For millennia, Western medicine was in thrall to the humoral theory of ancient Greece. It wasn’t until the scientific revolution of the Victorian era that germs were understood to cause illness, but even then medical ideas about a woman’s body had more in common with those espoused by Helenic doctors than modern ones. Germs there may be, thought the medical establishment, but the womb still wandered and women who didn’t get good sex could still come down with hysteria.

Women, according to humoral theory, needed sex because unless the mouth of the womb was “bathed” in semen, they could become very ill. Until well into the 20th century, doctors and laymen still believed the womb could become unhinged, and start wandering around the body wrecking havoc. Women were, by nature, ‘cold’ and ‘wet’ and ruled by emotion, so they needed the hot, dry seminal fluid of men to keep them balanced. That’s why women had to be kept under such close social control – their internal cravings for man-juice would drive them slutty if they were left to their own devices. Moreover, husbands had to be careful about having coitus, or voracious wives would ‘drain’ them of so much vital essence they could die.

Unmarried women were at dreadful risk because of the lack of regular rumpy pumpy. Adolescent girls in particular could suffer from the lack of a husband to inseminate them. Young women could go so pale they took on a faintly green tinge, couldn’t eat properly, had no energy, felt short of breath, and suffered headaches … because they were virgins.

The populace embraced this belief as much as the medical establishment, and there were several colloquial names for this condition, including “morbus virgineus” (virgin’s disease), “white fever”, and “love fever”. If your daughter started drooping and getting malaise, she needed a husband ASAP.

The ideology behind the disease of virgins was poppycock – but the illness itself was (and is) real. It’s true name is hypochromic anemia and it often occurs when a girl or young woman has such heavy menses that she becomes anemic from blood loss, or from the more common anemic causes of iron deficiency, vitamin B6 deficiency, and thalassemia. It has nothing to do with virginity, of course, but it does strike adolescent girls more often than adult women, so you can see why the ancient physicians associated it with unmarried women, who were axiomatically thought to be virgins.

In 1554, German physician Johannes Lange called this illness by the term “green sickness”. By the end of the Tudor period and through the Regency era green sickness was the go-to colloquial term in Britain for virgin’s disease. The medical term for this illness, however, from 1615 onward was the more official sounding “chlorosis” … which means “greenish”.

The idea of who could be suffering from green sickness kept expanding through the centuries. Although it was still mostly young maidens who were presumed at risk, by 1681 English physicians like Thomas Sydenham claimed the ailment not only adolescent virgins, but any “slender and weakly women that seem consumptive” could get it, even if they were married. The treatment for green sickness was to ingest iron, which would cure the anemia even if the theory behind why it worked was bogus.

In the 18th century some physicians began to argue that green sickness could be caused by masturbation (which could also make both genders feeble-minded, blind, weak, and insane). Nevertheless, most doctors disagreed with this diagnostic criteria for green sickness, since orgasm (manually produced or not) was considered part of the treatment for the disease. When masturbation (especially women’s masturbation) became ‘dangerous’ in the 19th century, orgasm (called the hysterical paroxysm) without intercourse was only considered a healthy way to prevent hysteria and green sickness when it was facilitated by a doctor in a clinical setting.

Of course, once electricity became more common toward the end of the Victorian period, home kits for treating green sickness became very popular. These kits were vibrators, and they were for HEALTH not SEXUAL PLEASURE so it was totally okay for women to use them.

During the Regency period, when Jane Austen was writing her novels, green sickness was still the “disease of maids occasioned by celibacy” and considered particularly likely among those young women who had gracile frames and fragile constitutions, but it had also developed overtones of class and idealized femininity. It had become, like consumption, a rather romantic disease and a sign of a sensitive mind. It struck women who were dainty both inside and out. Women with nervous dispositions and no emotional fortitude. Women who were timid and passive. Women who were the exact opposite of bold, hearty, active manhood. Women who were, in short, extra girly.

In Austen’s novel Mansfield Park, the heroine, Fanny Price, is just such the kind of ethereal maiden that would get green sickness. Fanny had all the hall-marks of green sickness except the color, but since ‘green’ was interchangeable with ‘pale’, and Fanny was pale as a moonbeam, she could have still had green sickness. She couldn’t walk far without getting tired, had little appetite, got headaches easily, wept often from excess sensibility, was afraid of her own shadow, so passive she was practically an invertebrate, and was in general a tender flower of idealized womanhood.

Fanny’s pitiful, pallid physique and emotional frailty was in stark contrast to the robust health and lively mind of her nemesis, Mary Crawford. The reader of the time would have understood the implication that Fanny was a ‘better’ woman than Mary because the fragile Fanny was more ‘feminine’. Mary’s hardy and active makeup – both physical and mental – was a touch to masculine. It was a sign she was not endowed with as much heart as Fanny, and was a touch too worldly. Mary’s health was a sign her feminine attributes had been corrupted in some way … as Edmund Bertram would find out.

The idea that green sickness correlated with delicate feminine needs persisted even in the 20th century. Even though Sir Andrew Clark of London Hospital had “proposed a physiological cause for chlorosis, tying its onset to the demands placed on the bodies of adolescent girls by growth and menarche” in 1887, and pathologist Ralph Stockman of the University of Edinburgh had shown “that chlorosis could be explained by a deficiency in iron brought on by loss of menstrual blood and an inadequate diet” in 1895, here was still debate in medical circles about whether chlorosis was caused by anemia or a friable excess of femininity (or both) all the way into the 1930s. Yes, doctors were still ascribing green sickness to an overabundance of girlishness when Albert Einstein was debating quantum mechanics.

God forbid they let go of the idea the woman’s body is naturally weak and subject to her unmanly emotions!

Finally, in 1936 “Arthur J. Patek and Clark W. Heath of Harvard Medical School concluded that chlorosis was identical to hypochromic anemia.” Eventually the very idea of green sickness disappeared from popular culture. The debunked belief that women are ‘more emotional’ than men continues, though.