Hysteria at the Edinburgh Infirmary: The construction and treatment of a disease, 1770–1800

IIn the introduction to his History of sexuality, Michel Foucault pointed to the eighteenth century as the period in which sexuality became a medical concern and women were, in his words, subjected to "hysterization".'By this term, Foucault probably meant that medicine began to pay greater attention to female bodily functions, trying to explain anew women's behaviour and physical complaints within the prevailing theoretical frameworks of the time.Thus, Foucault's seemingly novel "medicine of hysteria" replaced traditional and popular views based on humours, vapours, and the effects of a wandering womb.In his view, this was just one aspect of the medicalization imposed on eighteenth-century life with its inherent shifts in power relationships which constitutes one of the central motifs in his writings.2The present investigation started out as an effort to organize a rich source ofprimary clinical material: lecture notes and patient case histories from the Royal Infirmary of Edinburgh during the late-eighteenth century.3The analysis focused on hospitalized patients labelled as suffering from "hysteria", trying to document and perhaps clarify Foucault's ideas on the subject.Using such historical evidence, this study made some rather unexpected discoveries.It not only exposed the ambiguities inherent in the construction of disease entities, but also refuted Foucault's account of the sexualization of working-class women, at least for late-eighteenth-century Edinburgh.Before presenting the archival data, however, it will be useful briefly to consider the views regarding women's health and especially hysteria prevalent in the medical literature during the latter part of the eighteenth century.As with other health problems, the public certainly wanted explanations from medical practitioners and demanded measures designed to ameliorate or even cure the troublesome fits.Despite