Medical Muses: Hysteria in Nineteenth-Century Paris

"I work everyday with people who have seizures that a hundred years ago would have been called hysterical seizures. It’s impossible to be a neurologist, or a neurologist dealing with dissociative seizures, and not be fascinated with Charcot’s era. It was a pivotal era for neurology in general, as well as for hysteria in particular. Many of the pathological conditions we now know about, things like motor neurone disease and multiple sclerosis, Charcot described them first. He believed that hysteria too was a neurological disease. He did not believe that it was psychosomatic. It’s from him really that we coin the term “functional disorder” – he believed there were swellings coming and going in the brain that stopped it from functioning. He absolutely believed that there was a pathology in hysteria that he just couldn’t find. Get the weekly Five Books newsletter Up until Charcot, people had dismissed this disorder. It was seen as a disease of women – there were theories about wandering uteruses and things like that. It was easily ignored, and patients were put into asylums. But Charcot studied it scientifically. A lot of people don’t realize that. He’s famous for these “medical muses” that Hustvedt describes. We see these women pictured in various states of undress and in bizarre poses and it all looks very circus-like and exploitative. After his death, his ideas about hysteria were discredited. His theories were wrong. But he focused proper scientific rigour and attention on this disorder for the first time. And he drew Freud’s attention to it, which brought the next step of understanding. This is one of the things I liked about Medical Muses the book. I think Hustvedt set out with the idea that Charcot would be a misogynistic person who exploited women, and I don’t think she came out with that idea at the end. Neither Freud nor Charcot thought this was a disorder of women. They both had male patients. But they both exclusively wrote about their female patients, I can’t say why. As a junior doctor, I resisted the idea that this is a more female disorder. I could see that male doctors were much more willing to diagnose it in women than they were in men. That creates some of the bias. However I am a female doctor and most of my patients too are female. So I have to accept that overall, women are more susceptible. No one has the ultimate answer to why, but there are a few possible reasons. First, I think women are more likely to find themselves in the sort of situations that produce these disorders. They arise in trapped situations, in people who have suffered physical or psychological abuse, and that is something that happens to women more than men. Also, men and women deal with hardship and stress differently. Men are more likely to drink or become aggressive, women are more likely to turn the pain inward and manifest it as illnesses. And finally I think there’s a gender difference in which kinds of complaining are socially acceptable. It’s also important to say that this is a more male disorder than people realize. In young people these seizures are much more common in women but among older people, they increase significantly in men."