Book Reviews - Summer 2011

Beyond Nerves

Three women who helped engender modern psychiatry

By Laure Murat | June 3, 2011


Medical Muses: Hysteria in Nineteenth-Century Paris, by Asti Hustvedt, Norton, 372 pp., $26.95

Hysteria no longer exists, its symptoms now dispersed among more modern diagnoses like schizophrenia, conversion disorder, and bipolar disorder. But in the 19th century, the condition, especially prominent among women, was an object of fascination for the numerous writers, photographers, and artists who documented the suffering of its victims, as well as for the doctors who sought to understand and treat the disease—among them the young Sigmund Freud. His later achievements—the discovery of the “unconscious” and the practice of psychoanalysis—owed much to the work of neurologist Jean-Martin Charcot at the Salpêtrière Hospital in Paris, whose study of female hysteria defined the disease and served as nothing less than the starting point of an epistemological revolution in the burgeoning field of psychology.

In Medical Muses: Hysteria in Nineteenth-Century Paris, Asti Hustvedt, an independent scholar who specializes in the study of the condition, aims to answer a simple and often neglected question: who were the female hysterics that Charcot studied, scrutinized, exhibited, and used as guinea pigs? She approaches the subject through a careful examination of the lives of three “queens of hysteria”: Blanche, Augustine, and Geneviève.

Although the three women were very different from each other, they had in common low social standing, history of childhood abuse, and repeated sexual assault or rape as adults. Indeed, their symptoms—paralysis and nervous attacks spectacular enough to be mistaken for epilepsy—were thought to be rooted in the trauma, reminiscence, and emotional imagination stemming from sexual abuse.

Medicine in the second half of the 19th century was powerless to cure hysteria. Believing the ovaries might be responsible for the disorder, Charcot employed a device called an “ovary compressor,” which applied pressure to the patient’s abdomen to trigger or arrest hysterical episodes. The technique was often used in combination with ether, to which many of his patients formed addictions. Charcot believed that hysterics were uniquely sensitive to hypnosis. Partly in order to make his point, he blurred the line between science and theater by opening the Salpêtrière’s hysteria ward to the public. Blanche was his favorite model, obeying all her master’s orders with such drama that audiences suspected a setup. Was she his willing accomplice? Probably. Was she a victim of science? Undeniably. As Hustvedt writes, Blanche’s body was literally a “blank page”; it was not only put to sleep and publicly manipulated, but used as a model for experimentation for things like “dermagraphism,” a method for marking the patient in order to test her skin sensitivity. “We used the point of a stylus to trace the name of the patient on her chest, and on her abdomen, we traced the word ‘Salpêtrière,’” a doctor wrote about Blanche in 1878. After years of demonstrations and experiments, which made her a star of “tout Paris,” Blanche’s attacks ceased. There is no explanation for her miraculous recovery, except that it coincided with Charcot’s death in 1893. The muse didn’t have to perform anymore. She remained at the Salpêtrière as a technician in the radiology laboratory, where, in 1913, her status as a medical celebrity took an unexpected turn when she became one of the world’s first documented victims of radiology-induced cancer. She died after the amputation of her arms failed to halt its spread.

Like Blanche, Augustine took to her role as a model, documented by the Iconographie photographique de la Salpêtrière, a photography studio that recorded hysterics during their attacks. But her affliction was real. She could suffer up to 154 attacks in a single day; in 1877 alone, they numbered 1,296. The sharpness of the images recording her “passionate attitudes,” however, indicates she was able to hold still for the camera.

Hustvedt uses Geneviève, the third of these medical muses, to address yet another aspect of hysteria: its relationship to “possession.” Geneviève, an abandoned child rejected by several foster families, embodied the perfect example of the hysteric supposedly possessed by religious spirits. She starved herself and cut off her left nipple with a pair of scissors in order to feel closer to the suffering Christ. With her seizures alternating between demonic expressions and ecstatic trances of beatitude, Geneviève’s cure came unexpectedly: angry with Charcot, she willed her symptoms away—a self-healing act of autosuggestion that showed hysteria could be cured by the same mechanism that had provoked it: suggestion.

Drawing on an impressive array of medical accounts, memoirs, articles, photographs, and period fiction, Hustvedt has produced an excellent survey on hysteria in fin-de-siècle Paris. The empathy she feels for her three heroines never strays into emotionalism, and her tone is always balanced. These qualities, along with Hustvedt’s talent for storytelling, lend the book its narrative power. One might regret that she did not devote more attention to explaining where Charcot fits into the broader development of psychology or how his work on hysteria influenced Freud and Josef Breuer, the founders of psychoanalysis, both barely mentioned. Instead, the book’s epilogue jumps to the present day, where Hustvedt deplores our modern tendency to despise diseases rooted in psychic frailty. Still, her book remains highly valuable and enjoyable.

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