Medical Discourse, Women’s Writing, and the “perplexing Form” of Eighteenth-Century Hysteria

The condition sometimes known as hysteria was, in eighteenth-century Britain, notoriously difficult to define. In 1702, poet Anne Finch noted its “varying” and “perplexing Form”; for her, it was “Proteus to abus’d Mankind,”¹ whose “real Cause” was yet to be found, and which refused to remain “in one Continued Shape.”² Thomas Sydenham, a physician known in his time as “the English Hippocrates,” anticipated Finch’s view of the condition, writing in 1689 that its manifestations were “multiform in type” and comprised a “farrago of disorderly and irregular phenomena.”³ Similarly, in 1729, physician Nicholas Robinson declared that “the Subject [of hysteria] opens to my View such a perplexing Scene of Nature, that it’s with the utmost Difficulty I can discover any sure Footing on which to rest.”⁴ Diagnoses of hysteria were further complicated by its very terminology. Hysteria, hypochondria, melancholy, spleen, vapours, bile, fits, and nerves—what G. S. Rousseau calls the “entire vocabulary of being in ‘the dumps’”⁵—designated largely indistinguishable conditions with a plethora of overlapping physical and mental symptoms. Moreover, the continued use of terms such as “hysteria” (which derives from the Greek for “belonging to the womb”) and “vapours” (which can be traced to the idea that vapors rose from the uterus and disturbed the brain) suggested that, even though hysteria was beginning to be understood through new mechanical and nervous models of the body, metaphors of wandering wombs, corrupt menstrual blood, and diseased uteri lingered. Doctors in particular insisted on using the term “hysteria” for female patients, and they promoted notions of women’s inherent hysterical inclinations and deficient physiology. The complex, multi-layered, and largely “perplexing” views surrounding hysteria suggest that it was at once a veritable malady, a figurative construct, and a metaphor for the weaknesses and dangerous excesses of the female sex. For these reasons, it is useful to consider the condition not only by exploring sources written by male physicians, but also by studying accounts by women who themselves exhibited hysterical symptoms. These women’s accounts provide rigorously critical—if sometimes contradictory—engagements with discourses of hysteria by effectively capturing its complexities and even bringing into question its very existence.

The value of moving beyond official medical documents to consider the voices of female sufferers is made even clearer when we take into account the nascent and fluid nature of eighteenth-century medical culture. “Medical knowledge,” notes Roy Porter, “was not yet a terrifying, esoteric specialism, the monopoly of medics, but rather part of a common, open, intellectual culture, to be weighted in the balance before the tribunal of the educated and opinion-makers in society at large.”⁶ Women were certainly part of this tribunal. The female doctor emerged in the period as a figure who straddled the divide between medical authority and educated layperson. James Makittrick Adair, like many medical men of the age, was sceptical of such “lady doctors” and suggested that it was essentially impossible for them to attain any real medical knowledge.⁷ Nonetheless, in his 1787 treatise, he describes female doctors as “very much superior in every liberal and medical accomplishment” to the quacks—or “nostrum-mongers”—that abounded in English society,⁸ and concedes that they were useful when limited to “simple and intelligible” advice and prescriptions.⁹ As a result of women’s partial entrance into the medical establishment, many women who were not official doctors began to assert their medical opinions on hysteria and on other matters. The accomplished woman of letters Lady Mary Wortley Montagu, who famously popularized the Turkish practice of smallpox inoculation in England, declared in mid-century that she had “no partiality to [the medical] profession.”¹⁰ She claims she “was misled in regard to [her] own Health,”¹¹ and, in a 1749 letter, offers this scathing critique of the medical establishment:

When I recollect the vast Fortunes rais’d by Doctors amongst us, and the eager persuit after every new piece of Quackery that is introduc’d, I cannot help thinking there is a fund of Credulity in...