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From "The Technology Of Orgasm" by Rachel P. Maines, pub John Hopkins University Press
-- basically about how (1) (pre-20th century) doctors would sexually arouse their female patients as "treatment" and (2) how this led to the development of the vibrator.
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In 1653 Pieter van Foreest, called Alemarianus Petrus Forestus, published a medical compendium titled Observationem et Curationem Medicinalium ac Chirurgicarum Opera Omnia, with a chapter on the diseases of women. 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:
When these symptoms indicate, we think it necessary to ask a midwife to assist, so that she can massage the genitalia with one finger inside, using oil of lilies, musk root, crocus, or [something] similar. And in this way the afflicted woman can be aroused to the paroxysm. This kind of stimulation with the finger is recommended by Galen and Avicenna, among others, most especially for widows, those who live chaste lives, and female religious, as Gradus [Ferrari da Gradi] proposes; it is less often recommended for very young women, public women, or married women, for whom it is a better remedy to engage in intercourse with their spouses.
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. Descriptions of this treatment appear in the Hippocratic corpus, the works of Celsus in the first century A.D., those of Aretaeus, Soranus, and Galen in the second century, that of Äetius and Moschion in the sixth century, the anonymous eighth- or ninth-century work Liber de Muliebria, the writings of Rhazes and Avicenna in the following century, of Ferrari da Gradi in the fifteenth century, of Paracelsus and Paré in the sixteenth, of Burton, Claudini, Harvey, Highmore, Rodrigues de Castro, Zacuto, and Horst in the seventeenth, of Mandeville, Boerhaave, and Cullen in the eighteenth, and in the works of numerous nineteenth-century authors including Pinel, Gall, Tripier, and Briquet. 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.
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 BC until the American Psychiatric Association dropped the term in 1952, was known mainly as hysteria. 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. 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. Androcentric views of sexuality, and their implications for women and for the physicians who treated them, shaped the development not only of the concept of female sexual pathologies but also of the instruments designed to cope with them.
Technology tells us much about the social construction of the tasks and roles it is designed to implement. 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." The vibrator and its predecessors in the history of medical massage technologies are the means by which I shall examine three themes: androcentric definitions of sexuality and the construction of ideal female sexuality to fit them; the reduction of female sexual behavior outside the androcentric standard to disease paradigms requiring treatment; and the means by which physicians legitimated and justified the clinical production of orgasm in women as a treatment for these disorders. In evaluating these technologies, the perspective of gender is significant: for example, men typically react to figure 1 by wincing, and women laugh. Clearly, where technologies impinge on the body, especially its sexual organs, the sex of the body matters.
When the vibrator emerged as an electromechanical medical instrument at the end of the nineteenth century, it evolved from previous massage technologies in response to demand from physicians for more rapid and efficient physical therapies, particularly for hysteria. 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 1920s, and mechanizing this task significantly increased the number of patients a doctor could treat in a working day. 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. Physicians had both the means and the motivation to mechanize.
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. Thus the symptoms defined until 1952 as hysteria, as well as some of those associated with chlorosis and neurasthenia, may have been at least 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. The historically androcentric and pro-natal model of healthy, "normal" heterosexuality is penetration of the vagina by the penis to male orgasm. 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.
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. 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 effect, doctors inherited the task of producing orgasm in women because it was a job nobody else wanted.
There is no evidence that male physicians enjoyed providing pelvic massage treatments. 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 some tireless and impersonal mechanism. This last, the capital-labor substitution option, reduced the time it took physicians to produce results from up to an hour to about ten minutes. Like many husbands, doctors were reluctant to inconvenience themselves in performing what was, after all, a routine chore. The job required skill and attention; Nathaniel Highmore noted in 1660 that it was difficult to learn to produce orgasm by vulvular massage. 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 heads with the other." At the same time, hysterical women represented a large and lucrative market for physicians.
These patients neither recovered nor died of their condition but continued to require regular treatment. 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 market for therapeutic services. 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. 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.