One of the most arresting features of Asti Hustvedt's Medical Muses is its photographs. Taken in the psychiatric ward of the Salpetriere Hospital during the regime of neurologist Jean-Martin Charcot, the images capture women seemingly mid-audition, frozen in poses of saints and starlets playing to an invisible audience. In photo after photo, windswept young patients lie sprawled out on beds, prostrate across chairs, with hands clasped in prayer and eyes cast beyond the camera's gaze. These are Charcot's hysterics, women who were documented, manipulated, prodded and scrutinized — often in full view of crowds — in the name of a disorder that to this day remains the subject of debate.
Since antiquity, the word hysteria has served as a bellwether for societies' relationship to women and medicine, revealing more about attitudes than any specific medical condition. Ancient Greeks attributed the disorder to wandering wombs (an archaic belief that a woman's uterus freely floated within her body), Renaissance physicians to demonic possession, and Charcot, striding into modern medicine, to neurology and internal lesions. There was not, at the time, a standard definition of hysteria — one attempt to catalog symptoms ran over 70 pages — but accounts typically included theatrical descriptors such as "a predilection for drama and deception" and "excessive emotionality." While Hustvedt argues that the coining of the catchall euphemism was more than the result of misogyny, diagnosis and treatment were unquestionably gendered: vibrators and Victorian fainting couches were considered acceptable medical options.
When Charcot assumed control of Salpetriere in the 1860s, the institution had a notorious history of warehousing patients deemed insane or socially unfit. Over the next decade, as Charcot's lectures became a Parisian sensation, the hospital grew into the leading site of hysteria research, with its output permeating broader culture and law.
Nowhere was hysteria's uneasy relationship to science more apparent than in photographs. Andre Breton once called hysteria the "greatest poetic discovery of the late 19th century," a notion that lingers below the surface of clinical observation. Like Muybridge's images of horses in motion, Charcot used photography as a mode of forensics and a means to parse illness. For the neurologist, a lifelong doodler, "art became a method to immobilize the tumultuous fits of his patients and order the savage thrashing into a sequence of static images." It's no coincidence that "Augustine," Charcot's most documented hysteric, arrived at the hospital in 1875, the same year that its first darkroom was installed. But more than a century later, these photos — many of which have the macabre look of a still from a Bela Lugosi film — are in no way native to the realm of medicine. Instead, Hustvedt uses them to highlight the historically foggy divide between science and art.
So did hysteria actually exist? Perhaps. Unable to untangle how much of the disease was physically or socially determined, Hustvedt sidesteps the question, concluding that one of Charcot's main contributions to medicine was to provide a "language of hysteria," which allowed women of the 19th century and beyond to "articulate their distress" over a repressive society. Hustvedt notes that hysterical mass illness still exists today — in the wake of the Sept. 11 attacks, hundreds of schoolgirls broke out in rashes — and expresses concern that biology has supplanted psychology as the primary means of making sense of it.
Though prone to tangents and flat academicism, Hustvedt approaches her subject with a scholar's clarity and attention to detail, leaving the reader with a sense of the subtlety and complexity of the disorder's history, unexpectedly engrossing anecdotes about obscure French neurologists, and no doubt that she accomplished her goal of writing a "nonhysterical book about hysteria."