History of hysteria: Ilza Veith’s legacy

História da histeria: o legado de Ilza Veith

Histoire de l’hystérie : l’héritage d’Ilza Veith

Historia de la histeria: el legado de Ilza Veith

The 1965 book Hysteria: The History of a Disease, by the German American historian Ilza Veith, certainly represented a milestone in the historiography of hysteria. Praised at first as an innovative work, unprecedented in its comprehensiveness and scholarship, it became, over time, object of multiple criticisms regarding its omissions, its psychoanalytic bias, and the teleological character of its approach. This article aims at pondering these contrasting assessments and discussing the historical significance of Veith’s work from a contemporary perspective. To this end, a brief overview of historical studies on hysteria before Veith is outlined. This overview is followed by a descriptive and critical presentation of her work, a discussion of certain aspects of its reception and, as conclusion, an evaluation of her contribution and legacy to this research field.

Key words:
Hysteria; history of hysteria; historiography of hysteria; Ilza Veith; psychoanalysis

Resumos

O livro Hysteria: The History of a Disease, da historiadora germano-americana Ilza Veith, publicado em 1965, representou certamente um marco na historiografia da histeria. Elogiado inicialmente como uma obra inovadora e sem precedentes em sua abrangência e erudição, tornou-se com o tempo objeto de múltiplas críticas com relação a suas omissões, ao viés psicanalítico e ao caráter teleológico de sua abordagem. O objetivo deste artigo é ponderar essas avaliações contrastantes e discutir a significação histórica do livro de Veith com base em uma perspectiva contemporânea. Para tanto, traça-se um breve panorama da situação dos estudos históricos sobre a histeria antes de Veith. A seguir, é feita uma apresentação descritiva e crítica de seu trabalho, discutem-se certos aspectos de sua recepção e, a título de conclusão, ensaia-se uma avaliação de sua contribuição e de seu legado para esse campo de pesquisas.

Palavras-chave:
Histeria; história da histeria; historiografia da histeria; Ilza Veith; psicanálise

Le livre Hysteria: The History of a Disease, de l’historienne germano-américaine Ilza Veith, publié en 1965, a certainement représenté un tournant dans l’historiographie de l’hystérie. D’abord acclamée comme une œuvre innovante et sans précédent par son exhaustivité et son érudition, elle est devenue au cours du temps l’objet de multiples critiques concernant ses omissions, son parti pris psychanalytique et le caractère téléologique de sa démarche. L’objectif de cet article est de réfléchir sur ces évaluations contrastées et de discuter de l’importance historique du livre de Veith dans une perspective contemporaine. À cette fin, on fournit d’abord un bref aperçu de l’état des études historiques sur l’hystérie avant Veith et ensuite une présentation descriptive et critique de son travail. On discute d’ailleurs certains aspects de sa réception et, en guise de conclusion, on présente une évaluation de sa contribution et de son héritage dans ce domaine de recherche.

Mots clés:
Hystérie; histoire de l’hystérie; historiographie de l’hystérie; Ilza Veith; psychanalyse

El libro Hysteria: The History of a Disease, de la historiadora germano-estadounidense Ilza Veith, publicado en 1965, representó, sin duda alguna, un marco en la historiografía de la histeria. Elogiada inicialmente como una obra innovadora y sin precedentes por su amplitud y erudición, con el tiempo se convirtió en objeto de múltiples críticas por sus omisiones, por el sesgo psicoanalítico y por el carácter teleológico de su enfoque. El objetivo de este artículo es ponderar estas evaluaciones contrastantes y discutir la importancia histórica del libro de Veith desde una perspectiva contemporánea. Para ello, se traza un breve recorrido por el estado de los estudios históricos sobre la histeria anteriores a Veith. A continuación, se realiza una presentación descriptiva y crítica de su obra, se discuten algunos aspectos de su recepción y, a modo de conclusión, se ensaya una evaluación de su contribución y legado a este campo de investigación.

Palabras clave:
Histeria; historia de la histeria; historiografía de la histeria; Ilza Veith; psicoanálisis

Introduction

More than fifty years ago, the physician and historian Ilza Veith (1912-2013) set out to systematically present and assess the many disagreements surrounding the historical development of the approaches to hysteria, contextualizing them according to the changes taking place in medical thought over time. Her book was at first acclaimed both for its pioneering character — there was no comprehensive history of hysteria in the English language at the time — and for its scope and scholarliness.¹ However, it was to be later criticized and rebuked for its alleged omissions, misunderstandings, and biases. Even so, Hysteria: history of a disease (Veith, 1965) provided detailed accounts of the succeeding theories. The book also discussed the medical and scientific context in which each theory had been proposed. It is a far-reaching synthesis that helped shape the history of hysteria for decades and, to some extent, still today. Its reception also varied according to the diferent disciplinary contexts in which it was situated (historical, medical, psychoanalytic).

What can fifty years change in a text’s appraisal? In the case of a work that has become classic, this hiatus most likely does not interfere with the readings in the various professional and scientific disciplines involved. On the other hand, the field of concept historiography is marked by constant critical revisions of its narratives, made possible by the growing knowledge in the field and the emergence of new theories and methodologies (Doroshow, Gambino & Raz, 2019; Kroll, 1995).

This is especially true when dealing with complex notions that require considering the multiple factors that determine them. In this case, half a century may be time enough for certain assumptions of an established interpretation to be shaken, requiring revisions and reassessments of its conclusions, implications, and repercussions. Can this distancing thus allow for a more balanced assessment of Veith’s actual contribution to the historiography of hysteria? This question is the subject under discussion here.

To this end, a brief overview of the historical studies on hysteria before Veith is outlined. This overview is followed by a descriptive and critical presentation of her work, a discussion of certain aspects of its reception and, as conclusion, an evaluation of her contribution and legacy to this research field.

Early history of hysteria

Studying a concept’s history, its transformations through time, and how diferent authors have worked on it requires exploring the context from which that concept emerged. One must also consider the contextual changes that acted upon its reformulations. However, each approach to this historical process also reflects its own intellectual environment. In turn, this environment is sensitive to the prevailing theoretical discourses of the time and responds to changes in these discourses (Koselleck, 2002). It is worth noting that, over millennia, virtually every author engaged in explaining hysteria has claimed to have conducted extensive and detailed observations of countless cases to advocate an anatomical seat’s identification or a clinical condition’s account. They also claimed to have applied reliable methods and called upon some great authorities’ endorsement for their theories while asserting a rupture with some preceding tradition. As Arnaud (2012) points out, it is surprising how these researchers ended up arriving at totally disparate views by (allegedly) employing the same methods.

To situate the emergence of Veith’s History of a disease (1965) in its proper context, one must go back a century in medical history. The 19th century was marked by developing the research field dedicated to studying the nervous system’s structure and functions, especially concerning their relationship with the mind and its passions. This study opened new investigation lines for alienists and neurologists, including those engaged in understanding hysterical phenomena as a nervous disease. New contentious issues joined the longstanding controversy regarding hysteria’s etiology, if uterine or encephalic. These issues included the mind-body relationship, the conficting organogenetic and psychogenetic etiological theories, and the delimitation of neurology and alienism’s respective competencies (Tremine, 2009). The historical overview outlined in Castel (1998), with its chronologies and bibliographical surveys, records the frenetic output by medical scholars working in the field from 1870 onwards. It reflects the great diversity of often opposed theoretical and clinical approaches, justifying the title chosen by the author: “La querelle de l’hystérie” (“The dispute on hysteria”).

Not that hysteria had been, until then, a subject devoid of polemics. On the contrary, it is unlikely that any other clinical entity has raised so many passionate questions through time. However, the discussions regarding neurology, still incipient as a medical specialty during most of the 19th century, strengthened what Porter (1987, p. 178) described as an “alternative geography” for anxiety and symptomatic acts. This situation revived the debates and the endless quarrels about hysteria.

However, Castel’s work does not record any historical approach to hysteria in the period covered by his surveys. Neither Otto Marx’s rich study of German psychiatric historiography of the same period refers to any hysteria’s history (Marx, 1994). Among the thousands of theoretical or clinical articles directly or indirectly related to hysteria published at the time, only two or three allude to any “history” in their titles. Even among them, if one examines, for example, Jules Soury’s Histoire des doctrines de psychologie physiologique contemporaines (1892), no more than a few short and superficial references to the hysterical condition can be found.

A particular thematic field may appeal to historians due to cultural, social, or political circumstances. However, it only becomes the object of actual historical narratives when the relevant scientific communities evolve in such a way as to be open to these narratives (Barros, 2007). Amid that efervescence of discussions, their protagonists remained unaware that, while they were writing their works, they were also making a history that others would later chronicle.

However, the first actual chronicler of this history was not that far. Glafira Abricossoff’s L’hystérie aux XVIIe et XVIIIe siècles appears in 1897 and presents a first historical articulation of the medical theories about hysterical conditions. She studied at the Salpêtrière under Jean-Martin Charcot (1825-1893), to whom she says to owe all her medical knowledge and dedicates her dissertation, a hysteria’s “methodical and detailed history” (Abricossoff, 1897, p. 5). Before Abricossoff, Paul Richer (1849-1933) had added a “Historical Appendix” to his Études cliniques sur la hystéroépilepsie (Richer, 1881, pp. 615-726). Gilles de la Tourette (1857-1904), in his monumental Traité clinique et thérapeutique de l’hystérie, published in three volumes between 1891 and 1895, had also committed an introductory preface to historical considerations on this neurosis (Tourette, 1891, pp. 1-36). Nevertheless, Abricossoff’s was the first academic monograph entirely devoted to the history of hysteria (Micale, 1990; 1995). Not by chance, all these first essays in hysteria’s intellectual history appeared related to the Salpêtrière school. Charcot had endeavored to demonstrate the persistence of hysteria throughout the ages, not only in medical accounts but also in the arts and narratives of demonic possession, as a strategy to reinforce his argument for the reality of hysterical neurosis (Charcot & Richer, 1887; Céard, 1994).

Without the Kahoun and Ebers papyri that would later become mandatory sources in the history of hysteria, Abricossoff’s narrative begins in Greece. With Freud’s early works too recently published for a proper assessment of their significance, she finishes it with the Salpêtrière. Born in Russia and part of the first generation of women to be accepted for medical training in France (who were often foreigners), Abricossoff privileges in her work the period between the Renaissance and the Enlightenment. She maps out in detail the comings and goings of neurological and uterine theories of hysteria, the emphasis on, and the disregard of, sexuality as an etiological factor, and the emergent approaches to male and infantile hysteria. Her work understandably concludes with Charcot’s theories that coronate all this development (Micale, 1990; 1995).

Two other works also emerging from the French context shortly after these pioneering studies are noteworthy. Gaston Amselle, like Abricossoff, devoted an academic dissertation to the history of hysteria, this time also published in book form (Amselle, 1907). According to Micale (1995), his work is connected to the Nancy school as the previous ones were to the Salpêtrière. Amselle presents Charcot as still endorsing eighteenth-century neurological theories while emphatically praising Hippolyte Bernheim’s (1840-1919) new psychodynamic view at the end. Henri Cesbron’s (1909) is the most complete and exhaustive work in this early historiography. It goes beyond the dispute between the Nancy and Salpêtrière schools and finds its intellectual hero in Joseph Babinski (1857-1932), celebrating his concept of pitiatism² as the scientific culmination of the medical approaches to hysteria (Edelman, 2003).

In the nearly seventy years between Abricossoff’s pioneering monograph and Veith’s Hysteria: history of a disease, a new medical historiography emerged that gradually abandoned the uncritical, but never neutral, narratives of medical discoveries and great personalities’ biographies. It was also the time of the hieratic texts’ dissemination and acknowledging Freud’s achievements in the field. According to Schullian (1957), the second post-war era significantly contributed to building up a more solid material and institutional base for medical historians, with the establishment of systematic medical bibliographies, the organization of specific scientific events, and re-editions and translations of classical works. George Mora draws attention to the appearance, at this same time, of a growing number of publications dedicated to the history of mental disorders, but not yet to the history of hysteria (Mora, 1970).

These seventy years were the scene of crucial social movements, the deep epistemic rupture represented by psychoanalysis, and medical texts’ transformation into fully acknowledged historical sources. In the more than fifty years that separate us from Veith’s History of a disease, a new social status for women has developed, critical evaluation of Freud’s thought become more frequent, and the historiography’s consolidation took place, with a more rigorous and complex methodological approach to the sources. Returning then to the initial question, one can ask: what have all these years changed in the appreciation of historical works?

Ilza Veith and her narrative

A psychiatrist and a historian, Ilza Veith was born in Germany in 1912 and lived in the United States from 1937 onwards, dying in California in 2013 (Nunes, 2015). Having studied medicine in Geneva and Vienna, she emigrated from Europe to the United States because of Hitler’s politics like many great twentieth-century authors in medical history. She joined the Johns Hopkins University that had become home to the first English-language academic institution for medical historiography. This Institute of the History of Medicine was directed between 1932 and 1947 by Henry Sigerist (1891-1947), a Swiss immigrant regarded as one of the greatest medical historians in the first half of the twentieth century (Fee, 1989). Veith studied under Sigerist and, in 1947, became the first Ph.D. in History of Medicine. A victim of a brain stroke in 1964, she later recorded the impact of this hard blow on her life and the subsequent disabilities in the book Can you hear the clapping of one hand? Learning to live with a stroke (Veith, 1988). Fluent in Japanese and Mandarin,³ Veith translated into English a treatise of traditional Chinese medicine, published as The Yellow Emperor’s classic of internal medicine (Veith, 1949/2002). She also wrote several articles and reviews on Eastern medicine (Veith, 1955; 1963; 1973).

In the brief Preface to Hysteria: history of a disease, Veith emphasizes the strict historic nature of her work, explains her proposal’s guidelines, and underscores the topic’s importance, the relative scarcity of scholarly works, and her determination to fill in this gap. Her assessment of the field is entirely justifed, given the distance discussed above between the mid-1960s when Veith published her book and the first historical approaches to hysteria in the late nineteenth and early twentieth century.⁴ According to Micale (1989), the book became the standard historical approach to hysteria for a whole generation of readers, not only in North America but also in Britain and France. He also claimed that “no single text in the historiography of hysteria has had a wider readership” (Micale, 1995, p. 38). For Mora (1994), it remained the most comprehensive study on the subject for many years.

The book’s narrative assumes an internalist point of view, describing and analyzing the selected texts as they succeed each other in time. Its language adopts a formal style adequate to academic historiography. The authors referred to are situated in their time and related to the then prevailing styles of thought. Their concepts are usually exposed in a clear and accessible way. However, Veith does not make entirely explicit her relationship with the sources, which allows certain doubts to arise regarding the data’s accuracy and their impact on the discussion based on them. The research presented involves multiple sources, ranging from hieratic texts to extensive French literature, including classics of Ancient Greek medicine and many Latin works. This multiplicity and variety naturally force the historian to depend on translations. However, Veith’s book is often vague in specifying translations and secondary sources. This vagueness leads to significant uncertainties and inaccuracies, especially regarding documents written in ancient languages that are likely to cause ferce controversies about translation of crucial terms.

Examining clinical records, especially those concerning women’s diseases, in search of possible descriptions of hysterical conditions, Veith’s (1965; 1977) history begins with ancient Egypt and extends to the Viennese Belle-Époque. The approach to Freudian theories is the endpoint of this journey, which reveals that there are as many clinical and theoretical models of hysteria between the papyri and the couch as stages in medical thought development. Starting her approach with Egyptian medicine’s surviving records was, at the time, an innovative attitude since hysteria’s historical accounts until then almost invariably began with Hippocrates. Her next step was an extensive discussion of the “wandering womb” in the Hippocratic texts, based on sources highly influenced by the classic translation by Émile Littré (1801-1881). Littré’s interpretation was later the object of criticism that also extended to Veith’s account.

The British historian Helen King, a classical scholar specialized in the history of ancient medicine, attributes to Veith’s influence the current consensus among historians, physicians, and psychoanalysts that the description of hysteria as such dates to Hippocratic medicine. She traces this interpretation back to Littré’s renowned translation and shows how he read the Hippocratic texts through the lens of the medical knowledge and debates underway in France during the mid-nineteenth century (the relevant volumes of his edition appeared between 1851 and 1853). Besides the biased translation, Littré added headings and comments that introduced the term “hysteria” as it was then understood — a nervous disorder distinct from the female reproductive system’s organic diseases — where it was absent in the original text. The result is a retrospective diagnosis⁵ projecting into the past the medical categories of the present. This issue is particularly controversial concerning psychiatric categories (Schmidt, Wilhelmy & Gross, 2020). According to King, this interpretation was spread by the English translations that took Littré’s as a model and, through them, reached Veith. In turn, Veith’s influence turned the “Hippocratic hysteria” into a dogma for many contemporary views on this disease’s history. In short, says the author, “Veith’s claims for Greek medicine are seriously flawed,” and she “puts too great a trust in poor secondary sources” (King, 1993, p. 5).⁶

Starting from the Egyptian and Hippocratic “wandering womb,” Veith arrives at this hypothesis’ rejection by Galen and his proposal of a hysterical pathophysiology founded on sexual abstinence. She then traces back what she regards as a “deterioration of medicine” (Veith, 1965, p. 40) — namely, attributing supernatural origins to the derangements in body and mind — to Augustine and the episode of his sudden conversion to the Christian faith, when sexual abstinence’s etiological value in Galen’s sense was implicitly disavowed. The growing importance of demonic agents in bringing about women’s diseases, the role of sorcery, the Inquisition, and other related issues are approached in the chapters covering not only Medieval Europe but also Islamic and Far Eastern culture. Regarding the latter, as mentioned above, Veith had both the interest and the necessary linguistic skills for a hitherto unprecedented approach in the history of hysteria (Merskey, 1985).

It is worth noting that Veith avoids the frequent caricature of presenting the Middle Ages merely as a time of ignorance and darkness — a view that Butterfield (1965) also regards as a significant example of a gross historiographical misunderstanding. However, it would still take some years before Midelfort (1981), relying on state-of-the-art research, demonstrated that most women charged with witchcraft exhibited no discernible signs of hysteria (or any other insanity for that matter) and most likely only confessed under torture to their supposed demonic collusions.

Back to the development of clinical medicine, Veith acknowledges Paracelsus’ (1493-1541) significance but does not escape the common negligence of approaching the Renaissance physician and alchemist from the standpoint of his eccentric and turbulent personal life rather than discussing his innovative clinical practice. This practice was the main factor that made him a milestone in breaking up with classical and medieval thought and opening the path to modern medicine (Crone, 2004). In a straightforward instance of what Skinner (1969, p. 22) calls “mythology of prolepsis,”⁷ Veith discusses a hysteria that is absent from Paracelsus’ texts, making it equivalent to the chorea lasciva or some aspects of the sufocatio intellectus to which he refers. This identification is strongly arbitrary since the similarities between these conditions are far from evident. Here, one cannot blame her misunderstanding on translation difficulties since Paracelsus wrote most of his works in German, Veith’s native language. She then emphasizes Johannes Weyer’s (1515-1588) role in confronting the Holy Office and his eforts to liberate medical thought. However, she fails in identifying the many Paracelsian elements present in Weyer’s views (Schmidt, 2018).

The following chapters bring the reader back to the core of modern medicine (Mora, 1967). Nonetheless, the liberties taken with Paracelsus recommend some caution in considering Veith’s references to Charles le Pois (1563-1633). The Lorrainer medical doctor is acknowledged as the first scholar to emphatically affirm hysteria’s encephalic nature and reject both its uterine seat and its exclusive occurrence in the female sex. Pois’s work was published in Latin, and it is unclear if Veith’s analysis was solely based on the original or some unspecifed translation. Be that as it may, her reference to Pois opens the study of a new stage of medical approaches to hysteria, including important works by William Harvey (1578-1657), Thomas Willis (1621-1675), and Thomas Sydenham (1624-1689). Among them, Sydenham stands out for the evidence brought about by his necropsies, the role he attributed to the so-called “animal spirits”, and his theories about the nervous system. Veith discusses Sydenham’s 1682 Dissertatio epistolaris on hysteria and other issues with the length and detail it deserves from a historiographical point of view, considering its comprehensive and innovative views. Her preference for theories anticipating a psychodynamic approach to hysteria (or so interpreted) is perceptible here. Veith sees in Sydenham’s work the great turning point in hysteria’s history for acknowledging the possibility of psychogenic etiological factors.

As for the eighteenth century, she surveys Robert Whytt’s (1714-1766) neurological theories, Joseph Raulin’s (1708-1784) vapors, and William Cullen’s (1710-1790) neuroses, as well as the gynecological theories’ reappearance. For Veith, this century culminates in the genius of Philippe Pinel (1745-1826) and his inquiries into the causes and treatment of mental alienation. On the other hand, mesmerism, also emerging in this century, is only approached a few chapters later and without the disqualifying attitude usually accompanying the accounts of Anton Mesmer’s (1734-1815) life and work. In Veith’s view, even though one cannot disregard Mesmer’s alleged charlatanism, his contributions to the development of new manners to deal with hysterical conditions, both clinically and theoretically, cannot be neglected.

Concerning Pinel, Veith has the merit of not mentioning the myth of the liberation of Bicêtre’s inmates, the fabrication of which would only be fully elucidated almost thirty years after the publication of her book (Weiner, 1994). On the other hand, moral treatment is discussed only with respect to Robert Brudenell Carter (1828-1918) — a hardly understandable choice. Even though Pinel’s importance as a physician and alienist is undoubtedly acknowledged, there are some basic mistakes, such as associating the “furor uterinus” (nymphomania) with hysteria, since this condition’s description had already been long related to manic states, even in the context of the 1960s nosography. Veith also downplays Pinel’s significance in advancing an important “moral” — that is, psychological — theory of the hysterical condition (Arnaud, 2015). Incidentally, a critical gap in the History of a disease is failing to present and discuss the heated contentions in nineteenth-century France concerning hysteria’s etiology, especially those involving the moral causes’ advocates and the supporters of biological theories (Trillat, 1986/2006). This discussion could have provided a better narrative sequence extending to the diagnostic categories of “nervousness” and the so-called “mild hysteria.” These categories were commonly employed in the late nineteenth century but are absent from Veith’s account. In this case, the path leading to Charcot and the Salpêtrière school would have taken a more logical form.

Charcot’s crucial contributions to the clinical approach to nervous system diseases and his political role in establishing a more systematic scientific and institutional framework for studying hysteria are fully acknowledged. However, Veith also points out the noticeable limitations in his theoretical assumptions. Her analysis does not fail to consider the most distinguished personalities associated with the Salpêtrière school, such as Paul Richer and Pierre Janet (1859-1947). Charcot’s most famous rivals at the Nancy school, like Bernheim, are also adequately contemplated. This itinerary finally opens the way to the assumed culmination of the whole historical process of hysteria approaches that Veith reconstructed, namely, Freud’s early theories and the psychoanalytic understanding of hysterical phenomena.

In the author’s own words, the subversion that psychoanalysis caused in Western thought as a whole — and psychiatry, in particular — had already been anticipated in many aspects by the authors and theories she addressed throughout her narrative, so that “a summary of Freud’s concern with hysteria should form the conclusion of this book” (Veith, 1965, p. 258) — and, presumably, be its natural outcome.

Concluding remarks

As Micale (1989) observes, studies on hysteria involve a mixture of science, sexuality, and sensationalism that, at least in part, sustains the great interest that the history of this neurosis has aroused since the late twentieth century. However, one can understand a history of hysteria either as part of the medical thought’s history or as the disease’s social history, manifesting diferent biases and interests. Veith’s work relies mostly on this second perspective.

A crucial and striking feature of hysterical disorders is the wide-ranging and continuous variation of its pathoplasticity,⁸ i.e., changes in the disease’s confguration depending on historical and cultural contexts. As discussed above, this plasticity allows for the emergence of many diferent and often conficting etiological theories. According to Didi-Huberman (1982/2003, p. 73), this variety is one of the factors at the roots of the long-lasting and ferce dispute of “the uterine explorers against the encephalic inquisitors” (author’s emphases). The passionate attitude also typical in the discussions concerning this subject is proportional to the impact that references to hysteria can produce in the social imaginary. Until recently, few authors managed to approach hysteria without letting a strong underlying personal position manifest through their alleged objective accounts.

Contrarily to this frequent passionate attitude, Veith’s narrative generally maintains a neutral afective tone and even seems to avoid deliberately the more heated contentions defending specific stances. Indeed, one of the criticisms later addressed to her work referred to her neglect in adopting a feminist bias. This perspective had become dominant in the mid-1960s as hysterical phenomena became widely interpreted as an expression of historical gender inequality and women’s oppression. For example, Veith mentions the preferential targeting of women in the Holy Office’s actions, but, even so, feminist criticism accused her of implicitly endorsing sexist views by not openly denouncing all manifestations of women’s discrimination throughout history. Her endorsement of Freud’s theories, regarded as highly gender-biased and detrimental to women’s status, was also an object of the same form of criticism (Showalter, 1993).

If Veith manages to keep the stronger passions out of her account, she also clarifes her personal position, namely, that the whole history of theories and practice concerning hysteria leads to the emergence of Freud’s views. However, as Dobson and Ziemann (2009, p. 11) remark, “the proverbial ‘happy ending’” is “only one of the possible solutions” in historical narratives. In turn, George Mora considers that incorporating psychodynamic concepts was a crucial feature of academic medicine in the second half of the twentieth century. It resulted in a greater receptivity in the medical discourse to elements from the human sciences, with a substantial impact on medical historiography that became more open to mental medicine. Against this background, Veith’s work, where the emergence of these psychological views plays a central role, was substantially innovative for the time. Mora (1970) regards it as a representative example of the fortunate convergence between medical history and the history of psychiatry. However, over time, the same argument that made the book praiseworthy at its appearance also became a target of the same kind of criticism addressed to Veith’s Hysteria.

For Scull (2009), Veith interpreted the whole history of hysteria through psychoanalytic lenses. On the other hand, George Rousseau understands that, like other historians of her generation educated in the wake of the Freudian revolution, Veith envisaged hysterical pathology as a challenge. According to him, her strategy to deal with this challenge was to summon the most notable characters in the history of medicine to validate the itinerary she traced, leading the theories on hysteria to their eventual psychogenetic culmination (Rousseau, 1993). In fact, Veith seems to endow some of her progressive heroes, such as Carter, with the gift of premonition while attributing to others, like Cullen, a tendency to conservatism and immobility. This modus operandi makes her narrative vulnerable to the criticism of categorizing characters and institutions as clearly divided “into the friends and enemies of progress” (Butterfield, 1965, p. 5).

One of Hysteria: history of a disease’s first reviewers, George Mora, emphasizes the impact it caused at its release, acclaimed for its unprecedented character and original hard research work. His review affirms Veith’s merit in shedding new light on conceptual developments and clinical practices related to hysteria. Mora also praises her for presenting in detail the views maintained by prominent fgures in medical history who were still obscure or completely unknown in the 1960s. He mentions the previous reticence of psychiatrists and historians in engaging with hysteria’s history because of the vast difficulties brought about by the many changes both in the general conceptual framework and in the etiological hypotheses. He then celebrates Veith’s initiative in overcoming this reticence (Mora, 1967).

Mora also criticizes the emergence, in the early twentieth century, of a growing number of works on the history of mental disorders marked by low historiographical rigor and devoted to the exaltation of certain characters. These personalities were then called upon, justifably or not, as historical endorsers for the historians’ own perspective with all its biases and personal preferences (Mora, 1970). Mora does not include Veith’s work in this category, but from a contemporary viewpoint, one can doubt that her training as a historian completely shielded her from this recurrent psychiatric history trend that Micale and Porter (1994, p. 5) refer to as “usable pasts.”

On the one hand, examining critically a historical work written more than a century ago ofers an opportunity to follow its impact over time in diferent contexts and the reactions it caused in each new circumstance or researchers’ generation. However, on the other hand, this same temporal separation requires a carefully contextual reading to avoid anachronisms and the dangers of retrospective illusion. It is worth noting that, shortly after Veith’s publication, Skinner (1969) warned scholars in the history of ideas against the erroneous assumption that texts can contain timeless elements – a timeless knowledge entirely understandable only from the narrative itself. If one can criticize Veith’s research for its presentisms, parochialisms, and other anachronisms it may contain, one must also contextualize the historical work itself and consider what the author, writing at the time she did, could have effectively accomplished. One may then share Scull’s (2009) view that, on the one hand, Hysteria: the history of a disease is the first attempt at a global history of hysteria but, on the other hand, it also looks today like a charming relic of a stage already left behind in the historiography’s development.

Nevertheless, perhaps one can also argue for the current significance of Veith’s accomplishments, despite all their unavoidable limitations. By naming her work on hysteria a “history of a disease,” she makes this afection the immediate object of her discourse and dissociates it, at least in principle, from any necessary subordination to a specific medical approach. It may not be an exaggeration to see here the anticipation of a more contemporary methodological attitude emphasizing the scientific objects’ historical construction that avoids attributing any natural objectivity to them in terms of a naïve realistic stance. Hence the currently frequent reference to the “biography” of scientific objects implying that once constructed by science, they acquire a life of their own, allowing them to circulate in the culture (Daston, 2000). This metaphor appears, for example, in the title of Scull’s (2009) work that, despite the criticism mentioned above, comes out as the heir of a tradition one can trace back to Veith (Scull’s book is part of an editorial series named precisely “Biographies of diseases”). This example shows how even an old work can have unexpected current repercussions. Micale (1995) remarks the intensification of the historiographical interest in hysteria concomitantly with its decline in medical interest. He lists a vast bibliography that appeared in the thirty years between his book and Veith’s — the inaugural landmark of this trend. Micale’s survey could be comprehensively complemented today by the works produced since then, placing Veith’s book at the origins of a research tradition extending to the present.⁹

Thus, a historical account gains itself a historical significance that prevents it from being ignored. Despite its possible misunderstandings, the dense narrative presented by Ilza Veith has been and still is, more than ffty years later, a mandatory source for studying the history of an illness whose characteristics can only anticipate a constant need for new twists and revisions. These revisions, in turn, will undoubtedly write and inspire new chapters in medical historiography.

• 1
  Merskey (1985) provides an expressive sample of the book’s early enthusiastic reviews.
• 2
  A concept introduced by Babinski to describe the hysterical condition, emphasizing the symptoms’ psychogenic origin, their suggestive nature, and the possibility of influencing and removing them through persuasion (Gomes & Engelhardt, 2014).
• 3
  The title of Veith’s account of her illness is, in effect, inspired by a famous Japanese Zen koan by Hakuin Ekaku (1686-1769): “Two hands clap, and there is a sound. What is the sound of one hand?” (Hori, 1999). Her interest in Eastern medicine can also be traced back to his relationship with Sigerist (Veith, 1997).
• 4
  Micale (1995, p. 38) considers that “the gradual decline of the hysteria diagnosis during the first half of the twentieth century brought a corresponding diminution in interest in the disease’s history.” This decline itself is a much-discussed topic in the literature. Viewpoints on this phenomenon vary on whether it was an epidemiological occurrence (the disappearance of a once common disease) or a change in medical culture (abandoning specific diagnostic categories and adopting others). Other authors claim that hysteria never existed objectively and was only the expression of certain nineteenth-century institutional practices and their corresponding postulates and doctrines. For a detailed discussion of this issue, see Slater (1965), Satow (1980), Stone, Warlow, Carson & Sharpe (2005), and Stone, Hewett, Carson, Warlow & Sharpe (2008).
• 5
  Retrospective diagnosis in medical history is applying current or more recent diagnostic categories to the identification of past diseases known through textual or archaeological evidence. It can configure a form of the methodological bias history theorists call presentism, that is, the past’s interpretation based on current concepts and values (Arrizabalaga, 2002; Karenberg, 2009).
• 6
  Similar criticism had been much more concisely addressed to Veith before by Aline Rousselle (1980, p. 115): “It seems that I. Veith tends to search for an ancient approach to hysteria as we define it today.” See also Trillat (1986/2006).
• 7
  According to Skinner (1969), the mythology of prolepsis — a rhetorical device in which the speaker anticipates an objection to refute it before it is expressed — arises when the historian overlooks the difference between the historical significance that a past author’s claim has acquired over time and the author’s original intention in proposing this idea.
• 8
  German psychiatrist and neurologist Karl Birnbaum (1878-1950) introduced in 1923 the distinction between pathogenic factors that cause the fundamental structure of a disorder and pathoplastic factors that explain the individual, historical, or cultural variation of its manifestation (Luque & Moreno, 2020).
• 9
  In addition to Scull (2009), see also, for example, Arnaud (2015), Bronfen (1998), Bougousslavsky (2014), and Hustvedt (2011), to single out just a few.

Referências

• Abricossoff, G. (1897). L’hystérie aux XVIIe et XVIIIe siècles: étude historique et bibliographique Steinheil.
• Ackernecht, E. H. (1982). Short History of Medicine Johns Hopkins University Press.
• Amselle, G. (1907). Conception de l’hystérie: étude historique et clinique Éditions Doin.
• Arrizabalaga, J. (2002). Problematizing retrospective diagnosis in the history of disease. Asclepio, 54(1), 51-70.
• Arnaud, S. (2012). De la dénomination d’une maladie à son assignation: l’hystérie et la différence sexuelle entre 1750 et 1820. In N. Pellegrin, & M. Sonnet (Eds.), Les discours sur l’égalité/l’inégalité des sexes de 1750 aux lendemains de la Révolution (pp. 131-147). Presses de l’Université de Saint-Étienne.
• Arnaud, S. (2015). On Hysteria: The Invention of a Medical Category Between 1670 e 1820 The University of Chicago Press.
• Barros, J. d’A. (2007). História das ideias: em torno de um domínio historiográfico. Locus: Revista de História, 13(1), 199-209.
• Bronfen, E. (1998). The Knotted Subject: Hysteria and its Discontents Princeton University Press.
• Bougousslavsky, J. (Ed.) (2014). Hysteria: the rise of an enigma. Frontiers of Neurology and Neuroscience, 35 (Special Issue).
• Butterfield, H. (1965). The Whig Interpretation of History Norton & Company.
• Castel, P.-H. (1998). La querelle de l’hystérie: la formation du discours psychopathologique en France (1881-1913) P.U.F.
• Céard, J. (1994). Démonologies et démonopathies au temps de Charcot. Histoire des Sciences Médicales, 28(4), 337-343.
• Cesbron, H. (1909). Histoire critique de l’hystérie Éditions Asselin et Houzeau.
• Charcot, J.-M. & Richer, P. (1887). Les démoniaques dans l’art Delahaye et Lecrosnier.
• Crone, H. (2004). Paracelsus, the man who defied medicine: his real contribution to medicine and science The Albarello Press.
• Daston, L. (2000). Biographies of Scientific Objects The University of Chicago Press.
• Didi-Huberman, G. (2003). Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière The MIT Press. (Trabalho original publicado em 1982).
• Dobson, M. & Ziemann, B. (2009). Introduction. In M. Dobson, & B. Ziemann (Eds.), Reading Primary Sources: The Interpretation of Texts from Nineteenth and Twentieth-century History (pp. 1-18). Routledge.
• Doroshow, D., Gambino, M., & Raz, M. (2019). New directions in the historiography of psychiatry. Journal of the History of Medicine and Allied Sciences, 74(1), 15-33.
• Edelman, N. (2003). Les metamorphoses de l’hystérique du début du XIXème siècle à la Grande Guerre Éditions de la Découverte.
• Fee, E. (1989). Henry E. Sigerist: from the social production of disease to medical management and scientific socialism. The Milkbank Quarterly, 67(suppl. 1), 125-150.
• Gomes, M. M. & Engelhardt, E. (2014). Hysteria to conversion disorders: Babinski contributions. Arquivos de Neuropsiquiatria, 72(4), 318-321.
• Hori, G. V. S. (1999). Translating the ‘Zen phrase book’. Nanzan Bulletin, 23, 44-58.
• Hustvedt, A. (2011). Medical Muses: Hysteria in Nineteenth-century Paris W. W. Norton & Company.
• Karenberg, A. (2009). Retrospective diagnosis: use and abuse in medical historiography. Prague Medical Report, 110(2), 140-145.
• King, H. (1993). Once upon a text: hysteria from Hippocrates. In S. L. Gilman, H. King, R. Porter, G. S. Rousseau, & E. Showalter (Eds.), Hysteria Beyond Freud (pp. 3-90). University of California Press.
• Koselleck, R. (2002). Social history and conceptual history. In R. Koselleck (Ed.), The Practice of Conceptual History: Timing History, Spacing Concepts (pp. 20-37). Stanford University Press.
• Kroll, J. (1995). The historiography of the history of psychiatry. Philosophy, Psychiatry, and Psychology, 2(3), 267-275.
• Luque, R. & Moreno, J. M. V. (2020). Cultural configurators and the formation of mental symptoms. In I. S. Marková, & E. Chen (Eds.), Rethinking Psychopathology: Creative Convergences (pp. 91-101). Springer Verlag.
• Marx, O. M. (1994). The beginning of psychiatric historiography in nineteenth-century Germany. In M. Micale, & R. Porter (Eds.), Discovering the History of Psychiatry (pp. 39-52). Oxford University Press.
• Merskey, H. (1985). Hysteria: the history of a disease: Ilza Veith. British Journal of Psychiatry, 147(5), 576-579.
• Micale, M. S. (1989). Hysteria and its historiography: a review of past and present writings. History of Science, 27(3), 223-61.
• Micale, M. S. (1990). Hysteria and its historiography: the future perspective. History of Psychiatry, 1(1), 33-124.
• Micale, M. S. (1995). Approaching Hysteria: Disease and its Interpretations Princeton University Press.
• Micale, M. & Porter, R. (1994). Reflections on psychiatry and its histories. In M. S. Micale, & R. Porter (Eds.), Discovering the History of Psychiatry (pp. 3-37). Oxford University Press.
• Midelfort, E. (1981). Madness and the problems of psychological history in the sixteenth century. Sixteenth Century Journal, 12(1), 5-12.
• Mora, G. (1994). Early American historians of psychiatry: 1910-1960. In M. Micale, & R. Porter (Eds.), Discovering the History of Psychiatry (pp. 53-81). Oxford University Press.
• Mora, G. (1967). Ilza Veith. Hysteria: the history of a disease. Chicago: University of Chicago Press, 1965, 328 p. $7.95. Journal of the History of the Behavioral Sciences, 3(1), 87-88.
• Mora, G. (1970). The psychiatrist’s approach to the history of psychiatry. In G. Mora, & J. L. Brand (Eds.), Psychiatry and its History: Methodological Problems in Research (pp. 3-25). C. C. Thomas.
• Morgagni, G. (1761). De sedibus et causis morborum per anatomen indagatis Remondini.
• Nunes, E. D. (2015). Ilza Veith (1912-2013) and Genevieve Miller (1914-2013): long lives dedicated to the history of medicine. Ciencia & Saúde Coletiva, 20 (7), 2125-2128.
• Porter, R. (1987). Mind-forg’d Manacles: A History of Madness in England from the Restoration to the Regency The Athlone Press.
• Richer, P. (1881). Études cliniques sur la hystéro-épilepsie ou grande hystérie Adrien Delahaye et Émile Lecrosnier.
• Rousseau, G. S. (1993). “A strange pathology”: hysteria in the early modern world, 1500-1800. In S. L. Gilman, H. King, R. Porter, G. S. Rousseau, & E. Showalter (Eds.), Hysteria Beyond Freud (pp. 91-221). University of California Press.
• Rousselle, A. (1980). Images médicales du corps. Observation féminine et idéologie masculine: le corps de la femme d’après les medecins grecs. Annales: Économies, Societés, Civilizations, 35(5), 1089-115.
• Satow, R. (1980), Where has all the hysteria gone? Psychoanalytic Review, 66(4), 463-477.
• Schmidt, E. (2018). Paracelsus, Johannes Weyer and his publisher: a curiosity in the history of psychiatry. Recuperado em 23 fev. 2021 de: <https://www.researchgate.net/publication/328316580>.
  » https://www.researchgate.net/publication/328316580
• Schmidt, M., Wilhelmy, S., & Gross, D. (2020). Retrospective diagnosis of mental illness: past and present. The Lancet, 7(1), 14-16.
• Schullian, D. M. (1957). A decade of medical historiography. Bulletin of the Medical Library Association, 45(3), 285-290.
• Scull, A. (2009). Hysteria: The Biography Oxford University Press.
• Slater, E. (1965). Diagnosis of ‘hysteria’. British Medical Journal, 1(5447), 1395-1399.
• Showalter, E. (1993). Hysteria, feminism and gender. In S. L. Gilman, H. King, R. Porter, G. S. Rousseau, & E. Showalter (Eds.). Hysteria beyond Freud (pp. 286-344). University of California Press.
• Skinner, Q. (1969). Meaning and understanding in the history of ideas. History and Theory, 8(1), 3-53.
• Soury, J. (1892). Histoire des doctrines de psychologie physiologique contemporaines: les fonctions du cerveau Bureaux du Progrés Médical.
• Stone, J., Hewett, R., Carson, A. Warlow, C., & Sharpe, M. (2008). The ‘disappearance’ of hysteria: historical mystery or illusion? Journal of the Royal Society of Medicine, 101(1), 12-18.
• Stone, J., Warlow, C., Carson, A. & Sharpe, M. (2005). Eliot Slater’s myth of the non-existence of hysteria. Journal of the Royal Society of Medicine, 98(12), 547-548.
• Tourette, G. de la (1891). Traité clinique et thérapeutique de l’hystérie d’après l’enseignement de la Salpêtrière (vol. 1). E. Plon, Nourrit et Cie.
• Tremine, T. (2009). De la douleur à l’analgésie morale. L’Information Psychiatrique, 85(4), 347-353.
• Trillat, É. (2006). Histoire de l’hystérie Éditions Frison-Roche. (Trabalho original publicado em 1986).
• Veith, I. (1955). Psychiatric thought in Chinese medicine. Journal of the History of Medicine and Allied Sciences, 10(3), 261-268.
• Veith, I. (1963). The supernatural in Far Eastern concepts of mental disease. Bulletin of the History of Medicine, 37(2), 139-158.
• Veith, I. (1965). Hysteria: History of a Disease University of Chicago Press.
• Veith, I. (1973). Acupuncture in traditional Chinese medicine: an historical review. California Medicine, 118(2), 70-79.
• Veith, I. (1977). Four thousand years of hysteria. In Horowitz, M. J. (Ed.), Hysterical Personality (pp. 7-93). Jason Aronson.
• Veith, I. (1988). Can you Hear the Clapping of one Hand? Learning to Live with a Stroke University of California Press.
• Veith, I. (1997). Henry E. Sigerist: orientalist. In E. Fee, E., & T. M. Brown (Eds.), Making Medical History: The Life and Times of Hnry E. Sigerist (pp. 81-92). John Hopkins University Press.
• Veith, I. (Ed.) (2002). The Yellow Emperor’s Classic of Internal Medicine University of California Press. (Trabalho original publicado em 1949).
• Weiner, D. B. (1994). “Le geste de Pinel”: the history of a psychiatric myth. In M. S. Micale & R. Porter (Eds.), Discovering the History of Psychiatry (pp. 232-247). Oxford University Press.

Editor/Editor: Prof. Dr. Nelson da Silva Jr.

Publication Dates

• Publication in this collection
  15 Aug 2022
• Date of issue
  Apr-Jun 2022

History

• Received
  08 Mar 2021
• Accepted
  02 Mar 2022