The Wandering Womb and the Invention of an Ancient Hysteria

The “wandering womb” is one of the most familiar images from ancient medicine. In the usual telling, Greek doctors believed the uterus roamed the body like a restless animal, called the resulting illness hysteria, and prescribed marriage as the cure, and the diagnosis then ran on unbroken until Freud. Parts of that story rest on real ancient texts. Other parts were added by modern translators and historians, and the classicist Helen King, along with other historians of medicine, has spent many years separating the two.

A womb that moves

Some medical treatises in the collection known as the Hippocratic Corpus, written by several authors in the late fifth and fourth centuries BC, did describe the womb shifting to other parts of the body. As King summarizes them, the gynecological treatises Diseases of Women and Nature of Woman blame the movement on menstrual suppression, exhaustion, too little food, sexual abstinence, and a womb that had become dry or light. A dried-out womb might travel toward the liver in search of moisture, or rise toward the head, the heart or the ribs, and the symptoms depended on where it went. The most prominent was pnix, a choking or stifling sensation.¹ (For the wider Hippocratic theory of menstrual blood that underlies this, see our article on the history of menstruation.)

The cures matched the mechanism. Practitioners bound bandages around the body to keep the womb in place, gave drinks and pessaries, and relied heavily on fumigation and scent: foul smells held to the nose to drive the womb down, pleasant ones applied below to draw it back.¹ King stresses two points that later retellings tend to lose. First, for these writers the movement was a physical, organic event, not a disorder of the mind; the Hippocratic texts draw no line between psychological and bodily illness. Second, the cure most often attributed to them, marriage and pregnancy, appears in the womb-movement chapters she examines only once, in a passage on the womb moving to the hypochondria. Intercourse and childbirth were valued throughout Hippocratic gynecology because they were thought to moisten the womb and open the body’s channels, so prescribing them was not peculiar to this condition.¹

The name that is not there

The common claim that the Greeks named the disease is harder to support. In 1965 the historian Ilza Veith wrote that the term “hysteria” first appears in the Hippocratic writings, in what she called “the thirty-fifth aphorism.” King traced what the Greek says. The passage is Aphorisms 5.35, and it uses not the noun “hysteria” but the plural adjective hysterika. In King’s translation: “In a woman suffering from hysterika, or having a difficult labor, a sneeze is a good thing.” The adjective hysterikos meant “from the womb” or “connected with the womb,” and in Hippocratic writing every disease of women could be described that way.¹ The noun hysteria, she found, is not used in the ancient medical texts at all.

Where, then, did the Hippocratic hysteria come from? King points to Émile Littré’s French edition of the Hippocratic works, whose gynecological volumes appeared in 1851 to 1853. Littré added section headings that have no counterpart in the Greek manuscripts, labeling several passages “Hystérie” and sorting the womb movements into “imaginary” ones, which he called hysteria, and “real” displacements. Later English translations and histories took his categories as if they were ancient. As King puts it, “the diagnosis of hysteria is one made not by the ancient authors of the texts, but rather by the nineteenth-century translator of the Hippocratic corpus.”¹

The older story has proved durable. A 2012 review article in a mental-health journal still states that “Hippocrates (5th century BC) is the first to use the term hysteria.”² Other historians have accepted King’s argument. When she revised the chapter for her 1998 book Hippocrates’ Woman, a reviewer in the Bryn Mawr Classical Review judged that it convincingly challenged the idea that hysteria names the same condition across more than two millennia, and that it showed the diagnosis does not date from the Hippocratic Corpus.³ In the same 1993 volume in which King’s essay first appeared, the historian Roy Porter summarized her conclusion bluntly: “antiquity and medieval Europe had no need of the hysteria concept.”⁴

Plato’s animal and Aretaeus’s log

In King’s reading, the image of the womb as a creature comes chiefly from a different kind of text. Near the end of Plato’s Timaeus, a philosophical account of the cosmos and the human body, the speaker says that the gods placed in each sex a desire for procreation. Of women he says, in Benjamin Jowett’s translation, that “the animal within them is desirous of procreating children, and when remaining unfruitful long beyond its proper time, gets discontented and angry, and wandering in every direction through the body, closes up the passages of the breath.”⁵

The most vivid medical version comes about five centuries later from Aretaeus of Cappadocia, a medical writer of the second century AD. In Francis Adams’s 1856 translation of his chapter “On Hysterical Suffocation,” the womb is “closely resembling an animal,” moves of itself, seeks fragrant smells and flees fetid ones, and is “like an animal within an animal.” Aretaeus also compares the buoyant uterus to a floating “log of wood,” and he says the condition strikes young women rather than old ones, because in the young the way of life and understanding are more mobile.⁶

King urges caution with both passages. The Timaeus uses animal comparisons for several organs, including the penis, and mixes simile with metaphor, so its language should not be pressed too hard. Plato’s account of conception also differs from the Hippocratic one, and the Hippocratic scent cures carry no suggestion that the womb is a living being. She notes that Aretaeus’s Greek phrase could be rendered less dramatically as “like a living thing inside another living thing,” and that in his own day his image stood out as old-fashioned.¹

Not every scholar weighs the animal imagery the same way. Christopher Faraone, reading magical texts alongside the medical ones, describes how both traditions came to picture errant wombs, like demons, as wild animals to be driven off with fumigations. Over time, his abstract says, the organ was imagined as “a mechanically defective body-part, a sentient and passionate animal, and then finally a demon with malicious intent.” He also argues against the assumption that the idea began among midwives or wet-nurses.⁷ King and Faraone agree that ancient Greeks believed the womb could move; they place different weight on the creature image.

Ancient doctors who disagreed

The wandering womb was contested in antiquity itself. Herophilus of Chalcedon, working in Alexandria in the third century BC, is credited with first describing the ligaments, which he called membranes, that anchor the womb in the abdomen. King observes that the discovery did little to change treatment. Aretaeus knew of these membranes and still described the womb rising and falling.¹⁶

King’s account of the second-century physicians shows the same dispute. Soranus, she explains, rejected the claim, made by some, that the womb is an animal. He explained the apparent success of scent remedies differently: smells worked, he said, by relaxing or constricting tissue, not by luring or frightening a creature. Galen, in On the Affected Parts, quoted the Timaeus and treated the living-womb theory as Plato’s rather than Hippocrates’. In the translation King reproduces, he reports the competing views of physicians, including that “Others deny that the uterus wanders around like an animal.” Galen’s own account of uterine suffocation blamed not movement but menstrual blood or seed retained in the womb, and it drew on theories of the body’s innate heat and of breathing through the skin. His version became the dominant one in medieval Western medicine after Arabic medical works were translated into Latin from the eleventh century onward.¹

From suffocation of the mother to the nerves

Early modern physicians inherited the condition as “suffocation of the mother,” the mother being the womb. In 1603 the London physician Edward Jorden published a short treatise on it, written, as the title page says, on an occasion that had led people to suspect possession by an evil spirit. The title page announces that “diuers strange actions and passions of the body of man, which in the common opinion, are imputed to the Diuell, haue their true naturall causes.”⁸ Jorden described the womb as tied in place by membranes and a ligament, and he explained how “by consent, the principall partes of the bodie may bee affected from the matrix”: through vapors and humors carried along the vessels and nerves, as well as through some upward movement of the organ itself.⁸ The womb was still the source, but its journey was shrinking.

Later in the century the anatomist Thomas Willis went further. The literary historian G. S. Rousseau shows that Willis attacked the idea of a womb that suffocated the body by roaming through it and, in a 1672 treatise and other writings, placed hysteria in the brain and the “nervous stock” instead. That move let Willis consider that men could suffer from it too. His contemporary Thomas Sydenham treated hysteria as largely a disorder of the mind, and by the eighteenth century the nerves had become the main framework for the diagnosis.⁹

The nineteenth century and the long tale

The womb did not leave the story. Porter describes how, in the nineteenth century, the new specialties of gynecology and psychological medicine supported “the rehabilitation of uterine theories of hysteria,” and how this led to surgical treatments, including removal of the uterus or ovaries and, occasionally, genital operations justified as remedies for mental disorder.⁴ Not every physician agreed. In 1853 the English practitioner Robert Carter dismissed uterine irritation as a cause, though he replaced it with an explanation rooted in the emotions and sexual feelings.⁴ This was also the period in which Littré was writing hysteria into his headings for the Hippocratic texts.¹

Seen this way, the familiar narrative of one disease named by the Greeks and diagnosed for 2,500 years looks less like a record of continuity than like a story assembled backward. Nineteenth-century physicians, arguing about whether hysteria belonged to the womb or the nerves, looked for ancestors and found them in Plato’s metaphor, Aretaeus’s animal and a Hippocratic adjective. What the ancient sources do show is narrower and in some ways stranger: practical treatises that imagined a dry womb moving through a soft, wet body in search of moisture, treated with smells and fumigations, and an argument, already under way in antiquity, about whether it could move at all.¹⁹

Footnotes

1. King 1993, pp. 4-8, 12-28, 33-43. ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

2. Tasca et al. 2012, section on ancient Greece. ↩

3. Cabré, BMCR 2000.07.20. ↩

4. Porter 1993, pp. 227, 255, 262. ↩ ↩² ↩³

5. Plato, Timaeus 91b-d, trans. Jowett. ↩

6. Aretaeus, Acute Diseases 2.11, trans. Adams 1856, pp. 285-287. ↩ ↩²

7. Faraone 2011, abstract. ↩

8. Jorden 1603, title page and ch. 2. ↩ ↩²

9. Rousseau 1993, pp. 140-146. ↩ ↩²