Medical Muses: Hysteria in Nineteenth-Century Paris (review)

Meticulously documented and beautifully illustrated, Hustvedt's book showcases the lives of three women—"Blanche," "Augustine," and "Geneviève"—who in the 1870s ended up at the Salpêtrière hospital in the care of Jean-Marie Charcot. Approaching her project with a preconceived notion—that because hysteria was in part "an illness of being a woman in an era that strictly limited female roles," hysterics must be victims "of a misogynist institution led by the tyrannical Charcot" (4), Hustvedt was surprised to discover "something far more nuanced" (5): the Salpêtrière may have been "a warehouse for the women Paris no longer wanted" (38), but it gave hysterics a home and a language to articulate their suffering.

The opening chapter, on Charcot, lays the groundwork for the three case studies to follow. Nicknamed the "Cæsar of the Salpêtrière," the "Napoleon of Neuroses," Charcot at first had little interest in hysteria, which he deemed an illness for family doctors or alienists; it was only when the hospital was restructured that he took on the hysterics. His insistence on clinical observation and detailed patient dossiers led him to identify four distinct phases of hysteria and to define it "not [as] madness or malingering" but as an inherited neurological disorder (21). Yet his fixation on 'hysterogenic zones' privileging ovaries and mammary glands suggests that he considered it primarily a female condition.

Hustvedt then turns to Blanche, the "Queen of Hysterics" who some believed to be in cahoots with her doctors, a claim refuted by Hustvedt, who argues that she suffered from very real symptoms that were over time "molded, altered, and tweaked to fit [Charcot's] elaborate nosology" (49). Hustvedt likens Charcot's staging of elaborate skits to method acting, noting that what seem to us like "burlesque experiments" are described in the documentation "matter-a-factly (sic), side by side with the more 'scientific' experiments [. . .]" (78). Hustveldt highlights the paradoxes in Charcot's approach: the doctor who strove to rid hysteria of its stigma also hypnotized patients to perform in erotically charged scenarios, a practice which may reveal "more about the physician's fantasies than the patient's illness" (81-82).

If Blanche was the most hypnotizable hysteric, Augustine was the most photographed. Hustvedt analyzes the pros and cons of using photography in this context, explaining that while the photographs were intended to illustrate specific neurological symptoms, they "also inevitably depict the girl," which "compromis[es] their status as medical illustration" (146); she questions, too, how, in the middle of an attack, a hysteric could be transported to a studio, not to mention held still while movie-star-esque pictures were taken.

Geneviève's case demonstrated the battle between doctors and priests "for control of women's bodies" (215). Not surprisingly, the Catholic church was threatened by neurology and psychiatry, cutting-edge disciplines that "openly accused religion of [. . .] standing in the way of progress" (235), though, in the final analysis, the Salpêtrière doctors "didn't debunk religion as much as they appropriated its stature" (282). What was for the church a sign of holiness—Geneviève's self-starvation, for instance—was for doctors a symptom of hysteria. Hustvedt adds that however guilty the church may have been of taking advantage of suggestible women "to perpetrate (sic) its superstitions and maintain its power," the same women might just as easily have been manipulated by medical professionals (242).

Hustvedt's study fairly brims over with fascinating facts. Who knew that the Nazis melted a statue of Charcot for scrap metal, that 1889 Paris could boast of over 500 cabinets somnambulists (sic) for the treatment of illnesses resistant to traditional medicine, that centers for abandoned babies and orphans established during the July Monarchy had to reduce the size of the cubbyholes used for drop-offs to discourage the deposit of older children. Readers will not want to miss the descriptions of draconian devices such as the ovary compressor, a...