Medical Muses: Hysteria in Nineteenth-Century Paris BY Asti Hustvedt (W.W. Norton, 2011) From the Publisher: “A fascinating study of three young female hysterics who shaped our early notions of psychology. Blanche, Augustine, and Geneviève found themselves in the hysteria ward of the Salpêtrière Hospital in 1870s Paris, where their care was directed by the prominent neurologist Jean-Martin Charcot. They became medical celebrities: every week, eager crowds arrived at the hospital to observe their symptoms; they were photographed, sculpted, painted, and transformed into characters in novels. The remarkable story of their lives as patients in the clinic is a strange amalgam of intimate details and public exposure, science and religion, medicine and the occult, hypnotism, love, and theater. But who were Blanche, Augustine, and Geneviève? What role did they play in their own peculiar form of stardom? And what exactly were they suffering from? Hysteria — with its dramatic seizures, hallucinations, and reenactments of past traumas — may be an illness of the past, but the notions of femininity that lie behind it offer insights into disorders of the present.”

Research has surged in recent years into the complex interplay among mind, body, emotion, and behavior in determining overall health. Using MRI technology, for example, neuroscientists can observe the real-time effects of anxiety on the subjective experience of pain. In mapping out brain activity as it occurs, we’re glimpsing ourselves as we never have before: the human animal’s impulses and responses, from axon to annoyance to indigestion, lighting up the screen. Still, the term psychosomatic carries a taint, a lingering whiff of illegitimacy, of hysteria. Take the hundreds of teenagers across Portugal who in 2006 developed mysterious rashes, respiratory problems, and dizziness, some so severely that schools were forced to close. When officials found no causative pathogen, the outbreak came to be known as the “Strawberries with Sugar virus.” Unwittingly, it appeared, the teens had taken on symptoms exhibited by characters on a popular TV soap opera, Morangos com Açúcar. Hustvedt’s ardently researched book is also one of great empathy. Photographs… have left her subjects frozen as medical curiosities, but Hustvedt thaws them out, showing their symptoms as a striving toward language, an expression… Such outbreaks, known variously as mass hysteria, mass psychogenic illness, and psychogenic epidemics, are by no means rare, nor are they new (the French Dancing Plague of 1518 led to dozens of deaths from heart attack and stroke). In her gripping social history, Medical Muses: Hysteria in Nineteenth-Century Paris, Asti Hustvedt relates the stories of three French women — Blanche Wittmann, Augustine Gleizes, and Geneviève Basile Legrand — whose manipulation by, and of, a paternalistic medical system has much to say about how we treat mysterious illness today. In 1877 Marie Wittmann, a poor and illiterate eighteen-year-old, secured a job as a nursing assistant at the Salpêtrière Hospital in Paris. Traumatized and intermittently homeless — her mother and five of her eight siblings had died, her father had been institutionalized, and the furrier she was apprenticed to had sexually assaulted her — Marie was beset by incontinence, muteness, paralysis, and convulsions. Along with others of her social class, she was exploited for labor in exchange for admission. Jean-Martin Charcot, the Salpêtrière’s pioneering neurologist (and teacher to a young Sigmund Freud), recognized in Marie the hallmarks of hysteria. Charcot insisted that hysteria had a neurological rather than a sexual basis, a switch from the Hippocratic notion of the womb (hystera, in Greek) as the source of all disease in women. In the “hystero-epilepsy” ward, Marie underwent Charcot’s hysteria regimen: ether inhalations, ovarian compressions, magnet therapy, hypnosis. The treatments effected only momentary relief, but they transformed Marie, onetime wayward orphan, into a star: Blanche, Queen of Hysterics. “Located on the problematic border between psychosomatic and somatic disorders,” Hustvedt writes, “hysteria was a confusion of real and imagined illness” (p. 5). That border remains a troubled place in medicine, especially for women. In her 1997 polemic, Hystories: Hysterical Epidemics and Modern Media, for example, Elaine Showalter examined contemporary manifestations of “hysteria,” placing chronic fatigue syndrome on par with alien abduction, enraging many women who already felt marginalized and derided. By contrast, Hustvedt’s ardently researched book is also one of great empathy. Photographs (reproduced in this book) have left her subjects frozen as medical curiosities, but Hustvedt thaws them out, showing their symptoms as a striving toward language, an expression, as Rimbaud wrote, of “[a]ll forms of love, suffering, and madness.”

For Augustine Gleizes, that meant assuming “passionate poses” for a series of seminude photographs, reliving childhood rapes through hallucination, and becoming “a kind of mascot” (p. 145) of hysteria for generations of artists. For Geneviève Basile Legrand, an orphan who endured the horrors of nineteenth-century foster care, it meant self-mutilation, false pregnancy, sexual obsession, and divine apparition.

Only true hysterics succumbed to hypnosis, Charcot claimed, and as he practiced it the treatment provoked a three-part trance — lethargy, catalepsy, and somnambulism — designed to induce hysteria so that the patient’s chaotic nature could be studied and ultimately controlled. Physicians sought to create, Hustvedt writes, “an artificial woman, with no organic interior” (p. 64), inert, rigid, utterly compliant. In the cataleptic state, a patient became so unfeeling that pins could be passed through her flesh to “authenticate” the trance. In the somnambulant state, her gender could be switched, her personality split in two, her paralysis transferred from one side of her body to another, or even to another patient.

Professor Jean-Martin Charcot teaching at the Salpêtrière
in Paris, France: showing his students a woman
(“Blanche,” Marie Wittman) in an “hysterical fit,” 1887
BY André Brouillet
Université Paris V-Descartes

Blanche excelled in her susceptibility to hypnosis, and Charcot’s demonstrations of her sessions became popular entertainments as compellingly lurid as anything found on reality television today. When her physicians suggested to a hypnotized Blanche that a blank plate they held up was a photograph of her naked body, she grabbed and destroyed it. When they told her to poison a man in the room, she complied, handing her victim a glass of liquid she believed to be lethal. Such performances went on until Charcot’s sudden death in 1893, at which time, Hustvedt writes, Blanche Wittmann “never experienced another convulsion, paralysis, or delirium” (p. 137).

So: was Blanche a master manipulator who defrauded her doctor and his audience? Or was Charcot a charlatan, molding his patient in service to his fame? The answer isn’t clear cut. According to Hustvedt,

In late-nineteenth-century France, the appropriate symptoms, especially for marginalized women, included contortions, mutism, anesthesia, convulsions, visual and auditory hallucinations, ecstasy, erotic delusion, demonic attacks, insomnia, stigmata, vomiting, spontaneous blindness and deafness, urinary retention, a feeling of choking, and neurotic tumors. One small town even had a case of meowing nuns.

Although Charcot endeavored to the end of his life to locate the seat of hysteria in the central nervous system, his work was full of contradictions. Men got hysteria, he claimed, but “without its great classical attributes.” He mapped out the body’s “hysterogenic zones,” which when manipulated would start or stop an attack, but placed the ovaries (or testicles) and not the brain at the center. Michel Foucault wrote that Charcot’s hysterics were involved not in a pathology but rather a struggle — “the process by which patients tried to evade psychiatric power.”

It is to Hustvedt’s immense credit that in presenting her subjects as metaphors we also see them as individuals.

That sounds right. In failing to establish hysteria as a neurological disorder, Charcot forged a diagnosis that reinforced the old duality — mind dominating body and body responding as a victim does, with acquiescence, manipulation, and rebellion — and extended into Freudian ideology. In the foundational psychoanalytic text, Freud and Josef Breuer’s 1895 Studies in Hysteria, Breuer wrote, “I do not believe that I am exaggerating when I claim that the great majority of severe neuroses in women originate in the marital bed.”

In an epilogue Hustvedt writes that our current-day “epidemic” is not hysteria but depression, which Western medicine neither diagnoses nor treats with certainty, as is the case with so many other syndromes: anorexia and bulimia nervosa, autoimmune diseases, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome. Hustvedt notes that women receive such diagnoses in far greater numbers than men, and despite some advances in diagnosis and treatment, the medical model still regards many of them as mysteries. (Hustvedt’s sister, the novelist Siri Hustvedt, recently published a memoir, The Shaking Woman or A History of My Nerves, that chronicles her own struggle with inexplicable illness.)

As for mass psychogenic illness, many cases in the last five years have been reported. To name a few: the nearly sixty people (mostly women) at a Melbourne airport who showed signs of chemical poisoning; the dozens of Tanzanian schoolgirls who at exam time had sudden fits of rigidity and fainting; the Bangladeshi children who fell ill after consuming biscuits distributed by a relief organization; the forty or so Vietnamese adolescents who screamed, convulsed, and fainted daily between the hours of one and three p.m. In all cases, officials blamed “hysteria.” Evidently, some find the label a difficult one to retire.

It is to Hustvedt’s immense credit that in presenting her subjects as metaphors we also see them as individuals. In the course of her research, she scoured the cemeteries of the French countryside for the grave of Geneviève’s adolescent fiancé — a boy who perhaps existed only in the mind of a long-dead hysteric. But he mattered as little else did to Geneviève, and because Hustvedt is such a mesmerizing storyteller, he matters to us.