Tradition or Truth?
By the mid-sixteenth century, the hysteria tradition was complete: the translation into Latin of texts from the Arabic and Greek made available virtually the full range of authors discussed above. Every commentator on suffocation of the womb knew which ancient authorities to consult for a description. Since these ancient authorities had themselves known and used the work of many of their predecessors, it is not surprising that the result was often merely further repetition. Latin and Middle English treatises from the thirteenth to fifteenth centuries tend to be heavily dependent on the Arabic writers' versions of Galen, and retain the features of scent therapy, provoking a sneeze as a cure (as opposed to
welcoming a spontaneous sneeze), venesection, and therapeutic intercourse.[303] However, in the mid-sixteenth century something new does occur: the stated desire to compare authorities, not only with each other, but with reality.
As an example of this we may take the work of Pieter van Foreest (1522-1597), Observationum et curationum medicinalium , Book 28 of which concerns women's diseases.[304] As the title suggests, rather than simply repeating the authorities, he also presents cases that he himself has seen. Observations 25-34 concern suffocation of the womb, covering cases due to retained seed or menses in widows, in pregnant and other women, and of varying severity. Rhazes, Ibn Sina, and Galen are cited; Galen is particularly favored and, although he is a supporter of the Hip-pocratic revival, van Foreest accepts Galen's attack on the Hippocratic theory that the womb dries out and seeks moisture.[305] He notes that the ancients believed the womb itself traveled the body, whereas "more recent writers" believe it is vapors that rise. The motif of the woman who uses hysteria to manipulate men is reintroduced, echoing Martial's epigram on women who announce they are hysterica in order to have intercourse with a young doctor; van Foreest states that some women simulate hysterical suffocation by imagining sexual intercourse, and he cites the "notorious poem" mocking this.[306]
His use of his own observations is first suggested when, after repeating Galen's statement that the symptoms from retained seed are worse than those from retained menses, he adds, "And this is true."[307] Even Galen must be tested against experience. Observation 27 repeats the story of the woman who lay as if dead, based on Pliny, and gives the standard tests for life, adding that a sneeze is more reliable than the wool or water tests. Observation 28 includes Galen's story of the widow who was cured after passing some thick seed. In Observation 30, on hysterical suffocation in pregnancy, he gives two cases he himself has seen, one dated to October 1589, while in Observation 31 he describes the case of a woman called Eva Teylingia, who was married in 1561 and was known to his wife. She was unsuccessfully treated by several named doctors for suffocation, and "on the third day I myself was called." Van Foreest's therapy—based on foul-smelling substances placed in the navel—was successful. In Observation 33 he gives the case of a girl of twenty, treated in September 1579, and in Observation 34 he gives a case dated March 1566.
Such works as this were used by Edward Jorden in his treatise of 1603, A Briefe Discourse of a Disease Called the Suffocation of the Mother .[308] What is most striking about this work, in which he sets out to show "in a vulgar tongue" that symptoms "which in the common opinion are imputed to
the Divell" are in fact due to the suffocation of the womb, is not the use of authorities such as Hippocrates, Galen, Pliny, and Ibn Sina, but his citation of recent cases seen and reported by men such as van Foreest, Amatus Lusitanus, and Andreas Vesalius.
Is this, then, the triumph of experience over tradition? It is not. As T. Laqueur puts it, "Experience, in short, is reported and remembered so as to be congruent with dominant paradigms."[309] Many elements of the hysteria tradition have an extraordinary vitality as paradigms, continuing to be repeated well into the nineteenth century. To take one example, Jorden himself repeats the story of the woman who lay as if dead but was known to be alive by the presence of the innate heat; he uses the version given by Pliny.[310] This story has inordinate staying power, turning up many times in seventeenth-century literature; for example, Guillaume de Baillou (1538-1616) claims that many women are being buried alive because it is wrongly assumed that the absence of a pulse indicates death.[311] In the nineteenth century, Thomas Lay-cock's Treatise on the Nervous Diseases of Women has a section on "Apparent Death" citing Diogenes Laertius's version of the same story, here diagnosed by Laycock as hysteria. As a general rule, Laycock recommends delaying burial in such cases until there are signs of decomposition.[312] He refers readers to Leigh Hunt's play A Legend of Florence , first performed in 1840, the year of publication of Laycock's own work. In this play, the moral and married Ginevra, receiving letters from a nobleman who declares his love for her, has a fainting spell and is mistakenly buried—fortunately, in an open vault. She wakes up but has difficulty persuading the people of Florence that she is not a ghost:
I am Ginevra—buried, but not dead,
And have got forth and none will let me in.
(act 4, scene 4)
This highly popular piece of drama, seen by Queen Victoria a number of times and regarded as Leigh Hunt's greatest dramatic success, was in turn based on Shelley's "Ginevra," published in 1821.[313] In Shelley's version, Ginevra marries a man she does not love and, on her wedding night, falls into a trance that drifts into death itself, in order to keep faith with her disappointed lover.
They found Ginevra dead: if it be death
To lie without motion or pulse or breath,
With waxen cheeks, and limbs cold, stiff, and white,
And open eyes . . .
(lines 145-148)
Shelley's words echo Diogenes Laertius's third-century A.D . account of the woman "without breath or pulse" but preserved, according to Galen, by her innate heat. Such powerful motifs as apparent death weave in and out of the medical accounts of suffocation of the womb and of later hysteria. Do such elements survive simply because they make such good stories? Or is the persistence of certain parts of the tradition evidence for the accuracy of that tradition, and thus for the accuracy of the diagnosis of hysteria?
Throughout this chapter I have emphasized how medicine worked as a series of texts. Medical education, particularly where it concerned women's bodies, was based on the text in the Byzantine, Islamic, and medieval worlds; even after publication of Vesalius's De humani corporis fabrica in 1543, "anatomy and surgery continued to be taught from books rather than from experiment and observation."[314] Specifically, in the texts of the Hippocratic corpus, neither the diagnosis of hysterike pnix nor of hysteria is made. The womb moves, causing a range of symptoms according to its eventual destination. At an unknown date, possibly—from the medical papyri—in the second century B.C ., a disease category of suffocation of the womb is created by the merger of a number of discrete Hippocratic texts giving symptoms, causes, and therapies. Galen challenges the label, but keeps the concept and develops a different explanation based not on womb movement so much as retained blood and seed. In the early Roman Empire, further stories are added to the disease picture, surviving in the different cultural climates of the Latin West, Greek East, and Arabic world. Particularly resistant to change are two of the original Hippocratic components, womb movement and scent therapy: so too is the need to give the concept antiquity by tracing it back in its entirety to the father of medicine.
I would suggest that what we hear in such texts as those discussed here is not the insistent voice of a fixed disease entity calling across the centuries, but rather what Mary Wack has called "the rustle of parchments in dialogue."[315] Indeed, it is rarely even a true dialogue. Deaf to pleas from anatomy and experience, the texts continue to tell one another the traditional stories. The language may shift—the womb travels, vapors rise, sympathy transmits symptoms through the body—but the message remains the same: women are sick, and men write their bodies. Nineteenth-century hysteria, a parasite in search of a history, grafts itself by name and lineage onto the centuries-old tradition of suffocation of the womb, thus making Hippocrates its adopted father. It is time that father disowned his hybrid child.