I really wanted to title this “universal orgasmic mutuality” [see below] but I figure this post is already going to draw too much of the wrong traffic to my blog. ::sigh::
This book was far more interesting than I ever imagined. It was quite the page turner. It describes the 2000-year plus history of the medicalization of normal female sexuality, the androcentric model of sex that supports this, the highly lucrative medical service of manual massage for “hysteric” female patients, the drive for efficiency in this procedure that led to the invention of the vibrator and related technologies, and how all this ties together in where we are today.
The story it tells, and the facts it is based on, are illuminating, intriguing, sometimes titillating, and frequently sad and maddening.
Let me record up front that the author does not lay this state of affairs entirely at the feet of men. In the last chapter she writes:
“The penetration myth is not a conspiracy perpetuated by men; women want to believe in the ideal of universal orgasmic mutuality in coitus” (115).
I am not so sure that men or, more specifically, the male medical establishment, ought be let off so easy, though.
Bottom line: I found this book fascinating and highly recommend it to pretty much anyone. OK, anyone past the age of puberty and with a modicum of maturity.
My one complaint is that it would have been nice to know where the images were when several pages away. That is, in addition to image number provide the page number as the images were never on the pages they were mentioned on and, frequently, were several or more pages away.
The rest will pretty much be some quotes to whet your appetite. I have also included all of the section headings so you can get a better feel for the content.
Contents:
- Preface
- 1 The Job Nobody Wanted
- 2 Female Sexuality as Hysterical Pathology
- 3 “My God, What Does She Want?”
- 4 “Inviting the Juices Downward”
- 5 Revising the Androcentric Model
1 The Job Nobody Wanted
“Descriptions of this treatment [manual stimulation] appear in the Hippocratic corpus, the works of Celsus in the first century A.D., those of Aretaeus, Soranus, and Galen in the second century, …. Given the ubiquity of these descriptions in the medical literature, it is surprising that the character and purpose of these treatments for hysteria and related disorders have received little attention from historians” (1-2)
While “hysteria” is no longer defined as a disease, it was “from at least the fourth century B.C. until American Psychiatric Association dropped the term in 1952, …. This purported disease and its sister ailments displayed a symptomatology consistent with the normal functioning of female sexuality, for which relief, not surprisingly, was obtained through orgasm, either through intercourse in the marriage bed or by means of massage on the physician’s table” (2).
The author uses the vibrator and its predecessors to examine three themes:
- androcentric definitions of sexuality and the construction of ideal female sexuality to fit them
- reduction of female sexual behavior outside the androcentric standard to disease paradigms requiring treatment
- means by which physicians legitimated and justified the clinical production of orgasm in women as treatment for these disorders (2)
“Massage to orgasm of female patients was a staple of medical practice among some (but certainly not all) Western physicians from the time of Hippocrates until the 1920s, and mechanizing this task significantly increased the number of patients a doctor could treat in a working day” (3).
“The demand for treatment had two sources: the proscription on female masturbation as unchaste and possibly unhealthful, and the failure of androcentrically defined sexuality to produce orgasm regularly in women” (3).
“There is no evidence that male physicians enjoyed providing pelvic massage treatments. On the contrary, this male elite sought every opportunity to substitute other devices for their fingers, such as the attentions of a husband, the hands of a midwife, or the business end of some tireless and impersonal mechanism. This last, the capital-labor substitution option, reduced the time it took physicians to produce results from up to an hour to about ten minutes” (4).
“Hysterical women represented a large and lucrative market for physicians. These patients neither recovered nor died of their condition but continued to require regular treatment” (4). [See below for economic impact of women's health in 1870s.]
§ The Androcentric Model of Sexuality
“The androcentric definition of sex as an activity recognizes three essential steps: preparation for penetration (“foreplay”), penetration, and male orgasm. Sexual activity that does not involve at least the last two has not been popularly or medically (and for that matter legally) regarded as “the real thing”" (5).
>50% (perhaps >70%) of women do not reach orgasm via penetration alone. “This majority of women have traditionally been defined as abnormal or “frigid,” somehow derelict in their duty to reinforce the androcentric model of satisfactory sex” (5).
“In the development of Western medical thought been thought on the subject of sexuality, it has been thought both reasonable and necessary to the social support of the male ego either that female orgasm be treated as a by-product of male orgasm, or that its existence or significance be denied entirely” (6).
§ Hysteria as a Disease Paradigm
§ The Evolution of the Technology
“In 1869 and 1872 an American physician, George Taylor, patented steam-powered massage and vibratory apparatus” (14)
The first electromechanical vibrator internationally marketed, a British model by Weiss, was designed by physician Joseph Mortimer Granville. Battery powered, it was patented in the early 1880s. (15)
“By 1900 a wide-range of vibratory apparatus available to physicians,” (15) and “Mary L.H. Arnold Snow, writing for a readership of physicians in 1904, discusses in some detail” about twenty-four different vibrators, “including musical vibro-massage, counterweighted types, tissue oscillators, vibratory forks, hand- or foot-powered massage devices, simple concussors and muscle beaters, vibrates (vibrating wire apparatus), combination cautery and pneumatic equipment with vibratory massage attachments, and vibrators powered by air pressure, water turbines, gas engines, batteries and street current through lamp-socket plugs” (16-17).
“In the first two decades of this century [20th], the vibrator began to be marketed as a home appliance through advertising in such periodicals as Needlecraft, Home Needlework Journal, Modern Women, Hearst’s, McClure’s, Woman’s Home Companion, and Modern Priscilla. The device was marketed mainly to women as a health and relaxation aid, in ambiguous phrases such as “all the pleasures of youth .. will throb within you”" (19).
In the late 1920s vibrators “disappeared both from doctor’s offices and from the respectable household press.” Was this due to “greater understanding of women’s sexuality by physicians” or the appearance of vibrators in erotic films? They reemerged in the 60s as an “openly marketed” sex aid. “Its efficiency in producing orgasm in women became an explicit selling point in the consumer market” (20).
2 Female Sexuality as Hysterical Pathology
§ Hysteria in Antiquity and the Middle Ages
“Hysteria was a set of symptoms that varied greatly between individuals (and their physicians), including but not limited to fainting (syncope), edema or hyperemia (congestion caused by fluid retention, either localized or general), nervousness, insomnia, sensations of heaviness in the abdomen, muscle spasms, shortness of breath, loss of appetite for food or for sex with the approved male partner, and sometimes a tendency to cause trouble for others, particularly members of the patient’s immediate family. The disorder was thought to be lack of sufficient sexual intercourse, deficiency of sexual gratification, or both (23).
“Hysteria appears in the medical corpus as early as 2000 B.C. in Egypt, but it was not until the time of Hippocrates in the fifth century B.C. that the Western clinical definition of the disorder began to take shape” (23).
§ Hysteria in Renaissance Medicine
§ The Eighteenth and Nineteenth Centuries
“Russell Thacher Trall, …, who was associated mainly with the hydropathic school, wrote in 1873 that women, including but not of course limited to hysterics, were an economic godsend to the profession of medicine, claiming that “more than three fourths of all the practice of the profession are devoted to the treatment of diseases peculiar to women” and that of the annual estimated aggregate income of United States physicians of more than $200 million, “three-fourths of this sum—one hundred and fifty millions—our physicians must thank frail woman for.” This amount “equaled just under half of the entire federal budget” (38).
§ The Freudian Revolution and Its Aftermath
3 “My God, What Does She Want?”
§ Physicians and the Female Orgasm
§ Masturbation
§ “Frigidity” and Anorgasmia
§ Female Orgasm in the Post-Freudian World
§ What Ought to Be, and What We’d Like to Be
4 “Inviting the Juices Downward”
§ Consumer Purchase of Vibrators After 1900
§ Hydropathy and Hydrotherapy
§ Electrotherapeutics
§ Mechanical Massagers and Vibrators
§ Instrumental Prestige in the Vibratory Operating Room
§ Consumer Purchase of Vibrators After 1900
5 Revising the Androcentric Model
§ Orgasmic Treatment in the Practice of Western Medicine
“The history of physical therapies for hysteroneurasthenic disorders … tell us several things about Western physicians.”:
- normal conditions can be medicalized, especially in women
- doctors both create and become invested in dominant social and medical paradigms
- disease paradigms go in and out of fashion (111)
In Western medical practice, “[t]here is a systematic effort to subsume the knowledge that the clitoris, not the vagina, is the seat of greatest sexual feeling in most women into the androcentric model and to avoid one-to-one heterosexual confrontation over orgasmic mutuality by shifting the dispute onto medical ground” (112).
§ The Androcentric Model in Heterosexual Relationships
“Many questions can and should be raised about the persistence of Western belief that women ought to reach orgasm during heterosexual coitus” (115).
“The penetration myth is not a conspiracy perpetuated by men; women want to believe in the ideal of universal orgasmic mutuality in coitus” (115).
“In our own culture there have been, and remain, powerful means of negatively reinforcing women’s demand for orgasmic mutuality” (117). [See also the rest of the paragraph!]
“Despite the systematic perpetuation of ignorance and misunderstanding—by women as well as men—most heterosexual men have looked to the female orgasm to reinforce their self-respect as sexual beings” (118).
§ The Vibrator as Technology and Totem
My conclusion:
Bottom line, this is an excellent book. It does a first-rate job detailing a bizarre, multi-millenial history of the medicalization of the normal functioning of women’s sexuality. Sadly, we have not really left it behind despite physicians no longer manually massaging women to orgasm, while denying that was what it was, and despite the APA dropping “hysteria” as a psychiatric condition.
There still exists far too much ignorance and misunderstanding about normal sexual functioning and far too many men measure their sexual (and general) self-worth on bringing their partner to orgasm via the androcentric model.
Read this book. It will give you a lot to think about.

