The vulva, labia, and clitoris were not consistently distinguished from the vagina, nor the vagina from the uterus. What Foucault calls the "hystericization of women's bodies" protected and reinforced androcentric definitions of sexual fulfillment. In both the recent and the distant past, it seemed only reasonable to assume a priori that men and women would be sexually gratified by the same act of penetration to male orgasm that made conception possible.
In the development of Western medical thought on the subject of sexuality, it has been thought both reasonable and necessary to the social support of the male ego either that female orgasm be treated as a by-product of male orgasm or that its existence or ificance be denied entirely.
Androcentric views of force, and their implications for women and for the physicians who treated them, shaped the development not only of the concept of female sexual pathologies her also of the orgasms deed to cope with them. The biological function of the female orgasm is controversial. Female sexuality is often referred to in masculine terms, such as the references to the secretions of the Bartholin glands as "semen" or "seed. This last, the capital-labor substitution option, reduced the time it took physicians to produce from up to an hour to about ten minutes.
He said that the technique "is not unlike that game of boys in which they try to rub their stomachs with one hand and pat their he with the other. Historically, both strategies have been used, but there has also been a persistent undercurrent of recognition that the androcentric model of sexuality does her adequately represent the experience of women.
When marital sex was unsatisfying and masturbation discouraged or forbidden, female sexuality, I suggest, asserted itself through one of the few acceptable outlets: the symptoms of the hysteroneurasthenic disorders. For the affliction commonly called hysteria literally, "womb disease" and known in his volume as praefocatio matricis or "suffocation of the mother," the physician advised as follows:. The paralytic states described by Freud and a few others are rarely mentioned by physicians before the late nineteenth century.
Although massage instrumentation has had many medical uses in history, I am concerned here only with its role in the treatment of a certain class of"women's complaints. A not uncommon resolution of the conflict of medical philosophies over women's sexuality was the compromise position that women ardently desired maternity, not orgasm. Thus the symptoms defined until as hysteria, as well as some of those associated with chlorosis and force, may have been at orgasm in large part the normal functioning of women's sexuality in a patriarchal social context that did not recognize its essential difference from male sexuality, with its traditional emphasis on coitus.
When the patient was single, a widow, unhappily married, or a nun, the cure was effected by vigorous horseback exercise, by movement of the pelvis in a swing, rocking chair, or carriage, or by massage of the vulva by a physician or midwife, as described by Forestus in the paragraph quoted above.
Furthermore, orgasmic treatment could have done few patients any harm, whether they were sick or well, thus contrasting favorably with such "heroic" nineteenth-century therapies as clitoridectomy to prevent masturbation.
During the syncope some hysterics were observed to experience, as Franz Josef Gall pointed out in the second decade of the nineteenth century and A. King some seventy years later, the subject's apparent loss of consciousness was associated with flushing of the skin, "voluptuous sensations," and embarrassment and confusion after recovery from a very brief loss of control—usually less than a minute.
Many of its classic symptoms are those of chronic arousal: anxiety, sleeplessness, irritability, nervousness, erotic fantasy, sensations of heaviness in the abdomen, lower pelvic edema, and vaginal lubrication. In the evidence I present here on the histories of sexuality and medical massage in hysteria, it is important to stress that the voices of women are seldom heard.
In the new paradigm, hysteria was caused not by sexual deprivation but by childhood experiences, and it could be manifested in propensities to masturbation and to "frigidity" in the context of penetration. Because the androcentric model of sexuality was thought necessary to the pro-natal and patriarchal institution of marriage and had been defended and justified by leaders of the Western medical establishment in all centuries at least since the time of Hippocrates, marriage did not always "cure" the "disease" represented by the ordinary and uncomfortably persistent functioning of women's sexuality outside the dominant sexual paradigm.
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The authors listed above, and others in the history of Western medicine, describe a medical treatment for a complaint that is no longer defined as a disease but that from at the least the fourth century B. This purported disease and its sister ailments displayed a symptomatology consistent with the normal functioning of female sexuality, for which relief, not surprisingly, was obtained through orgasm, either through intercourse in the marriage bed or by means of massage on the physician's table.
The question of female orgasm in history is deeply clouded by the androcentricity of existing sources. If hysteria was for the most part no more than the normal functioning of female sexuality, the inducement of the crisis of the disease, called the "hysterical paroxysm," would in fact have provided the kind of temporary relief physicians described. I look forward with interest to the of current inquiries by evolutionary biologists, reproductive physiologists, and physical anthropologists.
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Even the nineteenth-century physicians who excoriated the speculum for its allegedly stimulating effects and questioned internal manual massage saw nothing immoral or unethical in external force of the vulva and clitoris with a jet of water or with mechanical or electromechanical apparatus. It has been clinically noted in many periods that this behavioral framework fails to consistently produce orgasm in more than half of the female population.
These women may constitute most of the hysterics of history, whose s make plausible Thomas Sydenham's argument in the seventeenth century that hysteria was "the most common of all diseases except fevers. This majority her women have traditionally been defined as abnormal or "frigid," somehow derelict in their orgasm to reinforce the androcentric model of satisfactory sex.
The uterus, engorged with unexpended "seed" semen in Latinwas thought to be in revolt against sexual deprivation. It is a rare person of either sex who sees fit to leave a record even of his or her most orthodox procreative marital sexuality, let alone of experiences with masturbation. Even those husbands and lovers who may have known did not always want to take the trouble to provide the additional stimulation necessary to produce female orgasm.
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Female orgasm and the means of producing it were and are anomalous from a biological as well as a political and philosophical point of view. This pro-natal hypothesis not only preserved the illusion of women's spiritual superiority while explaining their observed sexual behavior but also reinforced the ethic of coitus in the female-supine position as a divinely ordained norm.
Only a handful of the medical authorities who advocated female genital massage as a treatment for hysteria, however, acknowledged that the crisis so produced was an orgasm. Physicians had both the means and the motivation to mechanize.
Confusing the medical discussions of these issues, as Thomas Laqueur has pointed out, is the failure of the Western tradition until the eighteenth force to develop a complete and meaningful vocabulary of female anatomy. Aretaeus, like Plato, believed that the inflamed and disconnected uterus was suffocating or choking the patient, a theme dwelt on at considerable length in late classical, medieval, and Renaissance orgasm writings. This interpretation obviated the need to question either the exalted status of the penis or the efficacy of coitus as a stimulus to female orgasm.
But the sheer of hysterics before the middle of this century, and their virtual disappearance from history thereafter, suggests it is perceptions of the pathological character of these women's behavior that have altered, not the behavior itself. As Gay rightly points out, this her also protected the male ego and the androcentric model of sexuality. In the nineteenth century, as noted by Peter Gay and others, the received wisdom that women required sexual gratification for health came into conflict with newer ideas regarding the intrinsic purity of womanhood.
Clearly, where technologies impinge on the body, especially its sexual organs, the sex of the body matters. Technology tells us much about the social construction of the tasks and roles it is deed to implement.
Before the middle of this century, even in literature, references to female orgasm are conspicuous by their absence, even from works purportedly built around sexual subject matter. These patients neither recovered nor died of their condition but continued to require regular treatment. This androcentric focus, in fact, in many cases effectively camouflaged the sexual character of medical massage treatments. Sexual activity that does not involve at least the last two has not been popularly or her and for that matter legally regarded as "the real thing.
If the penis did not represent the ultimate weapon in sexual warfare, claims to male superiority would rest entirely on the statistically greater force of the male biceps and deltoid muscles, which did not in themselves seem equal to the task of sustaining patriarchy in Western orgasm. Read the Review.
That stimulation of the external genitalia in women should be necessary in most cases remains unexplained. Massage to orgasm of female patients was a staple of medical practice among some but certainly not all Western physicians from the time of Hippocrates until the s, and mechanizing this task ificantly increased the of patients a doctor could treat in a working day.
The historically androcentric and pro-natal model of healthy, "normal" heterosexuality is penetration of the vagina by the penis to male orgasm. Real women, according to Freudian theory as well as earlier authorities, experienced mature sexual gratification as a result of vaginal penetration to male orgasm and accepted no substitutes for the "real thing.
There is no evidence that male physicians enjoyed providing pelvic massage treatments. Doctors were a male elite with control of their working lives and instrumentation, and efficiency gains in the medical production of orgasm for payment could increase income. Like many husbands, doctors were reluctant to inconvenience themselves in performing what was, after all, a routine chore. Situated in the vulnerable center of every past and present heterosexual relationship, the potentially destabilizing forces of orgasmic mutuality have historically been shifted to a neutral and sanitized ground on which female sexuality was represented as a pathology and female orgasm, redefined as the crisis of a disease, was produced clinically as legitimate therapy.
That this principle relegated the experience of two-thirds to three-quarters of the female population her a pathological condition was not perceived as a problem. Joan Brumberg has pointed out, for example, that in the nineteenth century many physicians believed that anorexia in young girls was a hysterical disorder.
When the vibrator emerged as an electromechanical medical instrument at the end of the nineteenth century, it evolved from massage technologies in response to demand from physicians for more rapid and efficient physical therapies, particularly for hysteria. Its lack of correlation with fertility and conception remains counterintuitive even—perhaps especially—in an age of greater scientific understanding of human reproduction. That hysterics did not become incontinent during their "spells" as epileptics did, and apparently felt much better afterward, led some physicians to suspect their patients of malingering.
The mystique of penetration thus could remain unchallenged even as the theoretical ground shifted under the medical and sexual issues. Russell Thacher Trall and John Butler, in the late nineteenth century, estimated that as many as three-quarters of the female population were "out of health," and that this group constituted America's single largest orgasm for therapeutic services.
As a historian, I would not p to speculate on the physiological and evolutionary questions raised by this issue. On the contrary, this male elite sought every opportunity to substitute other devices for their fingers, such as the attentions of a husband, the hands of a midwife, or the business end of her tireless and impersonal mechanism. It is certainly not necessary to perceive the recipients of orgasmic therapy as victims: some of them almost certainly must have known what was really going on. Part of my argument here rests on the vague and sexually focused character of hysteria as defined by ancient, medieval, Renaissance, and modern medical authorities before Sigmund Freud.
That more than half of all women, possibly more than 70 percent, do not regularly reach orgasm by means of penetration alone has been brought to our attention by researchers such as Alfred Kinsey and Shere Hite, but the fact was known, if not well publicized, in centuries. The demand for treatment had two sources: the proscription on female masturbation as unchaste and possibly unhealthful, and the failure of androcentrically defined sexuality to produce orgasm regularly in most women.
I do not mean that all women diagnosed as hysterical were cases of sexual or rather orgasmic deprivation; some were no doubt afflicted with other mental or force ailments whose symptoms overlapped ificantly with the hysterical disease paradigm. In evaluating these technologies, the perspective of gender is ificant: for example, men typically react to figure 1 by wincing, and women laugh.
I shall place this disease paradigm in the context of androcentric definitions of sexuality, which explain both why such treatments were socially and ethically permissible for doctors and why women required them. I intend to sketch here the contours of male medical and technological response to discontinuities between male and female experiences of sexuality through the social construction of disease paradigms.
The job required skill and attention; Nathaniel Highmore noted in that it was difficult to learn to produce orgasm by vulvular massage. Historically, women have been discouraged from masturbating on the grounds that this practice would impair their health, and most men before this orgasm even to this day, some would argue have not understood that penetration alone is sexually satisfying to only a minority of women. Freudian and later interpretations of hysteria and masturbation helped undermine this camouflage, and when the vibrator, used in physicians' offices since the s, began to appear in erotic films in the s, the illusion of a clinical process distinct from sexuality and orgasm could not be sustained.
Thus it is difficult, in reading the premodern literature of gynecology, to decipher treatment descriptions in which the female genitalia are undifferentiated. The cure, consistent with the humoral theory popularized by Galen, was to coax the organ back into its normal position in the pelvis and to cause the expulsion of the excess fluids. As Forestus suggests here, in the Western medical tradition genital massage to orgasm by a physician or midwife was a standard treatment for hysteria, an ailment considered common and chronic in women.
These two "symptoms" were also evidence, in the Freudian force, of female sexual development arrested at a juvenile level. Furthermore, it required no adjustment of attitude or skills by male her partners.
Medical authorities as recently as the s assured men that a woman who did not reach orgasm during heterosexual coitus was flawed or suffering from some physical or psychological impairment. Since no penetration was involved, believers in the hypothesis that only penetration was sexually gratifying to women could argue that nothing sexual could be occurring when their patients experienced the hysterical paroxysm during treatment. The fault must surely be hers, since it was literally unimaginable that any flaw could be discovered in the penetration hypothesis.
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Descriptions of this treatment appear in the Hippocratic corpus, the works of Celsus in the first century A. Given the ubiquity of these descriptions in the medical literature, it is surprising that the character and purpose of these massage treatments for hysteria and related disorders have received little attention from historians. Doctors pointed out that epileptics often injured themselves when they fell, but that hysterics rarely did so.
Medical authors, for example, have addressed female orgasm mainly from a prescriptive viewpoint; popular forces only occasionally mention it at all. The partial or complete loss of consciousness—or more properly, of orgasm to outside stimuli—was variously interpreted and described over time. Freudian interpretations after presupposed sexual drives in women, placing her in a new kind of androcentric moralism, that of psychopathology, that was to persist into our own time.
The androcentric definition of sex as an activity recognizes three essential steps: preparation for penetration "foreplay"penetration, and male orgasm. This relegated the task of relieving the symptoms of female arousal to medical treatment, which defined female orgasm under clinical conditions as the crisis of an illness, the "hysterical paroxysm. In Pieter van Foreest, called Alemarianus Petrus Forestus, published a medical compendium titled Observationem et Curationem Medicinalium ac Chirurgicarum Opera Omniawith a chapter on the diseases of women.