provided humanity with a wellspring of puzzlement and wonder—their reproductive powers reliably arouse responses ranging from reverence to fear. In keeping with the human instinct to understand and conquer nature, for thousands of years people have endeavored to harness female sexuality. Early philosophers and doctors zeroed in on the uterus as a nexus for these unknowable strange and scary forces in an attempt to control and contain them. The uterus was thought to be responsible for a considerable host of afflictions that fell under the heading of "hysteria."

Hysteria as an illness dates back to antiquity: the word derives from the Greek "hystera" which means uterus, or more literally, "of the womb." Thus "hysteria" has always connoted female concerns. (The American Psychiatric Association retired the term in 1952, later adopting the more gender-neutral "conversion disorder" instead.) Documented male cases of hysteria do exist, though they are far and away the exception rather than the rule. The disease became a sort of catch-all assessment for a variety of tangible yet unexplained symptoms stemming from no obviously discernable cause. Doctors stamped the hysterical label on many conditions that we now recognize as other things: schizophrenia, anxiety and panic attacks, epilepsy, etc. But they also applied it to a vast cornucopia of symptoms like nervousness, boldness, fainting, excessive energy, apathy in the bedroom, an overly hearty sexual appetite—basically anything not readily identifiable as something else.

The most frequently prescribed and preferred treatment for hysteria was marriage, and for a woman to be "strongly encountered" by her husband. Pre-20th-century logic determined that if the symptoms emanated from the womb, a sexual release would purge them. However, with the female body being so enigmatic, not many doctors recognized the fact that traditional intercourse alone does not provide said release for a significant number of women. If marriage proved unsuccessful, which it often did due to many women's uncooperative physiology (today, figures are quoted that anywhere from 50-70% of all women do not achieve orgasm without some form of clitoral stimulation), those women were considered deficient or abnormal and in need of further remedy.

The Victorian era in particular embraced the diagnosis of hysteria with perhaps a tad too much gusto. Conservative sexual attitudes at the time contributed to a rampant proclivity for purging any behavior or characteristic that did not conform to societal norms. An ideal woman radiated chastity and modesty; feelings of lust or desire were considered unseemly or abhorrent, and often indicative of an underlying problem requiring fixing. And yet, contradictorily, though a passionless woman was thought a pure woman, she was also sometimes proclaimed to need medical treatment, particularly if she objected to sex. The message to women was confusing: be chaste, but want sex a little bit (and of course only with your husband); don't show enthusiasm, but don't be lethargic either.

It was commonly believed back then that women had little or no sexual desire. From the female perspective, sex was to be endured. Victorian ideas about the purpose of intercourse indicate that most women thought sex existed mainly for reproductive reasons, and possibly for male pleasure, but very rarely did people acknowledge that sex might also provide pleasure for the woman. Dr. Clelia Mosher's famous study of 45 Victorian wives and their sex lives confirms that a large number of women knew next to nothing about sex until marriage. Some refer to having read parts of a female-penned populist guide to gynecology and midwifery in order to glean something ahead of time, but most went in all but blind. Without knowing much about what to expect, or what was expected of them, sex may have been a terrifying prospect for many women. Oftentimes, things would not go smoothly, and a couple would seek a doctor's advice, where a pronouncement of hysteria was likely.

If marriage failed to alleviate hysterical symptoms, doctors usually then prescribed "pelvic massage" in order to induce a "paroxysm," which literally means a sudden fit or convulsion, but we know now that in this context it was simply another name for an orgasm. It is interesting to note that while the favored remedy was a vigorous bedroom encounter with one's husband, doctors were yet able to achieve clinical distance with the pelvic massage they administered in their offices, maintaining that the "hysterical paroxysms" they induced were purely medicinal and contained nothing of the sexual about them.

Similar logic applied to the intense fear of masturbation, or "onanism," as it was referred to at the time. If a paroxysm occurred in a doctor's office or the marriage bed this was seen as a positive result, but if achieved by the woman herself (or a man, for that matter) in privacy, it became unacceptable and depraved. It was believed with absolute certainty that these two situations resulted in completely different effects, despite sharing the same outcome. Rachel P. Maines suggests a possible cause of this striking ability to compartmentalize in the preface to her book, The Technology of Orgasm: "Doctors who failed to recognize the orgasm in their patients must never have seen them in their wives:'

Physicians had been prescribing pelvic massage in various forms since ancient Greek times, and possibly earlier, as a cure for hysteria. The simplest method was also the most labor-intensive: the manual treatment. Using one's fingers to elicit a paroxysm could take an hour or more and thus prove quite tedious and tiring. As a result, doctors often handed the task off to a midwife. They also searched for ways to make the process easier. Hydrotherapy was a popular option: they experimented with showers, water pressure, and hot springs, resulting in spa towns like Saratoga Springs or Ballston Spa in New York boasting large populations of doctors. Other prescriptions included horseback and bicycle riding, travel in a carriage, or later a train, and even sewing, as the motion from early, pre-electric sewing machines achieved vibratory effect.