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女性作为医学的替罪羊:扭曲的鉴别诊断简史


Black hellebore,a flower of the deepest black and with petals the sinister shape of blunted arrowheads,在凉爽的环境中狂野生长,mountainous regions of the Balkans.Despite its unintimidating label as the"Christmas rose,"the hellebore has a much darker history,一个定制更多的是花的乌木色调,而不是其无害的昵称。The flower is said to have healing benefits. According to Greek mythology,the healer Melampus developed a tonic made up of aninfusion of hellebore to cure a group of virgins suffering from psychosis due to"uterine melancholy"and a lack of sexual stimulation.从梅兰普斯的神话中诞生了歇斯底里的扭曲概念,and with it the inevitable fate of women to become the unjust scapegoats of mental health.历史证明,从歇斯底里到精神分裂症再到吸毒,psychological disorders of ambiguous etiology have initially been tossed aside as mere afflictions of the"弱性行为,"虚弱的女性体质无力应付日常生活的严酷,由此产生的不足为奇的后果尽管这段历史并不令人惊讶,considering medicine of the larger part of the past millennia was generally developed by male physicians,在卫生行业中,性别平等的增加使我们得以摆脱这种趋势,并促使围绕心理健康的态度发生真正的转变。

尽管如此,it is impossible to ignore a past in which beliefs in the frailty of women have had tragic societal and medicinal consequences.这些传统的定罪是直接的,for example,在妇女中流行鸦片成瘾,a testament to the fact that the belief in the mythologized susceptibility of women was not lost with time.French artists of the Victorian era were enraptured by the image of吗啡单抗,,女性吗啡依赖者。在社会的各个角落都能找到她,一个在家里悠闲地闲逛的贵族或一个为养活自己和家人而工作的年轻女人。艺术家从吗啡单抗,with Paul Albert Bessnard'setching of Victorian upper-class morphine addicts与…形成鲜明对比尤金·格拉塞特的标志性作品La Morphinomane,a jarring image of a young,working-class woman donning a nightgown and a grimace while injecting opium into her thigh.

这一时期女性最常见的诊断之一是神经衰弱,一种由乔治·米勒·比尔德医生普及的女性传染病,who described it as a disease of neuralgias and anxiety attributable to the uncomfortably rapid urbanization of society.Beard's characterization of women as the"more nervous"sex contributed to women being disproportionately diagnosed with neurasthenia and subsequently prescribed opiates.Studies of the time显示在19世纪,between two-thirds and three-quarters of the chronic opium users in this country were women.While such disproportionality may seem shocking to us today,during the time the diagnosis of neurasthenia was in vogue,,physicians were attributing such inequalities to the obviously higher"有歇斯底里和慢性病的倾向”在女性中,a"歇斯底里和疑病症”哪种鸦片能充分安抚.

Interestingly,by the first half of the 20th century,女性温顺和敏感的特征为另一种精神疾病:精神分裂症提供了方便的解释。,The Protest Psychosis: How Schizophrenia Became A Black Disease,,psychiatrist Jonathon Metzl traces the history of mental illness,uniquely intertwining issues of race,class and gender into the story of the development of schizophrenia as a medical diagnosis.The majority of the work focuses on trends associating African-Americans with improper diagnoses of schizophrenia due to institutionalized racism,认为民权运动刺激了精神分裂症的诊断,是由于意识到的不服从和侵略行为。追溯这段历史,然而,Metzl承认在民权运动之前,schizophrenia was believed to be a disease of the"sensitive"和”与世隔绝。”这是一种被轻蔑地称为中产阶级白人妇女疾病的疾病。As Metzl describes,某些消息甚至声称精神分裂症只是婚姻不幸福的外在表现。This image of the"schizophrenic housewife"成为主流文化的一部分,甚至在《女性家庭杂志》上找到了自己的路,which attributed schizophrenia and premenstrual symptoms to a"Dr.杰基尔先生。Hyde"syndrome in women.就像之前的歇斯底里和神经衰弱,schizophrenia joined the list of diseases attributable to female debility,a frailty too often legitimized by the psychiatry of the times.

It is undeniable,然而,尽管女性被围绕她们感知到的弱点的陈词滥调所损害,它们也是挑战现状的基础。Perhaps one of the most effective means by which women have challenged the popular"女性虚弱”conjecture has been through literature.几个世纪以来,writers like Sylvia Plath and Charlotte Brönte have produced some of the most memorable female characters of literature.In looking closer at their works,it can be seen that several of these characters have served to shed light on the injustices facing women,尤其是那些与心理健康有关的刻板印象。伯莎在布隆特小说中的声名狼藉角色Jane Eyreprovides a vivid example of the plight of female mental illness,graphically portraying a woman confined to an attic and condemned by her own husband to live alone for eternity.Believed to have descended into an incurable madness,Bertha was ignored,被遗忘了,在很多方面都因为她的病而受到诋毁,a fact of moral ambiguity that Brönte was likely aware of.Similarly,in writingThe Bell Jar,西尔维娅·普拉斯将她的个人经历倾注于埃丝特·格林伍德的性格中,a young woman who finds herself trapped by a profound depression.她的病使她走上了一条永不停息的电击疗法和药物之路。这部小说不仅揭示了精神健康问题,而且还揭示了一长串其他心理社会因素,使埃丝特无法感受到她认为男人拥有的同样自由。Plath herself committed suicide soon after the publication of her now-classic novel,perhaps for reasons mirroring the very oppressive forces supposedly keeping Esther down.

百年前的梅兰普斯神话把黑色的地狱宝藏描绘成女性压迫的象征,a kind of subservience in chemical form.也许可以更好地理解花代表女性的力量,an object of beauty and fragility but also an object with the power to crush oppressive forces that have served to keep women down for centuries.像以斯帖和伯莎这样的人物说明了历史倾向于给女性贴上标签。different"as women who are"insane."他们的经历提出了这样一个问题:这种被感知的精神错乱是否是女性在大多数历史中所面临的成见的另一种表现。歇斯底里,上瘾,neurasthenia and schizophrenia are only a few of many mental health issues that have historically been relegated to the world of women,a trend that perhaps reflects a path of least resistance and a path in which medicine has historically been able to over-simplify rather than truly understand.过去的女人,无论是真实的还是虚构的,have provided countless example of the dangers of gender inequality as it relates to the issue of mental health.然而,带着希望,their examples will serve as the impetus that medicine needs to continue to make progress,to continue to equalize the playing field,继续确保过去的错误永远不会重演。

Photo credit: Photograph by杰基·迪。

Arya Shah 雅利安·沙赫(2 Posts)

Contributing Writer

Mayo Clinic School of Medicine


我是洛杉矶女孩,born and raised.I'm currently in the Midwest at the Mayo Clinic School of Medicine and hoping to pursue a career in psychiatry,neurology or some combination of the two.是什么让我度过了寒冷,dark Minnesota winters is my writing,my hot yoga,and my perpetually growing to-do list of art projects.In continuing to pursue creative endeavors,为了让我的同学们参与艺术工作,我希望向人们展示,创造性的表达可以帮助人们远离疲劳,帮助人们在医学上保持人文主义的活力。