Hysterical Men: The Hidden History of Male Nervous Illness

December 11, 2008

Did you know that many of the paintings by Francis Bacon, most notably Study for Crouching Nude (1952), were influenced by photographs of convulsing male hysterics from the Salpetriere hospital in Paris? These photographs were taken for Dr Jean-Martin Charcot by Dr Albert Londe in the 1880s, but did not appear in public until the 1980s. Some of these images are reproduced in this fascinating book by historian Mark Micale, whose research is enriched by his extensive knowledge of European intellectual debates and his particular interest in France.

This is not Micale's first foray into the subject of hysteria. In 1994, he published Approaching Hysteria: Disease and its Interpretations. Here his focus is on men, bringing to light new evidence from case notes and personal memoirs on a diagnosis that was traditionally confined to women. Most of us know that the gendered portrayal of hysteria began with Greco-Roman notions of what happened to a woman whose womb became restless due to reproductive inactivity - she was likely to show symptoms including "the sensation of suffocation, heart palpitations and loss of voice". What is less well known is that the association of hysteria with women continued to prevail in medical texts in spite of the emergence of evidence that might have contradicted the theory - ie, similar complaints in male patients.

Using material from letters, diaries, memoirs, novels and autobiographies, Micale exposes the suppression of this information. This "selective amnesia" served to uphold notions of manhood and womanhood that suited both professional and political interests for many centuries. In England, Robert Burton, in The Anatomy of Melancholy (1621), discussed specific hysterical symptoms suffered by "Maids", "Nuns" and "Widows", although he did acknowledge his own "bachelor's melancholy". Like other writers of the time, Burton did not focus on the gender differences in nervous disorders. However, this changed during what Micale terms "the great Victorian eclipse" from 1790 to 1860, when medicine and science emphasised the difference between men and women. The concept of male hysteria became submerged and that of female hysteria thrived.

The main dissenting voice came from Paris later in the century, where Charcot set up a special unit at the Salpetriere hospital for the treatment and study of male hysteria. His work was controversial as he questioned many existing theories, such as those that argued that male nervous disorders were associated with specific conditions such as puberty, youth, leisure, effeminacy or homosexuality. One of the students listening to Charcot was the young Sigmund Freud.

However, in spite of his early interest in the subject and his work with male patients such as Herr E., Freud did not include male cases in his seminal work Studies in Hysteria (1895). Thus, his published work supported the notion that hysteria was confined to women. This is astonishing in the light of his letters to his friend Wilhelm Fliess, in which he admitted that many of his own troubles were classic conversion symptoms.

Micale gives the reader his own views on the reasons behind the suppression of so many ideas that would have changed the popular and professional view of hysteria. Interesting as this debate is, it is surpassed by the detailed unfolding of the history of ideas through words written in diaries, memoirs, fiction and letters, and through illustrations and photographs from case notes.

If you would like to see the photographs that inspired Francis Bacon, if you are interested in the links between medicine and literature, if you are a student of gender or of mental health ... you simply must buy this book.

Hysterical Men: The Hidden History of Male Nervous Illness

By Mark S. Micale. Harvard University Press. 384pp, £19.95. ISBN 9780674031661. Published November 2008

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Reader's comments (1)

I am a layperson and I have contracted toxoplasmosis without developing antibodies, which is a seriously life-threatening form of the disease. The symptoms I suffer are in line with those described by women diagnosed with "hysteria" 100 years ago. I have been doled out a series of MH diagnoses, including "conversion disorder", which was the new name for hysteria when it became outmoded. I have been refused tissue testing (antibody and PCR (DNA) blood tests are obviously negative because there are no antibodies and the parasite does not reside in the bloodstream) and so it has been allowed to progress cerebrally and to disseminate. Diagnosis could easily be made but I am literally being refused this. I believe not only the old attitudes are still here but the way in which I am being treated by medical "professionals" is deliberate, discriminatory and appalling. The standard meds for the disease have been discontinued in the UK in any event and the upcoming, effective, medication for it has not been trialled yet. It will probably be sat on for decades. I find the ignorance around this disease hard to believe and can only think that it is a deliberate policy, for monetary reasons or because it is unpopular. I am continuing to try to seek help, but I am very much alone with this, whilst up to 4 billion people have the same ailment worldwide, 20% of them to the extreme degree that I have it, for one reason or another. This situation must change, but unfortunately probably not in my now shortened lifetime. Thanks for reading.


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