Nymphomania in the body

In 1841, Miss T., the twenty-nine-year-old daughter of a Massachusetts farmer, was diagnosed with nymphomania. According to the physicians who described the case in the Boston Medical and Surgical Journal, her conversation and actions left no doubt that she suffered from the disease: she uttered the "most disgusting obscenities" and moved her body in ways that expressed her uncontrolled "libidinous feelings." Although in good health, she had been restless and morose, exhibiting a "paroxysm of hysteria" when the doctors arrived. After a vaginal examination, they determined that her uterus was enlarged, her vagina over-abundantly moist, but her long and "tumid" clitoris was the telltale sign of nymphomania. They applied various caustics to her genitals to cool her ardor and tried other traditional remedies, such as bleeding and cold-water douches. After several weeks, the doctors pronounced her greatly improved, with "not a symptom remaining referable to nymphomania." This time when she was examined vaginally, she exhibited "every appearance of modesty," including a retracted and very diminutive clitoris.

At the time, the doctors' treatment of Miss T., particularly the use of bleeding and caustics, was a typical medical approach to most illnesses. Physicians did not understand much about the causes of disease and still relied on traditional remedies based on ancient Greek notions: disease meant that the body's system was out of balance. Consequently, bloodletting or purging restored the necessary equilibrium in the body. Blistering and caustics created a counterirritant, which drew poisons to the surface, and stimulated the body to return to its natural balance. Cooling baths, moderate diet, and sedatives calmed overstimulated nerves. This belief system was widely shared by both lay people and physicians. Doctors and patients alike looked to the results of strong emetics or bleeding as tangible evidence that the physician was resolutely treating the disease.

In diagnosing Miss T., the doctors understood her to have a disease connected to her genitals. Men, too, would have been bled, purged, and blistered for a variety of conditions; but physicians were less likely to connect men's ailments to their genitalia, while assuming that women's reproductive organs caused both physical and mental disease. At a time when many women were overworked and undernourished, and further burdened by numerous pregnancies, it is not surprising that they experienced a variety of physical maladies. Consequently, debilitating conditions related to the ovaries and uterus were not that unusual.

But ideological beliefs played a crucial role as well. It was widely accepted that women's reproductive capacity—from puberty to menopause—dominated their entire being. Wombs (and by the middle of the nineteenth century, ovaries) shaped and determined women's nature far more than testes affected men's lives. As a result, not only doctors but average citizens as well believed that gynecological problems lay at the root of many female diseases, including nervous and mental conditions.

Since all parts of the body were thought to be interrelated, an upset stomach or an inflamed organ could lead to a disordered mind, and vice versa. In particular, a theory of "reflex action" posited that a disease in the genitals caused a sympathetic response in other organs of the body, particularly the brain. Reflex action presumably affected men as well, but women's more delicate nerves and monthly "crises" increased their vulnerability to potential maladies. Much more frequently than men, women faced the potential danger of reestablishing an internal equilibrium following the monthly loss of menstrual blood.

These theories shaped medical notions of ill-defined diseases such as nymphomania. In the case of Miss T., the physicians tell us nothing more about what happened to her, other than to pronounce her cured, but if she had not responded to their medical therapy, she might have been placed in one of the newly created mental institutions. There doctors observed firsthand the most extreme forms of the female behavior which they diagnosed as nymphomania: indecent attacks on asylum attendants, lewd and obscene language, violent tearing off of clothes, and incessant, public masturbation. The women described in these accounts may have been psychotic or suffering from brain disease. On the other hand, they may have been rebelling against the institution's strictures, while asylum doctors and attendants understood their unladylike behavior to be a symptom of a sexual disease.

In any case, medical men who wrote about nymphomania made a connection between inappropriate behavior observed among patients in mental hospitals and women who came to them to express concern about their sexual desires. As a result, physicians saw the potential for nymphomania in a wide range of behavior. Nymphomania was diagnosed in behavior as diverse as lascivious glances, on the one hand, and sexually attacking a man, on the other.

In the Victorian period, both doctors and the patients who sought medical help believed that strong sexual desire in a woman was a symptom of disease. Self-control and moderation were central to the health of both men and women, but women's presumably milder sexual appetite meant that any signs of excess might signal that she was dangerously close to the edge of sexual madness. Not surprisingly, physicians registered the greatest concern when the disease appeared in "refined and virtuous" women.

Many different medical theories attempted to account for the causes of nymphomania: overwrought nerves, brain inflammation, spinal lesions, misshapen heads, as well as irritated genitals and enlarged clitorises. But the physicians' concern was also a moral one. They understood nymphomania to be about sexual indulgence and excess, about sexual desire uncontrolled by the will, about succumbing to temptation. While attempting to define excessive sexual desire as a disease, physicians continued to identify the patient's lack of moral restraint and willpower as central to the malady. The first full-length study of the disease, Nymphomania, or a Dissertation Concerning the Furor Uterinus, written by an obscure French doctor, M. D. T. Bienville, and translated into English in 1775, emphasized that particular connection. Eating rich food, consuming too much chocolate, dwelling on impure thoughts, reading novels, or performing "secret pollutions" (masturbating), according to Bienville, overstimulated women's delicate nerve fibers and led to nymphomania.

Bienville's successors continued to repeat these same concerns, and exhortations to virtuous behavior intensified throughout the nineteenth century. Without any medical breakthrough or discovery concerning "excessive" or "ungovernable" sexuality, and with very few cures for nervous and mental diseases in general, the physician's best weapon remained a combination of common sense and moral proclamations, administered along with traditional remedies. In the last quarter of the century, as we will see, some gynecologists thought they had finally found the answer to curing nervous and mental disorders by surgically removing female reproductive organs.

Full article:
Nymphomania
A History
By CAROL GRONEMAN
W. W. Norton & Company