Something “Wicked” this way comes.
In the wildly popular musical-turned-movie primed for release this week, Elphaba — who later becomes the the Wicked Witch of the West — turns up to Shiz University with bright green skin, the result of her mother drinking a suspicious elixir while pregnant.
But here in the real world outside of Oz, there is evidence of a non-magical condition that caused young women’s skin taking on a verdant hue.
According to the National Library of Medicine, chlorosis, a type of hypochromic anemia, was frequently observed in inactive girls and young women in the 18th and 19th centuries.
Hypochromia occurs when red blood cells are paler than normal. It is a consequence of insufficient hemoglobin, the pigment that carries oxygen in the blood.
Also called “green sickness,” chlorosis was characterized by the skin taking on a greenish-yellow tinge, as well as exhaustion, shortness of breath, halted periods, reduced appetite, a bluish cast in the sclera or whites of the eyes, and a taste for sour foods like pickles.
According to Time Magazine, chlorosis bears a striking resemblance to “AAA disease,” a condition suffered by ancient Egyptians and immortalized in hieroglyphs.
Due to the youthful population that was most commonly afflicted, doctors in the Middle Ages called chlorosis morbus virgineus, or virgin’s disease.
Doubling down on the virgin association, William Shakespeare invoked the “green sickness” to describe a chaste Juliet in his play “Romeo and Juliet,” suggesting that the condition was caused by prolonged virginity and that sanctioned sexual experience was the only anecdote.
Chlorosis was also a popular subject for portrait painters, as the signature green hue has long been associated with nature, fortune, youth, inexperience, and envy.
The condition is believed to be caused by iron deficiency and, in addition to sex under the banner of marriage, was typically treated with iron supplements.
Iron deficiency continues to plague young women. A 2023 JAMA study found that nearly four out of every 10 teen girls and young women in the US have an iron deficiency, which can lead to low energy and brain fog.
In 1903, a doctor wrote that chlorosis “usually [hearlds] some disturbance of menstrual function, but chiefly characterized by deficiency of hemoglobin of the blood.”
He noted that it was not typically seen in girls in early childhood, nor woman over age 30, and was most common at the beginning of puberty.
“Sedentary occupation, indoor life, unsuitable food, excessive physical and mental activity, emotional or psychic disturbances are all causative in the majority of cases of chlorosis,” he said, calling it “remarkably frequent in girls who menstruate prematurely.”
After World War I, the incidence of chlorosis declined, thought to be due to changes in diets and better understanding of conditions like anemia.
In 1936, Professor Willis Marion Fowler of the University of Iowa published an obituary of the disease in the Annals of Medical History.
“The reasons for the disappearance of chlorosis remain in darkness, and with its disappearance, the explanation of its etiology becomes increasingly difficult,” he reported at the time.
Many scholars believe the disease was not a singular affliction but a name that applied to two distinct conditions, the hypochromic anemia described above and “chloro-anorexia,” a psychological condition related to anorexia nervosa that flourished throughout the nineteenth century and was also known as “the virgin’s disease” or “febris amatoria,” the fever of love.
In this instance, green may have been less literal and more metaphorical, an allusion to innocence rather than a physical descriptor.
