‘Double, double toil, and trouble’

From the witch trials to modern medicine: A brief overview of hysteria

Given it’s getting to late October and we’re well into Spooky Season, I was sitting down to write my first blog post for Sanitree about the history of witches and how that has helped shape modern perceptions and biases. During my research, I came upon an article mentioning that during the Middle Ages, hysteria (and related syndromes) were thought to be caused by witchcraft, among other things.

If I told you to imagine a witch, what comes to mind? 

Whether you picture the Wicked Witch of the West, Ursula, Hermione Granger, the Sanderson sisters of Hocus Pocus, or an entirely different more generic old hag with a hooked nose complete with pointy hat and broomstick- they likely all have something in common. Chances are, they’re all women. 

I’m not exempt from this subconscious bias. Yet the Oxford English Dictionary defines a witch as “A person[…]who practises witchcraft or magic, esp. of a malevolent or harmful nature.” Admittedly, it is now usually associated with women despite its gender neutral definition. Yet, the more male-associated term of wizard carries positive connotations of wisdom and practicing divination, lacking the negative associations seemingly reserved for the feminine ‘witches’. Despite both wizards and witches having occult powers and practicing sorcery, it was witches who were hunted. Medieval texts such as ‘On the secrets of women’ helped lay the groundwork for the figure of the witch, labeling women as evil based on their biology, ultimately leading to the deaths of many women. Menstruation and period blood were seen as further evidence of women’s supposed ‘defectiveness.’ 

Additionally, during Medieval times, other syndromes, of a hysterical nature emerged, and were attributed as being “products of witchcraft, demon possession, and sorcery that also had historical associations with dissociative phenomena.” Hysteria comes from the Greek hystera  meaning uterus. It was thought that the uterus would move from where it normally sits within the pelvis and would move throughout the body. This uterine movement would cause symptoms in the places that it passed, leading to hysteria. Over the years, symptoms of hysteria have included: swollen abdomen, chest pain, excessive emotion, increased or decreased sex drive, increased appetite, increased heart rate. Treatments for hysteria have ranged from pelvic massage, leeches, marriage, to hysterectomy (removing the uterus), and placement in asylums.

While initially it had been thought to be a physical condition, hysteria later became classified as a mental condition instead, with the term serving as a catch-all for symptoms and behaviours that made men uncomfortable. Shockingly, hysteria was “a formally studied psychological disorder” found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders until 1980. That’s 60 years after women in the USA could vote, 11 years after Apollo 11 landed on the moon, and 7 years after the US Supreme Court’s landmark  Roe Vs Wade decision in 1973.

Much scarier than the existence of witches, I think, is that the idea of hysterical women is just as pervasive and entrenched today than ever. Multiple sclerosis (MS) is a condition affecting the brain and spinal cord, which cannot be cured but can be managed to help improve symptoms. It is three to four times more common in women than in men, but until the 1920s, when symptoms were the basis for diagnosis (MRI scans are now used) men were diagnosed with MS more commonly than women, because women who had the same symptoms were diagnosed with hysteria instead. In one emergency department in the US today, women were more likely to have abdominal pain but were less likely to get pain medications, and if they did get pain medications women were more likely to have waited longer to get them than men.

Moreover, conditions like autoimmune diseases, chronic pain syndromes, and disability which affect women at higher rates than men, attract less funding for medical research. Additionally, women are still underrepresented in clinical trials. An examination of over 20,000 clinical trials between the years 2000 and 2020 found that women were underrepresented in clinical trials in numerous specialties, including cardiology, neurology, and immunology. Indeed, until 1993 women rarely participated in clinical trials, which means that there is a lack of knowledge as to how well many medications and devices work for women. This impacts the healthcare women receive, and affects health outcomes. One 2013 study found that women had a 29% higher rate of implant failure after having a metal hip replacement than men, due to anatomical differences and inadequate testing in women. Furthermore, it was thought that women who have heart attacks have ‘atypical’ symptoms because they didn’t have the symptoms that men normally have when experiencing a heart attack. However, a 1999 American Heart Association guide recognised that women have different heart attack symptoms to men, which are typical for women. They were only ‘atypical’ in comparison to men, because male bodies are still often the default in medical research. Furthermore, period pain can be as bad as a heart attack, as many women have described, yet they are left in agony by a lack of research into women’s reproductive health. Some medical researchers even avoid using female mice, because of higher costs of buying and housing both sexes, and worries that changing hormone levels in female mice would confuse the study results.

Throughout history, women’s bodies have been considered ‘atypical’. Whether this was in the Middle Ages, which led to women being labeled as witches leading to suffering and death. Or whether it’s in more recent history where women could have been diagnosed with hysteria as late as 1980 and dismissed. Or whether it’s the present time where women still report worse health outcomes despite living longer than men. The after-effects of ‘othering’ women, despite making up 50% of the population, are still being felt. The historical ripples of witches are still impacting society today. We may no longer be burning women at the stake, hanging them after finding them guilty of witchcraft, or committing them to asylums for hysteria…But we are dismissing women’s pain, we are still ‘othering’ women for the fact that they’re not men, and we are still exiling women who are menstruating. 

This needs to change, and progress has been made. New tests and treatments for endometriosis and other former ‘women’s ailments’ are under development and showing promise, and menstruation and period blood are viewed as the normal features of everyday human existence they are, evidenced not least by the Scottish government deciding to make period products available in all schools and public buildings in Scotland.  

But we cannot become complacent, lest we end up what future generations picture as witches.


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