Male hysteria in theory and practice: Analyzing patient records of the Tartu Psychiatric Hospital (Estonia), 1881–1895

During 1881-1895, a small number of male patients-18 in total-were diagnosed with hysteria at the University of Tartu Psychiatric Hospital. Rather than constituting an obscure psychiatric institution on the margins of European medical traditions, Tartu during these years witnessed the arrival of several influential psychiatrists: Hermann Emminghaus (1845-1904), Emil Kraepelin (1856-1926), and Vladimir Chizh (1855-1922). Yet, when comparing patient case records of male hysteria written by doctors who also published journal articles and medical textbooks on the topic, one can detect a clear inconsistency between the theory and practice of psychiatry at an important moment of its formation. Contrary to the simplified characterizations in the textbooks, there was no uniform formulation of male hysteria in the case records. The clinical description differed remarkably, throughout the career of individual doctors, between symptomology presented in a textbook and clinical picture described in a patient record, and between different doctors who practiced in the same clinic during this 15-year period. This study highlights the importance of using patient case records in conjunction with a formal medical treatise to provide new insights and nuances to the intellectual history of hysteria, but also other diagnoses and clinical practice more broadly.