The 'secret' source of 'female hysteria': the role that syphilis played in the construction of female sexuality and psychoanalysis in the late nineteenth and early twentieth centuries.

In the late nineteenth and early twentieth centuries, the unspoken fear of syphilis played a significant role in the development of beliefs about female sexuality. Many women were afraid of sexual relationships with men because they feared contracting syphilis, which was, at that time, untreatable. Women also feared passing this disease on to their children. Women's sexual aversion, or repression, became a focus for Freud and his colleagues, whose theory of psychosexual development was based on their treatment of women. This article examines the case of Dora, the memoirs of Mabel Dodge Luhan and other sources to argue that the fear of syphilis was a significant factor in upper- and middle-class women's avoidance of heterosexual relationships. The fear of syphilis, in turn, became a significant factor in the psychoanalytic construction of female sexuality. The social suppression of the fear of syphilis has had a profound impact on theories of women's development. The implication for psychiatry is that our models of psychological development occur within a sociocultural milieu and cannot escape suppressed aspects of our culture.

Comparison of dose distribution by means of bolus versus water bath phantom techniques in treatment of cutaneous sarcoma of an extremity.

Cutaneous involvement by Kaposi's sarcoma (KS) is frequently diffuse, requiring large field irradiation. Selective tissue compensation techniques, accomplished with either a 1.5 cm bolus cast or water bath phantom, are compared. Dosimetric determinations were performed using 6 MVX with bone heterogeneity corrections. Application of 1.5 cm bolus effectively eliminated dose buildup and provided tissue compensation equivalent to water bath phantom technique. Treatment of other cutaneous malignancies, such as angiosarcoma, requiring higher total doses, should be accompanied by dosimetric evaluation, because cutaneous and midline dose inhomogeneity may result in a significant total dose differential over the target volume. Application of 1.5 cm bolus improved accuracy in treatment positioning, eliminated concerns regarding infection control in AIDS-related KS, and provided dose homogeneity comparable to the more standard water bath phantom technique.