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Book review: "Hystories: Hysterical Epidemics and Modern Culture"

Hystories: Hysterical Epidemics and Modern Culture. Elaine Showalter. PICADOR, London 1997, pp207. ISBN 0330 34670 9. £16.99

Elaine Showalter is Professor of English at Princeton University. This terrific book takes the reader through the classic work of Charcot and Freud to what she calls the modern epidemics of hysteria, spread by stories - hence the term hystories.

Chronic Fatigue Syndrome, Gulf War Syndrome, Recovered Memory, Multiple Personality Syndrome, Satanic Ritual Abuse and Alien Abduction are all dissected elegantly as hystories. The roles of the media and religion as intermediaries are spotlighted and there is a lovely twist to what are perceived as predominantly female hystories (Chronic Fatigue, Recovered Memory, etc.) and the male variants (Gulf War Syndrome). This links back to shell shock in the World Wars, and to Bandolier's reading last summer of Pat Barker's beautiful First World War trilogy "The Regeneration Trilogy".

In the hystories book I particularly enjoyed the idea that there is, in any given culture, a legitimate symptom pool. Hysteria mimics culturally permissible expressions of distress. "An Englishman can legitimately complain of headache or fatigue but not that his penis is retracting into his body - a perfectly legitimate symptom in Malaysia and South Asia". This links beautifully to two bees in Bandolier's bonnet, to Medically Unexplained Physical Symptoms (MUPS), to the type of reassurance, and to how that reassurance is provided.

There are many obvious medical hystories. Drug scares on the media, like contraceptives and thrombosis, result in personal disaster, and we don't seem to have improved the way we handle such pronouncements (or the criteria for making them). Wearing Bandolier's EB hat perhaps the most important twist is how do you prove that there is no medical basis to hystories? The glaring example at present is Gulf War Syndrome - how can you be certain that there is no biological cause? Professor Showalter uses the words evidence, testimony and proof in the same sentence. While in medicine we tend to substitute anecdote for testimony, and relish the pejorative connotations, we struggle as our masthead reflects to sort out when something is conclusively proven. For hystories, as in many other aspects of medicine, our uncertainties reveal more than our certainties. Best read this year.

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