The Technology of Orgasm: "Hysteria," the Vibrator, and Women's Sexual Satisfaction (4 page)

Historically, women have been discouraged from masturbating on the grounds that this practice would impair their health, and most men before this century (even to this day, some would argue) have not understood that penetration alone is sexually satisfying to only a minority of
women. Even those husbands and lovers who may have known did not always want to take the trouble to provide the additional stimulation necessary to produce female orgasm.
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Medical authorities as recently as the 1970s assured men that a woman who did not reach orgasm during heterosexual coitus was flawed or suffering from some physical or psychological impairment. The fault must surely be hers, since it was literally unimaginable that any flaw could be discovered in the penetration hypothesis.
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If the penis did not represent the ultimate weapon in sexual warfare, claims to male superiority would rest entirely on the statistically greater potential of the male biceps and deltoid muscles, which did not in themselves seem equal to the task of sustaining patriarchy in Western civilization.

Female orgasm and the means of producing it were and are anomalous from a biological as well as a political and philosophical point of view. Its lack of correlation with fertility and conception remains counterintuitive even—perhaps especially—in an age of greater scientific understanding of human reproduction. The biological function of the female orgasm is controversial.
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In both the recent and the distant past, it seemed only reasonable to assume a priori that men and women would be sexually gratified by the same act of penetration to male orgasm that made conception possible. That stimulation of the external genitalia in women should be necessary in most cases remains unexplained.
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As a historian, I would not presume to speculate on the physiological and evolutionary questions raised by this issue. I look forward with interest to the results of current inquiries by evolutionary biologists, reproductive physiologists, and physical anthropologists.

The question of female orgasm in history is deeply clouded by the androcentricity of existing sources. Medical authors, for example, have addressed female orgasm mainly from a prescriptive viewpoint; popular writers only occasionally mention it at all.
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Before the middle of this century, even in literature, references to female orgasm are conspicuous by their absence, even from works purportedly built around sexual subject matter.
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In the development of Western medical thought on the subject of sexuality, it has been thought both reasonable and necessary to the social support of the male ego either that female orgasm be treated as a by-product of male orgasm or that its existence or significance be denied entirely. Historically, both strategies have been used, but there
has also been a persistent undercurrent of recognition that the androcentric model of sexuality does not adequately represent the experience of women.
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Confusing the medical discussions of these issues, as Thomas Laqueur has pointed out, is the failure of the Western tradition until the eighteenth century to develop a complete and meaningful vocabulary of female anatomy. The vulva, labia, and clitoris were not consistently distinguished from the vagina, nor the vagina from the uterus. Thus it is difficult, in reading the premodern literature of gynecology, to decipher treatment descriptions in which the female genitalia are undifferentiated. Female sexuality is often referred to in masculine terms, such as the references to the secretions of the Bartholin glands as “semen” or “seed.” Thomas Laqueur says that physicians writing of anatomy “saw no need to develop a precise vocabulary of genital anatomy because if the female body was a less hot, less perfect, and hence less patent version of the canonical body, the distinct organic, much less genital, landmarks mattered far less than the metaphysical hierarchies they illustrated.”
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HYSTERIA AS A DISEASE PARADIGM

I intend to sketch here the contours of male medical and technological response to discontinuities between male and female experiences of sexuality through the social construction of disease paradigms. Situated in the vulnerable center of every past and present heterosexual relationship, the potentially destabilizing issues of orgasmic mutuality have historically been shifted to a neutral and sanitized ground on which female sexuality was represented as a pathology and female orgasm, redefined as the crisis of a disease, was produced clinically as legitimate therapy. This interpretation obviated the need to question either the exalted status of the penis or the efficacy of coitus as a stimulus to female orgasm. Furthermore, it required no adjustment of attitude or skills by male sex partners. What Foucault calls the “hystericization of women’s bodies” protected and reinforced androcentric definitions of sexual fulfillment.
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Part of my argument here rests on the vague and sexually focused character of hysteria as defined by ancient, medieval, Renaissance, and modern medical authorities before Sigmund Freud. Many of its classic
symptoms are those of chronic arousal: anxiety, sleeplessness, irritability, nervousness, erotic fantasy, sensations of heaviness in the abdomen, lower pelvic edema, and vaginal lubrication.
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The paralytic states described by Freud and a few others are rarely mentioned by physicians before the late nineteenth century.
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During the syncope some hysterics were observed to experience, as Franz Josef Gall pointed out in the second decade of the nineteenth century and A.F.A. King some seventy years later, the subject’s apparent loss of consciousness was associated with flushing of the skin, “voluptuous sensations,” and embarrassment and confusion after recovery from a very brief loss of control—usually less than a minute.
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That hysterics did not become incontinent during their “spells” as epileptics did, and apparently felt much better afterward, led some physicians to suspect their patients of malingering. Doctors pointed out that epileptics often injured themselves when they fell, but that hysterics rarely did so.
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I do not mean that all women diagnosed as hysterical were cases of sexual (or rather orgasmic) deprivation; some were no doubt afflicted with other mental or physical ailments whose symptoms overlapped significantly with the hysterical disease paradigm. Joan Brumberg has pointed out, for example, that in the nineteenth century many physicians believed that anorexia in young girls was a hysterical disorder.
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But the sheer number of hysterics before the middle of this century, and their virtual disappearance from history thereafter, suggests it is perceptions of the pathological character of these women’s behavior that have altered, not the behavior itself.
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The partial or complete loss of consciousness—or more properly, of reactivity to outside stimuli—was variously interpreted and described over time. Aretaeus, like Plato, believed that the inflamed and disconnected uterus was suffocating or choking the patient, a theme dwelt on at considerable length in late classical, medieval, and Renaissance medical writings. The uterus, engorged with unexpended “seed”
(semen
in Latin), was thought to be in revolt against sexual deprivation. The cure, consistent with the humoral theory popularized by Galen, was to coax the organ back into its normal position in the pelvis and to cause the expulsion of the excess fluids.
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When the patient was single, a widow, unhappily married, or a nun, the cure was effected by vigorous horseback exercise, by movement of the pelvis in a swing, rocking chair, or carriage, or by massage of the vulva by a physician or midwife, as described by
Forestus in the paragraph quoted above. Single women of marriageable age who experienced hysterical symptoms were usually urged to marry and, as Ambroise Paré expressed it in the sixteenth century, “bee strongly encountered by their husbands.”
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Masturbation by the patient herself was not recommended as a treatment for hysteria until the early twentieth century, and then only rarely.
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If hysteria was for the most part no more than the normal functioning of female sexuality, the inducement of the crisis of the disease, called the “hysterical paroxysm,” would in fact have provided the kind of temporary relief physicians described. Only a handful of the medical authorities who advocated female genital massage as a treatment for hysteria, however, acknowledged that the crisis so produced was an orgasm.
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In the nineteenth century, as noted by Peter Gay and others, the received wisdom that women required sexual gratification for health came into conflict with newer ideas regarding the intrinsic purity of womanhood. A not uncommon resolution of the conflict of medical philosophies over women’s sexuality was the compromise position that women ardently desired maternity, not orgasm.
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This pro-natal hypothesis not only preserved the illusion of women’s spiritual superiority while explaining their observed sexual behavior but also reinforced the ethic of coitus in the female-supine position as a divinely ordained norm. As Gay rightly points out, this proposition also protected the male ego and the androcentric model of sexuality.
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Freudian interpretations after 1900 presupposed sexual drives in women, placing these in a new kind of androcentric moralism, that of psychopathology, that was to persist into our own time. In the new paradigm, hysteria was caused not by sexual deprivation but by childhood experiences, and it could be manifested in propensities to masturbation and to “frigidity” in the context of penetration.
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These two “symptoms” were also evidence, in the Freudian view, of female sexual development arrested at a juvenile level. The mystique of penetration thus could remain unchallenged even as the theoretical ground shifted under the medical and sexual issues. Real women, according to Freudian theory as well as earlier authorities, experienced mature sexual gratification as a result of vaginal penetration to male orgasm and accepted no substitutes for the “real thing.” The role of the clitoris in arousal to orgasm was systematically misunderstood by many physicians, since its function contradicted
the androcentric principle that only an erect penis could provide sexual satisfaction to a healthy, normal adult female.
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That this principle relegated the experience of two-thirds to three-quarters of the female population to a pathological condition was not perceived as a problem.
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This androcentric focus, in fact, in many cases effectively camouflaged the sexual character of medical massage treatments. Since no penetration was involved, believers in the hypothesis that only penetration was sexually gratifying to women could argue that nothing sexual could be occurring when their patients experienced the hysterical paroxysm during treatment. Even the nineteenth-century physicians who excoriated the speculum for its allegedly stimulating effects and questioned internal manual massage saw nothing immoral or unethical in external massage of the vulva and clitoris with a jet of water or with mechanical or electromechanical apparatus.
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Freudian and later interpretations of hysteria and masturbation helped undermine this camouflage, and when the vibrator, used in physicians’ offices since the 1880s, began to appear in erotic films in the 1920s, the illusion of a clinical process distinct from sexuality and orgasm could not be sustained.
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In the evidence I present here on the histories of sexuality and medical massage in hysteria, it is important to stress that the voices of women are seldom heard. It is a rare person of either sex who sees fit to leave a record even of his or her most orthodox procreative marital sexuality, let alone of experiences with masturbation. In most historical times and places in Western culture, a woman’s keeping such a record would have been unspeakably shocking and unchaste; its discovery might have subjected her to severe social sanctions. Even historians of male heterosexuality struggle with the lack of primary material; what remains may be fragmentary, or revised by embarrassed heirs or publishers. Historians must rely on largely prescriptive androcentric and pro-natal medical sources for much of our information on humanity’s most intimate activities, because we have nothing else. Nearly all my sources relate to members of the middle to upper classes of white women in Europe and the United States, and it would be presumptuous to generalize from them to other cultures, classes, or races.
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