The Race of Hysteria: "Overcivilization" and the "Savage" Woman in Late Nineteenth-Century Obstetrics and Gynecology

Hysteria, we learned from feminist historical scholarship in the 1970s, was never just a disease. It was also the way nineteenth-century U.S. and European cultures made sense of women's changing roles. Industrialization and urbanization wrought one set of changes, while the women's rights movement brought another. Together, these included higher education for women, their increasing participation in a (rapidly changing) public sphere, paid employment, and declining fertility. These cultural changes were accompanied by a virtual epidemic of "nervous weakness" largely among women, causing feminist historians to begin asking whether the diagnostic category of hysteria was simply a way of keeping women in the home. ¹ In light of recent work in race theory, it is worth examining these scholarly insights to ask: could hysteria equally be said to be about race? I will argue that it was, centrally, in two senses. First, nervousness was often characterized as an illness caused by "overcivilization," ² which located it in a scientific and popular discourse that defined cultural evolution as beginning with the "savage," culminating in the "civilized," but also containing the possibility of degeneration--"overcivilization." In this literature, "savage" or "barbarian" was applied to indigenous peoples, Africans, Asians, Latin Americans, and sometimes poor people generally. As a disease of "overcivilization," hysterical illness was the provenance almost exclusively of Anglo-American, native-born whites, specifically, white women of a certain class. Second, the primary symptoms of hysteria in women were gynecologic and reproductive--prolapsed uterus, diseased ovaries, long and difficult childbirths--maladies that made it difficult for these hysterical (white) women to have children. As such, hysteria also implicitly participated in a discourse of race and reproduction, one which identified white women of the middle and upper classes as endangering the race through their low fertility, while non-white women, immigrants, and poor people had many children. A reading of the American Journal of Obstetrics suggests that its physician-contributors understood and deployed these distinctions extensively, characterizing white women as weak, frail, and nervous while non-white women and poor people were described as strong, hardy, and prolifically fertile. Ultimately, this doubled discourse of women had profound consequences for medicine and science: the frailty and nervousness of one group provided the raison d'être of obstetrics and gynecology, while the insensate hardiness of the other offered the grounds on which they became the experimental "material" that defined its progress.

Hysteria in the nineteenth century was not a single disease or entity but entailed a profusion of symptoms. As a description, "nervousness" did heroic labor, and accounted for the most various distresses of body and mind. "Hysteria" and its variants neurasthenia and nervousness were part of the lexicon of psychiatry, neurology, obstetrics and gynecology and also of reformers cautioning about the dangers of cities or of women's education or labor. ³ One physician, George Beard, wrote a catalogue of symptoms that ran to seventy-five pages, and he counted it incomplete. ⁴ Both women and men suffered from neurasthenia, but the overwhelming majority of its victims were women. The treatments were drastic: bleeding, extended bed rest and for women, surgery to remove the ovaries. Scholars of women and gender have long argued that hysteria participated in powerful narratives of cultural crisis, which goes a long way toward explaining the logical glue that held together an apparently endless catalogue of symptoms as a singular syndrome. The hysterical woman, women's historians suggest, is both sign and symptom of conflict over the cultural meaning of gender. In this scholarship, hysteria is at once a diagnostic gesture of dismissal of women as competent participants in public life, a social role uncomfortably inhabited by suffering women, and a warning about the dangerous consequences for women of engaging in "unfeminine" behavior. ⁵ Barbara Ehrenreich and Deirdre English, for example, consider hysteria virtually a diagnostic fiction, arguing that nineteenth...