New York Times
"A knowledgeable, tightly constructed piece of scholarship."—Washington Post Book World
New York Times
New York Times
Los Angeles Times
Philadelphia Inquirer, Carlin Romano
- Norton, W. W. & Company, Inc.
- Publication date:
- Edition description:
- 1 ED
- Product dimensions:
- 5.85(w) x 8.56(h) x 1.07(d)
Read an Excerpt
nymphomania in the body
In 1841, Miss T., the twenty-nine-year-old daughter of a Massachusetts farmer, was diagnosed with nymphomania. According to the physicians who described the case in the Boston Medical and Surgical Journal, her conversation and actions left no doubt that she suffered from the disease: she uttered the "most disgusting obscenities" and moved her body in ways that expressed her uncontrolled "libidinous feelings." Although in good health, she had been restless and morose, exhibiting a "paroxysm of hysteria" when the doctors arrived. After a vaginal examination, they determined that her uterus was enlarged, her vagina over-abundantly moist, but her long and "tumid" clitoris was the telltale sign of nymphomania. They applied various caustics to her genitals to cool her ardor and tried other traditional remedies, such as bleeding and cold-water douches. After several weeks, the doctors pronounced her greatly improved, with "not a symptom remaining referable to nymphomania." This time when she was examined vaginally, she exhibited "every appearance of modesty," including a retracted and very diminutive clitoris.
At the time, the doctors' treatment of Miss T., particularly the use of bleeding and caustics, was a typical medical approach to most illnesses. Physicians did not understand much about the causes of disease and still relied on traditional remedies based on ancient Greek notions: disease meant that the body's system was out of balance. Consequently,bloodletting or purging restored the necessary equilibrium in the body. Blistering and caustics created a counterirritant, which drew poisons to the surface, and stimulated the body to return to its natural balance. Cooling baths, moderate diet, and sedatives calmed overstimulated nerves. This belief system was widely shared by both lay people and physicians. Doctors and patients alike looked to the results of strong emetics or bleeding as tangible evidence that the physician was resolutely treating the disease.
In diagnosing Miss T., the doctors understood her to have a disease connected to her genitals. Men, too, would have been bled, purged, and blistered for a variety of conditions; but physicians were less likely to connect men's ailments to their genitalia, while assuming that women's reproductive organs caused both physical and mental disease. At a time when many women were overworked and undernourished, and further burdened by numerous pregnancies, it is not surprising that they experienced a variety of physical maladies. Consequently, debilitating conditions related to the ovaries and uterus were not that unusual.
But ideological beliefs played a crucial role as well. It was widely accepted that women's reproductive capacityfrom puberty to menopausedominated their entire being. Wombs (and by the middle of the nineteenth century, ovaries) shaped and determined women's nature far more than testes affected men's lives. As a result, not only doctors but average citizens as well believed that gynecological problems lay at the root of many female diseases, including nervous and mental conditions.
Since all parts of the body were thought to be interrelated, an upset stomach or an inflamed organ could lead to a disordered mind, and vice versa. In particular, a theory of "reflex action" posited that a disease in the genitals caused a sympathetic response in other organs of the body, particularly the brain. Reflex action presumably affected men as well, but women's more delicate nerves and monthly "crises" increased their vulnerability to potential maladies. Much more frequently than men, women faced the potential danger of reestablishing an internal equilibrium following the monthly loss of menstrual blood.
These theories shaped medical notions of ill-defined diseases such as nymphomania. In the case of Miss T., the physicians tell us nothing more about what happened to her, other than to pronounce her cured, but if she had not responded to their medical therapy, she might have been placed in one of the newly created mental institutions. There doctors observed firsthand the most extreme forms of the female behavior which they diagnosed as nymphomania: indecent attacks on asylum attendants, lewd and obscene language, violent tearing off of clothes, and incessant, public masturbation. The women described in these accounts may have been psychotic or suffering from brain disease. On the other hand, they may have been rebelling against the institution's strictures, while asylum doctors and attendants understood their unladylike behavior to be a symptom of a sexual disease.
In any case, medical men who wrote about nymphomania made a connection between inappropriate behavior observed among patients in mental hospitals and women who came to them to express concern about their sexual desires. As a result, physicians saw the potential for nymphomania in a wide range of behavior. Nymphomania was diagnosed in behavior as diverse as lascivious glances, on the one hand, and sexually attacking a man, on the other.
In the Victorian period, both doctors and the patients who sought medical help believed that strong sexual desire in a woman was a symptom of disease. Self-control and moderation were central to the health of both men and women, but women's presumably milder sexual appetite meant that any signs of excess might signal that she was dangerously close to the edge of sexual madness. Not surprisingly, physicians registered the greatest concern when the disease appeared in "refined and virtuous" women.
Many different medical theories attempted to account for the causes of nymphomania: overwrought nerves, brain inflammation, spinal lesions, misshapen heads, as well as irritated genitals and enlarged clitorises. But the physicians' concern was also a moral one. They understood nymphomania to be about sexual indulgence and excess, about sexual desire uncontrolled by the will, about succumbing to temptation. While attempting to define excessive sexual desire as a disease, physicians continued to identify the patient's lack of moral restraint and willpower as central to the malady. The first full-length study of the disease, Nymphomania, or a Dissertation Concerning the Furor Uterinus, written by an obscure French doctor, M. D. T. Bienville, and translated into English in 1775, emphasized that particular connection. Eating rich food, consuming too much chocolate, dwelling on impure thoughts, reading novels, or performing "secret pollutions" (masturbating), according to Bienville, overstimulated women's delicate nerve fibers and led to nymphomania.
Bienville's successors continued to repeat these same concerns, and exhortations to virtuous behavior intensified throughout the nineteenth century. Without any medical breakthrough or discovery concerning "excessive" or "ungovernable" sexuality, and with very few cures for nervous and mental diseases in general, the physician's best weapon remained a combination of common sense and moral proclamations, administered along with traditional remedies. In the last quarter of the century, as we will see, some gynecologists thought they had finally found the answer to curing nervous and mental disorders by surgically removing female reproductive organs.
Brain or Genitals?
The development of medical specialties such as gynecology, neurology, and psychiatry over the course of the nineteenth century led to turf wars in which each specialty promoted its own physiological explanation and treatment for women's diseases. Yet nymphomania remained elusive, despite attempts to classify its symptoms and to categorize its causes on sound scientific principles. Some medical specialists, such as neurologists and alienists (the earlier name for psychiatrists), looked for a physiological cause of nymphomania in cerebral lesions, changes in the brain's blood vessels, thickening of the cranial bones, or overexcited nerve fibers. They generally took issue with the "uterine theory," which argued that diseased genitals caused the malady. By doing so, they hoped to be able to diagnose, treat, and perhaps cure nymphomania, staking out their particular medical specialty's claim to expertise.
Neurologists looked to the relationship between the brain and the nervous system to explain cases of oversexed men and women. Through postmortem examinations of spinal fluid, for example, they hoped to find some evidence that might help them sustain their claim to treat these disorders. But autopsies that showed no significant alteration in the brains of those defined as nymphomaniacs critically challenged the nerve doctors' theories. Neurological research found little organic evidence linking nymphomania to the brain. Even so, for lack of alternatives, neurologists continued to recommend treating the disease with cold compresses, long periods of enforced inactivity, and other remedies directed at the brain and the nervous system.
Alienists, while identifying suppressed or disordered menstruation and similar symptoms as connected to female nervous and mental illness, also looked to the brain and the nervous system as the location of the disorder. As superintendents of newly opened mental asylums, they espoused the then modern idea that mental illness was curable. The most progressive advocated that it be dealt with by "moral treatment": maniacs and others diagnosed insane were no longer to be restrained in basements and attics, but placed in institutions and treated with a pleasant environment, simple work, and a "regular mode of living." Although uncertain of the causes of female disorders, such as hysteria, hysteromania, and nymphomania, alienists remained confident, until later in the century, that positive change could be brought about through this new, humane approach.
During the early part of the century, phrenologyat the time thought to be a serious sciencetook another approach to the question of sexual excess. Phrenologists believed that mental faculties could be determined by measuring the shape of the skull: an enlarged cerebellum (the part of the brain located at the back of the head, which controls muscle coordination and bodily equilibrium) indicated inordinate sexual appetite. But a particularly sensational case, mentioned in the 1840s in both the American Journal of Psychological Medicine and Mental Pathology and the British medical journal, Lancetwhose tantalizingly few details were cited throughout the nineteenth centurydramatically refuted this claim: an autopsy report on a twelve-year-old girl diagnosed as a nymphomaniac declared that she had no cerebellum. No further details were given, and we do not know why she was diagnosed with nymphomania, but without a cerebellum the girl would presumably not have been able to walk.
If some nineteenth-century doctors located women's diseases in as-yet-undiscovered lesions in the brain or in too highly strung nervous systems, gynecologists emphasized the central role played by the reproductive organs, not only in diseases of the body but in those of the mind as well. Gynecology, not yet a respected medical specialty in the first half of the nineteenth century, had to fight to establish its professional status and to counter the unseemliness of male doctors examining female genitalia. Social mores combined with female modesty to limit what a doctor could see or touch. In the early part of the century the physician generally viewed the patient fully clothed, asked probing questions, looked at her face, hands, and feet, then made a diagnosis without ever physically examining her genitals.
By midcentury, gynecologists very tentatively began to use the speculum (forerunner to today's instrument, which is inserted into the vagina) and to undertake more elaborate physical examinations, although moralists of all stripes protested this invasion of women's bodies. One critic even feared that the use of the speculum itself might so excite a woman's passions that it could cause nymphomania.
Medicine was not a monolith in the nineteenth century and doctors did not speak with one voice about women's diseases. In addition, patients and their families had treatment alternatives from which to choose: homeopathy, hypnosis, hydrotherapy (water cure), and folk remedies. Various medical specialties developed competing theories, definitions, and treatments, especially for uncertain diagnoses such as nymphomania. As we will see, women patients also influenced the concept of nymphomania by the way they described their symptoms to the physician.
In the following case, discussed by Dr. Homer Bostwick, author of A Treatise on the Nature and Treatment of Seminal Diseases, Impotency and Other Kindred Affections, in its eighth edition in 1855, we meet such a woman, who presents herself as so inflamed by passion she fears she might go crazy.
A Case of Nymphomania
Mrs. R., described as a short, stout, recently widowed twenty-year-old woman with a lively disposition, came to Dr. Bostwick out of desperation. She explained, "If I can't be relieved of this agonizing condition, I am certain that the struggle between my moral sense and lascivious longings must soon send me to the grave." She blamed reading novels and attending gay parties in her youth as the cause of "my imagination [being] wrought up to the highest point." She appeared to be familiar with the assumption that women's reason was thought to be inferior to men's. As a result, she understood that stimulating the imagination in these ways was very dangerous. Her passions were so strong, she told Dr. Bostwick, that "it was with the greatest difficulty that I could conduct myself in a decorous and ladylike manner in the presence of the other sex." Even after her marriage, her "inordinate desire" was not entirely subdued and she continued to practice "self-abuse" (masturbation). Since her husband's death, "my passion has been more inflamed than ever, and I fear that, unless something can be done to relieve me, I shall go crazy."
This case, presented in Mrs. R.'s words, reads like one of the cases Bienville described in his classic study of nymphomania. It contains all the elements that shaped the eighteenth-century understanding of the disease: inflamed imagination, uncontrollable desire, novel reading, moral struggle, and an inevitable downward slide into madness. Mrs. R.'s assertion that" I am sure my lascivious feelings cannot be naturalthey must be the effect of disease," suggests the influence of "medicalized" notions about female sexual desire and women's sense of proper conduct. It is unlikely that Mrs. R. read Bienville or other medical texts, and yet she was obviously affected by the ideas they contained, including the notion that sexual improprieties required a doctor's help.
Dr. Bostwick used a speculum to examine the "irritated" and "inflamed" genitals, including an elongated clitoris. He treated Mrs. R. with various remedies: hip baths, spare diet, douches, bags of pounded ice applied to the genital region, and leeches to the uterus, presumably to draw off the noxious blood. After several weeks, Dr. Bostwick declared that he had completely cured this "highly respectable" Boston widow. She even married again.
Here, as in several other cases Dr. Bostwick described, defining nymphomania was not simply the physician's prerogative. Patients shared similar ideas about the body and the passions. They, too, were highly suspicious and fearful of "unnatural" feelings and interpreted them to mean sexual disease.
Nymphomania vs. Satyriasis
Nineteenth-century professional journals, medical textbooks, and encyclopedias often declared that satyriasis was the equivalent of nymphomania. Yet, in keeping with their belief that women were less highly sexed than men, many doctors took for granted that the male disease occurred far less frequently. Medical men also assumed that nymphomania, as a disease, was much more severe than satyriasis. The consequences predicted for the nymphomaniac were generally worse than those for the satyriasist; a nymphomaniac's fate was prostitution or the insane asylum, while at least some physicians thought that a satyriasist might go through life without getting into trouble if he learned to control himself.
Further, many doctors recognizedalthough they publicly criticized the factthat it was easier for men to fulfill their sexual desires in "illicit indulgences." According to an influential English psychiatrist and editor of the Journal of Mental Science, Henry Maudsley, such liaisons were "openly condemned, secretly practiced, and tacitly condoned."
The case studies of satyriasis, both in mental institutions and in private treatment, vary enormously. Like nymphomania, cases of satyriasis included men who openly masturbated, exhibited their genitals, and sexually attacked women, children, and mental institution attendants. Similarly, the causes of satyriasis were varied: genital inflammation, lesions of the "cerebro-spinal system," brain tumors, use of opium, and extreme sexual abstinence or overindulgence. Some medical authorities confused satyriasis with "priapism," an extremely painful condition in which a man's penis remains erect for hours and even days. Castration was sometimes used as a treatment for satyriasis, but this drastic procedure does not appear to have been a routine treatment for mental disorders in men. Moreover, none of the satyriasis cases presented male behavior equivalent to the flirting, lascivious glances, or wearing of perfume, which was sometimes called "mild nymphomania."
The standards of behavior for women were, of course, much stricter than those for men. And some doctors recognized the role that social strictures played in limiting women's sexual expression. At an 1869 meeting of the Boston Gynecological Society, a woman diagnosed with nymphomania was brought before the gathered doctors. Typical of these medical presentations, the patient wore a mask, presumably to protect her identity. Even so, we can assume that exposure to a roomful of physicians must have been excruciating for this unnamed Victorian woman. One doctor responded to her in a patronizing, but possibly sympathetic manner: "If this woman could go ... to a house of prostitution, and spend every night for a fortnight at sexual labor, it might prove her salvation." He hastily concluded that, of course, no physician could recommend such a course of treatment.
In the nineteenth century, sex had become fraught for both men and women; bourgeois respectability demanded increased control, moderation, and self-discipline. Middle-class women in particular were expected to be a model of purity, to control men's lusts by the strength of their example. Although we do not know how the great majority of women coped with these moral pressures, some at leastlike Mrs. B. in the following caseinternalized contemporary notions of illness and consulted doctors with their sexual fears and concerns.
Mrs. B.'s Lascivious Dreams
In 1856, Mrs. B., a twenty-four-year-old, middle-class married woman, went to the Boston office of gynecologist Dr. Horatio R. Storer, future vice president of the American Medical Association. Described by Dr. Storer in his published case notes as small and pale, Mrs. B. sought the doctor's help for decidedly un-Victorian feelings. Excessively lascivious images of sexual intercourse with men not her husband, she told Dr. Storer, filled her dreams. Recently, whenever she met and talked to a man, she dreamed about having intercourse with him. Even during the daytime, if she conversed with a man, erotic feelings overwhelmed her. Up to that moment, she had resisted any actual sexual encounters, but she greatly feared that if the malady increased, she might not be able to restrain herself in the future.
We can only surmise how difficult it must have been for a mid-Victorian woman to speak of these very private matters to a male physician. What we do know is that she understood these feelings to be a medical issue, which should be discussed with a gynecologist, not a clergyman. Whether or not she knew what nymphomania was, she interpreted her dreams as dangerous, laden with sexuality, and a warning that she was losing control.
Encouraged by the doctor to tell her story, Mrs. B. revealed that although she had never masturbated, from a young age she had felt strong, undefined desire. She assumed that she had inherited these feelings from her mother, who had experienced similar, intense desire as a young woman. This strong sexual need had driven Mrs. B. to marry at a relatively youthful seventeen years of age. She was happily married, she assured Storer, and greatly enjoyed intercourse with her husband, a wine merchant and much older man. In fact, during the seven years of their marriage, she and her husband had engaged in intercourse every night. She admitted that even when her husband restrained himself, she could not keep away from him. Recently, however, her husband complained that she had an obstruction that made intercourse difficult. She disagreed; the problem, she believed, was that her husband was having difficulty sustaining an erection.
Mrs. B. came to Dr. Storer not because she was concerned about the strong sexual desire she felt for her husband, the frequency of their marital intercourse, or her husband's possible impotence, but because she was afraid she was not going to be able to limit her sexual desire solely to her husband in the future. At a time when women were supposed to be innately less passionate than men, and during a period when Victorian modesty prevented many women from speaking about sexual matters to their physicians, Mrs. B.'s revelations to Dr. Storer suggest just how worried she must have been by her potentially adulterous feelings.
Interestingly, in this pre-Freudian time, Dr. Storer probed further into the meaning of her erotic dreams: Mrs. B. thought they arose because she and her husband longed for but had not yet conceived a child. Of all the possible explanations for her nymphomaniaincluding the timing of her husband's presumed impotenceMrs. B. chose the one which reflected her understanding of her role as a woman in the mid-nineteenth century. At least in what she reported to Dr. Storer, Mrs. B. determined that barrenness, not lack of sexual satisfaction, had caused her sexual dreams and daytime desires. For a Victorian middle-class woman, this conclusion is not surprising. It reflected prevalent assumptions that having children was not only a woman's major function in life but also the focus of her sexuality.
Dr. Storer, like most nineteenth-century doctors, looked to Mrs. B.'s body to explain her disorder and interpreted her libidinous dreams about a man other than her husband as a symptom of nymphomania. After a general physical examination, the physician pronounced her in tolerably good health: normal heart and lungs; regular but scanty menstrual flow; daily bowel movement; and good appetite.
He then turned his attention to her genitals. Like most gynecologists of the time, he undoubtedly was extremely careful in examining Mrs. B. Deciding that a speculum was unnecessary in this case, Storer reported on his examination: Mrs. B.'s clitoris was normal-sized, her vagina slightly overheated, and her uterus somewhat enlarged. According to Mrs. B., her clitoris constantly itched. In order to determine the seriousness of her condition, Dr. Storer gently touched it, at which point she shrieked, not with pain, but with excitement. Shocked and concerned about the extent of her disorder, Storer warned her that if she continued without treatment, she would most likely end up in an asylum.
The recommended course of therapy involved her whole family. First, Mrs. B. must totally abstain from intercourse with her husband. Because she was "unable to restrain herself," her husband was required to leave home temporarily. Her sister moved in and oversaw that Mrs. B. restricted her intake of meat, brandy, and all other stimulants that might excite her animal desire. The patient was ordered to replace her feather mattress and pillows with ones made of hair to limit the sensual quality of her sleep. To cool her passions, she was to take a cold sponge bath morning and night, a cold enema once a day, and swab her vagina with borax solution. Finally, she had to give up working on the novel she was writing. We learn nothing more about Mrs. B.'s literary output, but Dr. Storer was obviously concerned that dwelling on romance and passion was dangerous to her highly excitable mind.
Because medical casesthis one includedare usually published to illustrate a diagnosis and treatment, the narrative abruptly ends after the prescription is determined. We have no way of knowing whether Mrs. B.'s lascivious desires subsided, whether she and her husband had a child, or whether her husband's erection returned. Dr. Storer had only a brief, but hopeful, final comment about the case: Mr. B. remained absent and Mrs. B.'s lewd dreams had not reappeared.
A Young Working-Class Nymphomaniac
The medical understanding of female sexuality shared by both Mrs. B. and Dr. Storer affected more than just the middle class. Poor and working-class girls generally did not go to private physicians in the nineteenth century, but in the mid-1850s, the mother of a seventeen-year-old girl contacted Dr. John Tompkins Walton because her daughter was having a "fit." In his discussion of this case in the American Journal of Medical Science, Walton described what he saw when he came to Catherine's house: her face was disfigured and her body contorted by a "peculiar and revolting paroxysm," marked by a "lascivious leer" and an "insanity of lust."
Walton feared that as the only male present, he was contributing to Catherine's agitation; he proceeded to calm the girl by mesmerizing (hypnotizing) her. Then, borrowing from a technique he remembered described in medical schoolfarm wives who had difficulty getting their laying hens to give up their eggs would plunge the chickens' posteriors in cold waterWalton forced Catherine to sit in a tub filled directly from the tap. Quieted, Catherine was able to submit to his examination. He concluded that she was suffering from nymphomania because her attacks of ungovernable sexual excitement always occurred when she was alone or with lewd acquaintances.
In what appeared to be a contradiction of his initial statement, Walton commented that a lay person would see in Catherine an "ingenuous countenance" and "pleasing deportment." But because of his professional training, he claimed that he was able to see beyond these superficial observations to the primary cause of her affliction. Catherine's well-proportioned body and her "animal organization"small, drooping eyes, large, broad nose and chin, thick lipswere the keys to her overdeveloped sensuality, and ultimately to her nymphomania. Reading Dr. Walton's reading of Catherine, we can see how contemporary racial and class theories influenced him. He "saw" Catherine's face and body in the categories available to him: pseudo-scientific theories that claimed those physical features revealed her character. According to these theories, proof of the primitive races' and the lower classes' licentiousness could be found in the shape of their lips, the look on their faces.
Looking for additional signs of Catherine's character, Dr. Walton determined that she was not a virgin, based on the "flaccidity of the nymphae" (the inner lips of the vagina) and the "distension of the vagina." The extreme sensitiveness of Catherine's clitoris proved to the physician that she was addicted to masturbation as well. At first he found her unwilling to confess to him, but under his unrelenting cross-examination, Catherine admitted that she was "a wanton" and that her appetite for masturbation was "insatiable."
Dr. Walton deplored the corrupting effects of Catherine's environment: she lived in a house with several families, shared a water closet with the whole courtyard, and associated with the young men lounging about the place. Some contemporary physicians would have recognized these conditions as signs of poverty, not moral failing. They believed that social and environmental factors contributed to diseasewhether cholera or nymphomaniaand advocated solutions such as cleaning up the slums. Dr. Walton did not share those reformers' sentiments.
Walton tried various medical remedies: inserting cool water into the vagina, putting leeches on the perineum (the area between the anus and the vaginal opening) to draw off the excess blood, and placing caustics on the vagina's mucous membrane, which was supposed to lessen its sensitiveness. In addition, the physician enlisted both her mother and her mother's clergyman to try to correct Catherine's moral "lesions." He entreated her mother to watch Catherine at all times. She diligently followed his orders; Catherine complained that her mother watched her so closely "as to prevent sexual fruition save at rare intervals." With typical Victorian moralistic fervor, Walton entreated Catherine to obey his strict regimen or else face the terror of an early and horrible death.
Catherine apparently rejected the physician's advice and was soon intercepted "in coitu," which presumably meant sexual intercourse. Outspoken and assertive over the months of treatment, she repeatedly denounced Walton for having destroyed her "virility." Because of the seriousness of her "insanity of venereal desire," Dr. Walton says he "rendered her emasculate" for a time (although he did not describe his method). He continued to control her "with threats of exposure on the one part, if she destroyed my work, and, on the other, promised to render her sexually fit to assume the duties of a wife whenever such services were needed." After six months of treatment, Walton claimed that "though she now occasionally experiences a slight venereal orgasm," Catherine was no longer inclined to resume her old habits.
These two casesMrs. B. and Catherinereveal striking similarities. Even though Mrs. B. is married, middle class, and seeks medical help, and Catherine is working class, unmarried, and struggles mightily against medical interference, both cases define female sexuality as diseased. Nymphomania in Mrs. B.'s case consists of lascivious dreams, overwhelming sexual desire, and fear of losing control; in Catherine's case, nymphomania involves masturbation, and sexual intercoursepresumably with the young men in the courtyard. Physical causes are assigned in both cases, but nymphomania is still interpreted as a moral issue: inappropriate, problematic, out-of-control female sexuality, which requires watching, restricting, and taming.
and post it to your social network
Most Helpful Customer Reviews
See all customer reviews >