The Yellow Wallpaper

The "Nervous" Diseases and Hysteria: Medical Predecessors to Neurasthenia

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In the “The Yellow Wallpaper,” the narrator is diagnosed with neurasthenia, a disease characterized by so-called “nervous exhaustion” and extreme excitability. The narrator is prescribed S. Weir Mitchell’s “rest cure” in an effort to calm her nervous depression and allow her to resume her proper position in the household. Significantly, Gilman’s story is not the first time that a relationship between weak nerves and women has been highlighted in medical practice. In fact, the idea of nervousness, particularly among females, has dominated medical theory for centuries.

In the 18th century, this type of illness was categorized as one of the “nervous diseases.” Named because of their connection to the nerves, or emotions, the nervous diseases were particularly common among women. Because they were thought to have delicate bodies and sensitive minds, women were thought to be extremely susceptible to any disorder that could affect their emotional state.

These nervous diseases were associated with numerous symptoms, such as pale urine, a visible swelling of the stomach, headaches, fainting, palpitations of the heart, long faintings, wind in the stomach and intestines, frequent sighing, giddiness, watching, convulsive crying, convulsive laughing, despair, and melancholy. In other words, any sort of personal dissatisfaction or depression would presumably be a sign of a nervous disease. Although men could also suffer from the nervous diseases, women remained the primary victims because of their physical and mental inferiority to men.

In the nineteenth century, the idea of “nervous diseases” in women underwent transformation and became categorized as a new disease, called “hysteria.” Stemming from the Greek word for “uterus,” hysteria was immediately presented as a solely feminine ailment. Any activity of the uterus, specifically menstruation, childbirth, or sexual intercourse, was thought to accentuate a woman’s vulnerability to hysteria, in the same way that sensitive nerves and general emotional instability would.

Hysterical fits were recognized first by their barrage of emotional and physical symptoms, ranging from heart palpitations, fits, choking, laughing, fainting, and second, by the quick transition from one symptom to the next. Although some physicians argued that hysteria was directly linked to abnormal sexual activity, the disease was generally understood to result from emotional sensitivity or "nervousness" on a fundamental level.

As a disease, neurasthenia has clear similarities to both the nervous diseases and hysteria and can be recognized as a relative, if not descendant, of the other two. Neurasthenia was first described in 1869 as a disease characterized by depression, extreme anxiety, and fatigue.

When the narrator is diagnosed with neurasthenia, it is significant to note that she also exhibits symptoms of the two other diseases, particularly as the yellow wallpaper begins to affect her. Her fatigue and depression correspond closely to the symptoms of neurasthenia. At the same time, her constant melancholy and mental and emotional agitation are sure signs of the nervous diseases. Finally, hysteria is highlighted in the fact that the narrator is a new mother; her mental instability could certainly be seen as a result of her female physiognomy.

While the narrator eventually shows elements of each of these diseases, it is unclear if the narrator is ill when the story begins. In the first few paragraphs, her only palpable symptoms are mild depression and a desire to express her creativity through writing; she certainly does not seem to be the typical patient for the "rest cure."

Whether or not she is actually ill, the narrator is still immediately forced to accept a diagnosis that insists that her melancholy restlessness is due to weak nerves, emotional incapacity, and her feminine nature. Whether the diagnosis actually corresponds to the symptoms of the nervous diseases, hysteria, or neurasthenia, the fact remains that the narrator is forced to undergo a treatment that suppresses her creativity and emphasizes her inferiority to men. Moreover, as the historical background of these diseases suggests, the medical doctrine of the time was ultimately sexist and oppressive. The narrator is not only at odds with her husband and brother; she is placed in direct conflict with centuries of medical practice and beliefs about female nerves and female reproduction.

Perhaps the narrator is truly an honest victim of the sensitive nerves and active uterus that characterized the nervous diseases and hysteria. Then again, perhaps she is forced to endure the "rest cure" in order to quell her creative inclinations and allow her to take on the role of a proper wife to her husband. Either way, as the narrator plunges deeper into the world of the yellow wallpaper, the reader cannot help but wonder how many other “nervous” or “hysterical” women have suffered the same fate.