The Technology of Orgasm: "Hysteria," the Vibrator, and Women's Sexual Satisfaction (7 page)

Hysteria appears in the medical corpus as early as 2000
B.C.
in Egypt, but it was not until the time of Hippocrates in the fifth century
B.C.
that the Western clinical definition of the disorder began to take shape. In the Hippocratic corpus, hysteria is a disease of the womb, treatable with exercise and massage.
⁸
Plato’s reference to hysteria as a disease caused by the uterus, “an animal inside an animal,” is well known. By the time of Celsus and Soranus in the first century
A.D.
, genital massage and exercise, usually passive, were standard prescriptions for hysteria.
⁹
Soranus advocated manipulating the groin and pubic area: “We … moisten these parts freely with sweet oil, keeping it up for some time.” He suggested baths and swinging in a hammock as adjunct therapies for chronic cases.
¹⁰
Aretaeus Cappodox, writing a century later on mania as a chronic disease, discusses the causes of the ailment, asserting that “women … become affected with mania from want of purgation of the system, when the uterus has attained its full development.”
¹¹
Caelius Aurelianus, writing
in the third century
A.D.
, recapitulates the symptomatologies of Hippocrates, Soranus, and Aretaeus.

Galen (ca.
A.D.
129–200), the physician’s physician for centuries after his death, described hysteria as a uterine disease caused by sexual deprivation, to which passionate women were particularly susceptible. This theme of female sexuality as pathology was to reappear in various forms in later centuries. He describes in detail a genital massage therapy, resulting in contractions and the release of a fluid from the vagina, after which the patient was relieved of her symptoms. His account is literally the classic description of massage therapy for hysteria, which was to be repeated almost verbatim in later texts and to be regarded as therapeutic gospel in some medical circles until the end of the nineteenth century. Rudolph Siegel’s translation has often been quoted: “Following the warmth of the remedies and arising from the touch of the genital organs required by the treatment, there followed twitchings accompanied at the same time by pain and pleasure after which she emitted turbid and abundant sperm. From that time on she was free of all the evil she felt.”
¹²

Later writers echoed Galen’s advice, sometimes adding clinical observations of their own. Äetius of Amida (502–75), described in his “Tetrabiblion” a hysterical paroxysm characterized by uterine contractions, muscular spasm in the entire body, and discharge of fluid from the vagina.
¹³
As in both earlier and later accounts, this event is described as bringing the patient symptomatic relief. Moschion’s (Mustio, Muscione)
Gynaecia
of the same century makes similar, if less graphic, references to the paroxysmal therapeutic result of manual friction to the vulva.
¹⁴

Medieval texts rarely called the disorder in question “hysteria,” although it retained its character as a disease of the uterus. Much of this literature recalled Plato’s account of the uterus wandering around the body, causing problems as it went, particularly strangulation as it allegedly crawled up into the chest and windpipe.
¹⁵
The panting and shortness of breath associated with the hysterical paroxysm, and eventually the disease itself, came to be called the “suffocation of the uterus” or the “suffocation of the mother.” The medieval corpus attributed to Trotula says this ailment is due to “the retaining of blood or of corrupt and venomous uterine humors that should be purged in the same way that men are purged of seed that comes from their testicles next to the penis.” Both sexes were thought to suffer illnesses from retention of this seed.
¹⁶

The literature of midwifery, some of which was written by women, paralleled an elite body of medical works by men in the Middle Ages. One of the male luminaries of this period was Rhazes (865?-925?), an influential Arabic physician. His work on massage of the vulva in hysteria was widely cited and quoted by Western physicians. Danielle Jacquart and Claude Thomasset summarize the views of Avicenna (980–1037) on hysteria. Marriage was the best remedy, but if all else failed, masturbation to orgasm was indicated: “According to Avicenna the cure was efficacious only if the sensations of coitus that is, pleasure and pain, were felt. Medieval doctors generally omitted to refer to this aspect of the treatment when recommending recourse to manipulation; yet it was evident that female sexual discharge accompanied orgasm.”
¹⁷
One might infer from this passage that Avicenna or his colleagues might have occasionally advocated masturbation by the woman herself. This is not the case. In the
Canon
he warns of women’s resorting to “rubbing, among other women” as a possible consequence of unsatisfying intercourse; it is clearly not intended as advice on recommended practice for women.
¹⁸
The privilege (or drudgery) of such “rubbing” was reserved for husbands, doctors, and midwives.

Arnaldus of Villanova (ca. 1235-ca. 1311) recommended that the discharge of offending fluids be achieved in widows and nuns by friction and internal massage with what Veith calls “irritating suppositories inserted in the vagina,” consistent with the theory of readjusting the balance of humors.
¹⁹
The thirteenth-century document by Pseudo-Albertus provides the usual background to the etiology of the disease in sexual deprivation and makes the mandatory reference to Galen’s massage techniques. Marriage and intercourse were, as usual, prescribed. According to Helen Rodnite Lemay, the Italian Anthonius Guaynerius (Antonio Guainerio, d. 1440) discussed the disease in substantially the same way; Lemay says of his account that “among the indications of suffocation caused by retention of sperm is the absence of male companionship in the life of a woman who was accustomed to it.” One of the treatments was “to anoint the mouth of the vulva with different odoriferous materials, for which the prescription is also included, and to rub it into the neck of the womb as well. The rubbing, which should be done with the midwife’s finger, will cause the womb to expel the sperm or corrupt humors and free the patient from disease.”
²⁰

Giovanni Matteo Ferrari da Gradi (d. 1472), the “Gradus” of the Forestus quotation in
chapter 1
, wrote a commentary and explication of Rhazes’ medical practice for the Europeans of his day called
Practica, seu Commentaria in Nonum Rasis ad Almansorem
. He essentially repeats the therapeutic advice already familiar by his time, adding that the chest should be rubbed and covered closely with large cupping glasses, after which “the midwife would be instructed to use sweet-smelling oil on her finger and move it well in a circle inside the vulva.”
²¹
Ferrari da Gradi goes on to mention that marriage and childbearing sometimes cure, but only if the woman experiences “maior delectatio” (greater pleasure) in conjugal sex, and how in successful treatment, the patient experiences “simul … delectatio & dolor” (pleasure and pain at the same time). This too echoes earlier descriptions. He describes the release of fluid after the paroxysm and says that retention of these fluids by the chaste and widowed causes hysteria.

A transitional figure between the Middle Ages and the Renaissance was Paracelsus (1493–1541), whose real name was Philippus Theophrastus Bombastus von Hohenheim. A famous, or perhaps notorious, physician and alchemist, in “On the Diseases That Deprive Man of His Reason” he wrote of hysteria, which he also called “chorea lascivia.” The crisis of this disease, he asserted, was characterized by contractions of the uterus and vagina.
²²

HYSTERIA IN RENAISSANCE MEDICINE

The tradition of treating hysteria by evacuating fluids insalubriously retained is continued in the sixteenth and seventeenth centuries. The famous surgeon Ambroise Paré (1517?-1590) wrote some lively accounts both of hysteria and of its proposed treatments:

Those who are free’d from the fit of the suffocation of the womb either by nature or by art, in a short time their color commeth in to their faces by little and little, and the whole beginneth to wax strong, and the teeth, that were set, and closed fast together, begin (the jaws being loosed) to open and unclose again, and lastly som moisture floweth from the secret parts with a certain tickling pleasure; but in some women, as in those especially in whom the neck of the womb is tickled with the Midwive’s finger, in stead of that moisture com’s thick and gross seed, which moisture or seed when it is fallen, the womb being before as it were rageing, is restored unto its own proper nature and place, and by little and little all symptoms vanish away.
²³

Marriage and intercourse were thought to be curative in many cases. When hysteria was diagnosed, “If she be married, let her forthwith use copulation, and bee strongly encountered by her husband, for there is no remedy more present than this.” If this remedy was unavailable, “Let the mydwife annoint her fingers with
oleum nardinum
or moschetalinum, or of cloves, or else of spike mixed with musk, ambergreese, civet and other sweet powders, and with these let her rub or tickle the top of the neck of the wombe which toucheth the inner orifice.”
²⁴

Audrey Eccles quotes Riverius (Lazare Rivière, 1589–1655) as follows:

Womb-Furie is a sort of madness, arising from a vehement and unbridled desire of Carnal Imbracement, which desire disthrones the Rational Facul[ty] so far, that the Patient utters wanton and lascivious Speeches … [Although it mainly affects virgins and young widows,] it may also betide married women, that have impotent Husbands, or such as they do not much affect, whereby their seminary vessels are not sufficiently disburthened … [If marriage fails as a remedy] some advise that the Genital Parts should be by a cunning Midwife so handled and rubbed, so as to cause an Evacuation of the over-abounding Sperm.
²⁵

According to Eccles, Riverius’s assessment of the situation was typical of his time. Quoting Nicholas Culpeper, she asserts that “most authors were persuaded that the best way to bring down the uterus and discharge the seed was by sexual intercourse” and goes on to describe the standard method involving the midwife’s finger dipped in aromatic oil. “Not unnaturally,” she says, “there was some doubt whether this course of action was quite unexceptionable, morally speaking, a scruple which Culpeper considered a foolish Popish superstition.”
²⁶

Robert Burton (1577–1640) discusses a symptomatology cognate with hysteria under the heading “Maid’s, Nun’s and Widow’s Melancholy.” Like most of his predecessors, he recommends marriage as a cure.
After general discussion of diet and environmental issues, he tells us that “the best and surest remedy of all is to see them well placed and married to good husbands in due time, hence these tears, that’s the primary cause, and this is the ready cure, to give them content to their desires.”
²⁷
Burton opposed celibacy for nuns and priests, partly on the grounds that, in his opinion, it encouraged masturbation. Giulio Cesare Claudini, writing in 1607, recommended massage as an alternative to marital intercourse in the treatment of hysterics, observing that “limited counterirritation applied to the lower parts, with which friction of the parts at the same time, painful binding, and an abundance of lubricating oil are regarded as appropriate.”
²⁸

Concerns about the mental state of women religious was not unusual in the seventeenth century. G. Rattray Taylor comments on concerns with hysteria and supposed demonic possession among nuns, remarking on the similarity of symptoms between hysterical and sexual manifestations. He notes that “hysterical seizures usually bear a close relationship to the unconscious fantasy: in particular, women sometimes exhibit convulsive body movements, or become rigid, with the body arched so that the pudenda are thrust forward as in coitus.”
²⁹
Taylor interprets this behavior in the context of the androcentric model and assumes that it is driven by a repressed desire for penetration.

Michael MacDonald observes somewhat patronizingly that seventeenth-century physicians perceived a correlation between women’s medical conditions and their psychological states and that “they tried to persuade their fellow practitioners and the literate public that an ailment they called ‘suffocation of the mother’ was widespread.” Hysterical symptoms were caused by “the alleged propensity of the uterus to become a vagabond, leaving its proper place in the womb
[sic]
and wandering into the upper parts, near the passionate heart.”
³⁰
As we have seen, this disease paradigm was well entrenched in the medical community long before the seventeenth century.