What is hysteria, and why were so many women diagnosed with it? - Mark S. Micale

翻译人员: Alexis Young 校对人员: Tianyun Liu

Do you ever feel tired? Overwhelmed?

你是否曾感到疲倦？压力过大？

Nervous? Depressed?

还是紧张？抑郁？

Do you have headaches, dizziness, cramps, difficulty breathing?

你是否有头痛、头晕、痉挛 或呼吸困难的症状？

From 300 BCE to the early 1900s,

从公元前 300 年到 20 世纪初，

if you answered yes to these questions and you had a uterus,

如果您对这些问题都回答是， 而且您有子宫，

a European or American doctor would likely diagnose you with hysteria.

那么欧洲或美国的医生很可能会 诊断你患有歇斯底里症。

No, not mass hysteria.

不，不是集体歇斯底里，

Ladylike hysteria.

而是女性的歇斯底里。

The catch-all term “hysteria” was used by physicians, who were mostly men,

“歇斯底里”这个统称是由医生使用， 通常以男性为主

to describe just about any unexplainable medical condition

来描述女性患者所遭受的、

suffered by female patients.

任何无法解释的医学状况。

By some interpretations,

根据某些解释，

being a woman was itself long considered a pathology

身为女性本身长期以来 就被视为一种病态，

from which all kinds of problems arose.

从而引发各种问题。

Throughout its long history, hysteria was used as a cultural signifier

在其悠久的历史中， 歇斯底里一直被用作一种文化象征，

for what men with authority found contemptible and incomprehensible

代表那些掌权的男性对于女性行为中 他们认为可鄙且难以理解的部分——

in the behavior of women who lacked, or tried to exercise, power.

尤其是那些缺乏权力或试图行使权力的女性。

The term hysteria is derived from the Greek word for uterus,

歇斯底里一词 源自希腊语中的“子宫“，

and was first used in the 4th century BCE.

在公元前 4 世纪首次出现。

Drawing on earlier Egyptian beliefs, and not a great deal of medical rigor,

基于早期埃及的信仰 并缺乏医学依据，

the Greeks viewed hysteria as a malady of the womb,

希腊人认为歇斯底里 是一种子宫的病症，

arguing that the uterus could dislodge and move throughout the body,

认为子宫会脱离正常位置 并在身体内移动，

causing a variety of ailments.

引发各种疾病。

They believed the uterus wandered because it longed to bear children,

他们相信子宫四处游走 是因为它渴望生育，

and for that reason,

因此，

unmarried women were the most likely to get a hysteria diagnosis.

未婚女性最有可能被诊断出歇斯底里。

The usual prescription was immediate marriage, impregnation,

当时的常见处方是立即结婚、怀孕，

or the use of uterine fumigations

或使用子宫熏蒸

to entice the rebellious organ back into place.

来引导叛逆的器官回到原位。

By the 2nd century CE,

到公元 2 世纪，

Roman physicians rejected the wandering womb theory.

罗马医生否定了 “子宫游走”的理论，

But they still viewed the uterus as the source of hysteria,

但他们仍然认为子宫 是歇斯底里的根源，

believing, without much evidence, that it produced a secretion similar to semen,

认为它会产生类似于精液的分泌物，

which— if not released— corrupted the blood and irritated the nerves.

这些分泌物如果不排出， 会污染血液并刺激神经。

As a result, midwives would often treat hysteria by manually inducing orgasms

因此，助产士经常透过手动 诱导女性患者高潮

in female patients.

来治疗歇斯底里。

By the late Middle Ages, Christianity had spread throughout Europe,

到了中世纪晚期， 基督教传遍了整个欧洲，

and its influence had likewise infiltrated Western medical practice.

其影响力也渗透到西方医学行为中。

Physicians started to posit that hysteria was a malady not of the womb,

医生开始假设歇斯底里 不是子宫的病症，

but of the soul, and reflected Satanic influence.

而是灵魂的问题，反映了撒旦的影响。

Doctors continued to dismiss women’s symptoms and pain,

医生们继续忽视女性的症状和痛苦，

now misogynistically shifting the blame to their supposed inherent weak wills

现在则是性别歧视地将责任 推给她们所谓的弱意志

and susceptibility to sin.

和易受罪恶影响的天性。

This situation worsened through the 16th and 17th centuries,

这种情况在 16 世纪 和 17 世纪进一步恶化，

as women, especially those who didn’t conform to social expectations,

因为那些不符合社会期望的女性，

risked being accused of witchcraft, which often carried heavy consequences.

往往面临被指控为女巫的风险， 而这通常带来严重的后果。

In late Victorian Europe and North America,

在维多利亚晚期的欧洲和北美，

some medical doctors started arguing that hysteria’s true origin

一些医生开始主张歇斯底里的真正起源

lay not in the body or soul, but rather, in the mind.

不是在身体或灵魂，而是在心理。

Middle class women, facing intense demands of social respectability

中产阶级女性中被认为不庄重

and strict codes of sexual conduct,

和不符合严格性行为规范者，

were often referred to “nerve doctors”

经常被转介给“神经科医生”，

who’d use isolating and unfounded rest cures

这些医生使用隔离和无根据的休养疗法

to treat any emotional and psychological distress.

来治疗她们的情感和心理困扰。

When writing her semi-autobiographical short story, “The Yellow Wallpaper,”

在撰写她那篇半自传性短篇小说 《黄色壁纸》时，

Charlotte Perkins Gilman drew from the distressing treatment she underwent

夏洛特·珀金斯·吉尔曼从她自己 因“歇斯底里倾向”

for her so-called hysterical tendencies.

所经历的痛苦治疗中汲取了灵感。

The narrator, suffering from what would now likely be diagnosed

小说中的叙述者的症状

as postpartum depression,

很可能在今天会被诊断为产后忧郁症。

describes being confined alone in an attic

她被描述为被单独囚禁在一个阁楼中，

and being denied any intellectual activity,

并被剥夺了任何智力活动，

including reading or writing.

包括阅读或写作。

Around this same time, Sigmund Freud was rising to fame.

大约在同一时期， 西格蒙德·弗洛伊德开始成名。

He believed hysteria, like other nervous conditions,

他认为，歇斯底里和其他神经症状

was caused by repressed emotional trauma.

都是由压抑的情感创伤引起的。

His treatment required drawing these memories out of the unconscious

他的治疗方法是将这些记忆 从潜意识中抽取出来，

so they could be acknowledged and addressed.

以便能够识别并解决其中的问题。

Freud also dismissed the idea that hysteria was unique to women.

弗洛伊德还否定了歇斯底里 是女性专有的想法。

Belief in “male hysteria” became prominent during and after the First World War,

“男性歇斯底里”的观念

在第一次世界大战期间 及战后开始盛行，

but was framed as the more masculine-sounding “shell shock.”

但被称为更男性化的“炮弹冲击”。

Over the 20th century,

在 20 世纪，

the term hysteria was slowly replaced by specific, less gendered diagnoses,

歇斯底里这个术语逐渐被更具体、 更性别中立的诊断所取代，

including anxiety, depression, PTSD, and epilepsy.

包括焦虑症、抑郁症、 应激障碍和癫痫。

And hysteria was officially removed

1980年，歇斯底里被正式

from the “Diagnostic and Statistical Manual of Mental Disorders” in 1980.

从《精神疾病诊断与统计手册》中删除。

Today, most scholars argue that the blanket disease hysteria

如今，大多数学者认为， 歇斯底里这种笼统的疾病

was always a figment of doctors’ imaginations.

终究是医生想象出来的。

As outright medical sexism declined, so did its diagnosis.

随着医学性别歧视的明显减少， 这种诊断也随之消失。

Nevertheless, its legacy reflects Western medicine’s

然而，这些过往反映了西方医学

long, storied, and ongoing history

长期以来对女性痛苦的错误归因 和微小化的历史，

of misattributing and trivializing women’s pain.

并且至今仍在持续发生。