In honor of the month of March, I want to focus this blog on the earliest history surrounding what we now know as Endometriosis. The saga of misrepresentation, sexism, and assumption around the existence and then diagnosis of this condition has plagued women in pain for centuries, and it has a rather fascinating back story. While we have made leaps and bounds with Endo research over the years, it's amazing how long it's taken us to make progress with how much was already ascertained about pelvic pain as early as 400 BC. I honestly had no idea there were already inklings of this disease being discussed in medicine. So how in the hell are we still struggling with this today? Read on to learn about the early days of suffocation of the womb, Hysteria, demonic possession, Nymphomania, and Lovesickness.
Classical and Late Antiquity Period
Looking back at history, as presented in ancient texts from the classical and late antiquity period, one of the first mentions we find of Endometriosis is in fact, Plato way back in 375 BC. He actually mentioned the extreme pain that women suffered calling it the result of "suffocation of the womb". He believed that it was due to an empty womb too long after puberty, an interesting notion by today's standards, but obviously passable at that time. Then, a century later, Soranus claimed that this pain stemmed from inflammation of the uterus. He witnessed women falling unconscious from the severe pain caused by the uterine contractions. I literally blows my mind that so far back in time people were already studying this condition, and yet we still have so far to go in educating people on it and solidifying sufferers to receive a proper diagnosis. The next generation of doctors brought the Roman scholar Celsus, who identified women reacting as if Epileptic to the disease of their womb, but lying down like they're asleep instead of their eyes rolling back or foaming at the mouth as with those having seizures. A few decades later, the Greek physician Pedanius Dioscorides acknowledged "strangulation of the uterus", describing how women would fall down and into the fetal position. He was the first to suggest that medical intervention was necessary to treat these episodes. Next, a century later, Claudius Galen of Pergamom described inflamed ligaments that suggest the existence of adhesions. His contemporary, Aretaeus, stated similar observations, saying that the uterus would move upwards and crush the intestines to cause this. By this point, unexpected deaths were growing and in need of explanation. The translations from these texts are not perfect, so take it all with a grain of salt, but it's certainly interesting to see what the early thinkers were proposing was going on within the female bodies of the time.
The Middle Ages
During this era, Aetus of Amida, in the 500 AD's, hit home that this "suffocation of the womb" was brought on by menstruation. Avicena brought our modern day sentiment to light that pain is not beneficial for healing or a form of karma. However, since demonology played a pretty big role in this era there were still many instances where women were written off as being possessed when they would come to seek divine help. Europe saw a resurgence of superstition at this time, while Asia flourished with scientific advances, and Muslim medicine paved the way for many modern pharmaceutical advances as Persian physicians such as Haly Abbas (?–994), Avicenna (980–1037), and Rhazes (865–925) helped translate texts to discover dozens of medicines.
The Renaissance
Henri de Mondeville, the Father of French surgery and surgeon to the king of France, challenged the belief that wounds needed suppuration to heal and after 1250 autopsies this was made a regular part of medical education in Europe (later moving mountains for Endometriosis practice). At this time suffocation/strangulation of the womb was being called hysteria, hysterik fits, or dysregulated vapors (vapours), a word used for menstruation. Ambrose Pare was the one to suggest that it wasn't just virgins and widows who were dealing with the disorder, but married women who abstained from sexual relations as well (Vaginismus, much?). He explained that these women had a swollen uterus (which we now know could have been Adenomyosis) and that they truly felt they were near death. He also helped us learn that the ligaments were involved by noticing their fullness. It's very disturbing, but women were convicted and sometimes tortured and executed on behalf of their hysterical conditions, due to the statutes from England's Witchcraft Act of 1604. Finally, a Dutch man named Johannes Weyer (also Weir) (1515–1588) was called into a witchcraft trial and gave this stirring speech to call this to an end. I bet this hits home for many of you Endo sufferers out there:
"Don't you know that these poor women have suffered enough? Can you think of a misery anywhere in the world that is worse than theirs? If they do seem to merit punishment, I assure you, their illness alone is enough."
In the 18th century, Hysteria was also diagnosed as Nymphomania, referred to as madness from the womb, womb-fury, and furor uterinus. Even women in nunneries were accused of this, stating that their unfulfilled desire was driving them nuts. Lovesickness was also described as causing this issue. This major set back in women's health care led to the concept known as the ‘‘Curse of Eve’’, stemmed from a misinterpretation of the Biblical passage Genesis 3:16. Originally, it suggested that women were cursed by God to endure painful childbirth labor, but later men added painful menstruation and intercourse to the curse, making it even more problematic (religion induced Vaginismus much?).
There are still many more facts to go through over another 200 years so I may write a part 2 to this blog later. I just didn't want to make the history lesson too long and lose readers, but I found this all very fascinating. All of these facts came from the article linked in the beginning of the blog. So many years of men telling women what is happening inside their bodies, judging them, and controlling their lives with misdiagnoses galore. Hopefully one day we'll reach a point where there is no longer a regular occurrence... one fine day.