Hysteria in the Georgian Era

The diagnosis of hysteria in the Georgian Era was a catch-all term given to sufferers who were readily excited, highly nervous, or emotionally distressed. Georgian doctors claimed it was brought on because of surprise created by joy, grief, fear, etc., and doctors also asserted it affected people early in life — primarily between the age of puberty and thirty-five. Eighteenth century doctors also declared that hysteria could affect both sexes. Male hysteria was called masculina and said to be caused by a man retaining semen and the surest cure was “excretion.” Female hysteria, called foeminina, was considered much more common than male hysteria. It occurred in all women but was said to occur more frequently in “women of a delicate habit.”[1]

Delicate women were supposedly predisposed to attacks of hysteria because of an inactive or sedentary lifestyle, grief, anxiety, menstrual problems, or eating unwholesome foods. It was reported they could also suffer from one of several types of hysteria as listed below:

• Hysteria Choloritca – caused from retardation of the menses
• Hysteria Emphractica – caused from visceral obstruction
• Hysteria a Menorrhagia – caused from excessive discharge during menses, bloody
• Hysteria a Leucorrhoea – caused from excessive discharge during menses, ferous, or fluor albus
• Hysteria Libidinosa – caused from sensual desires
• Hysteria Stomachica – caused from diseases of the stomach

Before an attack, sufferers claimed they usually felt one or more of the following:  

• anxiety
• dejected spirits
• difficulty breathing
• heart palpitations
• tears
• upset stomach

There was also the belief that hysteria was less likely to affect females under the age of twenty and only an occasional occurrence of hysteria happened to a female before puberty. In the 18th century, hysteria became associated with mechanisms in the brain and later it was linked to “uterine disorders,” but the Cyclopaedia of Practical Medicine published in 1833 noted that “the uterus is not the only organ of which the irritations may affect the nervous system as to produce hysteria.”[2] By the 19th century Jean-Martin Charcot, a French neurologist and professor of anatomical pathology, argued that hysteria derived from a neurological disorder and showed that it was more common in men than women.

Eighteenth century doctors argued that hysteria was sometimes difficult to distinguish from hypochondria or dyspepsia. This was partly because hysteria was believed to have a wide variety of symptoms. One eighteenth century medical book described hysteria as a “rumbling of the bowels [and a] sense of a ball rolling itself in the abdomen, rising toward the stomach and gullet, and there giving a sense of strangulation.”[3] Once this feeling of strangulation occurred, sufferers felt faint and were sometimes affected by stupor or insensibility.

Sufferers also experienced other symptoms and in fact, during the Victorian Era, Dr. George Beard created a 75 page list of hysteria symptoms and pronounced it incomplete. Fits frequently involved a person’s trunk and limbs, with the trunk turning “to and fro” and the person’s limbs flailing wildly. Laughter, crying, or screaming could accompany the fit, and, sometimes sufferers uttered incoherent statements. Some sufferers also reported violent pains in the back, clammy sweats, or coldness of the extremities. Mrs. Bennett in Jane Austen‘s novel Pride and Prejudice noted what some people might describe as hysteria symptoms:

“I am frightened out of my wits; and have such tremblings, such flutterings, all over me, such spasms in my side, and pains in my head, and such beatings at heart, that I can get no rest by night nor by day.”[4]

In the eighteenth and nineteenth centuries, hysteria’s varied symptoms were usually followed by “sleep, convulsions, copious discharge of limpid urine, [sometimes gas was passed, or a frothy saliva … discharged from the mouth].”[5] Sufferers also usually claimed to have no memory of the incident but reported they felt sore all over or had severe head pain.

Nineteenth-century American physician Frederick Hollick was a firm believer that hysteria was primarily caused by licentiousness being present in women. Rachel Maines, a current American scholar, hypothesized that physicians commonly treated hysteria into the twentieth century by manually stimulating the genitals or in other words masturbating female patients to the point of orgasm, which was denominated “hysterical paroxysm.” She suggested that this stimulation may have resulted in the production and marketing of the vibrator. Despite a large amount of literary documentation that doctors did masturbate women, some historians dispute her claims. They claim it was a distortion and likely did not happen while other historians believe this only happened to a small group of women.

During a hysteria attack, there were several pieces of advice given to bystanders. If an attack occurred indoors, windows were to be opened to allow air to flow freely into the room. Tinctures, laxatives, or opiates might also be given. When women suffered from an attack, bystanders were also advised to loosen “the stays and all tight strings.”[6] In addition, bystanders were to guard the patient from injury by using some sort of restraint, and to shorten the duration of the fit, they were advised to sprinkle water on the person or using common smelling salts to revive the afflicted.

Physician treatments for the condition varied. In the eighteenth-century French physician Philippe Pinel was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients. He therefore freed hysteria patients detained at Paris’ Salpêtrière asylum stating that kindness and sensitivity were needed to formulate good care. Other physicians used different approaches. Some prescribed some sort of anti-hysteric, purgative, or antispasmodic. Sometimes bleeding or cupping was recommended. Doctors also tried to subdue the sufferers’ passions and relieve their mental anxiety. This was thought to be best achieved by focusing on the person’s bowels and digestion and resulted in sufferers being advised to eat light meals and little meat. Sufferers were also told to avoid getting cold, exercise in the open air, and strengthen their minds with healthy pursuits and “rational amusement.”

References:

• [1] Hooper, Robert, A New Medical Dictionary, 1817, p. 398.
• [2] Dunglison, Robley, The Cyclopaedia of Practical Medicine, Vol. 2, 1833, p. 570.
• [3] Cullen, William, Nosology, 1800, p. 128.
• [4] Austen, Jane, Pride and Prejudice, 1813, p. 98.
• [5] Cullen, William, p. 128.
• [6] Macintosh, John, etal., Principles of Pathology, and Practice of Physic, Vol. 2, 1837, p. 143.