Elinor Cleghorn

'Seamlessly melding scholarship with passion, Unwell Women is the definition of unputdownable' Telegraph 'A richly detailed, wide-ranging and enraging history... Unwell Women is not just a compelling investigation, but an essential one' Observer 'A passionate and indignant history' The Times 'A searing, brilliant investigation, an intricate and urgent book on how women's health has constantly been misunderstood and miscast throughout history' Kate Williams 'One of the most important books of our generation' Fern Riddell 'UNWELL WOMEN is a powerful and fascinating book that takes an unsparing look at how women's bodies have been misunderstood and misdiagnosed for centuries.' Lindsey Fitzharris 'We are taught that medicine is the art of solving our body's mysteries. And as a science, we expect medicine to uphold the principles of evidence and impartiality. We want our doctors to listen to us and care for us as people, but we also need their assessments of our pain and fevers, aches and exhaustion to be free of any prejudice about who we are, our gender, or the colour of our skin. But medicine carries the burden of its own troubling history. The history of medicine, of illness, is a history of people, of their bodies and their lives, not just physicians, surgeons, clinicians and researchers. And medical progress has always reflected the realities of a changing world, and the meanings of being human.' In Unwell Women Elinor Cleghorn unpacks the roots of the perpetual misunderstanding, mystification and misdiagnosis of women's bodies, and traces the journey from the 'wandering womb' of ancient Greece, the rise of witch trials in Medieval Europe, through the dawn of Hysteria, to modern day understandings of autoimmune diseases, the menopause and conditions like endometriosis. Packed with character studies of women who have suffered, challenged and rewritten medical orthodoxy - and drawing on her own experience of un-diagnosed Lupus disease - this is a ground-breaking and timely exposé of the medical world and woman's place within it.

A Journey Through Medicine And Myth in a Man-Made World

Unwell Women

Laura Mei

Jemima Scott

Medicine has historically pathologised what it means to be a woman, and what it is to live in a female body, to such a degree that being unwell has been normalised in society and culture, while a woman's rights over her own body remain contested even today

Bekki

In the late Middle Ages, medical men were putting a new theological spin on the ancient teachings. 

All human women were daughters of Eve who had to endure God's punishment by submitting to their husbands and suffering the pain of childbirth. 

At the beginning of City of Ladies, she asked how her trusted God could have made such a horrendous mistake when he allowed the creation of women. 

But the problem, she knew, wasn't God, but mortal men who manipulated Christianity's foundational myths to justify society's subjugation of women.

The Hippocratic Corpus was written at a time when most women had few, if any, civil or human rights. 

In the patriarchal social order of ancient Greece, girls were the properties of their fathers, and women of their husbands. 

They had no ownership over land, property, money or even their own bodies. 

They were seen as weaker, slower, smaller versions of the male human ideal, deficient and defective precisely because of their difference to men. 

But, in their difference, women possessed the most useful and mysterious organ of all: the uterus. 

Since their sole purpose was to bear and raise children, women's health was entirely defined by their uteruses. 

Medical ideas reflected and legitimised society's control over the female body and its precious procreative power.“

Accusing woman of witchcraft was an effective way for social and religious authorities to maintain male dominance and supremacy in their villages and towns. 

And trying and executing women was a measure to cleanse communities of those who were not performing the marital and reproductive duties assigned to them under patriarchy. 

Independent women, solitary women, women past childbearing age – in fact, all women who were not subordinated by marriage and motherhood – were a threat, a hazard, a scourge.

In 1542, under the rule of King Henry VIII, the Witchcraft Act was passed in England, which meant that accused women could now be punished by death. 

Implemented after the English Reformation, which wrested control of the Church of England from the authority of the Pope and the Catholic Church and instituted the monarch as supreme religious leader, the act empowered ecclesiastical courts to exercise responsibility for such ungodly crimes. 

For the Renaissance anatomists, the clitoris confused the physiological differences between men and women that they were so eager to define: men were supposed to be sexual agents, and women the reproductive vessels. 

Imagine how threatened, not to mention envious, men must have been to realise women had a capacity for pleasure they just couldn't get to grips with. 

This was reason enough not only to ignore the clitoris, but to malign and mythologise it as a pathology, a deformity, an aberration.

He saw women as domestic martyrs ordained only for mothering. 

He thought the ‘pain of parturition’ was a God-given agony that helped mothers love their babies, a myth that still exists today.²⁷(...) 

Meigs objected to Simpson’s attempts to popularise obstetric chloroform. 

In a letter to Simpson in 1848, Meigs declared labour pain the ‘most desirable, salutary, and conservative manifestation of life-force’. 

He believed women needed only the ‘cheering counsel’ of male obstetricians to relieve them. 

This, by the way, came from a man who decided women only suffered pain during contractions, and that during an (entirely unrealistic) average labour of four hours women had no more than fifty contractions lasting thirty seconds apiece. 

So, according to Meigs’s calculations, labouring women endured only twenty-five minutes of pain²⁹ – and that was hardly worth expending morality-ruining chloroform on, was it? 

As well as believing labour pain was perfectly tolerable, he also saw women’s expressions of pain as a helpful guide for obstetricians during complicated births. (...)

Many obstetric physicians objected passionately to chloroform. 

Some, like Meigs, argued that labour pain was natural and necessary; others thought chloroform was highly dangerous, and resisted its use on religious grounds. 

Some feared its intoxicating properties would rid women of inhibition and reduce them to sexually depraved beasts. 

The English gynaecologist William Tyler Smith disagreed; he thought pain neutralised the ‘sexual emotion’ of childbirth. 

No decent woman would dream of abandoning her chastity and self-control during such an intimate occasion.³¹

On the cause of epilepsy / Female genital mutilation 

Convulsions and loss of consciousness, mostly affecting women, had been associated for centuries with lunacy, mania and even demonic possession. 

Throughout the nineteenth century, epilepsy was a feminised disease thought to induce an 'epileptic personality' inclined towards moral defects, violence, lewdness, nymphomania and hyposexuality (no interest in sex). 

Epilepsy was deemed incurable, and it was often diagnosed in patients admitted to lunatic asylums across England. 

Many patients at the home were young, middle-class girls with epilepsy.  Brown observed that many of them masturbated, which says far more about the trauma of his treatment and his perverted obsessions than it does about his medical ‘expertise’. 

Nonetheless, he decided masturbation was both a cause and symptom of epilepsy, a disease provoked by the ‘mental emotion’ women were ‘naturally prone’ to.²¹

It was completely logical to Brown that ‘irritating’ that fleshy nub, full of nerves, used up all the energy a woman’s brain needed to function properly. 

Epilepsy was so dreadful and hopeless that clitoridectomy, Brown claimed, was a sufferer’s only hope.

Apart from damaging the digestion, circulation, nervous system, brain, senses and appearance, masturbation, the author claimed, was a symptom of the disease of prostitution. (...)

Brown’s horrific procedure probably seemed like a small sacrifice to readers of this material, terrified that their nervous daughters might be diddling themselves into a life of disrepute. 

Clitoridectomy wouldn’t only improve the lives of sufferers, he insisted, but 'the well-being of the whole human race'.²³

He recommended intervening as early as possible, but drew the line at operating on girls younger than ten.

Even when middle-class wives contracted syphilis or gonorrhoea, their husbands were never suspected of being carriers. 

Refined men were not thought capable of spreading these diseases, and besides, women’s infectious sensibility meant this was easy to explain away. 

If a man’s wife contracted VD because he’d been cavorting where he shouldn’t, some physicians would cover for him by diagnosing something completely different.

Early feminist campaigners rallied against the injustices of punishing women for sexually transmitted diseases. (...) 

In a letter of 1870, Butler wrote: ‘If all the male doctors in the world were to tell me with one voice that the operation is painless, and two or three female prostitutes ... were to whisper in my ear with sobs and shudders ... that “the pain is dreadful” ... 

I should believe the female prostitutes ... because I am a woman, I know my own make.’

1851, Edward Tilt proposed that disorders of the ovaries, which he termed ‘ovaritis’, were caused by having sex too often or not often enough.

He referred to autopsy findings by Dr Oldham – who testified to Brown’s barbarism – which suggested ‘the ovaries of prostitutes are seldom without morbid lesions’.’ Tilt, of course, blamed these ‘lesions’ entirely on women sex workers’ excessive sexual activity. 

It didn’t occur to him that poverty, living conditions, lack of access to medical care, or anything other than female voracity might be the cause.

If ‘ordinary’ women weren’t receiving enough sexual stimuli (from their husbands, naturally), ovaritis could activate a ‘cerebrospinal’ sympathy manifesting in hysteric symptoms. 

In addition to a dearth or surfeit of sex, causes of 'ovarian irritation' included childhood illnesses, horse-back riding and taking train journeys while menstruating. 

Women prone to nervousness were most vulnerable, as were girls with long eyelashes.

But some causes were neither physical nor 'constitutional'. The disease often arose from 'moral causes' or 'excitements' which exaggerated 'the impulse of unsatisfied desires'.⁷ 

He believed women could overexcite their ovaries by looking at books and pictures, having conversations, listening to music and enjoying a social life.

 For unmarried women and girls, the delights of literature could even cause an orgasm. 

If the patient continued to get overexcited by reading, she would irritate her ovaries so much she would inevitably turn hysteric.¹⁰

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