AILING OVARIES AND UNRULY UTERUSES
These four historical (and false) afflictions were believed to ravage women’s minds and bodies – and treatments ranged from the bizarre to the downright dangerous
1 Wandering womb
In ancient Greek discourse on female bodies and health, including the Hippocratic Corpus, many illnesses of the female body were attributed to the womb “wandering” from its rightful place and impacting other vital organs such as the heart and liver. Thought to be caused by the womb becoming dry and stifled from lack of moisture, women who were not having marital sex or bearing children were most vulnerable to afflictions of the “wandering womb”.
In the fourth century BC, Plato likened the womb to a creature that hungered for intercourse and conception, while around the second century AD, the physician Aretaeus described it as an “animal within an animal”. Although the belief that the womb could wander unbidden was dispelled, these classical physicians set the precedent for centuries of medical theories that placed the womb, and its almost animalistic imperative to procreate, at the centre of discourse about the diseases of women.
2 Ovaritis
Ovaritis was a term used by English gynaecologist Edward Tilt in the mid-19th century to describe a disorder of the ovaries that could lead to hysteria. Ovaritis was most common in middle- and upper-class young women who excited their ovaries with activities including horse-riding, reading, listening to music and too much physical exercise while menstruating. At the time, recent understandings of the role of the ovaries in menstruation, and theories about the sympathy between ovaries and the nervous system, meant attention had shifted away from the uterus as the epicentre of female hysteric illnesses.
The primacy of the ovaries in emerging theories about women’s physical and mental health led to the ovariotomy – surgical removal of the ovaries – becoming popular in both the UK and the US. Ovariotomy was a dangerous and controversial procedure with a high mortality rate. Some surgeons, including Thomas Spencer Wells, prioritised women’s safety and limited oRerations to those suʘerinI life-threatening ovarian cysts and tumours. But others were not so scrupulous; ovariotomy was often performed when no evidence of ovarian disease existed. Needless – and dangerous – ovariotomies were endured by women deemed morally depraved or mentally defective, in public asylums in the UK and the US, in the late 19th century.
3 Hysteria
Derived from the ancient Greek word hystera, meaning womb, hysteria was a diagnostic term used from the 17th to the 20th century for collections of physical and psychological symptoms seen almost exclusively in women. Used to pathologise the influence of Yomenos eZcessive emotions on their already delicate constitutions – and vice versa – the apparent causes of hysteria were variously ascribed to the reproductive organs, the nervous system and the brain from the 17th to the early 20th centuries.
Diagnoses of hysteria also carried the implication that the patient was feigning, exaggerating or embellishing their pain and other symptoms. Moreover, physicians tended to label an illness “hystericalq Yhen the[ Yere baffled b[ its courses and causes. Treatments for hysteria and its associated afflictions Yere as all encomRassinI as its de nitions, but man[
– including stays in asylums, the Rest Cure and gynaecological surgical interventions – were punishing and barbaric.
4 Womb fury
In the late 16th century, and possibly before, furor uterinus or “womb fury” – sexual obsession ascribed to uterine agitation – was thought to be caused by corrupt humours emanating from an unruly uterus when it wasn’t procreating. Treatments for furor uterinus ranged from the predictable – marital sex – to the bizarre, including vaginal fumigation, massages with salt-and-vinegar sprinkled linen, and loudly shouting the patient’s name in her ear.
In the 18th century, furor uterinus was linked to unmarried women’s unrequited desires. Remedies to curb a lascivious imagination – and, by extension, control female sexuality – included, alongside marriage and pregnancy, a morality-improving regimen of bland foods, baths, bloodletting and constant supervision.
When a new gynaecological tool called the vaginal speculum gained popularity in the mid-19th century, some physicians argued that being examined internally could induce sexually obsessive hysteria similar to furor uterinus. English ophthalmologist Robert Brudenell Carter believed the speculum would cause [ounI Yomen to become so Zated on their genitals that they would be morally ruined and unmarriageable. His suggestions for taming such illicit attentions – also thought to cause heavy menstrual bleeding and abdominal pain – included chess, astronomy, winding a wheel around for hours and no reading.
neurologist who devised the infamous Rest Cure for nervous disorders, proclaimed in 1875 that hysteria “were as well called mysteria for all its name teaches us of the host of morbid states which are crowded within its hazy boundaries”. But while he was questioning the legitimacy of hysteria, Mitchell was also using it as a diagnostic slur to invalidate and belittle unwell women.
After being subjected to the Rest Cure in 1887, the American feminist writer, lecturer and activist Charlotte Perkins Gilman wrote The Yellow Wallpaper, a short story that remains one of the most widely read texts on the invalidation and mistreatment of women’s pain. Gilman spent months following Mitchell’s prescription of complete bed rest with little intellectual or creative activity after she became desperate to cure her severe depression. But this punishing regimen pushed her “near the borderline of utter mental ruin”. The Yellow Wallpaper, about a woman whose mental health disintegrates after she is confined to bed by her physician husband for a “slight hysterical tendency”, was written partly to help women who might be vulnerable to these medical “therapies” and empower them to challenge the presumed authority of male physicians. “It was not intended to drive people crazy,” Gilman reflected, in 1913, “but to save people from being driven crazy. And it worked.”
Gilman began to recover when she was treated by the pioneering and progressive American physician, scientist and teacher Mary Putnam Jacobi, who believed that symptoms labelled “hysteric” should be treated by stimulating a patient’s intellect, not diminishing it. Putnam Jacobi, who campaigned for equality in medical education, had disproved the myth that education and professional occupations were detrimental to women’s menstrual and reproductive health. By analysing physiological data gathered from hundreds of women in the 1870s, she showed that study and physical exercise had no impact on women’s menstrual health.
Fighting for rights
Arguments around women’s right to be educated to the same standard and level as men, and to be admitted to male-dominated professions including medicine, were rife in Britain and the US in the mid to late 19th century. Putnam Jacobi was one of several trailblazing physicians, health experts and social reformers who worked tirelessly from the late 19th through to the early 20th century to dispel accepted medical beliefs that female biology was far too delicate and susceptible to damage for women to pursue lives outside the “separate sphere” of marriage, homemaking and motherhood.
In this article I’ve highlighted just a few of the incredible physicians, activists, researchers, scientists, rebels, campaigners and patients who fought against the sexism perpetuated and promoted throughout medicine’s history. They all exposed and redressed ingrained mythologies about women’s bodies, minds and lives that became embedded in discourse on female illness and disease.
In today’s gender pain gap, we have inherited the legacy of female health concerns being invalidated, women’s pain being misdiagnosed, and women’s accounts of being unwell sidelined and distrusted. This gap was forged over centuries of women’s symptoms being interpreted through discriminatory beliefs and stereotypes about “female nature”. But we have also inherited a legacy of incredible women-led and feminist activism against the misogynistic medical attitudes that have insidiously controlled women’s lives. As Christine de Pizan knew more than 600 years ago, and as all those fighting to close the gender pain gap understand today, women need to be trusted as the most reliable narrators of what is happening in their own bodies.
Elinor Cleghorn is the author of Unwell Women: A Journey Through Myth and Medicine in a Man-Made World (Weidenfeld & Nicolson, 2021). Her Twitter handle is @elinorcleghorn. Elinor will be appearing on the HistoryExtra podcast to discuss unwell women throughout history: historyextra.com/podcast
A prescription of months of complete bed rest pushed one woman “near the borderline of utter mental ruin”