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

譯者: Alexis Young 審譯者: Amanda Zhu

Do you ever feel tired? Overwhelmed?

你是否曾感到疲倦？壓力過大？

Nervous? Depressed?

還是緊張？抑鬱？

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

你是否有頭痛、頭暈、痙攣 或呼吸困難的症狀？

From 300 BCE to the early 1900s,

從西元前 300 年到 20 世紀初，

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

如果您對這些問題都回答是， 而且您有子宮，

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

那麼歐洲或美國的醫生很可能會診斷 你患有歇斯底里症。

No, not mass hysteria.

不，不是集體歇斯底里，

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」這個統稱是由醫生使用， 通常以男性為主

to describe just about any unexplainable medical condition

來描述女性患者所遭受的、

suffered by female patients.

任何無法解釋的醫學狀況。

By some interpretations,

根據某些解釋，

being a woman was itself long considered a pathology

身為女性本身長期以來 就被視為一種病態，

from which all kinds of problems arose.

從而引發各種問題。

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

在其漫長的歷史中，歇斯底里 常被掌握權力的男性，

for what men with authority found contemptible and incomprehensible

在應對缺乏權力 或企圖掌握權力的女性

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

做出他們無法理解 或他們鄙視的行為時給予的解釋。

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

歇斯底里一詞 源自希臘語中的「子宮」，

and was first used in the 4th century BCE.

在西元前 4 世紀首次出現。

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

基於早期埃及的信仰 並且缺乏醫學依據，

the Greeks viewed hysteria as a malady of the womb,

希臘人認為歇斯底里 是一種子宮的病症，

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

認為子宮會脫離正常位置 並在身體內移動，

causing a variety of ailments.

引發各種疾病。

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

他們相信子宮四處游走 是因為它渴望生育，

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診斷出歇斯底里。

The usual prescription was immediate marriage, impregnation,

當時的常見處方是立即結婚、懷孕，

or the use of uterine fumigations

或使用子宮熏蒸

to entice the rebellious organ back into place.

來引導叛逆的器官回到原位。

By the 2nd century CE,

到西元 2 世紀，

Roman physicians rejected the wandering womb theory.

羅馬醫生否定了「子宮游走」的理論，

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

但他們仍然認為 子宮是歇斯底里的根源，

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

認為它會產生類似於精液的分泌物，

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

這些分泌物如果不排出， 會污染血液並刺激神經。

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

因此，助產士經常透過手動 誘導女性患者高潮

in female patients.

來治療歇斯底里。

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

到了中世紀晚期， 基督教傳遍了整個歐洲，

and its influence had likewise infiltrated Western medical practice.

其影響力也滲透到西方醫學行為中。

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

醫生開始假設歇斯底里 不是子宮的病症，

but of the soul, and reflected Satanic influence.

而是靈魂的問題，反映了撒旦的影響。

Doctors continued to dismiss women’s symptoms and pain,

醫生們繼續忽視女性的症狀和痛苦，

now misogynistically shifting the blame to their supposed inherent weak wills

現在則是性別歧視地將責任 推給她們所謂的弱意志

and susceptibility to sin.

和易受罪惡影響的天性。

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

這種情況在 16 世紀 和 17 世紀進一步惡化，

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

因為那些不符合社會期望的女性，

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

往往面臨被指控為女巫的風險， 而這通常帶來嚴重的後果。

In late Victorian Europe and North America,

在維多利亞晚期的歐洲和北美，

some medical doctors started arguing that hysteria’s true origin

一些醫生開始主張歇斯底里的真正起源 不是在身體或靈魂，

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

而是在心理。

Middle class women, facing intense demands of social respectability

中產階級女性中被認為不莊重

and strict codes of sexual conduct,

和不符合嚴格性行為規範者，

were often referred to “nerve doctors”

經常被轉介給「神經科醫生」，

who’d use isolating and unfounded rest cures

這些醫生使用隔離和無根據的休養療法

to treat any emotional and psychological distress.

來治療她們的情感和心理困擾。

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

在撰寫她那篇半自傳性短篇小說 《黃色壁紙》時，

Charlotte Perkins Gilman drew from the distressing treatment she underwent

夏洛特·珀金斯·吉爾曼從她自己 因「歇斯底里傾向」

for her so-called hysterical tendencies.

所經歷的痛苦治療中汲取了靈感。

The narrator, suffering from what would now likely be diagnosed

小說中的敘述者的症狀

很可能在今天會被診斷為產後憂鬱症；

as postpartum depression,

describes being confined alone in an attic

她描述自己為被單獨 囚禁在一個閣樓中，

and being denied any intellectual activity,

並被剝奪了任何智力活動，

including reading or writing.

包括閱讀或寫作。

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

大約在同一時期， 西格蒙德·弗洛伊德開始成名。

He believed hysteria, like other nervous conditions,

他認為，歇斯底里和其他神經症狀

was caused by repressed emotional trauma.

都是由壓抑的情感創傷引起的。

His treatment required drawing these memories out of the unconscious

他的治療方法是將這些記憶 從潛意識中抽取出來，

so they could be acknowledged and addressed.

以便能夠識別並解決其中的問題。

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

弗洛伊德還否定了歇斯底里 是女性專有的想法。

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

「男性歇斯底里」的觀念

在第一次世界大戰期間 及戰後開始盛行，

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

但被稱為更男性化的「砲彈衝擊」。

Over the 20th century,

在20世紀，

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

歇斯底里這個術語逐漸被更具體、 更性別中立的診斷所取代，

including anxiety, depression, PTSD, and epilepsy.

包括焦慮症、抑鬱症、 創傷後壓力症候群和癲癇。

And hysteria was officially removed

1980年，歇斯底里被正式從

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

《精神疾病診斷與統計手冊》中刪除。

Today, most scholars argue that the blanket disease hysteria

如今，大多數學者認為， 歇斯底里這種定義籠統的疾病

was always a figment of doctors’ imaginations.

終究是醫生想像出來的。

As outright medical sexism declined, so did its diagnosis.

隨著醫學性別歧視的明顯降低， 這種診斷也隨之減少。

Nevertheless, its legacy reflects Western medicine’s

然而，這些過往反映了西方醫學

long, storied, and ongoing history

長期以來對女性痛苦的 錯誤歸因和微小化的歷史，

of misattributing and trivializing women’s pain.

並且至今仍在持續發生。