Medical muses : hysteria in nineteenth-century Paris /

Using newspapers, magazines, and medical publications, Hustvedt (independent scholar) constructs the history of hysteria in 19th-century Paris through the story of three well-known patients--Blanche, Augustine, and Genevieve. Neurologist Jean-Martin Charcot treated each woman in the hysteria ward of Paris's Salpetriere Hospital, and the three became instant celebrities in France. Parisian society was obsessed with their symptoms and treatment. Those who did not see them in the ward read about them in newspapers and magazines or saw their pictures in galleries. Blanche, Augustine, and Genevieve believed they were afflicted with a real disease, as did their doctor, Jean-Martin Charcot. By acknowledging hysteria as a medical disease, Charcot articulated a new paradigm for illness, one that superseded the widely accepted mind-body model of health and disease. Like Charcot, Hustvedt acknowledges the cultural, social, and medical aspects of hysteria in defining the disease. Her book is organized into four chapters, one dedicated to Charcot and the remaining three to his famed patients. The book ends with an epilogue, "Hysteria Revisited," which provides an important narrative of mental illness and disease definition in both 19th-century Paris and the 21st-century US. Summing Up: Highly recommended. Lower-division undergraduates through researchers/faculty; general readers. M. L. Charleroy University of Minnesota

READERS who can't identify Jean-Martin Charcot as the name of the French neurologist whose 19th-century experiments with hypnosis influenced Sigmund Freud's theory of neurosis may yet recognize the work he conducted at the Saltpêtrière Hospital in Paris. Photographs and illustrations of Charcot's patients, all women suffering hysteria, remain in currency today, 140 years after they were made, if more as curiosities than as clinically valuable documents. Once seen, these images - of, for example, a woman wearing little more than a tangle of bed sheets, her eyes rolled up into her head in either "ecstasy" or "delirium," or fixed on the invisible object of her "amorous supplication" - are not easily forgotten, let alone dismissed. Poses classified as "passionate attitudes," they have the disquieting aspect of pornography masquerading as intellectual inquiry. Charcot, as portrayed in Asti Hustvedt's consistently enthralling "Medical Muses," focused intently - myopically, one could argue - on using hypnosis to induce hysteria and make "his hysterics, with their bizarre fits and spasms, into ideal medical specimens." But the provocative behavior of those "specimens" transformed Saltpêtrière into something closer to a carnival than a teaching hospital. As much showman as physician, Charcot gave weekly two-hour lectures to a packed amphitheater, including demonstrations designed to captivate an audience accustomed to staged séances and exhibitions of mesmerism or telepathy. One of Charcot's students described the dramatic potential of exhibiting hypnotized women: "We can cut them, prick them and burn them, and they feel nothing." Plus ça change, Charcot might say, were he to cast his eye, described in Freud's obituary of his teacher as artistic rather than intellectual, over current illnesses that, like hysteria, exist, Hustvedt says, "on the problematic border between psychosomatic and somatic disorders": anorexia and bulimia nervosa, self-mutilation, idiopathic chronic fatigue, dissociative identity disorder. Charcot died in 1893 without having found the brain lesion he believed caused his patients' confounding symptoms. Two years later Freud declared hysteria to be the result of "repressed memories and ideas," and in 1925 faulted the neurologist for failing to examine the psychology of what he deemed manifestations of repressed emotion. By 1977, a University of Rochester scientist, George L. Engel, had posited today's "biopsychosocial" paradigm, a ready example of the gun analogy frequently applied to anorexia nervosa, in which, as is often said, "genes load the gun and environment pulls the trigger." As Elaine Showalter concluded in "Hystories," her controversial study of 20th-century manifestations of hysteria, the illness, "relabeled for a new era," is more contagious than ever, a result of mass and increasingly instant media. But no matter how hysteria might mutate, virus-like, from one age to the next, in the public imagination it remains what Hustvedt says it partly always was: "an illness of being a woman in an era that strictly limited female roles." So how did the 19th-century hysteric announce her condition? Evidence of primping - "the care that she takes in her toilette; the styling of her hair, the ribbons she likes to adorn herself with" - was enough for Charcot's disciple, Désiré-Magloire Bourneville, to predict what diagnostic hair-pulling, pinching and pricking confirmed. The attacks that followed - which might include fainting, contortions, paralysis, vomiting, screaming, hallucinations and seizures - proved the doctors' findings. "The hysteric always seems to be outside the rule," Bourneville explained. Often misperceived as willful bids for attention, yesterday's hysteria and neurasthenia, today's eating disorders, and whatever problematic behaviors emerge in the future command attention because they defy reduction by medical minds. They resist treatment. Sometimes, in their sufferers' refusal to be fixed and studied like insects pinned to a board, they inspire sadism. For his part, Charcot, the author notes, "confronted the chaos of the hysterical female body" and discovered "hysterogenic zones" privileging the ovaries and breasts that, when stimulated, either provoked or halted hysterical symptoms. Certainly his "ovary compressor," a device whose illustration begs for inclusion in a catalog of arcane implements of torture, got his patients' attention like nothing else could, allowing Saltpêtrière's doctors to administer what "closely resembled a sexual assault" with clinical detachment, dirtying no one's hands. If such therapies were not purposefully misogynistic, they were imposed, Hustvedt shows, by "healthy, educated and bourgeois" male doctors on "diseased, uneducated and lower-class" women who had been committed, often for life, to a warehouse for not only the mad but also the homeless, the pregnant and unwed, and others who refused to abide by the conventions of a stifling society - in other words, the same disenfranchised women who, centuries earlier, might have been tried and executed as witches. The lure of voyeurism made hysterical patients into celebrities, muses for their doctors and for a public that regarded the "condition of being a woman" as "one that can at any moment veer out of control and is therefore in need of medical regulation." But if Hustvedt's meticulous analysis of Charcot's methodology provides evidence of his exploitation of what he called his vast "reservoir of material," it also demonstrates that patients collaborated in what was an iatrogenic condition, "forged between patient and doctor." The "career" of Marie Wittmann, known throughout Europe as the "Queen of Hysterics" began inauspiciously. "Remarkable for her spirit of duplicity, lying and simulation" (as all women suffering hysteria were said to be), Wittmann, called Blanche by Charcot, arrived at Saltpêtrière because she had nowhere else to go after a childhood marked by tantrums so violent they prevented her going to school, the predation of an insane father, the early deaths of her mother and five of her eight siblings, and apprenticeship to a lecherous furrier whose advances provoked convulsions and loss of consciousness. Eighteen years old, exhausted by squalor and strife, she entered the hospital where she would spend the rest of her days. INITIALLY too "unpredictable and unruly" to be of clinical value, Wittmann was transferred from the hysterics' quarters to a cell in the ward for the mad. Allowed to return to Charcot's care after seven and a half months of what had been intended as a punishment for breaking windows and tearing up linens, she worked to secure her place in her increasingly famous physician's magnum opus, the ward for hysteria offering freedom and comforts denied inmates of other wards. There, the ubiquity of "photographs, drawings, wax casts, as well as staged re-enactments" encouraged any enterprising patient to determine and reproduce the ideal hysterical profile. Once she evolved into the "most hypnotizable" (and therefore predictable) of hysterics, she became Charcot's star performer, her symptoms "molded, altered and tweaked to fit his elaborate nosology." She even requested the "ovary compressor." Is it progress to replace antiquity's notion of the wandering womb with the conceit that there wasn't any hysteria - any acting out - that couldn't be effectively treated by striking out at the very organs in which femaleness resides? Though "equating hysterical symptoms with hypnotically induced symptoms" allowed Charcot to lay the groundwork for psychoanalysis, he necessarily failed to cure what "Medical Muses" reveals as women's defiance of patriarchal strictures. Misogyny and hysteria: another circle, this one vicious, to add to the notorious chicken-and-egg. Kathryn Harrison's new novel, "Enchantments," will be published next year.

Hysteria in the nineteenth century was a medica. trash ca. the amorphous receptacle where medically inexplicable symptoms, mostly experienced by women, were dumped. These symptoms included excessive emotionality, paralysis of the limbs, temporary deafness and muteness, willful starving, hallucinations, seizures, and fits of contortions. In Paris in the 1870s, patients so afflicted were sent to the Salpêtriêre Hospital, where they came under the care of Jean-Martin Charcot, a well-respected neurologist who, instead of looking for a cure, focused on managing and visually documenting the disease. Three of these young women Augustine, Genevieve, and Blanche, th. Queen of Hysteric. became celebrities, visited by crowds who photographed, painted, and sculpted them. Hustvedt describes their symptoms and their symbiotic relationship with Charcot, who became engaged in a battle with the church over whether the source of their aberrant behavior was hysteria or either God or Satan, as the priests claimed. Hustvedt concludes tha. the riddle of Charcot's sphinx has yet to be answered. and that hysteria's manifestations today may include both chronic fatigue and Gulf War syndromes.--Donovan, Debora. Copyright 2010 Booklist

Before she entered Salpetriere Hospital in 1877, Blanche Wittmann was just another damaged child from a poor neighborhood of Paris. Raped by an employer, angry and seizure-prone, the 17-year-old girl almost inevitably became a charity patient of the hospital's mental wards. Once there, however, she came to the attention of one of France's most famous scientists, the neurologist Jean-Martin Charcot. Acclaimed for his work in diseases of the nervous system (he was the first physician to recognize that ALS, amyotrophic lateral sclerosis, was a disease of motor neurons), Charcot had developed a keen interest in the kind of neurotic fits exhibited by the teenage Blanche. Under his care and-critics would claim-his manipulation, she became not just a patient but a star performer known as "the queen of hysterics." As Hustvedt details in this compassionate history, the doctor not only studied patients like Blanche, he turned them into public exhibits. Charcot and his colleagues, experimenting with treatment by hypnosis, often held theatrical demonstrations of their power over these troubled women: "Once hypnotized, Blanche became a smoothly running woman-machine...." These performances have led earlier writers to obsess over the circus-tent nature of the proceedings and the male arrogance of the research. And Hustvedt does explore those issues as well as Charcot's eventual fall from professional grace. But her real fascination is in turning these so-called machines into real women, and she tells her story by deliberately focusing on three very dissimilar patients: the celebrated and obedient Blanche; a pretty and incurably willful Augustine; and a religion-crazed, demon-obsessed teenager called Genevieve. They are also completely alike in being poor, powerless, desperate. Their lives provide a near shocking contrast to the privileged existence of Charcot, married into wealth, residing in an ornate mansion on the Boulevard Saint-Germain. That imbalance is so strong (and wrong) that even today it overshadows his research into the elusive nature of neurotic behaviors. Hustvedt comes from a literary family; her sister is novelist and essayist Siri Hustvedt, her brother-in-law Paul Auster. And she has worked as both an editor and translator. But this is her first time out as a book author, and it's not surprising to find signs of inexperience in the work. She struggles with doing justice to the complex nature of Charcot's work; she visibly gropes for a meaningful resolution to her tale. Still, she does a lovely, sympathetic job of illuminating the lost lives of the famous hysterics, reminding us that the story of science, far from being purely clinical, is ever the most human of stories. 40 illus. (May) Reviewed by Deborah Blum. Deborah Blum is author of The Poisoner's Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York. (c) Copyright PWxyz, LLC. All rights reserved.

A compelling analysis of hysteria told through the stories of three young women afflicted with the illness.In the late 1800s,the Salpetriere Hospital in Paris was notorious for its controversial director, neurologist Jean-Martin Charcot, and for its large population of women diagnosed as hysterics. The illness was mysterious, as Charcot's careful clinical methods failed to reveal a biological source of symptoms, and its treatment equally opaque; hypnosis, ether and metallotherapy are a few examples of Charcot's experimental methods. Three of the hysterics, Blanche, Augustine and Genevieve, all young women when they were admitted, became celebrities under Charcot's care. Their dramatic physical transformations when suffering a hysterical attack, and Charcot's ability todirect their minds and bodies while they were hypnotized,fascinatedthe public that clamored to see the spectacle for themselves. Hustvedt (A Society without Fathers or Husbands: The Na of China, 2001, etc.) delves into the stories of these three women, exploring how their experiences inform modern psychology and medicine, as well as revealing the true storiesbehind their treatment and exposure.The author questions whether these women weretruly afflicted, or were they playing a role? Was Charcot truly reaching medical breakthroughs with his analysis, or was he manipulating his clients in order to gain prestige? Citing ample historical evidence, Hustvedt contends that the women were legitimately affected by chronicphysical symptoms that fell into the grey area between psychosomatic and somatic disorder. In some ways, she suggests, it's possible that the manner in which women were treated in 19th-century Frenchsociety may have been manifested through these symptoms. Many of the women at the hospital were unmarried, poor, fatherless or abused, and strange myths about femininity abounded. Charcot was a pioneer for treating hysteria as a legitimate medical affliction, but after his death, his reputation suffered. However, heand the stories of his three star patientsraise important questions about the mind-body paradigm, especially in women,a tension that the author suggests remains misunderstood in modern medicine.Insightful, provocative medical history.]] Copyright Kirkus Reviews, used with permission.