I

Even in the earliest historical periods in the murky ages between 1300 and 1600, old man Proteus offers a steadfast clue to understanding the evolution of hysteria. In its progression from the Greeks to the medieval world, hysteria—as Helen King suggests—was transformed many times, such that by 1400 it was understood as something different from the conceptions given it by Hippocrates and Soranus. Vast cultural shifts—religious, socioeconomic, and political—as well as the growth of medical theory in the Renaissance, prompt hysteria to continue its prior altera-

tions and constructions after approximately 1500; so that by the period of the French and American revolutions it assumed a different set of representations altogether.

These historical transformations and representations—specially their protean ability to sustain the existence of a condition called hysteria without a stable set of causes and effects or, more glaringly, a category identifiable by commonly agreed upon characteristics—constitute the substance of this chapter. Throughout I will be attempting to explain how a category—hysteria—evidently without a fixed content can endure throughout the course of history.^[1] Furthermore, among all medical conditions hysteria formed the strongest critique of the traditional medical model up to the advent of psychiatry and psychoanalysis. Before approximately 1800 its discourses were compiled by doctors who were themselves often terrified of their hysterical patients, as is evident in the early Malleus Maleficarum . Hysteria is a unique phenomenon in the entire repertoire of Western medicine because it exposes the traditional binary components of the medical model—mind/body, pathology/normalcy, health/sickness, doctor/patient—as no other condition ever has.

My purpose here is dual: to show what hysteria was thought to be, as well as trace its representations. Within this goal I have a set of alternatives: whether to focus on what doctors chose to make of hysteria, or to gaze at its representations by those who were not doctors. Inevitably I work here sporadically as a historian of science and medicine whose eye is never far from the medical alternatives doctors chose to take, while inquiring into the representations of hysteria made by those who were not doctors. This is the "as is" (history) and the "as it could have been" (representations) of hysteria, strewn with a broad range of metaphors and language that attached to the condition.

But even in a historical and representational treatment like this one, it is easy to forget that for the modern era the history of hysteria extends over a period of four centuries (1400-1800), and because this somewhat synchronic view enables us to chart the flow of hysteria in its recorded versions, we possess certain advantages over both the doctors and the patients who were entrapped in their particular moment. This angle of vision is, of course, double-edged: we are also entrapped by our moment, and many voices of hysteria must have been lost over the centuries. Nevertheless, modern methods of research permit access to a wide body of knowledge about this condition not available before.^[2] Furthermore, some disjointed concepts pertinent to hysteria's transformations must be considered: in our time, when the revolt against Freud has been so vehement, it is important to remember that he launched

his psychoanalysis exclusively on the basis of his studies of hysterical women. As a consequence, hysteria in our century has assumed a more important role in psychiatry than have other categories.^[3] Although the diagnosis of hysteria in both women and men has virtually disappeared in our time, in practice its symptoms have been transformed into the medically sanctioned "conversion syndrome" and then (mysteriously and perplexingly) have gone underground.^[4] It is easy to forget that the ancient threat of an invasive and irrepressible female sexuality, a patent menace in epochs studied in this chapter, is in the lay imagination today far from having been removed in our own time.^[5] Indeed, the social oppression of women throughout history has only recently—since the eighteenth century—been acknowledged in any organized way, and this restraint bears serious implications for hysteria. Finally—and it will seem extraneous in this discussion about a complex but nevertheless presumed-medical category—because so much of hysteria in the period 1500-1800 is embedded in discursive practices, much more sensitive attention must be paid to language if we hope to disentangle hysteria's transformations.

We are thus presented with something of a paradox. On the one hand, hysteria appears to be a category without content; on the other, hysteria has an amorphous content incapable of being controlled by a clear category. The history of hysteria (pace Dr. Ilza Veith, the already-mentioned Freudian medical historian who amassed a great deal of information about hysteria) is therefore only a part of the story I tell here. Its representations count as much. No matter how complete any history, its discursive facet can only hope to be one part, its total realism requiring a larger canvas than historical narrative. The challenge I face is that I aim to "fill up" both categories (the medical category and its broader nonmedical representations) at the same time—a double task. But both require amplification, even when conjoined as they are here. Moreover, the medical category itself is so inadequate for the early period (1500-1800) that I often rebel against its constraints. The history of hysteria is as much the "his-story" of male fear—in this case literally his-story—as the history of Dr. King's hysterie pnix or any other wandering wombs. It is also the history of linguistic embodiments, rhetorics, and emplotments, many of which remain to be decoded and interpreted here.^[6]

Two truths then seem to emerge with rather startling disparity: first, that Dr. Thomas Sydenham, acclaimed as the "English Hippocrates," rather than Charcot or Freud, is the unacknowledged hero of hysteria (his entrance to my story is necessarily delayed until a later section as my organization is essentially chronological); second, that language,

rather than medicine (either theory or therapy), is the medium best able to express and relieve hysteria's contemporary agony. (The same conclusion can be drawn concerning other conditions, such as depression, but conventional hysteria or twentieth-century conversion syndrome is different in that its somatic involvement is much greater.) This is the conjunction of language and the body: hysteria's radical subjectivity. And as I shall suggest below, hysteria is also the most subjective of all the classifications of disease. These are bold assertions, and no one at this time wants to promote a history of medicine based on heroes and heroines. But writing—perhaps self-expression through any of the arts, rather than treatment with drugs or psychotherapy—alleviates the modern hysteric's pain and numbness best.^[7] To validate this claim we will prove that there remains no better medical therapy for contemporary hysteria, certainly no more effective remedy when hysteria is, as in Sydenham's version of the 1680s, presented as a "disease of civilization" rather than as organic lesions caused by psychogenic factors.^[8] If we ask what the three hundred years between 1500 and 1800 can teach us about hysteria, the answer can be found by looking at two factors: gender-based pain and social conditions, neither of which falls within accepted categories of modern medicine. It is consequently no small wonder that to its observers hysteria has continued to be one of the most elusive of all maladies;^[9] less so—as I suggest—to writers, poets, or artists, who have often adopted a gaze that differs from the traditional medical one. If we assign to hysteria a broad repertoire of gender-based pains caused by social conditions, we have the beginnings of a definition that pleases few medical theorists. We provide a set of contents incapable of being bound together by any logically constructed and demonstrably coherent category,^[10] and so our contents will be unsatisfactory to philosophers.

Moreover, of all the diseases classified in this early modern period, hysteria has been the medical condition most likely to generate private languages and discourses—languages that capture the cries and whispers of unspeakable agonies, most of which do not remain as single narratives because patients never recorded them. This was as true in the sixteenth and seventeenth centuries as it is of the twentieth. Hysteria's expressions of physical and emotional numbness and of chronic pain were captured in a personal, often disjointed, medium, most striking in its intrinsic subjectivity. Subjectivity, above all, has been the teleology of the annals of hysteria in Western civilization.^[11]

More specifically, mourning and melancholia, especially the grief and ecstasy associated with hysteria, are the shadow-categories that have haunted modern theories of subjectivity and representation since Freud. But even Freud intuited the history of this development in his inau-

gural linking of Hamlet and Oedipus Rex in his discovery of the Oedipus complex, in which Hamlet came to represent the figure that proves (and ruefully denies) the Oedipal rule, as much as literary criticism has taken Hamlet as its exemplary defective (hence modern) tragedy. And modern theorists (including Jacques Lacan, Walter Benjamin, and Nicolas Abraham) have repeatedly returned to Hamlet's disordered grief as touchstones for their insight into subjectivity and representation. From these positions it is only a short step to the feminist, psycho-analytic, and deconstructive attempts to articulate a supplementary position before, within, or beyond the interpretative paradigms practiced in Freud's (and Oedipus's) name. In our time, these have embraced—in brief—the literary, psychoanalytic, and deconstructive symptoms of hysteria: in Hamlet's famous phrase, the "forms, moods, shapes of grief."^[12]

But if mourning and melancholia have haunted modern categories of subjectivity and representation, language alone has recognized the silences beyond itself (i.e., beyond verbal language and discourse) to which the (usually female) hysteric has had to ascend if her desire, not always limited to the sexual realm, was to be acknowledged. The point is admittedly elusive, even if concretized in a tangible history of medicine. Historically speaking, hysteria has been the condition beyond others that wedded the body to body language, especially to gestures, motions, gaits, nonverbal utterances. As such, it never reflected—certainly not in the Renaissance or Enlightenment—a simple ontology of the mind or of mind functioning together with body, but rather captured the chronic numbness and ineffable despair usually incapable of being grasped in the subtleties of written language.^[13]

Ever since the Cartesian revolution of the seventeenth century and perhaps even before then, the philosophical concept of body had been of little use to theories of hysteria—viewed, as we shall see, as a metaphysical medical category—nor have mind and body, in conjunction, offered solutions to unravel the riddle of hysteria. Perhaps the difficulty arises from the suppressed desire of those who have presented themselves with hysterical symptoms. Language and desire; more precisely, desire in language; Julia Kristeva's yoking of these loaded words and their difficult concepts proved more useful, especially for the unspeakable realms of pain that she believes transcend language: the metalinguistic spaces.^[14] Language and desire may ultimately be the only categories through which the hysteric can arrive at self-understanding: language used in the act of self-analysis and offering balm to heal the hysteric. The traditional remedies discussed later in this book have usually produced little improvement.

Michel Foucault speculated in his history of madness about the "hys-

terization of women's bodies" through which the pejorative image of the "nervous woman" had been constituted.^[15] Such negative imaging was necessary in patriarchal cultures that confined power solely in the males to ensure civic cohesion. But Foucault's analysis would have been richer, and certainly more complete, if he had included the "hysterization of women's language," especially as it had been muted with the passage of time. For hysteria has been the condition paradoxically both constituted by and consistently misinterpreted by medical observation; the condition that neither the mere presence of the physician (whether appearing as savior or soothsayer) nor the persistence of his therapy can control. Sequences of despair, pain, numbness, and conversion syndrome ultimately could not be cured by makeshift remedies or the herbal concoctions of the Renaissance and Enlightenment apothecaries. Today, instead of examining the fabric of the society perpetuating this chronic physical and mental pain,^[16] we deny (perhaps imprudently) that hysteria exists. We drug patients until the pain is obliterated, the despair forgotten; until physicians can claim that questions such as "where has all the hysteria gone?" cease to exist as valid medical concerns.