How doctors got it wrong: 3 'conditions' they no longer recognise
Healthline/Medical News Today Jul 16, 2019
Medical research has changed how doctors diagnose conditions for the better. Read this Spotlight feature to find out about the top three "medical conditions" that healthcare professionals no longer recognize as such.
Throughout history—both recent and distant—doctors have made many mistakes. In some cases, they meant well, but they did not yet have the knowledge or technology to assess a person's health condition correctly. In other cases, however, they diagnosed non-existent medical conditions or disorders as a means of backlash against social outliers.
Some "conditions" that we will discuss in this Spotlight feature, such as "bicycle face," may sound amusing, while others, such as dysaesthesia aethiopica, may sound scary. But all of these fabricated "conditions," and especially the fact that some doctors and members of the public took them very seriously at the time, likely had a substantial adverse effect on the lives of the people who received a diagnosis for one of them.
1. Bicycle face: 'A physiognomic implosion'
"The cycling season will be coming on soon, and there is every reason to suppose that more people than ever will take advantage of it—women especially." This is the first sentence of an article called "The dangers of cycling," published by Dr. A. Shadwell in 1897, in the National Review.
Allegedly, this doctor coined the expression "bicycle face" to describe a pseudo medical condition—with mainly physiological symptoms—that affected women cyclists in the early days of cycling in the 1800s. In his article, Shadwell claimed that this "condition" caused a "peculiar strained, set look," as well as "an expression either anxious, irritable, or at best stony" in the rider.
Both men and women could develop bicycle face, though women were implicitly more affected by it since the condition could ruin their faces and their complexions, and thus make them less desirable. This condition was also a particular result of riding too fast and too far, giving free rein to what Shadwell implied was an unhealthful compulsion.
"A vice [...] peculiar to the bicycle," Shadwell wrote, "is that the ease and rapidity of the locomotion tempt to over-long rides by bringing some desirable objective within apparent reach."
"Going to nowhere and back is dull, going to somewhere (only a few miles farther) is attractive; and thus many are lured to attempt a task beyond their physical powers," he argued.
In her book, The Eternally Wounded Woman, Patricia Anne Vertinsky also cites sources describing "bicycle face" in women as a "general focusing of all the features toward the center, a sort of physiognomic implosion."
However, while this condition appealed to anyone who wanted to discourage cycling, especially for women, it did not last for long. Even at the time, some medical professionals debunked this and similar notions surrounding the alleged threats that cycling posed to health.
For example, according to an article in an 1897 issue of the Phrenological Journal, Dr. Sarah Hackett Stevenson, a female physician from the United States, explained that cycling poses no threat to women's health.
"[Cycling] is not injurious to any part of the anatomy, as it improves the general health. [...] The painfully anxious facial expression is seen only among beginners and is due to the uncertainty of amateurs. As soon as a rider becomes proficient, can gauge her muscular strength, and acquires perfect confidence in her ability to balance herself and in her power of locomotion, this look passes away."
—Dr. Sarah Hackett Stevenson
2. Female hysteria: 'A nervous disease'
The fake mental condition that researchers have referred to as "female hysteria" has had a long and fraught history. It has roots in mistaken ancient beliefs, such as that in the "wandering womb," which alleged that the uterus could "go wandering" through the female body, causing mental and physical problems.
In fact, the term hysteria derives from the Greek word "hystera," which means "womb." Yet, female hysteria became a much more prominent concept in the 19th century when the neuropsychiatrist Dr. Pierre Janet began to study psychiatric—and alleged psychiatric—conditions at the Salpêtrière Hospital in Paris, France, in the 1850s.
Dr. Janet described hysteria as "a nervous disease" characterized by "a dissociation of consciousness," which causes a person to behave in extreme ways or to feel very intensely. Other famous contributors to the field of medical science, such as Sigmund Freud and Joseph Breuer, continued to build on these initial concepts throughout the late 19th and the 20th centuries.
Little by little, a complex image of this nebulous mental condition emerged. Typically, doctors diagnosed women with hysteria, as they considered women more sensitive and easily influenced. A hysteric woman might exhibit extreme nervousness or anxiety but also abnormal eroticism. For this reason, in 1878, doctors invented and first started to use vibrators on their patients, believing that this—often enforced—stimulation could help cure hysteria.
It took a long time for doctors to give up on hysteria as a valid diagnostic, and they kept changing their minds. The American Psychological Association (APA) did not include hysteria in their first Diagnostic and Statistical Manual of Mental Disorders (DSM-I), which appeared in 1952. However, the "condition" made an appearance in the DSM-II in 1968, and finally left the stage of psychiatry for good in 1980 when the APA published the DSM-III.
Instead, the APA replaced this elusive "condition" that aimed to encompass too many symptoms with an array of distinct psychiatric conditions, including somatic symptom disorder (previously "somatoform disorder") and dissociative disorders.
3. Dysaesthesia aethiopica: 'A hebetude'
Nineteenth-century medicine did not just "target" women, however. Slavery was still widespread in the United States throughout the first half of the 19th century, and some doctors made victims of slavery also victims of scientific racism.
Dr. Samuel Adolphus Cartwright, who practiced medicine in the states of Mississippi and Louisiana in the 19th century, was guilty of inventing several "medical conditions" that made the lives and situations of enslaved people even worse.
One of these "conditions" was dysaesthesia aethiopica, a fictitious mental illness that allegedly rendered slaves lazy and mentally unfit. Cartwright described this "condition" as a "hebetude [lethargy] of mind and obtuse sensibility of body."
Dysaesthesia aethiopica was supposed to render enslaved people less likely to follow orders and make them sleepy. It also supposedly led to the development of lesions on their skin, for which Cartwright prescribed whipping. The lesions were, most likely, the result of violent mistreatment at the hands of slave owners in the first place. Enslaved people, however, were not the only ones exposed to this strange "condition." Their owners were also likely to "catch" it if they fell into one of two extremes: too much friendliness or too great cruelty.
Such was the case for "[owners] who made themselves too familiar with them [enslaved people], treating them as equals and making little to no distinction in regard to color; and, on the other hand, those who treated them cruelly, denied them the common necessaries of life, neglected to protect them against the abuses of others," according to Cartwright. While scientific racism has appeared repeatedly throughout history, some researchers warn us that we are not yet entirely free of its dangers.
A final note
In this Spotlight feature, we have presented some weird—and in some instances, disturbing—cases of pseudo conditions that healthcare professionals used to diagnose in people throughout history. Having reached the end of this list, you might issue a sigh of relief or maybe even feel a little amused—after all, these things happened so long ago, and medical practice is now, surely, free of prejudice.
However, discriminating and scientifically inaccurate medical diagnostics have persisted well into the 21st century. In 1952, the DSM-I defined homosexuality as a "sociopathic personality disturbance."
The next edition, the DSM-II, which appeared in 1968, listed homosexuality as a "sexual deviation." It took until 1973 for the APA to remove this sexual orientation from its list of disorders that required clinical treatment.
However, the effects of pathologizing something natural are visible to this day. For example, conversion therapy claims to "change an individual's sexual orientation, gender identity, or gender expression." Though unethical and unscientific, conversion therapy is still legal in many countries around the world, and most regions of the United States.
Moreover, it was only last May that the World Health Organization (WHO) finally dropped the definition of transgender as a gender identity disorder from their latest edition of the International Classification of Diseases manual (ICD-11).
While we have come a long way, past mistakes and narrow views in the medical field have often had far reaching and terrible consequences for people's lives and their social health. Going forward, it is essential to keep consolidating mutual trust with the help of real science, open-mindedness, and a healthy sense of curiosity.
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