- Chlorosis was a frequently diagnosed disease during the 19th century that gave the skin of the afflicted a greenish tinge.
- As a cure, doctors told young women to get married and reproduce, exercise or quit their studies, as befitted societal expectations.
- The disease, associated with iron deficiency, eventually faded away, likely because of better treatments and the end of overdiagnosis.
In the 1890s, 16 percent of those admitted to St. Bartholomew’s Hospital in London received the diagnosis of chlorosis. The disease entailed a host of symptoms, including anemia, amenorrhea, lack of appetite, pica (the urge to eat things one wouldn’t normally eat, like wax) and fatigue. But the most unusual — and the one that gave the disease its name — was the greenish tinge that the skin of the afflicted acquired.
Nowadays, if you Google “chlorosis,” all you’ll get are links to plant diseases. The plants have an iron deficiency, although the disease manifests as a loss of green, not an excess of it. Scattered human cases remain, but what was once an epidemic has largely disappeared. In the 1980s, hematologist William Crosby published a paper titled “Whatever Became of Chlorosis?”
For centuries, chlorosis was a constant — though the diagnoses behind it shifted with the societal and medical norms of the time. First described in 1554, it was known until the mid-1700s as the “disease of virgins,” and the best cure was thought to be intercourse (bloodletting was also a popular treatment).
Women were prescribed marriage as a cure.
Anna Scanlon, Illinois Wesleyan University
“Chlorosis was absolutely seen as a women’s disease, which meant, as it still often means today, that it got little attention and was easily dismissed with absurd cures,” says Anna Scanlon, director of the writing center at Illinois Wesleyan University and an avid researcher of chlorosis. Other treatments included telling women to conceive, exercise or abandon education. While there were physicians who believed that men could also contract chlorosis, such cases were thought to be extremely rare, and those men diagnosed with it were usually described as effeminate. The disease was predominately associated with the upper classes until the mid-19th century, when the medical establishment realized that poor women could also lack adequate nutrition and exposure to sunlight.
Boarding schools catering to the daughters of wealthy families were thought to be breeding grounds for chlorosis, much as they have been thought to be hotbeds of anorexia in modern times. The two diseases, it turns out, have much in common: Both have been strongly associated with femininity and thought to be diseases of the body and of the soul, born at least in part from the turbulence of adolescence and the restrictiveness of women’s societal roles. Treatments for chlorosis largely reinforced ideas of the time about what women should be: married, reproducing and not focused on education. “Women were prescribed marriage as a cure because they were considered unmarriageable if educated,” Scanlon says. “So it was essentially a way to kill two birds with one stone: Stop her from receiving an education and restore her to her proper place in society while also stopping the progression of the disease.”
So what did happen to chlorosis? The answer is likely threefold: the symptoms were shunted to a different diagnosis, hypochromic anemia; treatments became more effective by focusing on diet rather than on virginity; and doctors with young female patients no longer expected to find chlorosis everywhere they looked.
Much about the disease remains mysterious. It’s unknown, for example, whether the afflicted always turned green. A 1980 paper on the disease in the British Medical Journal suggested that “possibly many saw greenness because they believed they ought to,” and that the moniker “green sickness” might have been due to the women involved being metaphorically green (i.e., inexperienced).
Another reason chlorosis may have disappeared: There were bigger, flashier diseases to worry about. “Public health lost interest in chlorosis as larger concerns arrived on the forefront,” says Scanlon, such as “shell shock associated with the First World War, influenza and the pandemic of 1918.” Adolescent girls not getting their periods — even if it did turn them green — took a back seat and then faded away.