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Hysterical Men by Mark Micale. (Harvard University Press)

History of the Hysterical Man

Doctors once thought that only women suffered from hysteria, but a medical historian says that men were always just as susceptible

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The term “hysteria” comes from the Greek word for “womb” and refers to a disease that was once diagnosed almost exclusively in women. Women’s asthma, widow’s melancholy, uterine epilepsy -- these were all synonyms for a strange complex of symptoms that included unexplained pains, mysterious convulsions, sudden loss of sensation in the limbs and dozens of other complaints without apparent physical cause. Particularly during the Victorian age, doctors thought hysteria demonstrated the general fragility of the fair sex. The best remedy was a good marriage. But all the while untold numbers of men were suffering from the same illness. In his new book, Hysterical Men: The Hidden History of Male Nervous Illness, Mark Micale, a professor of the history of medicine at the University of Illinois, explores the medical tradition of ignoring masculine “hysteria,” and its cultural consequences.

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What is hysteria?
 

It’s more or less impossible to define hysteria in a way that a physician today would find acceptable. The meaning has changed dramatically over time. It’s an enormous collection of possible symptoms that are of the body but that can’t be traced to any known physical disease. It can look like a manifestation of epilepsy, a brain tumor, advanced syphilis, Parkinson’s, but upon examination it’s none of these. Ultimately the suspicion forms that though these are bodily manifestations, the cause is psychological.

Why don’t we hear that diagnosis anymore?
 

The term is no longer used because American psychiatrists over the past half century have decided not to use it. They’ve renamed it, breaking it into various parts, labeling it differently. These successor categories all have the quality of sounding more scientific, which is no coincidence. There’s “somatization disorder” and “psychogenic pain disorder” and a whole string of other labels that basically cover the same category that Freud and his predecessors were comfortable calling hysteria.

Why was it so rarely diagnosed in men?
 

It’s not that the behavior didn’t exist. It did exist. It was rampant. Men were as prone to nervous breakdown as women were. It was not diagnosed for social and political reasons. Men were believed to be more sane, more motivated by reason, more in control of themselves emotionally. If you were to diagnose honestly, that would have pretty quickly called into the question the difference between the sexes and the idea that men were more self-possessed than their fragile, dependent female counterparts. Ultimately it comes down to patriarchy and power.

For a brief time, in Georgian England, it was almost fashionable to be a hysterical man. Why?
 

In 18th-century England and Scotland, it was acceptable to acknowledge these symptoms in men and call them “nervous.” The label was applied, and self-applied, to men who were upper-middle or upper class, or aspired to be. They interpreted these symptoms not as a sign of weakness or unmanliness but as a sign that they had a refined, civilized, superior sensibility. If the weather depresses you, if you get emotionally involved in reading a Shakespeare play, if you tire out easily, it’s not because you’re unmanly, it’s because you have a particularly sophisticated nervous system that your working-class counterparts do not. And if you can convince other people in society of this, then doesn’t it mean you’re better suited to govern the state wisely?

How did historical events, like Napoleon’s conquests, shape hysterical diagnoses?
 

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About Abigail Tucker

A frequent contributor to Smithsonian, Abigail Tucker is writing a book about the house cat.

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