made for a good show, Hustvedt points out that the doctors did little to relieve their patients' symptoms. And the doctors clearly abused their power. They once asked Blanche (under hypnosis) to undress for them. Blanche, who was said to be very modest, at first complied, but then broke down in a hysterical fit.

Hustvedt doesn't mince words in describing Charcot's "treatments" for hysteria, describing the doctors as "giddy with power."

But she also gives Charcot his due. She acknowledges that his work with hypnosis, which influenced Sigmund Freud, laid the groundwork for psychoanalysis.

And while his theories on hysteria were discredited after his death, Charcot left a legacy of groundbreaking research in other neurological diseases. He discovered the pathology of multiple sclerosis and amyotrophic lateral sclerosis (Lou Gehrig's disease). By studying cadavers, Charcot found lesions in the brains of those who had suffered from the diseases. Hustvedt also credits Charcot for taking the symptoms of hysteria seriously and for recognizing that " 'hysterical' did not mean 'unreal.' " Doctors may no longer diagnose women with hysteria, but that doesn't mean they don't deal with illnesses that are just as mysterious to them as hysteria was to the doctors in the late 1800s. Chronic fatigue syndrome, for example, appears to affect mostly women, and like hysteria in its day, the illness has become somewhat of a "medical trash can," a diagnosis made by ruling out other possibilities. Recently, doctors have begun to question whether antidepressants, drugs taken by one in 10 Americans annually, work any better than placebos. Some researchers now say the "chemical imbalance" theory of depression may be on "just as shaky ground" as Charcot's theories, Hustvedt writes. As for whether the women's hypnosis was simply an act, Hustvedt acknowledges that it's possible. But she still believes that the women were suffering, and that hysteria, like depression, anxiety, or chronic fatigue syndrome, was simply a socially acceptable manner of expressing their pain.

"[Blanche] lived during a period that allowed her to express her suffering in a particular way, through a particular set of symptoms, symptoms that are no longer an admissible way to express illness," she writes.


Contact staff writer Joelle Farrell at 856-779-3237 or jfarrell@phillynews.com.