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Reviewed by:
  • Approaching Hysteria: Disease and Its Interpretations
  • Nancy Tomes
Mark S. Micale. Approaching Hysteria: Disease and Its Interpretations. Princeton: Princeton University Press, 1995. xii + 327 pp. $29.95; £24.95.

Reading the title of this book, historians of medicine may be tempted to say, “What, another book on hysteria?” But this superb set of essays by Mark Micale deserves their close attention, for he offers not only an invaluable guide to the vast literature on hysteria, but also a major contribution to the historical analysis of disease in general.

In the last twenty-five years, hysteria has been the subject of countless articles and books by literary critics, psychoanalysts, feminist theorists, historians, and other scholars. Approaching Hysteria represents Micale’s efforts to wrestle with the “new hysteria studies,” as he terms them, in the context of older historical interpretations of a disease that “has been key to medical efforts to discriminate meaningfully between organic and functional disorders” (p. 3). His training as both a historian of ideas and a historian of science makes Micale’s commentaries on the literature of hysteria particularly useful to historians of medicine.

The book consists of a series of extended historiographic musings that reflect Micale’s exhaustive reading of the past and present literature on hysteria, as well as his own extensive research on Jean-Martin Charcot, French neurology, male hysteria, and the “disappearance” of the hysteria concept in the early twentieth century. The first chapter presents a masterful review of the historiography of hysteria, starting with the early French histories of the disorder published in the late 1800s and early 1900s, and ending with the explosion of work in the 1980s and 1990s. The second chapter lays out Micale’s suggestions for future work, which he hopes will demonstrate an “integrated internalist and externalist approach and a willingness creatively to combine ideas, evidence, and insights from different fields of knowledge” (p. 175).

In part 2 of Approaching Hysteria, Micale practices what he preaches by looking more closely at the interconnections between hysteria’s “two primary histories,” the medical and the cultural. Chapter 3 examines the uses of the hysteria metaphor in the literature and politics of nineteenth-century France. Chapter 4, this reviewer’s favorite, explores how the “hysteric of the novel”—in particular, [End Page 166] Gustave Flaubert’s compelling portrait of Emma Bovary—influenced medical writings on hysteria.

Besides providing a perceptive critique of a huge body of historical writings—the bibliography contains hundreds of citations to work published in French, German, and English— Approaching Hysteria offers an interesting argument about the rise and fall of hysteria as both a medical concept and a cultural metaphor. As Micale sums up: “the classic nineteenth-century medical diagnosis ‘disappeared’ in the early twentieth century due in part to extreme clinical overextension. During the same period, hysteria in the arts and in the social and political arenas also exhausted its metaphorical potential and, as a result, receded rapidly from the scene” (p. 220).

Micale’s work embodies the virtues of the new cultural history, with its attention to language and metaphoric play, at the same time that it addresses issues of long-standing interest to medical historians. These erudite, gracefully written essays should be assigned to students as models of the historiographic art, as well as guides to conceptualizing the history of disease. Because it ranges so widely into so many topics, Approaching Hysteria is a demanding book to read. Like a very rich cake, it is perhaps best consumed slowly and in small bites, to allow the reader to appreciate the subtlety of Micale’s commentaries. His work deserves a wide reading not only by specialists in the history of psychiatry, but by generalists in the history of medicine and science as well.

Nancy Tomes
State University of New York at Stony Brook
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