Hillary Clinton Health Hysteria Has Deeply Sexist 19th-Century Origins

“Go online and put down ‘Hillary Clinton illness’ and take a look at the videos yourself,” former New York City mayor Rudy Giuliani instructed the viewers of Fox News Sunday in late August. He pointed viewers to a series of photographs and videos that created an impressionistic image of a frail, fragile, and sick Democratic candidate. There are videos of Clinton that claim she has some kind of mysterious seizure disorder, or perhaps it’s epilepsy or maybe Parkinson’s disease. Or, no, it’s multiple sclerosis. Or maybe it’s post-concussion syndrome, the result of brain trauma that was far more serious than Clinton led voters to believe (in 2012, Clinton suffered a blood clot after she sustained a concussion).

Or it could be dysphasia or some other serious disease—some kind of brain disorder that was affecting her body, making her movements jerky, causing her to cough, some enigmatic degenerative illness that had only begun to manifest on her body but would, according to conspiracy theorists, compromise her ability to lead the free world. Whatever it is, it’s clear that “there’s something seriously wrong with Hillary Clinton’s health,” as one Breitbart headline declared.

The evidence, they say, is mounting: from Clinton wearing sunglasses to coughing, nodding her head to getting lost mid-sentence, tripping on steps, sitting on a couch with pillows, and, of course, fainting. It’s why Clinton’s shaky episode at a 9/11 commemoration ceremony and her subsequent diagnosis of pneumonia turned into a major political scandal. It was somehow proof that the whispers were true, that she was as mentally and physically weak as some believed.

If the conspiratorial frenzy that follows Clinton’s health seems familiar, it’s because it echoes a centuries-old medical narrative of women and their bodies. It interprets deviation as disease and centers on lingering stereotypes about feminine weakness. The Clinton health alarmists fundamentally believe that the evidence is there—all we need is a handful of self-appointed men to analyze and inspect every step and stumble, to see what others can’t: to see her through an “objective” lens of observation, to see a body in crisis and recreate invisible neurological disease as an easily digestible image. Or at least that’s what they argue.

This hyper-focus on an unnamed disorder stretches back to the 19th century, when hysteria was reinvented as a neurological disease.

The Clinton health conspiracy would be almost comical if it hadn’t spread from the corners of the internet into the lingua franca of major media outlets. This can largely be traced to Fox News, which helped disseminate unfounded rumors under the popular journalistic guise of “just asking questions.” In multiple segments, Fox News has hosted Dr. Marc Siegel who, as part of the Fox health team, took the liberty of diagnosing Clinton with aphasia, a neurological disorder which affects language and comprehension (a diagnosis Donald Trump spokesperson Katrina Pierson would repeat), wondering aloud whether or not Clinton has undisclosed or undiagnosed brain damage. The doctor repeated that claim in an early August segment with Fox personality Sean Hannity. “I think a traumatic brain injury with symptoms down the road is very, very likely here especially since she had a blood clot on her brain,” Siegel said.

Here, finally, was a doctor throwing his clinical authority behind the Clinton health narratives that had eddied online for months. The narrative of Clinton’s health was now clearly mapped within the field of neurology.

It’s a striking determination, because health-related election questions usually occupy more mundane themes of age and fitness. Many questioned the longevity of Ronald Reagan and John McCain, but none suggested during their campaigns that they suffered from severe neurological disorders that, according to Donald Trump, puts into question Clinton’s very ability to be president. After all, the argument goes, when Franklin Roosevelt ushered America through World War II in a wheelchair, he could still rely on sheer intellectual force. But if Clinton is secretly suffering from a hidden disorder that renders intellect obsolete, then she is uniquely unfit for duty.

There were other, perhaps more traditional, roads to take: a whisper of good old-fashioned heart attack risk or the simple reminder that Clinton is over 65. It wouldn’t be hard to convince America that a grandmother was inherently frail—that particular trope has been popular long enough. But this hyper-focus on an unnamed neurological disorder stretches back to the 19th century where, in the dingy halls of a Parisian asylum, hysteria was reinvented as a neurological disease.

A diagnosis of “hysteria” can tenuously be traced back to the Greeks. Its plural form, hysterika, appeared in the Hippocratic text Aphorisms, dated from the 4th or 5th century B.C. For hundreds of years, hysteria was believed to be a disease of the womb, an organ that physicians believed wandered when it was ill-humored—making women weepy or angry or oversexed or undersexed—and could be coaxed to returning to its rightful place. “In a woman suffering from hysterika,” the Greek physician wrote, “having a difficult labor, a sneeze is a good thing.”

But in the 17th and 18th centuries, as doctors began to classify disease and disorder according to more modern standards of observation, some questioned whether or not hysteria was a disease of the womb—or one of nerves instead. They agreed that, regardless of where it came from, it was a disease suffered almost entirely by women.

The argument came to a conclusion when Jean-Martin Charcot, a highly regarded neurologist, was appointed the director of Pitié-Salpêtrière Hospital in mid-19th century Paris, a “great emporium of human misery,” according to Charcot himself. He was no quack: During his tenure at Salpêtrière, he identified and classified aphasia (also called dysphasia); Charcot’s Disease, which in America is called Lou Gehrig’s Disease; and Charcot-Marie atrophy. He also differentiated the symptoms of Parkinson’s from multiple sclerosis. Among his students were Georges Gilles de la Tourette and Sigmund Freud.

But amid these honorable discoveries, Charcot also insisted that hysteria was part of the same family as aphasia and the broader spectrum of neurological diseases. Renamed by Charcot “la grande hystérie,” the disease was either an inherited weakness or one brought on by severe trauma, like a fall that resulted in some kind of brain damage. Its diagnosis, as Michel Foucault wrote, referred “more easily to an image than a disease.”

Hysteria could manifest as an endless number of symptoms, from tics to twitching, muscular spasms to emotional distress, odd-sounding vocal inflections, sexual deviancy to extreme penitence, energetic ramblings to comatose silence, incontinence, excessive menstruation to none at all. If these symptoms sound familiar, it’s because they’ve been thrown around during this election cycle, and not to refer to Donald Trump. Clinton taking a bathroom break during a debate is a story. Dozens of internet videos deconstruct her movements, claiming to see spasms and twitches. Nearly any slight irregularity of a woman’s body or behavior could lead to a diagnosis of hysteria. Because the symptoms of hysteria were closely tied to long-held assumptions about ideal womanhood and femininity, any woman who fell short of the mark could be a hysteric. The disease, in short, behaved like a woman.

Even Charcot could not wrench hysteria away from its long association with wandering wombs, nor did he want to. Hysteria, like all degenerative neurological disorders, was, by 19th century understanding, the result of an inferior hereditary line. In Biblical terms, the sins of fathers revisiting themselves on multiple generations. At Salpêtrière, mental, moral, and physical degeneracy were all collapsed into a single body; best, then, that it be the body of a woman.

But Charcot was in a bind. He couldn’t demonstrate that hysteria existed (his many attempts to find traces of the disease on autopsied brains proved fruitless), but he was seeing it on the bodies of thousands of women across Europe. So he turned to photography where, over the course of many years, he documented the seizures and contortions and poses of the hysterical body and thereby created the image of a hysterical woman.

There are hundreds of photographs of Charcot’s patients, many reproduced in Iconographie Photographique de la Salpêtrière (1876-1880). Two young women in particular, his two “star patients” he named Augustine and Blanche, are seen over and over again, reenacting the fits and spasms of la grande hystérie. Their symptoms were proof enough that illness consumed both their brains and their bodies; all it took was a willing, rational man of science to scrutinize and interpret those bodies. The photographs fixed hysteria as an illness that worked better as a metaphor; it could not be proven, so the hysteric’s body had to be observed and interpreted through a “normal” female body.

It would be easy to dismiss hysteria as a vintage stereotype, but our worst assumptions about women are bound to the persistent effects of hysteria’s history. To this day, calling a woman hysterical conjures up images of women who are irrational, women who shriek and overreact are too emotional, women who are unable to control their bodies.

Think of the way we talk about Hillary Clinton’s voice and tone. She rarely just speaks or delivers a speech. Instead, like a hysteric, she yells, she shouts and is shrill. Clinton’s grating voice is evidence of her irrationality, of her inability to exercise control over both body and self. Just the fact that Clinton has come this far, that she can inscribe her name in history books, is a signifier of restraint and thus evidence of rationality; its lack suspiciously points back to hysteria. (It’s worth remembering that hysteria wasn’t removed from the Diagnostic and Statistical Manual of Mental Disorders-III until 1980, the same year Clinton gave birth to her only child.)

In Charcot’s day and in ours, pointing to an unprovable disorder is an easy way to frame women’s healthcare concerns, to wink at mental disorder without actually calling her crazy. It’s why a coughing fit generated hundreds of headlines and it’s why Clinton “swoons” rather than passes out. It reinforces the metaphor of illness; it all points to a particular feminine weakness. Even in 2016, conspiracy theorists are happy to settle on some mysterious, unidentified neurological disorder when they have no clear evidence of a real disease. Fox News hints at what Charcot would have called “la grande hystérie.”

Stassa Edwards is working on a book about hysteria.