Documente Academic
Documente Profesional
Documente Cultură
ty of California
ern Regional
ary Facility
BY
PIERRE JANET,
PH.D.,
M.D.
SECOND EDITION
BY
Set
up and
electrotyped.
NortaooU
J. 8. Cashing Co.
PREFATORY NOTE
ON
new
New
I avail
Let me,
Philippi,
drawing
too,
thank here
my
friend
M. Edouard
in
CONTENTS
PAGE
PREFATORY NOTE
vii
LECTURE
THE PROBLEM OF HYSTERIA
LECTURE
II
MONOIDEIC SOMNAMBULISMS
22
LECTURE
III
LECTURE
...
44
IV
DOUBLE PERSONALITIES
66
LECTURE V
CONVULSIVE
OF
FITS
ATTACKS,
SLEEP,
ARTIFICIAL
SOMNAMBULISMS
93
LECTURE
MOTOR AGITATIONS
VI
CONTRACTURES
.117
LECTURE
PARALYSES
DIAGNOSIS
VII
138
ix
Contents
LECTURE
VIII
PAGE
LECTURE
THE TROUBLES OF
VISION
.159
.182
IX
.
LECTURE X
THE TROUBLES OF SPEECH
208
LECTURE
XI
LECTURE
THE
....
XII
LECTURE
THE HYSTERICAL STIGMATA
227
245
270
XIII
SUGGESTIBILITY
LECTURE XIV
THE HYSTERICAL STIGMATA
THE CONTRACTION OF
THE COMMON STIG-
MATA
293
LECTURE XV
GENERAL DEFINITIONS
INDEX
317
.
339
modify
seem
It does not
to us
very useful to
it
much
my
my
certain of
One
first
preceding interpretations.
researches on hysteria
have directed
my
is
:
symptoms recognized in the attacks, the somnambulisms, the disturbances of motility and sensibility,
ent
my
first
in
I892,
all
1911, p. 239.
ri
Introduction
xii
ideas."
up
Symptoms
It
is
of Hysteria."
sum up
is
by that
disposition
them,
to
ical
all
This view
is
really interesting
fit
the patient
agitation.
is
agitated because he
is
is
thinking of
ought to be
still
extended.
One
of the characters of
Introduction
xiii
chiefly
the
of
paralyses,
the
depending on
This is what has
contractures
in this disease
constituted
the
essential
we
of
But
the neurosis.
is
if
before
in
mental in which
impairments
of
old
deliriums
hysteric
it will
are
nearly
forgotten
now;
these
lectures
English.
To be
able to explain a
symptom by
auto-
Introduction
xiv
mind
formed into a
belief,
and that
this belief
has played
is
No doubt
to suggestion, but
it
and
it is
rise to serious
my
it is
Major Symptoms
of
hysterical
anesthesias,
distractions,
Introduction
xv
tried to ex-
plain the hysteric neurosis through conversion, symCertain ideas, certain recolbolism, "driving back."
lections present themselves to the
mind
of the sub-
ject in a painful
them: he
and when
themselves
to
his
consciousness, he
they present
he
does
not
allow
them
to develop, to
stops them,
realize themselves in acts and clear thoughts, and
endeavours not to notice them, to forget them. "Driving back," it was said, forms a part of the systems
subject
The
In
my
last
had occasion
on subconscious phenomena. In that work I examined a remarkable case of left hysterical hemiplegy,
in which, after a tragical event relative to his left side,
Introduction
xvi
itself.
tried
nomena analogous
to
me
and wiih
stronger reason, I
consider the theories of "driving back" as incapable
of giving a complete explanation of the hysterical
neurosis.
The facts that are interpreted in this way
insufficient, so,
still
With
be considered as the
To produce
such
back must
al-
seems to
me
to
new
it
Introduction
xvii
if
It
This is why in my last writings, which attempt to complete these lectures on hysteria, I
have begun again the analysis and the interpretation
of the psychological phenomenon of impulsion, which
seems to me to constitute the essential part of all
ment.
is of
is
of a deferred
and conditional
act.
To
Introduction
xviii
both these forms of action, the essential is the establishment of a connection between the idea of the act
either
immediate or deferred,
it is
the
operation of assent.
individuals,
reflection.
The
ideas of
mind,
but they are stopped, suspended in their development, and are not immediately transformed into wills
or beliefs. They are compared, opposed to one another in this comparison, one does not only take into
;
Reflection calls
up moreover the
still
latent
It
is
which
by
The
wills or beliefs
tendencies,
weighed
all
of
personality, they are accompanied in the highest degree with the feelings of personality and reality.
Such assents are difficult and require mental activity
of a high order.
may be
Introduction
The
xix
assent
them,
like
reflective
It is such wills
beliefs,
and such
of automatism, deperson-
is
Selfish
interest
mode
who
xx
Introduction
by some
desire or other.
Impulsion appears to
me
to
evolution and
is
elementary assents.
We find here once more the fundamental phenom-
enon which plays an important part in all the disturbances of the mind, the decay, the lowering of the mind,
which passes from a form of higher activity to a lower
This phenomenon
too
much
is
is
of which
Introduction
xxi
fallen into
of the
depression, and
first
degree of
In that state
capable of reflection,
which disappears only in the third degree, that of
aboulias, but they are incapable of the rational or
still
efforts
powerless by themselves. At the level of mental laziness, the subject is passionate, selfish, lazy, and given
to telling
lies,
psychological activity assumes in this form of depression, but he has not yet any characteristic accidents.
relaxation.
Introduction
xxii
and
and
belief,
the strongest. It is at that moment that the suggestions, the fixed ideas, the deliriums arise which complicate the disease during longer or shorter periods,
till the subject reascends to the preceding level, that
of
mental
laziness.
In
all
inferior levels
falls
In
many
psychoses,
in
confusions,
in
toxic
or of reflex activities.
more or
profound aboulia. It is these oscillations, these depressions to a mean depth that account
for the insufficiencies of the mental synthesis and the
less
Such
are, briefly
summed
Introduction
in
my
last
works I have
tried to
xxiii
add to the
first
I have
investigations presented in these lectures.
simply indicated them in this preface to encourage the
PIERRE JANET
Paris, April 10, 1920.
The
interest
The
Brief
account of the evolution of the studies about this disease
The necessity for the psychological study of the neuroses
GENTLEMEN:
of hysteria
President
teaching which
is
It
is
mode
American
may
of
uni-
France.
great
aim
of
all
true
civilizations.
method
Unhappily the
is
very
difficult,
called
I congratulate
very
myself
of Hysteria
No
doubt
am
you
my
apologies;
then, I wish
you
may overcome
bad luck and forget as much as possible the inand strangeness of my language. This
done, let us all do our best
you to understand me
well
and
to
draw
from
these lectures some
tolerably
notions of what interests French students; I, to speak
nearly intelligible English and to give you as favourable
an impression as possible of the psychological study
this
correctness
French
universities.
With the approval of President Eliot and of ProJames J. Putnam, I have chosen as the subject
of these lectures the study of that nervous and mental
fessor
to
me
is
who
The
another country, he
is
expected
his
The Problem
of Hysteria
Well,
cookery.
most characteristic
it
in
seems
to
me
that
No
the development of
doubt, the clinic and
is
pathological psychology.
anatomic study of these same diseases
developed in
Germany and
France, and
it
in
have
in
is
whose names
was realized an
Ribot,
two of
my masters,
I like to recall,
interesting
union between
before.
for the
rowed from mental pathology which strongly illuminate the problems of psychology; on the other hand,
notions of experimental psychology have been made
use of in order to understand and sometimes to treat
patients' mental disturbances.
make you
seems
to
Among
feel
me
how
to
these
interesting
I
is
should be happy to
this
new
study, which
of
pathological
psychology,
and
of Hysteria
we have
for this
Look back
scientific reasons.
historical
Binet,
Fe're',
Tourette, Brissaud,
Marie,
and
Grasset,
Gilles
de
la
Freud, Morton
Prince,
kind
of
common
a
was, by
singular
understanding, the subject of all their works. No
doubt they seemed, like Professor Ribot, to speak of all
Moebius,
boeuf,
etc.
Breuer,
Remark what
possible mental diseases and to seek for mental disturbances in all the forms in which they present themselves.
Now
and
then,
it
is
true, they
devoted a few
but
lines to idiocy or insanity
you read their books
"
Malaagain, you will see that, whatever the matter is,
;
dies
de
la
Me"moire,"
"Maladies de
la
if
"Maladies de
Personnalite","
Volonte*,"
they always
la
met among
speak
memory, which
hysterical
som-
nambulisms of irresistible suggestions, hypnotic catalepsias, which are, as I will try to prove to you, noth;
siderable
The Problem
had the
greatest influence
new
science, but
are
somewhat
now
of Hysteria
on the development of
this
you
any marked
degree.
it
is
only
is
hypnotism
to
now
among
hys-
be found
in
the difficult
duced somnambulism and about its psychological properties were made on hysterical subjects.
Consider even
share
have always had for their starting-point hysteric phenomena as equivalences and anesthesias. In a word,
given to the development of that pathological psychology which has been growing these twenty
if
any
years,
for
its
No
interest
it
is
this interest
has
hysteric,
It
of Hysteria
is
We
many drawbacks,
diseases.
practical
same
patient,
for you.
is
full of difficulties
though
surely simple.
to say
that
The psychology
It is
we
are
of the
and
hysteric
obscurities, is
and
in laws,
what an
in-
another owing to
common
While no-
defi-
who
pathology of hysteria.
In short, I
The Problem
was
right in saying to
disease seems
now
of Hysteria
the reason
It is
why
I told
who
this
who
are not
To
:
the
who talk
dangerous, on whom we can
are easily managed,
tion.
first
studies were
we
practical order,
easiest
disease.
II
Do
of the hysteric
is
and by reasons
patients,
if
happily
it
is
The
study of these
is
at the
educated
am
man
know something
of this
and
still
attractive
mad
It is perhaps somepeople.
exaggerated, but it is nevertheless true that most
accomplished by
what
Hysteria
by means
of the
emotion
seemed
to
crowd because
be different from
human
who
their nature
nature.
Their
victions;
another
extraordinary delicacy of certain senses joined to extravagant insensibilities which enabled them to bear
the most dreadful tortures with indifference or even
with delight. Not only did they feel but they also lived
otherwise than other people; they could do without
of the
and burnt;
The Problem
Well,
of Hysteria
already, are
all
the usual
is
not,
from
exactly the
same now: we have changed only in apWe beatify but few saints and we burn
pearance.
but few demoniacs, yet we have not forgotten them;
they have become our somnambulists and mediums,
to
throw some
light
on the
Whom
is
certain direction
medically speaking,
it
a hysteric
is
person.
Understand
me
well.
do not mean
at all to tell
Ages
whom
I diagnosticate as hysteric.
be a saint
a hysterical person
person may
wonderful lucidity: that
;
is
undeniable.
hysterical
may have
I only
want
know
well in
what
tion
we
io
whom
of Hysteria
To
wonderful.
problems,
indispensable to study thoroughly this
disease of the mind.
it
is
This remark
is
truer
still if
mind
know
had a bad reputation, that a kind of dishonour was attached to this word, and that people tried
to persuade themselves that this shameful disease was
that
it
By
a kind of international
irony, people were willing to admit, after the innumerable studies made by French physicians, that hysteria
was frequent only among French women, which astonished nobody, on account of their bad reputation.
Do
terribly like
The Problem
of Hysteria
one of those
silly
countries,
it
it is first
them, then because they would not give them their real
When medical instruction is more general
appellation.
when
envying France.
So you
will often
You
them neurasthenic
I don't care.
I only
will
its
me
to tell
blunders.
It is
and
to treat
it
for
what
it is
not.
You
and one
of
12
of Hysteria
all
they
structions,
and above
tumours.
What happens
all,
of false uterine
and ovarian
Then
Do
number
of
arms cut
do homage
to
by
and
If I could
interest to the
knowl-
The Problem
of Hysteria
13
a very important
result.
Ill
in
We
our
own
way
exactly.
We
add our
efforts to theirs,
and
to
make some
steps
forward in the way they have laid down for us. The
history of these studies would be a very long one, for
they began in the remotest antiquity: Democritus
already has his theory about hysteria. But I think
that we can summarize this long history in a few
divisions,
history
of curiosity
admiration.
and
of
it
It is the
is
a period
uncritical
vulsionists of all
facts
14
etc.
wounds,
The second
of Hysteria
period, which,
in
reality,
it
that appertain to
the
phenomena
clearing away and
it.
to recognize
It is
a kind of
which
is
first
ancestors
sufficient to
remind you
and Fernel.
who gave
Lepois,
best descriptions;
hysterical nail,
(1758),
was one
little
later
we have
to cite Charles
one of the
the
Raulin
who supported
of the
men; Witt
first
and
The Problem
studies
of Hysteria
at
15
an interpretation im-
body
and occasioning various diseases,
until desire and love, bringing man and woman together,
make a fruit and gather it as from a tree." This pretty
into extreme dangers,
little
story
was
uterus
(va-repov),
first
its
existence
on the
in
exist-
The
men changed
the
remind you of the names of Georget (1821), of HufeGermany (1836), of Brachet and of Landouzy
land in
in
France (1845),
\6
who
of Hysteria
the articulations,
his
name
to
an
We must accord
general work
of real value
and
it
it
was the
prepared the
way
for the
the
Charcot,
who
in every
precision to the
of hysteria.
clinical
knowledge
With these studies are connected the distinction between the epileptic and the hysterical fit, which was for
a long time considered impossible;
the diagnosis of
we owe
motor accidents
limb.
In
all
The Problem
of Hysteria
17
common
to private
and hospital
this
much
in the physi-
to a certain
number
and
studies,
much more
in
domain
of the
moral
phenomena.
The
contest of the
of
twenty years,
however, that
are
still
its first
clear results,
though
interesting,
you against their attractive simplicity. A certain number of authors have been seduced by the psychological
It seemed to them that the mere words
and "thought" were enough to explain every-
explanation.
"
"moral
thing,
of Hysteria
mental explanation.
a psychic disease it
say,
taken in a vague sense;
is
is
it
Hysteria, they
the disease of suggestion,
consists in disturbances
that,
when
Many
it
There
is
my
some truth
We
should, in
physicians think
have
few
a
formulas
of this
they
expressed
it is
quite insufficient.
retain
opinion,
something of the precise
method of Charcot, of the search after the determination and the laws of hysteria, and apply it only to the
psychological fact, instead of always seeking for this
determinism in physical facts. We must therefore use
The
phenomena
of hysteria.
is
very
difficult, first
its
very vague. It is
contemporary authors do not
surprises
young people.
You
The Problem
reality definiteness
it
of Hysteria
19
exists
men
made
continuous.
Do
Remember
which may
other.
All this
is
still
truer in
we
certain
objective
lesion
invent.
when
cases,
phenomenon
a microscopic
be
a
and
the
guiding mark,
recognition
organism
of the bacillus of Koch will define a tuberculous lesion.
lesion;
is
of
and
to
accurate.
Nowadays
evidently a hypothetic, conventional part in the description and definition of a mental
there
disease.
Nobody,
of such hypotheses
is
When
2O
of Hysteria
possible subjects.
among
appears to be the
describes
measure
in
is
hystericals
or
all
the
shades these
symptoms may
Such symptomatic and hypothetic descriphave the inconvenience of being transitory, of dis-
hysteria.
tions
to seek
to
it
would be a singular
eternal.
One has
when one has done
do something
Charcot,
The Problem
whose method
I cited
of Hysteria
to you, applied
it
11
in
a rather
hysteria; he
exaggerated degree
described a type of hysterical which disappeared with
him nobody nowadays any longer describes the attack
in his description of
I think,
many
types of hysterical
We
wish they
may have
time.
If I
is
called
somnambulism,
patho-
of his patient
I shall thus
among them.
LECTURE
II
MONOIDEIC SOMNAMBULISMS
Somnambulism
as the typical
form
of hysterical accidents
The emanci-
an
idea, of
a partial system
somnambulism
that lack of
success I easily explain through his error of the startingThe hysterical fit of convulsions, far from being
point.
variable
22
Monoideic Somnambulisms
23
of consciousness;
of consciousness
may
illness
sums up
to construe that
nervous
affection
in
istic
symptom
of hysteria, a
somnambulism,
the
fit
moral symptom,
of
somnambulism
that
is
which
phenomenon, impossible
to explain, that
adds
itself
nambulism
troubles
neurosis,
well,
one
it
is,
is,
If
more or
less
constructed on
be chosen to be
24
of Hysteria
and the
easiest to understand.
somnambulism deserves
to be called monoideic,
and
com-
What, then,
exactly,
is
a somnambulist?
Popular
very well what sleep is. That answer means only that
the person spoken of thinks and acts in an odd way,
from that
of other people,
is
in
no truth
in
Gentlewoman.
field,
I have
seen her rise from her bed, throw her nightgown upon her,
unlock her closet, take forth paper, fold it, write upon 't, read it,
Monoideic Somnambulisms
afterwards seal
a most
it,
to
bed; yet
25
all this
while in
fast sleep.
Doctor.
benefit of sleep
Enter
LADY MACBETH,
Lo
my
life,
fast asleep
Doctor.
This
with a taper
is
How came
You
see,
and, upon
how
hands.
Gentlewoman.
It is
I have
her, to
seem
in this
why, then
!
26
of Hysteria
am
sure
of that;
's
all
still;
the
perfumes of Arabia will not sweeten this little hand. Oh, oh, oh
Doctor. What a sigh is there! The heart is sorely charged.
Gentlewoman. I would not have such a heart in my bosom
!
Doctor.
whole body.
Doctor.
yet I have
who have
known
died holily in
their beds.
Even so?
gate;
Doctor.
Will she go
now
to
bed?
Gentlewoman. Directly.
Foul whisperings are abroad.
Doctor.
Do
To
Unnatural deeds
Gentlewoman.
Good
night,
good doctor.
[Exeunt.
they
Monoideic Somnambulisms
27
Her
niece,
who
lives
window
of the
in a
fit
of delirium.
fails,
and we may notice the beginning of the singular symptoms we are going to speak of. Nearly every day, at
night and during the day, she enters into a strange
state; she looks as if she were in a dream, she speaks
softly
mires her fate, her courage, that her death has been a
She rises, goes to the windows and opens
beautiful one.
tries
them one
after an-
had happened.
my
works.
That woman, a
hysterical thirty-five
28
of Hysteria
very
little,
now
she pounces on
all sorts
of food, picks
up with her
teeth,
as she
them
is
and
tries to eat
them up.
unable to devour
in effigy.
won't
insist
mind
it is one of those
changes
about
by a suggestion or an
personality brought
invading idea which are already well known. At the
in
Third observation:
sents a
in bed,
still
A man
more singular
case.
He
usually remains
We
won't
Monoideic Somnambulisms
slowly,
jumps
29
we
takes his
for he
house
paralyzed in his
a poor
bed for months.
man who
has been
upon
relat-
We
daughter in a poor
The
girl
at
3<D
of Hysteria
back again
then,
as she put the limbs upright, the body fell to the floor,
and it took infinite exertion to lift it again into the bed.
and
acts,
own
suicide.
She discusses
it
aloud, seems to speak with her mother, to receive advice from her she fancies she will try to be run over by
;
a locomotive.
That
life.
detail
is
also a recollection of a
on the
is
floor of the
room, waiting
She
and impatience.
Monoideic Somnambulisms
31
poses,
of
minutes.
The
as
dif-
when
it
happened.
I could tell
the events of
life
in
girl reflects
kind of delirium
It is,
32
and
of Hysteria
in all
point whence
we
more complicated
II
do
it
to the return of
is
sudden, there
a half
faint.
is,
as
When
it
patient pays
slowly, or interrupts
activity
and
his
work.
close application
seem
In short, voluntary
to disappear, to give
dream.
When
Monoideic Somnambulisms
Undoubtedly we
33
all
Some
serve in
somnambulism.
we have
of
the
as
patients,
all its
we
various forms ;
will
We
his consciousness,
dull
memory
speaks
as
if
of,
and we may
and
they were
The
real.
them
exactly
unfolding of hallucinations
is
When
the patient
speaks, he has a fluency of elocution and even an eloquence that seems superior to his normal powers,
to express.
ness in his
movements
that
make a wonderful
actor of
was rescuing
One
of
my
patients
who does
not
know how
34
of Hysteria
somnambulism. It is no
there
is
no
and
wonder,
mystery about the case in the
somnambulic state that woman remembered the writing she had learned at school, as a child, and had to all
to write, writes during her
The development
of the
somnambulic delirium
is
not
The patient
only intense,
repeats the same words at the same moments, makes
the same gestures at the same place, every time he beit
is
He
seems to have on
when he has appropriated his somnambulism to a given room, he remembers all that he did at each different spot he knows
;
to find there.
up
remember
where he
perfectly at
last
what
a journalist and
who wrote a
novel;
he waked after
him.
In the next
crisis,
is
way
Monoideic Somnambulisms
35
if
brilliant
unfolding of some
This
stop
is
it
Lady Mac-
to all im-
To make
patient
and speak
to
in accordance with
his delirium.
As the
is
The somnambulism
to consciousness.
is
ended
is
shut up hi a
the patient
comes back
36
memory he has
knows
also
his life
lost
where he
he has, to
of Hysteria
all
He
of
which he
how
his
it
is
came about.
If
try to
awaken
memory by direct
happen.
the patient has just done in his delirium, you will either
revive his memory so vividly that he will fall back again
will
He
does not understand what you mean. All the preceding scene which hi reality is so lively and persistent
in his
memory,
since
of his consciousness.
characteristics that
it
crisis,
itself,
seems
at that
come out
in
two opposite
moment
quite out
chief psychological
somnambulism.
Dur-
characteristics manifest
a huge unfolding of all the phenomena connected with a certain delirium second, an
themselves;
first,
Monoideic Somnambulisms
37
the state that appears as normal, two other characteristics appear, opposite, to all appearance
the return of
:
all
that
is
memory, and
them unfolded
in every hysterical
phenomenon.
Ill
The
just
is
different
from what
Her
it
is,
et
38
of Hysteria
unable to
girl is
young
in
astonished at
die
is
from ?
do
mourning
something
did,
it.
do not understand.
I not feel
more sorrow
Why,
loving her as I
I can't
grieve
father,
mind.
illness,
anxieties about
many
curious instances
the
gap as well
on one point
is
memory.
the loss of
But I
memory
on the
may
it.
be extended to
He.,
who has
all
the de-
Monoideic Somnambulisms
39
Sm.,
who
is
remember
his
observation, in
which
this connection
this retrograde
a very singular
amnesia accom-
called Lucien.
Cf
"
.
p. 234.
N^vroses et Idees
fixes,"
1898,
69,
40
of Hysteria
related to the physician the story of her life and the beginning of the disease. It is worthy of note that the
her somnambulism.
According to my belief,
by an amnesia which is
is
But
I believe this
less concealed,
and
in proportion to the
somnambulism itself.
the somnambulism is followed
retrograde, and bears not only
How
can we understand, how can we picture to ourwhole of these facts? What is the essential
selves the
to
idea, the
memory
of
and
their
They have
also
a great
tendency to development
Monoideic Somnambulisms
when they
are
41
power.
Allow
me to
represent to you this system of psychological facts, which constitutes an idea, by a system of
points connected together
by some
FIG.
The
lines,
forming a sort
i.
point
S represents
the sight
V is the
sound
is
book,
my
first
42
of Hysteria
But
first
the utmost.
at the
same time
in healthy
connected with
it,
memo-
whole consciousness of the young girl with all its memories and other tendencies.
Let this large circle, P, near
the
girl,
little
the
memory
life.
depend on
it.
Generally the partial system remains
subject to the laws of the total system it is called up
only when the whole consciousness is willing, and within
:
Now,
to picture to ourselves
it.
Monoideic Somnambulisms
43
first,
study of the
because
it
because
first
it
phenomenon
will serve us as
of hysteria
repeated
it
exactly in
secondly,
you
it
will not
it
be long before
clearly.
LECTURE
III
forms
somnambulisms and
The emancipation of
GREAT many
feelings
and emotions
They
we have
same phenomenon.
Sometimes
somnambulism
just
sometimes
are still of the same kind they must be explained in the same manner, and, if we wish to understand hysteria well, it is very important we should know
the possible transformations of that fundamental state
phenomena
of
somnambulism.
nambulism.
The
first
fact
we meet
authors.
This fact
is
the hysterical
44
mania
of running
away
we
call
better, fugues,
We
if
we may keep
shall begin, as
certain
number
45
we
are
wont
to,
of clinical cases, as
by showing you a
if
it
The
eccentric,
life.
found in his family, since his brother was also a nocturnal somnambulist, who got out of his bed while asleep
to
work
at his exercises.
mistaking
vious
we
of,
somnambulisms
similar to those
we have
already
because they form a link between the
phenomena we have spoken of and those we shall
described,
first
it
One
have spoken
it
is
describe to-day.
This man,
P.,
was
One
day, in the
46
of Hysteria
was very
distressed.
him how
office.
fears.
trifling
it
remain
in that
German
police,
whom he
always believed
have their
may
be, the
man we
enlisted
for
much
On
loved.
incident took
who had no
great acquirements.
To
his
work
47
in the
He was made
trouble.
who was
quarrels
his brother,
conditions that
we come
to the third of
happened then.
He
left
railway
line, just
48
of Hysteria
as
if
to dwell
neuropathic patients.
The blow
It
is
just
fits,
of great changes of
what happened
in this case,
for
after
that
memory of all that happened afterwards on that Sunday, the third of February, 1895,
and on the following days.
When
at Brussels.
Nancy on
happened
in the
awoke
in the
All that
had
that
He
49
we
we
it
I shall only
hysteria that you have not yet acquired.
tell you that we contrived to know what happened during
it
to the story
of his fugue.
On
of guilt,
and
in the evening,
which he spent
in
wandering
quietly at
an hotel
home.
in
He
rose early,
rail-
station,
still avoiding with the greatest care the persons who, he fancied, were running after him. And in
fact he did avoid them very well, for his disappearance
Longwy,
At Brussels, he
first
went
50
to
of Hysteria
pity
an important
part, for
letter of introduction to
That
charitable foundation.
letter
he found
it
played afterwards
and
to recollect
terrible poverty.
Dutch Indies
the
He was on
;
Here something very extraordinary happened, something very interesting as a psychological fact. As he
thought he was at the point of death, he could not help
changing the bent of his thoughts, and in spite of himself,
You must
had never entered
idea
to himself,
from
know
"But, after
He
all,
why am
my
family?"
51
The
we must
observe
If
facts.
observation, you
I will only
sum up
will find
it
is
it
the
it
also
more
this entertaining
second
Here
volume
of
I shall
ideas.
to-day.
The
in the neck, of
lowing
is
which we
lectures.
him
to drink, and,
they would
which
fill
palm
deserts,
flustered,
and negroes
was
by those pictures,
However, when his
struck
half tipsy.
life,
honourable career.
to rise in that
Now
for he
come on
there
quite
unforeseen
accidents,
"
Necroses et Idees
52
of Hysteria
more or
St.
one idea
left in
and
his
head
he had but
sea, enlist
away towards
sail
on the highroad or
to
in
I will dwell
is
par-
ticularly
it
fifteenth of
of
Melun.
of succeeding in his
scheme and
Mediterranean.
fatigue
living
to
him
that go
more or
He
now
company with
He
piness.
53
it,
They went
slowly
evening,
The
old china
we
this,
the
August
boy
Why,
heedlessly said:
it is the feast
of
"The
fifteenth
the Virgin
of
Mary,
He
the anniversary of my mother's name-day."
had scarcely uttered these words when he appeared to
be quite changed.
He
looked
to
all
his
said,
of the preceding
months.
and had
lost all
They had
to
memory
go to the
the matter
to Paris,
conclusion of a fugue ?
54
The same
particular
observation, which
is
to
of Hysteria
be found in this
I will relate in
final
a few words.
when
newspaper
of a
young
name, and wondered what had become
of him.
"
Why,"
is
not
so,
and we could
easily collect
described,
the
same
and
in
twenty very
we have
just
easily recognize
features.
n
Let us then try and find the characteristic feature of
the observations we know.
You have noticed yourme, how obvious the analogy
between the phenomena called hysterical fugues and
In a
the monoideic somnambulisms we lately studied.
selves, while listening to
is
we
we
abnormal
state there is
55
latter.
First, during the
a certain idea, a certain system
applied to the
an exaggerated degree. It
evident that P., for instance, constantly thinks, during
the eight days his fugue lasts, of the charge brought
to the situation of
a railway
officer,
grocer's boy.
They
abnormal
state, the other thoughts, relating to the forthe family, the social position, the personality,
appear to be suppressed. It is very likely that during
their fugues those people assume false names, and
mer life,
you
personalities;
will
an interesting obser-
is
that these
personality.
system of
their
former
name,
ideas and wake up.
self,
they
their family,
fall into
another
56
that,
state,
of Hysteria
fit
or of the abnormal
to an extraordinary extent.
But, at
the
the same time,
thoughts and feelings connected
with an idea that predominated during the fugue have
ished,
and that
much
and
coffee trade,
none of the
tastes of
an adventurous
He
sailor.
does
very
-his fugues.
comes of himself
and be
rid of
really had,
.to
them.
all
to
him about
again, since he
the hospital in order to get advice
I insist on that point.
If the boy
might
if
so, for, during his normal life, his feelings are not
same as during the period of his fugue. You may
observe the same fact in the railway clerk, P. Wtyen
he is awake, he does not speak at all in the same way
of the charge his brother brought against him not only
does he realize perfectly that there is no truth in it,
doing
the
57
it is
of no importance.
He
not worth while to upset his home and spoil
is
it
his situation.
recalls the
filial
love.
normal you
find
of
ollection
nambulisms apply
to such cases.
you add
If to this
these fugues
the two
that,
of hysteric
som-
nambulisms.
We
and
must
insist
this diagnosis.
little
summary
In
my
be ranked among
reasons first, because they represent to us
:
all
the major
already known of hysterical somnamIn the next lecture you will learn a new char-
characteristics
bulism.
somnambulism that it may be artificially reproduced, and that in this artificially induced
somnambulism the memory of the first abnormal stage,
acteristic of this
of the
fit
of natural
somnambulism, reappears
entirely.
The Major
58
Symptorlis of Hysteria
Long
exactly in the fugues we are now examining.
awakening of his last fugue, when he seems
after the
have no remembrance
to
at
all
of
what happened,
the young Rou. can be put into artificial somnambulism and can then relate to us with amusing precisehis adventures in the
ness
all
and
Cadet, hauling
seems to
me
phenomenon apart
confusing
only
when
the
is
The second
It
reason
we must
it
to you similar
which must be
another classification.
insist
upon
is
that fugues
the
will
life
of
have
59
cannot help saying that I often doubt these diagnoses, that I am not sure of the diagnosis of epilepsy
me,
But
esting paper.
in the end,
if
you
in his inter-
find a genuine
a subject
in
who
is
preceding characteristics,
on the other hand an epileptic,
is
than with epileptical phenomena. This is rather frequent, and is not inconsistent with the important comparison we made just now of the phenomena of a fugue
and those
of hysterical
somnambulism.
ourselves,
we must
recognize differences.
the
idea
that
more ado,
lay
60
down on
ence
is
no
this
is
is
that differ-
The
Remember
there
of Hysteria
less
is
intense.
Secondly,
somnambulism
Our great somnam-
in the
room,
if
she heard
voice, she
my
on a railway
On the contrary,
track.
who make fugues need a great many perceptions and recollections to enable them to travel with"
out any mishaps.
What is most wonderful in fugues,"
"
Charcot said, is that these individuals contrive not to
the patients
number
and
of people.
speak
sometimes told that they were thought
odd, that they looked preoccupied and dreamy,
We are, it is true,
a
little
but after
all,
mad
people;
in the street,
is
not at
So you see
the same,
all
that the
We
called
normal:
the oblivion of
the
fugue
is
it
is
normal
by
self is
much more
idea.
state
total,
feel-
and the
complete.
61
While the
latter
state should
be attenuated.
Ill
In order to understand that degradation, that transformation of monoideic somnambulism into the hysteri-
in
to
understand the transformations of typical somnamI mean polyideic somnambulisms, which are
bulism.
opposed to the
first,
as their
One
stand
fill
name
them.
several.
is an hysterical woman, Leg., who has led
a very eventful life, and has had several very dramatic
Here
One
day, at the period of her menstrual discharge, she had searched her lover's desk and had found
a letter that confirmed her suspicions, showing her that
lisms.
62
Hysteria
Now
a third story.
One day, again at the
period of her menstrual discharge, she stole a revolver,
placed herself in ambuscade on the roadside, and saw a
to the rule.
She shot
After
in
all
hospital,
she
by
at
falls
air, pulls
These
63
The mind
is
That
hours together.
is
thing foreign to the idea itself that has unified those three
or four ideas and has gathered them into one crisis.
young
it
twenty
found
a
appears,
girl
same look of terror, she begins to sweep the room without seeming to think in the least of the scene of the rape.
Another time, it appears, she found a wheelbarrow and
rolled
it
64
of Hysteria
Read again
the amusing observation about the somnambulist of Mesnet already described in 1874. That
man had
One
idea, awakened by an
comedy; it awakens anand so on indefinitely. Somnam-
impressions he received.
of these
monoideic
states in a
few words.
There
is
a great
many
different ideas
somnambulism.
seem
to characterize the
part that the difficulty lies on the surthat at bottom the phenomena remain the
I think for
and
face,
65
my
The
event.
is
a well-defined
is
The
that
may on
Well, in polyideic
upon
this
more
many
different
a mental unity.
somnambulisms and
in fugues,
it is
borne.
It
is
odd deliriums.
certain
com-
LECTURE
IV
DOUBLE PERSONALITIES
The
interest of the
somnambulisms
rocal
tation of
X.
lida
of
amnesias
"Lady
oj
First type of
MacNish"
The
recip-
The group
complex
true denomination
The
The
and
oscil-
mental activity
THE
sential
phenomenon
metamorphosis, whose
scientific interest is
es-
new
very great,
when they
neurologist of
1894
it
New York
in practice.
M. Dana
celebrated
published in
570, a compre-
Double
Personalities
67
Let
sum
of the
well-known
cases.
it is
Such
it is in America
why, I don't know
that the greatest number of remarkable cases have
some reason
it
is American doctors, among them
MacNish, Wood, Weir Mitchell, Dana, and quite re-
appeared, and
cently one
of the greatest
We cannot,
in
which have been presented. I refer you for this subject to the recent book of Dr. Morton Prince, "Dissociation of a Personality," 1906, and to that of MM.
B. Sidis and Goodhart, "Multiple Personality," 1905.
You will find in these works all kinds of psychological
discussions in which I should not like to venture.
So
making
typical forms
known to you and to showing you in a few words in
what manner these new states, which present so many
three
somnambulisms.
68
of Hysteria
The type of double existences is given us by a celebrated case, more legendary than historical, published
in 1831, in a work of Dr. MacNish, entitled "Philosophy
of Sleep";
whose observation,
it
is
it
appears, dates
still
1
Mitchell and Elliot in I8I6.
observation
This
is
very
old
no longer
find
much
who
is
called the
"Lady
of
MacNish."
A well-informed, well-bred
stitution
was suddenly
to that
Double
Personalities
On
69
awaking, she
which she
was before her first sleep. But she had no remembrance
of anything that had passed during the interval.
In a
word, in the old state she was ignorant of the new state.
It was thus that she called her two lives, which were
continued separately and alternatively through remembrance.
During more than four years this young
state in
remember
new
state,
these states,
she
first sleep.
If
state,
to
new
state her
Revue
Azam, "Les
alterations de la
and
id.,
"Hypno-
yo
of Hysteria
method which
great use in
my
This schema, I
French students.
memory
their
No
different
in a very
varieties
al-
ready accustomed, in
little
various lesions of the organs, and especially to represent the disturbances of sensibility.
There existed no
schemata of
for
we have
this
There
resentation.
an oblivion two
in
are, indeed, in a
remembrance or
different things
We
resented simultaneously.
when the remembrance exists: for instance, it is
to-day that I remember the studies on double conscious-
time
ness ;
We
to
The
horizontal line
in
my
124.
OX in all these
Figures 2, 3, 4, 5,
the right, designates the different
periods of the course of life in their order of appearance.
It is on this line that we inscribe the remembrances at
from the
the
left
moment
to
of their appearance.
The
vertical line
OF,
Double
from the bottom
Personalities
71
same
periods,
"December
FIG.
2.
Schema of a
Kaempfen,
As this height
possesses at such or such a moment.
naturally increases as life passes away, and one can
up more remembrances, normal
be
memory
represented by this triangle, whose
base is the horizontal line OX, and which is formed by
theoretically
will
call
72
the diagonal
of Hysteria
If
will
you have to
mark a black
will
manner.
ceding time;
(Figure
as
life
3),
aspect of the
schema
is
You
the
memory.
We
can
It is
You
p. 109.
et
will
I dees
remark, in
fixes, 1898,
I,
Double
fact,
Personalities
73
remembrances alternate
In the
No.
i,
the
"Lady
of
Mac-
1891
Ma;
1892
,.1893
1896
180*
at all.
When
i,
she
have pro-
74
posed to
call this
somnambulisms."
form
of
of Hysteria
somnambulisms,
"
reciprocal
life
into
each other at
"
only a small number of cases with the type of the
MacNish."
of
kind, but at
Two
time.
and that
all
The
case of
Dana
of Habillon,
reported
Lady
perhaps of this
events the disease lasted a much shorter
is
by M. Guinon, approach
to that of
intelligent,
calm
child, rather
all at
somnambulisms in " L'etat mental des Hyste"riques," 1894, II, p. 197; "The Mental State of Hystericals," translation by Mrs. C. R. Corson, New York, G. P. Purnam's Sons, 1901,
1
The
reciprocal
p. 419.
2
S.
Weir Mitchell, " Mary Reynolds, a Case of Double ConThe Transactions of the College of Physicians of Phila-
sciousness," in
Double
State I
FIG. 4.
now on
75
II
II
U
Schema
Personalities
After
p,
we
shall
from eighteen
with
all
and
was
all
left
to
But
it
76
of Hysteria
cheerful,
was no longer
afraid
of
anything,
membrance
These
When
it
if
were,
I were
the second
corresponding period, with the same acquired knowledge and the same remembrances; but she again
forgot everything when she returned to the state No. i.
Double
Personalities
77
became
in a
manner
that, at the
end of her
since she
definitive,
remained
two
states;
No.
2,
i.
You
Mary
acteristic
of another
first.
II
have given to this new form the name of dominating somnambulism, because one of its essential
features is that one of the states dominates the other.
I
In this
more
intelligent
more
active,
more
memory, during
in the other.
is
lively,
particu-
this state, is
much
78
If
the
person of
of
"Lady
of Hysteria
MacNish" and
in that of
She
with Felida.
is
in the history of
Do
dogmatism
But
of Cousin's school.
not certain that there would be a professorship of psychology at the College de France, and
that I should be here, speaking to you of the mental
for Felida,
it is
state of hystericals.
It is
name
a physician of Bordeaux
who
Azam
"
Society
reported this astonishing history first at the
"
of Surgery," then at the
Academy of Medicine," in
"
January, 1860. He entitled his communication, Note
this case
an
would be possible
to
years.
made, was
And
it
this
communication, thus
to revolutionize psychology in
Azam
under-
As
this
I told
"
Taine, in his book on
Intelligence," then
"
Diseases of Memory," took possession
Ribot, in his
you,
first
Double
of this history,
to-day there
is
Personalities
79
woman.
the
since
appearance
This frequently
see later on.
She had
of
puberty.
examine now.
had changed
her character for the worse she was a reserved, melanShe had a great number of
choly, and timid person.
;
disturbances of sensibility,
and
consisting both
of
pains
diffuse insensibilities.
Among
all
it
Then
already remarked in most somnambulisms.
she would wake up suddenly, become gay and active,
and bustle about, without any anxiety or pain she no
longer had those painful sensations or those insensi;
bilities
new
state
"Lady
of
MacNish" and
of
Mary
Reynolds.
She had nothing to learn again, because she had forgotten nothing: she preserved a very clear remembrance of
all
her former
life,
of all she
had learned
before.
8o
Hysteria
ing to
On
state.
return-
usual one.
was
for her as
if it
and
lasted
state
developed singularly
an hour or two.
;
it
But,
little
with
read in
all
by
little,
this
and days,
it was
active,
You
will
Azam
The awakening
went to consult M.
known
to her."
Some time
Azam
after, the
about the
"The pregnancy
dared not make it
state
No.
she
now knew
Double
Personalities
81
total
almost
whole
the
of
her
life.
first
and
Henceforth
filled
Felida
this
to pass for
mad, and
new syncope
was now her
restored
state,
till
which
habitual one.
On
black
spots
representing
is
memory;
82
this
of Hysteria
is
bulisms
If
"Lady
FIG.
justifies the
which
of
5.
MacNish," are
Schema
of the dominating
somnambulism
in the case of
Felida X.
Dufay
(1893),
"
The Mental
Double
dwell upon
this.
Personalities
83
really
new
psychological phenomena.
But it would be well to form a third group, which
might be called the group of complex cases, in which
to be placed.
who have
great number
to
These
tions
reciprocal
memory;
when he
this state
No.
same
4.
is
in the state
No.
2 or in the state
time,
at the
For
which we
shall call No. 3 in which they not only rethe other periods of the state No. 3, but also
remember the periods of the state No. i and of the
member
by modifications
one period,
now
of character;
in
of the
another;
memory
affecting
now
secondly, by modifications
one state he
is
gentle
and
industrious,
84
of Hysteria
in another he is lazy and irascible ; thirdly, by modifications of sensibility and of motion; in one state he
is
insensible,
he
is
and paralyzed
etc.
An
in
another
plegic,
tried
group in a table these four modifications, characeach state. The most curious fact of this state
terizing
is
by acting on
state of
memory corresponding
especially interesting
point of view of the artificial reproduction of
from the
We
need not
But these
facts
are
let
somnam-
us consider
ham H.
you
Daily, 1894."
feel in
subject,
it
The
a kind of
history
is
strangely related
an exaggerated seeking
after surprising
and
Double
supranormal
Personalities
phenomena,
which of
85
course
inspires
you with some fear as to the way in which the observation has been conducted
it nevertheless contains
many
;
attacks, terrible
more or
sented
less
all
of this case
Lastly,
is
very amusing.
to point out the last and most re-
we have
felt
him.
Whatever precautions one may take, the
ideas of the observer in the end influence the develop-
to
ment
it an
of the
somnambulisms
artificial
complication.
of the subject,
However
it
and give
may
be, I
86
of Hysteria
this strange
phenomenon
of multiplex personality
in hystericals.
Ill
We
Besides,
works published
I only
discussions very well conducted.
before
this
to
wish,
lecture,
concluding
give you a few
indications as to the direction which, in my opinion,
find
these
and as
to a general concep-
phenomena.
a young
woman
celine, entered
of twenty,
the
hospital
a lamentable state.
For several months past she had not taken any food
her to swallow.
Besides, she
tion of evacuation;
she
last stage of
life
left;
Double
Personalities
87
she remained constantly lying in her bed, being incapable of standing. Her mental activity was as much
and seemed
of stupefaction.
her otherwise,
As we
we had
to
be in a serious state
practice.
into
and
singular
state,
we
which
appeared momentary
entrance
into
the hospital.
any vomiting.
without
Lastly, she
difficulty.
On the
perfectly
vivacity,
anterior
much
better, with
more
of all her
state
back
state,
see
new
this
fell
one more
dis-
turbance; namely, according to the law of somnambulisms, which you know, she had quite forgotten what
88
of Hysteria
we were
somnambu-
was very
long,
we
left
her.
So
that,
The
taneously, that
is
state of depression
had drawn
all
these disturbances,
do nothing else
but put her to sleep again, or rather bring her back to
her artificial state.
I could
Well, gentlemen, things continued in this way fc r fifteen years. Marceline would come to me in order to be
Double
Personalities
89
put to sleep, enter into her alert state, and then go away
very happy, with complete activity, sensibility, and
memory.
either
then,
slowly or suddenly,
some emotion,
fall
back
in
into her
consequence of
numbness, return
we had
ness
now
poor
girl,
who succumbed
to
the death
till
pulmonary
of the
tuberculosis.
Marceline to be explained ?
You see they are quite like what we have just described in connection with the dominant somnamstates of
bulisms of Felida.
The
latter
also
had two
states,
all
an
Marceline resembles
much
her so
We
by M. Azam, as well as by
all
We
at the
No.
when
is
seem
to
me
quite incorrect
applied to this case, which I followed so long. It
absurd to
call state
No.
i,
life,
it is
un-
90
by
in
of Hysteria
such a
state.
In
reality,
it is
false
she began
this
point.
The
hospital, with
all
an abnormal
state in
in
the
insensibilities,
No.
state
2.
But what
shall
we
why we
It
young
girl
lost sensibility
At
first
little
Double
Personalities
91
is
than before, G;
she forgets
*-..yc
FIG.
6.
Diagram
Marceline.
Then
she goes
down
If
very slowly.
you
let
her
fall
preceding periods.
It
which give
somnambulisms. 1
anesthesia,
of
I think
is
it
is
remembrance
total
these
falls,
of the
these returns to
to the
absolutely the
same with
all
such cases,
nominations.
No.
state
i,
Felida
also
had
in
her
exists,
childhood
except in her
life,
"The Mental
92
to
have kept.
There
is
of Hysteria
subject
In
was observed.
view things become somewhat clearer;
this
essential
phenomenon
that, in
my
which
is
falls
opinion,
is
a kind of
and
rises
sufficient
the
at the
oscilla-
suddenly.
transition,
of activity: the
one
These two
states separate
from
existences.
Here, again,
a mental dissociation more complicated than
There is dissociation, not only
the preceding ones.
there
of
an
is
of activity.
LECTURE V
CONVULSIVE ATTACKS, FITS OF SLEEP, ARTIFICIAL
SOMNAMBULISMS
hysterical
and
epileptical
fits
The
fits
The
of sleep
associa-
The diagnosis
crisis of
of
emotional
neurosis.
it is
be able to connect them with the more typical somnambulism, of which they are only inferior forms. You
will understand the interest of this study, if you notice
93
94
that
first
it
applies to two
Hysteria
in practice,
fits
of sleep.
tell
nomena
is
manner.
Sometimes
will
soon
by an ensemble
of
connected together in a
fits
see,
often constituted
choreic movements,
You
tics,
of
certain
the subject
we have
phenomena
first
to attend to,
Modern
have
attacks.
At
first sight,
the patients,
who seem
to
have become
Convulsive Attacks
unconscious,
and writhe
in
95
convulsions,
disorderly
to
appear
we have just studied.
gent manifestations;
his
drawer, to
There
is
nothing of
movements.
Yet
view,
is
These
bulisms.
stituted
have
crises of hysteria
A man
begins to
fall
96
of Hysteria
lamp
a
on
fire;
in others,
it
fall
began to have
forms.
terrible
You
fits
of hysteria,
which assumed
example that the starting-point of convulsive attacks is the same as that of the
preceding somnambulisms.
many
see
by
this
play an important part. It is true the patient maintains that the fit occurs irregularly, without her knowing why, and that it is brought on solely by physical
There may be some truth in the remark that
causes.
the time which has elapsed since the last attack plays
a great part.
When
had
their
fit
Convulsive Attacks
97
But besides this general prenone the less true that a thousand
it
disposition,
may produce
this effect.
The
sight of a flame,
some-
the dog
is
admirable in this
that a
respect:
enough
dog barks in the street,
she sees a cat pass by, the name of one of the animals
is pronounced, or even certain words are pronounced,
is
it
that a date
her to forbid
all
possible dates.
The
least thing
is
enough to bring about an endless fit, in which convulsions and howlings mingle together for fifteen or twenty
hours.
Is
it
all
an association of ideas between the dreaded perception and the remembrances which bring on the fit as
is
98
well as the
of Hysteria
The
somnambulism?
different terms of
find
it
more
difficult to
recognize
same law if you considered attacks, the startingpoint of which seems to be the touch or excitation of
the
importance was
You know
that formerly
which
the
at
men,
moment
on
either side.
of the
fit
Pains at
were so frequent
on
hysteria.
by
Plato,
You remember
which spread
all
kind of shame on
the
overexcited
and as
all
such patients.
matrix which
this satisfaction
It
was, he said,
required
satisfaction,
it
Ascended
through the body as far as the throat of the patients
and choked them. In fact, this sensation of uneasiness,
time
it
considered
as
quite
characteristic
of
hysteria.
Convulsive Attacks
The
as
99
it
She makes an
effort either to
big object.
may
intervene,
phenomena.
Do
if
there are
any
Then,
no part
in
in spite of appear-
our
life
and
in all
our
senti-
a part of the remembrance of the accienough that you touch one of these patients
the shoulder,
dent
it
is
is
on the shoulder
him
of his accident
crisis.
remind
The
idea
is
accompanied
the summit of the left
it
began.
The same
spirits,
ioo
What
of Hysteria
difficulty is there in
to this the
remembrance
an
of
affecting event.
now
Let us
struggling,
seems to wake up
all at
once or gradually,
her dress to rights, and, almost without any difficulty, gets up again and resumes her occupations.
Here is to be noticed a great medical fact namely, that
sets
the hysteric
fit
The
physical disturbance, as the epileptic fit does.
subject is not exhausted; she has not the stupefied,
haggard aspect of an awaking epileptic, nor the irresistible need of sleep which characterizes the comitial
fit.
Our
hysteric patient,
after
fit.
she
is
cries,
her indecent
She seems
to
have
Convulsive Attacks
101
it is
would only insist on the fact that our fit of real hysteria
ends with an oblivion like somnambulism itself.
I
now
Let us
are
They
itself.
patients grow
this extension
fit
first
stiff,
of
pression
tongue
the
mouth
patients
;
terror,
now
Now
ex-
the
they open
open with an
distorted.
their
piercing
in every
IO2
There
of Hysteria
is,
work
of Briquet.
said, "is
what happens to a somewhat impressionable woman experiencing a sudden and vivid impression. This woman
at once has constriction in the epigastrium, she feels
some
common
the most
most usual
hysteric spasm."
fits.
is
in fact
an ensemble of emo-
In
many
cases
tional manifestations.
ble to distinguish
thus
anger;
expressed.
they
It is
it is
even possi-
patients
strike, scratch,
bite,
plainly
and
manifest
and
and meanings have quite another
menacing;
not very
recognize erotic crises with the latter, for
they play certain scenes in a remarkable manner.
With the former, on the contrary, much oftener you
cries of the former.
It is
difficult to
Id., ib., p. 4.
Convulsive Attacks
have
crises of fear;
eyes, the
movements
103
are
quite
characteristic.
one who
In
phenomenon may be
many
said
to be intermediate;
her movements
more
expressive.
nambulisms, analogous
The
perfect.
crisis of
woman
the
For long
questionably belongs to this mixed type.
hours together the following phenomena mingle together
down her
the
first,
arms
declamations about
fate,
and
which
movements
of
L'homme
Man
To
is
these
bulisms,
est
un apprenti
an apprentice;
la
to
somnamsymptoms
IO4
which we
shall
of Hysteria
when we study
the tics
This
is
From
all
show us the
of the beginning
and
identity
essential manifestations,
we can conclude
that a great
number
somnamsomnam-
bulisms
tion
enlarged, disfigured.
simpler, coarser than
become
to
to
have
They seem
in
to
have
aspect
expressions.
They appear
to
inferior.
II
We
ing
shall reach
another
namely,
fits
equally
of sleep.
frequent
accident
of
hysterL
great curiosity
Such
patients,
who
Fits of Sleep
times for months together, do not
They
variety.
differ
in
105
all
the subject
his position,
fears.
of these
The face is
patients approaches that of a dead body.
of waxen paleness, without any expression, the eyes
are closed,
finds that
the pupils are dilated and that the eyes remain motionless; the skin seems to have grown cold, the visceral
ing
is
superficial
hollow and
certain
and
much
It appears that a
to perceive.
of patients in this state have been mis-
difficult
number
For
my
part, I
am
rise
always
None of
surprised when I hear of such mistakes.
the lethargic people I have had the opportunity of
seeing could, in my opinion, be the object of any illusion; a little attention was sufficient to avoid this
absurd mistake.
First of all
rather
numerous cases
stop
one cannot
tion,
it is
one seeks
well,
is
io6
never gives by
its
skin.
of Hysteria
little
peculiar
phenomena
ing hindered. In a word, I do not very well understand how one can mistake a hysteric patient in lethargy
for a
in
It
my
is
all
attacks.
We
shall
resume
this
who
sleep.
logical
do not think
many
First of
all,
few
little
movements
to speak, or
of the lips, as
if
Fits of Sleep
107
little is
By means
in detail,
of certain processes
self in relation
answer by speaking
sometimes he
will
answer by
If
to press it in order to say "yes," sometimes you obtain nothing but movements of the eyelids
and eyebrows: a slight lowering of the eyebrows will
mean
little
And you
mean "no."
cases,
you
will
Lastly,
be able, after
which
I shall tell
at the
end of
this
lesson.
By
and they
realize
is
much
mind
less physical
the fixed idea of
girl of six-
io8
teen,
terrified
by a
of Hysteria
bull
coming
to attack
which she
death:
by an accusation brought against him by a fellow- workman. When he meets with this individual, he becomes
motionless, like one petrified, and at last he slips to
the ground and lies, as if asleep, for hours together,
talking inwardly about the accusation brought against
him. He fancies he is before his employer, and defends
manner
same part
the
by the
We
special points
In
my
Fits of Sleep
end of these
109
fits
much from
ever,
you remember
were
intelligible
movements;
appeared;
that,
phenomena do
How-
somnambulisms, there
in
the
fits
of
sleep,
somnambulism was, as I told you, an idea persisting in consciousness and developing to an exaggerated
The development
is complete if it manifests
emotional
by
expressions, by words and acts;
much less complete if nothing remains but the first
degree.
itself
it is
may
still
persist
The
by anything outwardly.
by a kind of meditation from which nothing can distract him; he perceives no phenomenon foreign to his
dream, and this is the reason why he cannot be awakened
by any means whatever, and takes on the appearance of
being in a profound sleep. So we were right in saying
that this form of hysteric accident was also connected
with somnambulism, of which it was only the last
degree.
no
of Hysteria
III
I should not like to conclude this study of hysteric
place,
not a
new
to
form, at least
is
degree,
rare,
is
that
they can
be
artificially
re-
produced.
In most diseases, the accidents are not at our disposal.
To take only one striking example, we are not at all
masters of an epileptic
fit;
we cannot
stop
it
at will,
epileptic
wished that a
know,
us, try
logic
all,
fit
him
in every
We
phenomenon.
will not have the shadow
he
of
an
epileptic
fit.
An
fit.
no hold.
Somnambulisms
Artificial
1 1 1
diseases; nowadays,
ology, of microbiology,
plague,
when one
science,
It
pleased.
and sometimes
is
is
will.
in hysteric neuroses,
somnambulisms
that
first
is
it
nambulisms.
less precise
of
manner
whose development
it
it
is
up
necessary to recall
to dwell
is
mind
in the
fills
it
completely, to describe
sufficient to
make a
it
sometimes
sign, to call
the
window
you
will see
either,
\i1
to her illness
or,
if
you
insist
of Hysteria
a great deal,
if
you remind
in her dream,
at suicide
begun again.
What we have
forms
of
which
whom we
This patient, as you know, was transformed by hypnotism and kept during fifteen years two existences, the
former with depression, anesthesias, amnesias, anorexy,
and the latter with
etc., brought about by the hysteria
;
memory
de-
by
artificial
means.
Somnambulisms
Artificial
What
113
you of somnambulisms
is still
truer with respect to those incomplete forms of somnambulism which we have just studied under the name of
emotional
fits
and
fits
Those who
One
fell
abdomen
reappear
The
make
these
phenomena
artificially.
somnam-
phenomena. The
when
we
saw
we
studied polyideic
is,
that
new
ideas
somnambulisms,
may develop in this
identical with the original, natural
reason of this
as
114
The
thing whatever.
of Hysteria
greater
experimenter acquires over his subject is not long in transforming the somnambulism, in giving it a form and laws
that are often strange
and simply
result
of the experimenter.
One
accustoms her to
passionate discussions.
many
some subjects an
artificial
Thus
is
formed
in
my
personal opinion.
Is this
do not
for
my
state
in
hesitate,
tions
education.
if
you examine the subjects with whom
can be obtained, you will be convinced that
they are mostly hysteric patients, having already had somnambulism in some form or other, or for the remaining
Secondly,
this state
Artificial
part
Somnambulisms
115
hysteric
dents, but
hysteria.
Thirdly, you can verify, if you examine matters without preconceived ideas, the fact that subjects troubled
with other diseases than hysteria
epileptics, for instance, psychasthenics tormented
are not at
this artificial
who
whose mental
tends towards
be hyp-
notizable.
Fifthly,
and
lastly,
other
'
it
is
a somnam-
n6
of Hysteria
the
more than
half
LECTURE
MOTOR AGITATIONS
VI
CONTRACTURES
The
The diagnosis
anesthesia
Clinical importance
tractures
of
The
tremors
this
con-
The
accident
The degradation of
part played by mental phenomena
the movements in these hysterical accidents
history of which we are pursuing, very often present accidents of quite another
nature, which at
first
sight
seem
seem only
lar,
to
be different from
somnambulisms.
like the
we
the accidents
arm
In spite of
somnambulisms the
in
be general.
mind
or leg, the
while
they
may
the
affect
former
delirium
intact,
seemed
to
somnambulisms,
appearing
for days
at
determinate
in the interval,
they
may
moments, and
last for
a long time,
of the subject
may
be.
They may
117
exist
dis-
state
during the
fits
Ii8
and
of Hysteria
nomena
last century,
of
do not hesitate
to connect this
ensemble
hysteria.
nosis later
Perhaps we shall be able to justify this diagon by showing that the mental disturbance
by mere
conditions
as
the
preceding
somnambulisms.
The
we
somnambulisms.
After a
fit
they
may have spasms or paralysis; inversely, these disturbances of motion may disappear in a new fit or a
new somnambulism.
No
phenomena which
Motor
The motor
Agitations
Contractures
have the
disturbances that
are
characteristic
and
various
very
119
preceding
irregular;
we
first,
phenomena
which seem
and
to develop inop-
portunely and without his consent, and second, pheof deficiency, in which, on the contrary, motion
nomena
seems
to fail
and not
obey the
to
will
and consciousness
In the
of the subject.
first
on ideas
You
tics,
all
which
know
to
is
the
commonplace phenomenon
be met under so
many
of
circumstances;
You must
are
tics,
some
epileptic tics,
all tics
and even
are hysteric.
There
oftener, psychasthenic
some
tics that
bulisms.
These
tics
ments of the
random, without any relation either to the present circumstances or the consciousness of the patients. This
I2O
of Hysteria
name
is generally reserved for rather sudden little movements of short duration, and other terms are used when
the same involuntary movements have a greater extent.
These
little
muscular shakes
them
in the face;
The
they constitute grimaces of a thousand kinds, affecting the eyes, the nose, the mouth.
in
various ways,
noses or to sneeze
draw
to the
one
backward, or
notice
stiff
tics related to
the visceral
seem
suddenly or
to
move backwards;
the shoulders
they
are shaken convulsively; the legs, instead of regularly
performing the act of walking, every moment interrupt
Motor
Contractures
Agitations
121
of course
make walking
movements
tion
is
not essential at the bottom, and must not preall the motor agitations in the
same group.
very often in the hysteric fit it constitutes those complications of the simple fit which I have pointed out
;
to you.
consciousness,
to indulge in
cease
patients,
their
without recovering
manifestations
emotional
perfectly regular
gymnas-
tics.
One
of the
most commonplace
is
salute, then
falls
she
may
thus
make
movements
of the
this salute
arm
or leg;
122
saltatory
movements
of Hysteria
a hammer.
either
when
lying or
when
stand-
of others
which have no
definite
name
this
one clinches
fists
In
all
their
maximum
of strength
and rhythmical
they
may
The
is
fits.
in possession of the
all
his recollections,
his
or separate them.
Though the more distinct hysteric chorea is thus
characterized by a rhythm, you must not fancy that
every other chorea in which there is no rhythm is neces-
was believed
formerly, but this too simple diagnosis had to be reformed. No doubt, a very irregular chorea, consistsarily outside the great neurosis;
that
Motor
Contractures
Agitations
123
ing in characterless shakes of the arms and legs occurring without any kind of regularity amidst voluntary
movements,
is
usually
the
common
chorea,
called
depend on
hysteria.
old, terrified
tionably
hysteric.
Amidst
these
various
accidents,
had
and
yet
hysteric
we do not
phenomenon
patient.
We
it
was a
show
among
that the
the possible
Its diagnosis
then
it,
insist.
II
tics
or choreic movements
124
of Hysteria
it is
When
state,
the
movement thus
companies
exists
realize the
it.
on it.
want
Of
has no influence
at all to
make
this
movement, and by
all his
produce
it.
The
appear powerless;
up
aware of
it
his eyes, he
may
no longer moves
We
see those
will
entirely;
in the
a somnambulist
waking
state
he
is
is
merely amnesic
it is
amnesia
Motor
that
is
Contractures
Agitations
125
Then during
is
called hysteric
may
present
itself
he
it is
and
in particular,
is
able to
important.
degree in
tics of
of the psychasthenic.
appearing involuntary,
of consciousness
his tic
when he
and
that,
The
when he
attention.
thinks of
seems
is
and
it,
tries to
keep
subject performs
directs his attenit
motionless.
It
126
of Hysteria
tic
When
absorbed by something
his
tic.
it is
You
and
he leaves
else,
him
the
tic is
his
off
mind
is
performing
conscious, that
There
is,
therefore,
no anesthesia
in this case.
The
subject feels his movement very well and all that passes
in the diseased limb.
With the hysteric, the move-
phenomenon. In
are much more
fact,
We
appear to be.
the
tic
intellectual
notice
nambulisms.
som-
man who
constantly
blew through one of his nostrils had had for a long time
a scab in his nose, consequent upon a bleeding at the
nose.
home;
girl I
am
attending
she worked
all
day long by a
of the head.
at
relating to a
now
stiff
necks
movement
felt
very dull
window that
desire was to
Her strongest
street.
monotonous work and go out into the street
At every moment
at which she constantly looked.
she lifted her eyes from her work and turned her head
to the left in order to see what was going on in the
looked out into the
leave her
Motor
Agitations
Contractures
127
An
side.
These
ideas, these
nomena which
now
had
singularly ag-
more or
less definite
stiff
mental phe-
how
work-people, bewailing
of the
It
128
of Hysteria
movement continues
it
We
can make
certain experiments
By
by
to effect.
tic.
hundred
were precipitated
forward, that she suddenly takes a leap and has often
In
fallen while taking it.
What a strange vertigo
steps, she feels herself as
it
who
to her parents,
sharply
reproached her for her irregular conduct. On going
out of their house, she took a resolution that simplifies
she made up her mind to commit
many things,
suicide,
and
in
dream, of course,
for
she
was,
she fancied
she had got upon the parapet on the bank of the Seine,
took a leap, and was awakened by a fall to the ground.
In
all
that works
The
unknown
difficulty
is
to the subject
is
undeniable.
a function in
its
arm
which appears
clearer
it is
and
clearer through
new
it
studies.
will
become
Motor
Agitations
Contractures
129
m
Indeed, the problem raised by such dissociated motor
activities working separately, outside of consciousness,
and
tremors
refer
to
contractures.
an average
oscillations
are
arm has
the
differ-
regular
little oscilla-
These
continual.
nearly
subjects with whom they never stop, either when they
rest or when they move; there are some others with
whom
of disseminated sclerosis;
less
when
to that
various
conditions,
One
of the finest
workman, who,
in
Motor
Contractures
Agitations
131
began
The
in the right
A woman who
from consciousness.
hand
presented an in-
was enough
It
spirits.
to
So we had certainly
writing.
with an incomplete
tic,
and
assumed
hand
be transformed into
to deal with
subconscious
a kind of
action
which
It is
what we observe
exceedingly
serious
nomenon may be
of
Brodie,
1837,
phenomenon
You know
tractures.
in
that the
of
history
hysteric
of
this
con-
phe-
to the evo-
lution of the greatest problems of medicine, for physicians have been led gradually to separate the hysteric
1
See
"
II,
Observation 95,
p. 332.
132
contractures from
and nervous
all
of Hysteria
affections with
confounded.
is
an ensemble
of
and
manner.
indefinite
Such contractures
which
of the face.
dis-
tinguished from paralytic phenomena, which they simufrom the ptosis of the eyelids, which fall passively
late
instead of contracting; and from the paralysis of one
;
You know
to deviate
Here
or thorax, and in each place new problems arise.
it simulates diseases of the vertebrae, deviations of the
column; here it transforms the breathing
and causes you to believe there is a pulmonary disease.
In other cases it assumes the appearance of all possible
tumours of the abdomen. It is these contractures which
originate the great medical errors of which hysteria is
the occasion. As regards the limbs, we have the convertebral
Motor
Agitations
Contractures
133
lous coxalgy.
wrist.
There is not a more important clinical
than
that
of contractures.
problem
Curiously enough, we also meet here with an im-
elbow or
chology.
It is
clear;
we know
phenomena.
except
when
tion.
it
After verification,
all.
real
he says, a carriage
it is found that the
and that he
shock would do
less
felt nothing at
than this imaginary
shock.
the
tain
134
of Hysteria
make
When
springs.
hard shrivelled
legs, twisted
bearing away
have the
and miraculous
his carriage
is
also
have cured
processes,
phenomena
in
determinate conditions by
by the
electric current,
all
sorts of
by magnets, by the
You
also
nomenon
itself lasts.
First of
all,
the contracture
is
than
The limb
is
generally believed.
is
not
stiff
in
A woman
had died
Motor
Contractures
Agitations
135
the interval of the crises, the feet alone keep the contracture, it is very likely that something of the delirium
persists.
if
observe in contractures
many forms
of insensibility;
may
become independent.
I must however add
difficulty, the
found
1
"
in
Une
germ
that
of which, indeed,
was already
Let us
try,
to
be
with our
interna-
136
of Hysteria
you are much more awkward than a hysteric person, and that, unless you have practised specially to
that
this end,
to
regularity.
Try
first
of all
it is also manifested
by properties of the
movements themselves. The muscular movement of a
draughtsman's hand is not the same as the muscular
movement of a dog's or a crocodile's paw. There are
some particular physiological properties accompanying
the perfection of the act.
Some are known: the
of
the
much greater, and in
contraction
is
rapidity
Motor
Contractures
Agitations
137
I even
anatomical differences.
Great
stress
some
tions.
the
The
latter
fibres of
voluntary movements. I suppose that it will be possion to observe some modifications in the pro-
ble later
portion of these two substances in the muscles of different animals according to their state of evolution, and
in the different states of the
same muscles
in rest or in
movements
of
It is this
phenomenon of hysteric
paralyses.
LECTURE
PARALYSES
The
VII
DIAGNOSIS
these paralyses
Traumatic neuroses
The beginning of
The most fre-
The
intrinsic characters
'
it
Twenty years ago, it was hysteric somnambulism that was in fashion; nowadays, one seems
very much behind the age when one speaks of somnambulism. The latest fashion is to apply one's self
the others.
and psychology. This lecture will be devoted to the study of hysterical paralysis from the
clinical point of view.
The next lecture will analyze
of physiology
Paralyses
Diagnosis
139
have seen,
may
mean that a
woman who has had
does not
fits
and somnambulism
is
neces-
everywhere nowadays,
so;
to
show us
that
it
is
not always
These paralyses appear in about the same circumstances as the other phenomena they are always brought
;
is
Estelle,
quite typical.
old magnetizer,
M. Despine
d'Aix,
in
1840:
of
an
girl
1860.
140
Hysteria
by an aggravating circumstance
much
namely, her
girl
Such
on her backside.
facts were hardly known
whom we
spoke
lately,
at that time to
The same
Brodie, Todd,
any
authors
Duchenne
(de
Railway catastrophes give rise to many of these accidents, and some physicians had even adopted the exFalls from carriages, from
pression of railway spine.
horseback, and shocks received in battles are their most
common
origin.
the
lumbar muscles.
who appears
tions I
is
141
Diagnosis
Paralyses
is
only imaginary
wounded by a
One
carriage
very strange:
A man
travelling
hemiplegy.
Other circumstances
may
house-painter
felt his
when
hand very
located in a limb.
tired while painting
ceiling,
hand.
found
it
likewise in a girl
piano.
an emotional
Fere*
piano
who had
a
is
girl
to the fatigue
who
tires herself in
of his right
who was
tired their
learning
hands on the
must be added
observation of
she
is
pursued by a
Fe"re"
man and
142
of Hysteria
is
exhausted
with fatigue, though she has not moved. The next day
she is none the less paraplegic. Lastly, there are some
paralyses that follow somnambulisms and crises, without our knowing very well for what reason, but as we
shall see later on, they affect limbs formerly paralyzed,
or having in them causes of decay, rachitic deformation, old scars, varices, etc.
The
others for the end of this study, because they are parThe
ticularly interesting as regards the interpretation.
most
common
hysteric paralyses
seem
to
The most
be analogous
frequent, the
the paralysis
is
fortnight ago.
right
day on which he
and her
when
Paralyses
its
143
Diagnosis
On
manner,
in a
may appear
after a convulsive
fit
more dramatic
an accident of
who,
this
kind in a
man
if
he
The second
severe
is
paraplegy,
is
about what
way
of the legs."
It
phantom, was
under her and
shake
able to get
up
births,
and
after
somewhat long
diseases in
which the
144
The
form
of Hysteria
will
upon the
paralyses.
of the face
side.
He
only admitted in the face the existence of the glossoThis opinion has been much contralabiate spasm.
dicted
may be
Lastly, there
refer
you
to the
studies I have
The
matter.
well,
and who,
most
interesting, in
is
girl
my
of
all
making on
who had
on every
side.
this
fallen into a
and
opinion, of the
able flaccidity of
differently
remark-
She was
her head and body fell inAt the same time she had a
the diaphragm, on which we
sit,
remarkable paralysis of
cannot insist for the present. 1
what
insist
on
their diagnosis,
which
is
of capital im-
Nvroses
et Idees fixes,
I,
Paralyses
Diagnosis
145
n
The
two manners.
First, in
an
extrinsic
made
in
turbances of the intelligence, the simultaneous phenomena, the circumstances of the appearance, etc. Secondly,
you can make this diagnosis by an intrinsic examination, which chiefly takes into account the paralysis itself
and
its clinical
characteristics.
to
pears nowadays
is often preferred.
scientific
and
make any
inquiry of the
Let us then
first
characters, since, at the present time, they are considered as more serious. You may first, in certain
cases, take into account the localization
and form
of
An
the paralyses.
has insisted
Do
thus affected.
one that
The group
that
is
affected
is
may
be
always
146
of Hysteria
regions.
otherwise in
is
lesion of a nerve
may
organic paralyses;
all
affect
muscular groups.
For instance,
marks further
is
re-
often seated in
the extremities
of
in
is
very rare in
A man
in the gait
Hence
walks
he
he drags his
walking as if he did not trouble himin the least, as if it no longer existed at all.
paralyzed leg in
self
about
To
it
characteristics;
hysteric hemiplegy
is
not accompanied
by any other
in particular, there
long time
is
147
Diagnosis
Paralyses
is
no atrophy, or
required for
it
at least
a very
so you must always carefully measure the two limbs of the patient. The existence of a
notable atrophy will help you to recognize certain lesions
of immobility;
of the
medulla or brain.
Nor
degeneration, which
medullar
lesions,
In
On
number
of
be suppressed, as
in tabes,
The
trepidation.
paralysis.
14.8
You
stance,
will also
of Hysteria
reflexes
for
in-
some
irregularities in children
foot.
man
is
to
You know
strongly inclines
you
to
admit organic
lesions, either
movements produced by
associa-
This fact
is
analogous to the observation of the preservation of certain subconscious sensations in spite of hysterical anesthesia, that
we have
According
absolutely characteristic,
and
it
is
ensemble of signs
is
possible to recognize
Paralyses
149
Diagnosis
supposed.
when
The
observation.
but practically
Most
it
is
is
thing
of the signs
theo-
perfect
much more
than
difficult
we have spoken
of,
You cannot
eliminate hysteria
is
exceedingly
irregular.
little moved
upward when
ap-
when a
difficult to
their
knee
is
struck.
It
which
is
this is true
enough, but,
added
is
much
in practice, I
am
to
it,
generalized.
defy you to
and
All
make
inclined to believe
that in hysteric
a real
due
150
Hysteria
quite certain.
Babinski's sign of the toes
In
reality,
clearly
in a hysteric paralysis.
or react
is
exceedingly interesting.
But
Many
by a retraction
it is
in
a mass of the
leg.
The
importance;
be always on your guard when you meet with the sign
But this sign is not absolutely
of Argyll Robertson.
characteristic
either;
of
first
all,
many
neuropathic
have
In a word,
may
it is
exceedingly valuable indications. The invasion of the face, the disturbances of speech, the
gives
us
think one
is
quite
wrong
in
diffi-
Ill
is
derived
Paralyses
of
Diagnosis
151
in hysteria.
We
This anesthesia
We
is still
must therefore
more
insist
characteristic in paralyses.
now on
its
study.
You know
witches and
was
to
of the devil
fact that
in 1824,
of
152
and
in the muscles.
It
may
of Hysteria
mucous membranes
it
may
to
re-
gards contact by passing our finger or a blunt instrument over them. We may hope to obtain more accurate results
us
by the use
of the aesthesiometer,
which shows
how
examine on these same regions the temperaturesensations by alternately applying on the skin, unknown
will
You
meters.
ties
may
separately.
of the skin
You
will
ments without looking at them, or better still, to reproduce them with his uninjured arm. Here again you
will often
The
it
is
much
rarer
Further,
when
'53
Diagnosis
Paralyses
nearly so deep as
it is
easy to
in
hysteric
insensibility
it
is
vous system.
One
and one
by Charcot and
nowadays still appears to us to be
very significant the
:
or
localization
the
Charcot
form
of
segments,
that
it
nated by
geometric
meaning
is
termi-
FIG.
8.
Schema
distinct,
foreseen.
at the
median
line of the
is
154
On
as
we
of Hysteria
You may
intact.
feels quite
tongue
tongue.
forms of organic lesions, in certain lesions of the inone may at most say that it is rare, and
ternal capsule
;
there
is
a broader
sensibility.
One may
more
of sensibility are
confused
much
form
you
information.
more instructive
line
under the
to say.
birth to
'55
Diagnosis
Paralyses
particularly
point of view.
by no means
respond
physiological
cor-
the
of
or even
nerves
nervous
that the
of
plex-
You
uses.
from a
to the dis-
tribution
the
extraordinary
They
know
hand
is in-
nervated
by three
principal nerves,
the radial, the median, and the cubital.
section
of
FIG. 9.
Schema
segments
in the case of
of the arm,
and the
limit
it
portion of the shoulder above the deltoid, which is innervated by the cervical plexus (Figure 1 1). A lesion of
the sacral plexus brings about, it is true, the anesthesia
156
of the thighs
and the
bilities
on
of Hysteria
genitals.
On
anus
is
Mcdtin
FIG. 10.
Paralyses
culation of the blood,
157
Diagnosis
cir-
is
FlG. ii.
than to
its
anatomic
the
hand terminates
For the
at the wrist.
common
They
people,
don't care if all
person
who
know
that
158
Hysteria
the immobility of her fingers is due in reality to a muscular disturbance in her fore-arm.
She stops her
anesthesia at the wrist, as would the vulgar, who, in
their ignorance, say that
it
is
is
is
if
the
diseased.
Now
this
popular
In the
you
will
which
will
itself.
Such
will
be the
LECTURE
VIII
of
hysterical
anesthesias
Absence of any
attention
The
all
The
dissociation
The
and memory in the
The astasia- abasia
The systematic paralyparalysis
ses
The dissociation of a system of movements
The
movements
sensations
in
and
a
function
system of
Hemiplegy and paraplegy as dissociations of functions
of certain groups of sensations
in the anesthesia
studies
development in
have contributed much to the development of patho-
itself
and
160
of Hysteria
We
shall insist
on the
finds
we
its
We
all,
without any
in the reflexes?
change
astonish
us
who
M.
the contraction of
all
At
my
my
The
patients,
161
Psychological Conception
hystericals
made
by the section
preserved ;
ered with sores, and
the animal
it
disappears
be
Sensibility
by
is
little,
for
a safeguard
fingers
this accident.
They are
is
mostly
When you
namely, the indifference of the patient.
watch a hysterical patient for the first time, or when you
study patients coming from the country, who have
not yet been examined by specialists, you will find, like
ourselves, that, without suffering
suspecting
it,
from
it
and without
anesthesia.
many
6a
many
patients are
them
to
much
surprised
their insensibility.
of Hysteria
It is far
tom
of tabes,
it
it,
and they
will
dote.
We
it
ourselves, but
it
was given
to us
She
fell
the
wound had
united
fairly well when, a few days after the accident, the young
woman presented herself for treatment. She expe-
numbness
rienced a certain
no
was
The
The
163
Psychological Conception
case
severing of the
ficial
of the patient,
was a
we made a
and
hysterical,
She
singular discovery.
was
on her entire left side she
"
The
came here
of the
to tell
palm
of
"
:
Be
you what
my
right
that as
ails
hand
me
you think,
it is
sir,
the insensibility
and that
of
You
all
are
that
we have
it
and seems
to correspond to false
popular notions.
thesias.
five;
164
of Hysteria
to another, says
M.
Fere",
disIt
and
may
pass unnoticed.
However rapid
may
some
of the circumstances in
The
affected.
zation
of
Many
sensibility.
authors
have
noted
We
an opposite phenomenon.
Cel.,
the attack.
intelligent sign
the
becomes modified.
Often, as
recovered entirely. After
the attack, many patients, like Marg., return to their
usual condition others have for some time anesthesias
sible),
sensibility
it
is
thetic
on the
usual.
left side,
The
It often
Psychological Conception
anesthesias disappear.
tactile
165
We
prise at night,
using
wake them.
We
It
is
difficult
very
to
all
anesthetic side.
We
had the
or less completely:
become
entirely
many
sensitive
more
when drunk.
Chloroform-
stigmata, with the anesthesia as well as the contractures. "Among the most paradoxical consequences
all
of the
"we must
with subjects
who have
lost
it.
Ball,
cutaneous sensibility
...
hysterical,
tiveness restored.
terical
by M.
66
of Hysteria
who
and we could
the drug.
Many
effects.
*
The
object of our first work was, above all, the numerous modifications of sensitiveness during states
of
induced somnambulism.
This fact has been sometimes pointed out in old deWe have very often
scriptions of the magnetizers.
established these
searches before
same
our
re-
we had read
somewhat upon
tactile
sensitiveness causes
re-
when
Others again have a more complicated somnambulism; they pass through several states in which
longed.
sensibility and,
above
all,
It is
"
The
Sensibility
167
Psychological Conception
may
The
effects.
somnambulism.
Many
The
We
left
association of ideas
may
in
it.
the tickling of
it
at this
moment
left
quite sensitive.
is
that only a
in directing
it.
fix,
As a
and
gen-
i68
we may
eral thing,
upon
their
of Hysteria
for
anesthetic
please.
patient does not feel the electric current
when he has his eyes shut. He acknowledges a tickling
We
take that wafer off and a few minutes later she can
no longer
last
of the study.
it,
They
or suppress
it
they give
it
an extremely changeable
Now
will
it
as long as
it
nitely ?
Is
plicate the
present
it
problem of anesthesia
dictory.
Lasegue said
and
in
that
strange,
turbation, a sort of alienation.
The
studies
which sub-
on an altogether
special point,
The
Psychological Conception
that
is,
169
on
certain
electricity,
We
used to treat
For a long time we had thus been applymere pieces of wood. We continued
with
ing electricity
without fastening the wires to the ends, and the con-
had dropped.
We
whose skin
when
Is.
she does not feel anything. As she is very simpleminded, she accepts without demurring, and we discover then a furious contradiction. Although she has
her eyes carefully concealed behind a screen, although
170
of Hysteria
to
answer
to say
attentively.
He
the
left
"No" when we
Here now is
longer on the tactile but on the muscular
sense.
The
How
tion.
Psychological Conception
171
We
The
these facts.
first
interpretation of
anesthesia of hystericals
is
extremely
changeable and contradictory. These patients pretend
not to feel, and by very simple artifices we can prove
Their insensito them that they feel perfectly well.
bility
is,
therefore, simulated,
only means
to
This risumt of
and
facts
insufficient.
interest or pleasure in
with needles?
Do
is,
Do
hystericals take
any particular
these
young
girls
How
is
it
that,
logical
fact,
we must
seek,
among
We
are
happy
to
have Lasegue
172
of Hysteria
we have maintained
hysterical anesthesia
is
for
a certain species
"A
absent-mindedness.
of mind, he
is
so
many
their very
less
There
it
a pathological incapacity to
in a general perception.
sensations
elementary
In reality what has disappeared is not the elementary
sensation, the preservation of which we have just seen
point.
is
in
collect the
We
this
shall .often
problem, but
let
is
not
unknown
to us
we have already
studying the
amnesias
The
173
Psychological Conception
We
illness,
which were
its
starting point.
reproduce them?
Was
it
word, she had forgotten nothing and she had the power
to recite everything.
the oblivion?
The
She could
relate,
it is
true,
We
somnambulism
tried to
is
174
of Hysteria
clearness
still.
They
is
leg,
they
reflexes
we dwelt
for
same
some
kind.
time,
The most
much about
.this
disease,
we should
fret
perpetually
One
inertia.
incommode them
to
appear
walk with but one
to
effort to
leg,
leg.
they think
it
quite natural
her like
move
his restive
The
Psychological Conception
175
If you- question
who
on
Fe"r
it.
was one
"After having
shut the patient's eyes," he says, "I ask her to try to
represent to herself her left hand executing movements
of the
first
of extension
and
can represent
insisted
this point.
She
flexion.
is
not able to do
it.
She
have remarked
Here
is
William James,
"
Ch. F6i6,
"La
I,
p. 377.
176
left
of Hysteria
right
hand."
made
'I cannot,'
means,
it
"They
'I
same
kind,
and we
find
nomena
with those
identical
somnambulic amnesias.
There is but one difficulty
logical
left.
What
is
in
the psycho-
In somwas the idea of an event, and was relabut have we in our mind the idea of the
phenomenon
nambulism,
we have observed
it
tively clear;
legs ?
Is
it
Charlton Bastian,
"
The
Psychological Conception
177
not to have the least paralysis of the legs, when you examine them in their bed. Not only are the reflexes
but
intact,
and the
movements are
intact.
fact
If
more surprising
you tell them to raise
is
the
their
legs, to
is
made one
They
step
and
realize the
paradox of having
make
no paralysis of
In a few, de-
more complete
certain movements
iy8
Hysteria
this disease, which was called astasiaseemed to be almost alone of its kind, but soon
physicians were obliged to recognize that there were
many other paralyses belonging to the same type, and
abasia,
Some
M. Babinski has
all,
shown such
mouth
the
the other
movements
sufficient to
of the lips.
systematic paralyses in which a certain system of movements, grouped by education, separates from conscious-
its
own.
These phenomena come much nearer to our somnambulic amnesia. The oblivion of her mother's
death which came upon one of our patients, and of all
the care she had taken of her during her illness, was
the loss of a system of images and movements which
comes very near the oblivion of sewing or writing. You
more or
less
if it is
make
it
hysterical paralyses.
The ensemble
of the
movements
of the right
hand
is
The
179
Psychological Conception
a system of images and movements, exactly as the ensemble of the movements necessary to play on the piano.
Only it is a much more extended and, above all, a much
older system.
It is the reason why it contains in itself
and involves all the sensations of the hand, whereas
will
you
ask me.
The two
same.
but
cally
It is, in
legs
Our
mind the
of the same
same
level,
role to play:
segment.
such a segment enables us to stand, such another to
seize objects.
it
sociated in
hypotheses,
its
entirety.
Lastly, since
we must not
it
we
can be
are
dis-
making
is a phenomenon
The movements of one side of the body also
form a system we have a very clear idea of the ensemble
hemiplegy
abasia.
of the actions of the right side as opposed to the ensemble of the actions of the left side.
No
tell
spine.
a system
that
it
do not deny
is
is
it
fact that
When
I begin to
180
of Hysteria
bicycle; it means that these different images have associated together and regularly call forth one another.
It is very likely that this functional association cor-
little
It is
my
persists
ride
we understand
tions,
walk on two
and
that,
who
tres,
but
it
is
none the
less
a function, that
is
to say,
may
lose,
of
The
Psychological Conception
181
toms
more or
ena,
less
paralyses.
on the
enough
to
it
is
LECTURE
IX
troubles
of
different
The
hearing
perceptions,
of
this
and
The
The
amaurosis
amaurosis
The
vision
with
taste,
The dissociation
The problem of
characters
contradictory
field
smell,
function of vision
partial dissociation of vision
Hysterical blindness
Unilateral
touch,
of
The narrowing
of the visual
the
and
peripheric
hysterical hemianopsia
central
compared
The
hemiplegy
Dyschromatopsia
movements of the eyes
hysterical
troubles of the
You
have
just seen
may
hysterical
This remark
is
ex-
we cannot
domain
of
We
tactile sense.
Besides,
The Troubles
of Vision
183
Remember
motion.
this old
remark
French doctor
of a
whom,
to
done,
in
may
who need
perception
jects
You may
called
phenomenon
him on
on
and
allochiria,
vice versa.
which
in
what
is
the
done
to
may
Lastly, you
on the senses
and
of smell
No more
do
I insist
and breathing.
We
shall find
speech,
but
may
also
it
hysterical deafness;
1
With
reference
<FAttochirie, in
my
"
Beware
separately.
frequent and,
if
of
I mistake
to this
book
exist
is
184
recognize
numerous
of Hysteria
errors of diagnosis.
To
it,
am
The Brain, 1883. To recognize this afremember that it is a central and not a peripheric
published in
fection,
deafness.
ness
is
peripheric,
when it
is
dis-
You may
verify
it
by making him
bones of his
skull.
The
still
this anesthesia,
and by
But there
is now beginning to be in fashion.
a sense so interesting from the point of view of
hysteria, and the alterations of which are so characterisof
which
is
tic
for the
son
why
comprehension of
want
to
much time as possible, and it is the reaour study on the hysterical disturbances of the
devote to
it
as
all,
The Troubles
of Vision
185
it is
an analytic power;
cho-physiological
Nowhere
it
have
system,
this dissociation
is
to
separates
more
The
its
functions.
reason
is
that vision
is
it
may
it
separate at
Then
it
may
and the
the mind;
rarest dissociation.
that hysteria
him
in
hysterical blindness.
This phenomenon
is
rare, for
seems that the subject always keeps as much as possible the essential functions, and loses only a part of
it
the
vision.
established.
However, the
As long ago
86
this blindness.
it
of Hysteria
many
draw your
belongs to the
phenomena
of traumatic hysteria.
He washed
himself, but he
mark
felt
and
had much
difficulty in clear-
no pain
to see as
it
in
them.
However,
after
Re-
and that he
an hour, he seemed
this mist
grew thicker
ing days.
later
From
little,
The Troubles
When
two years.
of Vision
examined
187
was
is less
serious
it
lasts
A woman
of
pears suddenly.
while reading, she sees, as it
following singular habit
red
flash
of
a
were,
lightning which illuminates the room
she shuts her eyes and, when she opens them again,
;
Once
Her
needless to
tell
just as
sight
it
disappears.
you that, when the blindness
is
and
we have
Inquire into
Theoretically they
in hysterical blindness;
already seen.
It
was so
it
is
nosis.
Of course you
Sometimes
solutely in
this
abnormal
lisms; then
it is
will find
all right.
Lastly, you
somnambu-
will
sometimes
and
in
showing
can
see,
88
of Hysteria
seem not
Professor Jolly,
"Those
children,
who
have
like
which happily
very perplexing to physicians.
hysterical blindness,
is
rare,
is
always
Happily it is no longer so, when we consider the incomplete and more frequent forms into which hysteria
amaurosis, which
man
and you recognize that they see quite well when they
have both their eyes open, but see absolutely nothing
when one of their eyes is shut. These observations
are innumerable
studies
1
hysteria.
rise
It is
to
many
perhaps
"
Ueber Hysteria bei Kindern," Berliner Klin. WochenNo.
34, p. 4.
1892,
F. Jolly,
schr.,
The Troubles
of Vision
189
The
reason
is
odd conditions and was for oculists an irritating problem. Why? There is nothing extraordinary
It is
in the fact that an eye is affected separately.
in rather
character
of
hysterical
anesthesia.
First
this
blindness occurs without any appreciable organic disturbance and without any impairment of the elementary
The
eye
is
absolutely uninjured
reflexes are
infrequently,
recognize a suppression of the reflexes of peripheric
origin; I mean the corneal and conjunctival reflexes.
The touching of the conjunctiva or of the cornea with
modic shutting
of the eyelids.
We
have there a
reflex
But
of superficial sensibility which may be disturbed.
the pupillary reflexes to light and to accommodation
are mostly perfect, with a reservation of contractures
In these
of the iris, of which I told you to beware.
cannot
see.
is still
more
to take aim.
The
190
Hysteria
He
is
a fraud.
On an
ab-
out of paper,
some blue, others red. To the eyes of the subject is
applied a pair of eye-glasses, one of the glasses of which
is quite of the same blue tint as the letters, and the other
of the
same red
tint.
Through
letters cut
only the red rays pass through, the red letters on the
black ground can be seen, but the blue ones become as
is
person
who
left
com-
one eye with the other and reads the whole word
without difficulty. In these conditions, a one-eyed
pletes
he quietly reads
The box
(Figure 12)
of
all
Flees
is its
is
still
more
ingenious.
into a
Here
little
for instance.
These mirrors
The Troubles
of Vision
191
by the
FIG. 12.
left eye,
Schema
eyed man,
self
when
who has
box ?
conduct him-
He would
say
"I see only one wafer, the white one, B, for instance,
but what astonishes me is that it appears on my left
side
now usually, I am not able to see on this side."
;
192
of Hysteria
sees only
in presence of this
very absurd
both wafers.
account of their
fits
when
especially in France,
phenomenon
With the researches of that period are connected the names of Regnard, Parinaud, Bernheim, and
little
studied.
if
you
will
me
allow
many
You know
on one of his
to recall
others of
if
it.
much
To
the
if you
press slightly
he
sees
two
eyes,
objects instead of one,
The Troubles
of Vision
193
is
concording points of
conditions, without touching the eyes you put a prism
before one eye, the same phenomenon takes place,
a one-eyed person.
You can
verify
it
by shut-
yourself
ting one eye and slightly pressing on the other the obWell, in the unilateral
ject moves, but is not doubled.
amaurosis of hystericals, all these experiments and many
;
others of the
same kind
give the
same
results as with
self insisted
advice.
edge that
M. Parinaud has
They can
194
of Hysteria
some dogs, whose two eyes are nearly on the same plane,
things are more complicated. These beings may
have not only the preceding monocular and alternating
vision,
This vision
more
but
we
it
an improvement on the
is
same ob-
which we
utilize in
many
cases,
sometimes involuntarily
to see sideways, or
voluntarily
pistol or looking in
a microscope.
of which
and
we
this is
is
They mostly
human
two
scarcely suspected.
vision.
is
lose
they
it;
it
The preceding
experiments, by
by making it neces-
The Troubles
of Vision
You
195
which
their
gular amaurosis has already dissociated the visual function in an amusing manner, setting apart now the binocular,
now
II
we
gain ground and enter into more delicate funcThe most important symptom to be known now
tions.
is the famous narrowing of the visual field on which
will
still
we ought
to
that
human
face
is
this
but this
definition
is
practically
field of
sufficient.
If
you
instruments which are called campimeters and perimeters, the description of which would be too long, you
obtain the following figure, which I have presented to
you in this picture of the visual field of the right eye,
R, in Figure
circle,
ferior
formed by the
The Troubles
of Vision
197
The
circle is
is
narrowed concentrically. The extent of the simultaneous vision becomes smaller; the field is almost
or 20, as you see in the left eye of the
Sometimes the field has only 10 or 5,
circular at 30
figure
13.
and nothing
is left
It is
retinitis,
true that
and perhaps
an
As regards the
been said that
field is
it
has
sclerosis.
psychological properties
ence to the subject, and this
;
have elsewhere
1
"
The Mental
insisted.
State of
is
field
who makes
has interesting
As a matter
of fact nothing
Hystericals," translation
into
is
English,
198
of Hysteria
to
which
remarked
him
was reduced
to a point, and I asked him whether he would be capable of playing at ball, if he had before each eye a card
I
to
by a
fire,
The Troubles
of Vision
199
executed even
done
first
field
in
field
way?
In other words,
is
We
hemianopsia?
it
looks.
The
is
question
Hemianopsia, that
is
field, is
phenomenon of
more important than
a frequent phenomenon,
The
section of the
retina,
cians
is
had come,
2OO
of Hysteria
organic
destruction
of
the
centre
of
the
function.
when
it
is
be
it
alike.
Besides, did
exists.
in 1894
1
I think I
observations of functional hemianopsia.
of
the
demonstration
of
the
character
gave
hysterical
this
distinct cases,
a schema of which
"
N6vroses et Idees
fixes," I, p. 263.
"
Wilfred Harris, Hemianopsia with Special Reference to
Transient Variations," The Brain, 1897, p. 308.
2
its
The Troubles
myself,
some
of Vision
201
many
my
paper on
transi-
tory hemianopsia.
left
Each
of these eyes
and
two
left will
left
is still
now a
become
seldom goes so
far.
It
exists
and
is
sometimes however,
a profound accident
hysterical hemianopsia
which can be compared to motor hemiplegy.
1
"
Un Cas
3
.9
204
of Hysteria
111
while
still
It
green seem
to vanish
Violet, blue,
and
first.
Red appears
fact
showy
The
They
reason
is,
it
was
exaggeration in
are fond of
this,
and
it
is
more
There
is
likely that
some
moral
in this phe-
nomenon.
I think also that this loss of colours has been
examined
all,
visual
First
The Troubles
particular,
according
to
of Vision
the
lighting.
205
Besides,
in
father's
made her
coffin.
It
abhorrence, and has on that account a very fine perception of red and a visual field for red more extended than
for white.
some
other accidents, the types of which I must at least inThese accidents are the disturbances in
dicate to you.
the motion of the eyes, about
which you
will notice as
phenomenon
as
regards
become unable
interpretation.
to
move
their
This
is
from
206
But
of Hysteria
in certain cases,
which
is
will.
If the subject
is
an absolute immobility,
it is
sufficient to let
an object
fall noisily
may
be
less
irregular contractures.
deviate in
all
is
also important.
and particumay
the
muscles
of
the
lens.
Here again,
larly
crystalline
we have a function that becomes dissociated, that of
motion
accommodation.
from
thirty centi-
When
to
which
The Troubles
quite clearly, but
nearer or farther.
it is
am
207
This spasm
which
of Vision
hysterical disturbances
many
on
monoc-
Now
optics,
seems
Now
1
:
a kind of hemimacropsia.
if not two theses, at
two tendencies in the interpretation of these odd
phenomena. M. Parinaud and his school sought a
least
physical interpretation of the accidents in the contracture of the crystalline lens; others attribute a more
upon the
ways bears
solely
and seem
its
to
turn, separate
N^vroses
et
Ides
fixes,"
I,
p. 276.
LECTURE X
THE TROUBLES OF SPEECH
0} the disturbances of
speech
The
The
characters of hysterical
The absence
The
dumbness
for get-
phenomena
The alleged differences between hysterical mutisms and
The different forms of hysterical dumborganic aphasias
fulness of speech
ness
Aphonia
Stammering
of
paralytic
Aphemia
Agraphia
Automatic speech
case of hysterical word-deafness
mutism
or
alternating with periods of
during hysterical
dumbness
The emancipa-
of perceptions,
speech.
The
However, most mental derangements bear upon a somewhat higher level, upon the formation of ideas properly
so called.
On the contrary, hysteria, which bears
essentially
of motion,
upon
The Troubles
level to
of Speech
209
and
is
more
evident.
I
In antiquity certain impairments of speech had already been noticed, the rapid evolution and the surprising cure of which seemed unaccountable. The following observation made by Hippocrates appears to relate
Pierre
Marie,
"
La
2io
of Hysteria
she showed with her hand that the pain was in her hip."
This description seems to contain everything, the stop-
kill
Crcesus."
We may pass on to
the stories of
in
month
hearing and sight, but it was not the same with her
In the ninevoice, which was never restored to her.
teenth century, such cases become more numerous.
The
an
power of speech to
and dumb for
been
voiceless
a young lady who had
twelve years. Briquet, Kussmaul, Revillod, Charcot,
and Cartaz insisted very strongly on these phenomena,
which are now well-known
in their ensemble.
This accident
The Troubles
sudden emotion.
It
was
of Speech
211
the classi-
was deprived
is still
of utterance,
eighteen months.
liable to the
for
cured, he
at the least
emotion
of hysteria
which
has been
ill
since he
was twenty.
at that
much
dumb
it
for
very
two months.
is
enough
days.
to
In other observations,
212
parents.
pearance of a
man
of Hysteria
it
is
at forty-one.
of speech or respiration
the body.
back on
young man
In another curious
woman, a
great
medium, who,
after
interpretation.
it
and
is
not paralyzed. He has not that weak and sickly appearance of persons struck with an organic hemiplegy
consequent on a cerebral hemorrhage. Nor does he
offer a very visible intellectual weakness, the dazed look
of the latter patients; on the contrary, he seems intel-
The Troubles
and
ligent
singular attitude
213
He comes
lively.
understands
sive face,
of Speech
all
when he has
The
to answer.
charac-
makes, or that a foreigner makes when trying to express himself in a language he knows imperfectly.
He
if he thought it
possible to answer
he does not open his mouth he makes no
he answers with signs, or else takes up a pencil
with words
sound
and answers
in writing.
I insist
much
on
this character,
exaggeration in
distinction
between
because
my
all
opinion,
make
it
a sign of
hysterical
dumbness.
phenomena.
move easily in
who understands
soft palate
patient,
asked, moves
lips
The
everything, does
all
the
all
he
draws
movements
'
is
his
of
No
made about
this
somewhat too
theoretical description of
214
Charcot's
you
of Hysteria
mutes
cer-
an
said
is
ugliness;
my
functions,
impairments are
for the
slight,
enormous paralyses
observed.
If
we go
farther,
vocal chords.
is
summarized
we
Charcot's time,
in
He
no great disturbance
Certain authors have tried to
recognizes
in the vocal
chords.
establish
chords
this
is
to
movement before
us.
There
is
nothing to prove
it,
if
The Troubles
hysterical syndrome,
and
all
of Speech
215
II
One
lish
were so eagerly
Aphasias with destruc-
localizations
was
it
said,
the true impairments of the psycho-physiological function of speech; and these aphasias do not present the
same symptoms as
hysterical
dumbness.
never
cries,
he can give
make varied noises with his larynx; oftenest he
lost
all
power
to utter a
sound;
no more
read,
without
2i6
Hysteria
may
scribed.
Nothing
be found
in hysterical
it
is
to
make
1
aphasia patients do. It is
more restricted, for the disease seems to be limited to
the expression of words and not to impair kindred phe-
efforts to speak, as
nomena, such as writing, reading, and the understanding of words perceived by the ear. So the two things are
different, and as aphasia was considered as the impairment of the function and of the centre of speech, hysterical
To
must
first
which
this
answer
clinically.
Hysterical
dumbness,
is a type,
after Charcot,
it
by
this
author.
what
It is
arbitrarily chosen.
You must
not fancy
that, all
The Troubles
We
have
first
of Speech
to put beside
it
many
217
attenuated, im-
perfect, or rather incomplete forms, in which the function of language is analyzed as the visual function was
before.
the two
One
of the
degrees of vocal
We
is
air.
Very often
and the second is kept
emission of
is
very
little
it is what is called
aphoIn certain cases, the dissociation is still nicer;
certain subjects can sing aloud and cannot speak ex-
is lost
nia.
cept in whispers.
These
of astasia-abasia.
In
distinctions will
still
but stammers, or
less
remind you
stutters, or
it
is
more important
to study
cries,
either
spontaneously
2i 8
of Hysteria
when she
is asked.
Nor is she quite dumb, for she
speak, which the preceding patients did not do.
She makes with her tongue and lips movements that
or
tries to
"Miss
swers,
X.,
To
petitbedable."
to
you to-day?"
will
words
is
all
that
is
least,
she can
said to her.
She
reads very well I mean that she does all you ask her in
As for writwriting, but she is unable to read aloud.
;
it
is
is
a phenomenon
The writing has
it has become
very bad; it is curious
her
this
state with her norcompare
writing during
quite changed;
to
mal
writing.
You
markedly diminished,
we
if
How
is
can
not entirely
if not
by the usual words
lost.
The Troubles
of
of Speech
219
agraphia
It is
of
symptoms
them
we
could,
to disappear immediately.
if
we
chose, cause
as
we
even
It is
nomena
Sollier
Can we go
further?
Do
there
when
all
is
exist
in
For
my
why
T.
M.
Charcot,
"
part,
Lejons du Mardi,"
this dissocia-
hysteria
It
of this kind
p. 367.
22O
of Hysteria
to
chair,
she
almost
His conclusions were always the same and quite definite; this patient is not deaf by any means; all we
can say
that there
is
is
for her.
It is
them very
1
"
the
Ne*vroses et
Ides
airs.
She hears
Observation 134.
The Troubles
In a word,
understand them.
known under
of Speech
the
name
it
221
is
word-deafness.
of
present
The
know how
she could
manage
to repeat
movements has
If the
word-deafness
isolated, that
is
The
them.
is
quite
intact.
Now
what are the diagnosis and origin of this clinically incontestable word deafness?
They are most
A few years ago, this already impressionable
strange.
and nervous
girl
in
a convent.
At
asleep
in
The
child
had a disposition
to fall
These
sleeps
were
made
in her
arm.
On
222
Hysteria
that she
work
getting on.
all
is
to see her
we know about
those
sleeps, which lasted for nearly two years with the same
characteristics.
One day the nuns became incensed
was
of
no
The
use.
and
later on,
go to
The
hell.
was frightened
no more. When the
little girl
sleep
know
exactly
what happened.
Rachel asserts
However
it
may
be, after a
at all.
When
she
was spoken to, she did not answer, and her features
assumed a dazed expression every endeavour was used
to rouse her, but it was soon noticed that she understood
nothing and answered very badly. What was exactly
;
formation
no
is
insufficient
paralysis, but
well as hearing.
it
it
Our
in-
However
it
may
The Troubles
correctly, as
now
of Speech
223
made no
She reprogress.
mained, as at the outset, incapable of understanding
but the hearing of words
anything.
No
doubt,
The
speaking, and
made.
same manner
cidents.
and neuropathic
ac-
224
of Hysteria
III
To
speech,
already know.
of the hysterical
"
could only reply with the words
chacha petitbedable."
Often, in the midst of this state of aphasia, the patient
:
had kinds of
reveries or deliriums, in
questions and
slight
deliriums,
French or
left.
made
In
all
those
in English,
Observe
'
This fact
is
is
commonly
believed.
in
the period of
dumbness
dumb
patient
who
often
still
225
We
normal
is
himself, as
it
among them
all,
Elie Marion.
He
hand escapes
that his
his control
tics of
You
description of
them
in the little
disturbances of speech.
will find
a very good
M.
Seglas on the
book
of
should be inclined to go
many
verbal hallucinations
226
of Hysteria
any participation of
has emancipated
his self
it is
a mechanism which
itself.
symptom
preceding
and
concomitant
occurs to me.
hospital.
Bes.
speaking.
special
crises
in
power of
which her
the
tic
that
LECTURE XI
THE DISTURBANCES OF ALIMENTATION
troubles
Visceral
oj its
The
Hysterical anorexy
description
anorexy through
the
termination
refusal of food
anesthesia
of
by
The diagnosis
The theory of
stomach
The
the
The motor
hunger
explanations
ferent
of
The
dif-
physical exer-
The
tation
The
hysterical dissociation
of
this
function
The
AFTER
hystericals,
shall
now
enter
disturbances.
cians,
those
and
These
who want
disease.
respiration.
We
to give a
227
228
of Hysteria
tion.
To penetrate into the study of the mental disturbances of hysteria, we shall begin by studying a very
its
new
studies
and the
preceding ones.
I
which consists
sequent inanition.
long time very ill known; it was confusedly ranged
among the other manias of those patients, and their
strange way of living without eating was often ascribed
to the action of the
Its
demon
accurate description
simultaneously by
W.
or to that of God.
is
recent
it
Gull, in 1868,
this
named
it
disease
"apepsia
The
English physician
hysterica";
Lasegue
"hysterical anorexy."
is perfect
the absence of pepsine, which,
appellations
certain that
it
is
some subsequent
There-
The
made
Disturbances of Alimentation
aversion
to
food,
and
"sitieirgia"
is
(a-inov
229
to say,
etpyat),
The
also proposed.
last
better,
This accident
after
for
its
recognition.
and
hysteria
Many
but
in
it
may happen
characteristic
many
its
It is
enough
if
phenomena, which
Oftenest
it
will serve
women.
(Kissel)
it is
forty,
It
That
affection
chronic one.
which
It is
lasts less
is
than
The result
is
that
it
230
of Hysteria
cipal ones.
The
first
an emotion.
whom
Mu.,
more or
it is
The
is
is
lot of
what she
eats;
her
thing she
The
Disturbances of Alimentation
by
all
Now
231
beseech, threaten
spoil,
The
and
never consent.
have to
Supported
by
our
conviction,
around
is
her,
we
very important.
strange
patient
by every
possible
to
go and
spit
fill
their cheeks
them out
in the
232
lavatory,
when they
of Hysteria
but sometimes
later,
is foul,
of
my
The
patients.
skin becomes
arterial breaths.
Lastly,
makes
for, after
a rather
The
patients
who no
comatose condition.
two
different
ways
At that
and according as
which
the patient yielded completely or partially
was not
justified in .doing
moment he resumed
anything before.
his authority,
The
latter
case
more or
Disturbances of Alimentation
less
per cent,
of
saved at
fifty
Out
her
completely.
its
he cured
In
233
when
life
it
has
lost forty
the
weight;
and above.
It is
eat
and
intercurrent
disease
comes
on,
and an
broncho-pneumonia
Its
gravity,
subject,
show
that
it
its
evolution, whatever
is
due
to a
deep psychological
is but the outer
II
its
The
disease
consists essentially in
234
refusal of food.
Some
of Hysteria
have not
ashamed
to eat
sufficient food.
died
of
turnips,
To
the end
make up
girls
their
minds
in their innocence,
And,
for their
mode
of death, judging
it
famous:
hunger
to
becoming
to exceed.
big as
mamma."
Coquetries
eyes of a professor
her meals.
The
me
This
to
is
authors
ideas
seem
to
The
Disturbances of Alimentation
235
phenomenon
of the hysterical
neurosis; they belong at least as often to the psychasIt is in the latter neurosis that fixed
thenic neurosis.
r61e to the
end.
These patients
will
their
need of food.
honour not to
yield,
at
least
it
a point of
they get
up
so that one
their
no
mouth
hysterical anorexics.
idea,
which existed
In the
latter,
at the outset,
it is
and played a
phenomena, as the
loss of appetite,
phenomena
and
236
of Hysteria
by obsessions
chasthenics.
new
it
sensibility.
justify their
by
disturb-
all losses
of the sensa-
on the
secretions."
hysterical
phenomena, anorexy
in particular, disappear.
There
is
we must
settled,
much
recognize
and
tence of
First of
all,
well
numerous
anesthesias.
They
are observed
The
Disturbances of Alimentation
237
and
taste
smell.
and ask
for salt
and vinegar
and
to their food;
want
to
in order to give
some
taste
of the rectum.
and
The
is
the
more
and
itself
difficult to estab-
is
commonly
stomachs.
placed
Do
all
the parts
me
very likely.
particular those
saliva secreted
23 8
and smell
of Hysteria
of that object.
They
of their stomachs,
he recognized,
at least in
subject
felt
stomach.
From
disease.
new conception
great culprit.
and of the secretions of the stomach
is
is
of the
here the
movements
and
insensibility
There
is
some
not seem to
me
to
thesia of hystericals
into the
stomach
of the
most anorexic
hysterical,
if
you
comes
to
The
Disturbances of Alimentation
239
way.
his thesis
make
it
would not
gesting.
In
my opinion,
an exaggerated importance
by
these local
function
alimentation.
of
ascribed
mouth
hunger and
in the
phenomena
and stomach
is
of the
do not
we think
it.
it
reasonable,
when we
of the
I wish a
in
imperfectly elucidated
anorexic
of
patients.
noted by Lasegue.
This
It is well
1
unfortunately very incomplete article of Dr. Wallet.
"The patient," he says, "is exceedingly fond of long
walks. As she is growing thinner with enormous
"
Deux Cas d'Anorexie Hyste*rique," Nouvelle Iconth
Wallet,
de
la Salpetrtire, 1892, p. 276.
graphic
1
240
of Hysteria
to walk,
Then
after
the
refusal
the emotion,
The
to
she
It
eat.
refuses
This character
happens
to
is
return
at least
first.
first
much and
take too
much
exercise
by
virtue of a
The
Disturbances of Alimentation
order not to be
this explanation
241
I confess
compelled to eat more.
does not satisfy me. Many patients,
tation
by M. Wallet
grow
thin,
is
that
The
is
know
that
it
is
want
to
if
thin.
grow
some
You
in
particular
cases this exaggeration of motion can be explained by
such reasoning, it would be absurd to generalize the
explanation.
I believe that the
phenomenon
in question is
much
is
of fatigue,
which
is
here
much more
important, in
It
my
com-
of Hysteria
be traced to
chological side,
is
the hands,
lastly,
it
lips,
and tongue
also comprises
r61e in alimentation,
to the
from
phenomena
of improvement,
There
is
in
may
In
These
There
much
is,
besides, a
The
Disturbances of Alimentation
243
or somnambulistic state,
as
waking consciousness.
Ill
to
know, but
The
to dwell
dissociation of
which
have
just
long.
spoken to you
bear on
may
may be
less to
connected with
all sorts of
organs.
It is
need-
organs themselves.
Grant a
little
more attention
to
the functions of
Many of
Some
who have
make
their food
244
of Hysteria
am
is
to
make
still
may
of them.
Nothing
more impor-
know thoroughly
mistakes.
is
the neuro-
he can render
many
guilty
How many
young women
when
it,
of alimentation confirms
cal paralysis
of
LECTURE
THE
XII
OF RESPIRATION AND
ALIMENTATION
TICS
agitations
Polypnoea
yawn, hiccough
ical
cough
Inspiration
tics
Aerophagia
Laughter
The meteorism
The
sigh,
tics
Expiratory
HysterHysterical bark
Complex tics
of the
abdomen
The tics of alimentaand
The spasms
Polydipsia
polyuria
The
tic
eructation
The
cheeks,
of
pharynx
jaws,
tic of
regurgitation
tion
of the
Bulimia
vomiting
Hysterical
WE
the
phenomena
same
On the other
kind, though they are of less gravity.
hand, they are of infinite variety, and we might dwell
indefinitely
on
respiratory
disturbances,
paralyses,
the
apnceas,
on
on the innumerable
dyspnoeas, suffocations,
the varied respiratory
tics,
polypncea, yawn,
0} the
246
we
shall
be brief on
Do
of Hysteria
not be too frightened
the general rules once
;
to
Let us
first
lished a
and who
is
it
did.
The
that the girl did not breathe better than before, that,
des
M. Lermoyez,
Hdpitaux
"
Wishing
to prove to the
25, 1890.
247
There was
great surprise, it was not so.
the
the
nostrils,
patient writhed as
through
no breath
she were
on her trying again, while she
if
a word,
when you
In
As M. Lermoyez very
shut.
had forgotten how one manages
mouth was
through one's nose. Can a finer confirmation be found of our teaching on functional paralyto breathe
ses
Have we not
and amnesias?
The
latter was, as
sociation of the
we saw,
Is there
It
all respira-
tion
for
and
248
in the
book
it
For
part, I hesitate to
my
M.
of
against
of Hysteria
de
Gilles
admit that
la Tourette.
can be
it
true.
resulting
eral, of
A moment
that
is,
comes when
is
restored
prehension of aliments,
is
entirely
a con-
if
we
are in a
shall see
how many
foolish things
is
it
may
do;
but,
However
it
may
now we know
the
we understand
influence
of
the
brain
very
on
249
as
Mosso
called
it,
It is this respiration of
ify in
a thousand ways.
by an unconsciousness,
You
that
is
to say, with a
more or
systematic anesthesia.
less diffuse anesthesias distributed over the organs of
The nose is very often insensible, and the
respiration.
will
often find
anosmia
accomabsence of the perception of odours
disturbances
as
well
as
the
disthe
respiratory
panies
turbances of alimentation.
insensible.
to
make
geal
You know
this insensibility,
reflex
to
every hysteria.
tickling,
This
is
The pharynx
is
and the
of
wanted
loss of the
is frequent, since it
alimentation and those of respiration.
find disturbances of sensibility distributed
fact
very often
You
will
over the
250
What
is
more
interesting,
you
of Hysteria
will
be able, in certain
to
respiration
above
in
all,
we
feel
We
itself.
feel
this
respiratory
sensibility.
The
subject
by a
is
to breathe
is
obliged
closed
screw
what moment he
feels
a difficulty in breath-
ing.
The
figures obtained vary pretty much with the subthe hour of the day, and the movements the subject has just made, but I have been able to observe that
in hystericals the figures are often very different and
ject,
parable to anorexy
that
is
of hunger.
These disturbances
accompanied
The
subject complains of
251
head
may
is
paralyses.
A most
interesting
same reason.
phenomenon which
is
if
This
is
diaphragm.
they
in the
your thorax
make
same
direction.
It is useless to
in their various
that
efforts.
Bear
this detail in
mind
much when
252
Hysteria
rare
and
problem.
still
I,
discussed.
I merely indicate to
myself, communicated
you the
to the Congress of
important in
rhythm
You
my
opinion,
is
very
of the
1
Cheyne-Stokes in hysteria.
know, that about 1816, Cheyne of Dublin and
of
there
is
in some cases
then the active respiratory series
begins again. At the outset, this phenomenon was only
established in cerebral apoplexy, in most forms of agony,
minute
F.
Raymond
et Pierre Janet,
"
Un
cas
du rhythme de Cheyne-
253
254
of Hysteria
was
also
found
intoxications.
this respiratory
Later on,
it
M. Mosso was
the
first
to generalize
that
it
in
numbness.
At a time when I used to take systematically and with
some exaggeration the graphic of the respiration of all
general, in all states of general
much
astonished
pre-
I refer
you to
wish
to
see
studies
are
withwhich
not
my
you
out interest on the modifications of this rhythm. This
article
patient
if
was always
When
in a state of
absent-mindedness and
her
attention
who
of
any
attention.
It
when
vanishes
preconceived ideas.
In the same order of ideas, I wish to indicate to you,
rather as a curiosity, for this time I have seen only one
case of the phenomenon, a paralysis of the diaphragm
You know
normal
thorax
respiration,
rises,
If the
diaphragm
falls
that,
when
the
actively forces
the
255
diaphragm
is
paralyzed,
it
cannot perform
Graphic of the respiration in a case of polypnoea, 80 respirations in a minute, and of discordant respiration.
The signs have the
same meaning as in the preceding figure.
FIG. 17.
allows
itself to
;
256
of Hysteria
phenomenon
paralyzed in
consequence of a
fall into
is
and
a well.
You
and
of
FIG. 18.
young patient
of this case
of hysterical accidents,
think, of the
1
"
same kind.
Ndvroses
et
and
But
this
it is,
Idees fixes,"
I, p.
phenomenon was, I
own, a phenomenon
329;
II, p. 414.
whose presence
If this
in hysterics is
presence
is
confirmed,
257
still
open
to discussion.
we
shall
be obliged to
II
To
added, as
we know, automatic
agitations.
each of them
may emancipate
itself
separately
very varied tics.
Let us put in the first rank the exaggeration of total
tions,
and give
rise to
respiration, polypncea.
man
Here
is
fine case.
is
One day he
a seaport.
was commanding some workmen who were working a
capstan in order to raise a tall mast. He saw a rope
of thirty, a
foreman
in
on
his
258
of Hysteria
(Figure 19).
on
did not
motion-
breathe.
FIG. 19.
all
sat
in
dis-
then he
grief?
Was
case in so
it
a somnambulism or a
many
of the patients
crisis,
we passed
as
was the
in review
it
to
259
who breathed
us
first
which
and
is
will
You know
stronger, it will be a sob, then a yawn.
what importance was formerly attributed to the hysterical yawn, which was thought very amusing. Nothing, in
little
fact, is
long,
girls
who,
also a
phenomenon
in relation
all
till
day
they
is
it
is
alimentation.
It is
the
inspiratory
tic,
the hiccough,
which
in the graphic of
hiccough
260
of Hysteria
T and
1
A, are momentarily discordant.
This will presently play a great part
nomenon
and
is
in vomition.
abdominal
in the phe-
who swallow
When
looking
FIG. 20.
over
air,
hic-
my
Among
clinical observations
of experience
1
"
Nevroses
et
Idees fixes,"
II,
Observation 100,
p. 360.
261
Thus the hysterical hiccough is, to my mind, a rather serious phenomenon of bad prognosis. It points to a great
hysteria; the hysterical cough, which is almost like it,
a more commonplace and less serious phenomenon.
girl has had an irrepressible cough in conof
a
certain cough, of efforts in singing, or of
sequence
is
Almost every
fits
it
of bashfulness.
is
very difficult, in
and
One
of hysterics.
fits
You know
of joy.
Thus a girl
who surrounded
the hospital,
her,
as a
"
NeVroses
262
phenomenon
difficult to
of Hysteria
account
for.
One
cries,
It is
by
far less
not so epidemic, but nevertheless it exists very often under various forms.
In
many cases, this tic is mixed with some phenomena of
is
of those gases
Therefore, as you
made "nioup,
my
patients regularly
little
by adding
to
263
them disturbances
of
would repeat:
sounded about
"all
right,"
"
iou, iou."
savages sang
With those same complex
:
like to connect
tics of respiration I
should
the swelling of the abdomen or meteorism. It is necessary that you should know this phenomenon well, be-
cause
it is
common
delivery.
of the child.
the
It is
nancy, of
which
here than
to various
are attributed
However
that
may
Charcot connected
it
be, this
am
264
of Hysteria
much more
is
it
just
mentioned.
end; they force their pylorus open and send this air
into their intestine, which determines varied disturbances
of the digestion, and, in particular, diarrhoea, but, at
the
whole abdomen.
You may
imagine
many
of the
other com-
Ill
But, before leaving the subject of visceral disturbances, I should like to tell you briefly of some other very
tics which depend on the function of alimenwhich we have spoken. Most of these tics of
alimentation besides are at the same time complicated
important
tation, of
of
alimentation,
emancipated from the personal consciousness, may become exaggerated and give rise to various forms of
bidimia.
eating;
bulimia,
guard
it
is
be on your
It is to
265
feel
by some stimulant or
revive themselves
more or
less at
other, adopted
haphazard.
Some have
which
is in
which
it is
which
is
phenomenon, and
It is polydipsia,
right that you should know.
not to be confounded with dipsomania. The
twenty
he
is
liters of it
inevitable consequence;
polyuria.
on the phenomenon
itself.
in neuropathic patients.
I think it should rather be
connected with deliriums or with the disturbances of the
we have
turbances, spasms
the
1
pharynx,
Pierre
tics
"
Janet,
The Journal
of
April, 1906, p. 3.
to point out
of the jaws
a host of partial
and
cheeks,
of perpetual spitting
On
the
Pathogenesis of
and
dis-
spasms
oj
salivation.
Some Impulsions,"
266
which
Ptyalism,
is
in
frequent
You
also
of Hysteria
certain
I
do not
melancholy
on the
insist
which we alluded
to
know
in
our
and
the belches, of which; I have just spoken to you in connection with the hiccbugh.
But I must point out to you
a complication of the phenomenon, which is called
regurgitation, merycism.
Some of these
They know how
patients learn
to bring back
mouths the food they have swallowed. It has
been said that this constituted an odd physiological
phenomenon, in which the movement of the oesophagus
was reversed. I think, rather, that it is one of those
curious phenomena of aspiration, induced by abnormal
By making a movement of aspiration
respirations.
while
very quickly
shutting the glottis and preventing
the air from entering into the lungs, one induces a
vacuum in the thorax, which can react on all sides. A
certain individual, who was formerly celebrated in Paris,
thus drew up air through his anus and knew how to
into their
in
a melodious way.
We know
eject
it
draw
the oesophagus
may
be
many
thus
into
that
Hysterical vomiting
itself.
It is certainly
It
responsible for several deaths.
all the preceding disturb-
This vomiting
is
rarely pure
that
is
to say,
it
rarely
told
Nowadays, as
you
much more
organic
267
directed
affections
associated
to
that
are
at
the
hysteria,
the
to
starting-point
of
MM.
Mathieu
Lately,
and Roux, in a paper in the Gazette des Hdpitaux, 1 again
insisted on this point in connection with hysterical vomit-
hysteria, or
its
localizations.
cause.
its
This vomiting,
in fact,
is
exceedingly rapid
and easy; it immediately follows the meal; it is accompanied with very little nausea and no effort. It is
repeated with any kind of food and produces the most
It is also in cases of this kind,
the tuberculous complications supervene which
dangerous inanition.
that
almost
always
terminate
rather characteristic
cannot
seem
to
hysterical
endure the
inanitions.
phenomenon
is
from
des
become unconscious
Mathieu and
J.
Hdpitaux, February
in
Gazette
268
Many
of Hysteria
longer control.
connected
with
hysteria.
It
had been
and that very rightly too, that these hematemeses almost always coincided witfc the beginning of
noticed,
it
ent time, this notion of these neuropathic gastric hemorrhages tends to become obliterated, and physicians are
inclined to say that they are due to an unrecognized
ulcer of the stomach.
The symptoms
MM.
that
conducted discussion of
this fact.
will find
The
a very well-
authors, how-
ever,
269
hematemeses.
hysterical
it
not be
admitted that, in certain cases, this disposition to hemorrhage may be localized in the stomach?
formerly.
dence,
of course, necessary
is,
with fecaloid or
still
to deal
we have
nomena.
One
of hysteria
more
is
list
numerous enough
made
and
common
characteristics of these
LECTURE
HYSTERICAL STIGMATA
The need
XIII
SUGGESTIBILITY
without any participation of the will or of the personal conThe distinction between real suggestion and
sciousness
normal phenomena
The
The
conditions of suggestion
systematization of
Suggestibility as
a sign
of hysteria
after recovery
The disappearance
of suggestibility
from hysteria
THE examination, even rapid, of the numerous accidents of hysteria raises inevitable problems in our minds.
The most important one, the one that always torments
the
human mind
is
the problem
hystericals
were
and complexity
The
always
of their
270
first
authors
struck
with
symptoms.
who
the
"It
is
Hysterical Stigmata
271
Suggestibility
not a disease," said one of them, "it is a host of ailments." And you know that, to express the changeableness of hysteria, Sydenham called it "that Proteus
that cannot be laid hold of."
Sometimes
takes the
it
form of deliriums such as we have seen in somnambulisms, and we are in the domain of mental diseases.
Sometimes
it
which make
pneumonias.
the
first
and
the perplexity of
whom came
to
abhor
this tendency,
plexity.
The
intelligible,
and, above
all,
make
to seek to give
it
hysteria
some
unity,
by linking together those scattered accidents, by finding in all of them some fundamental features, which
serve at once to explain them, to connect
them with
phenomena,
in spite of their
enormous
differences, there
272
of Hysteria
is
the stigma, and one may say that, since the beginning
of the scientific study of hysteria, all the attention of
clinicians of
and search
Of course
reflects
to the study
of the stigma.
Now
this essential
now
hysteria
is
For about
that,
years past, other more important charbecome predominant, and you are aware
fifty
acters have,
especially
Hysterical Stigmata
Suggestibility
273
nook and
is
woman who
the subject,
our
we turn
his
changed.
This research has allowed clinicians to establish that,
in
many
hysterical
cases,
various anesthesias
symptoms.
and
ness,
phenomenon
better
accompany most
to
is
very clear
cutaneous sensitive-
to
it is
very important,
In the case of sensorial acci-
for
still,
muscular sensitiveness.
is
sometimes
visual field.
certain
274
of Hysteria
method
That
hysteria
which
consisted
characterizing
of the
in
make
great progress.
crowd
unknown
of
spasms,
hysterical
symptoms, of special
made an
essential
symptom?
etc.
Must
it
con-
his adversaries
opposed his
and interminable quarrel about traumatic neuroses,
which began especially in Germany in connection with
railway accidents, rests on this question.
is
This criticism
tainly does not play in practice the absolutely preponderant r61e that Charcot maintained it did.
all, it is only too certain that this anesthesia
not so easy to recognize as was believed. It has, as
First of
is
impressionable.
suffice to
and
But, above
all, it is
this is
more
serious
will
now
Hysterical Stigmata
will create outright
The study
well as
of the stigmata
on old ones,
275
Suggestibility
is
made on no
exist.
patients so
who
On
this
that,
is
rarer, less
point
I apologize myself,
more importance
attributed
and acknowledge
la Salpetriere, I formerly
to anesthesia than I
would
do now.
What
We
anesthesia as a stigma?
should understand one
another and not ask the sciences of observation, which
are so difficult, to furnish us with absolute theorems.
In
my opinion,
should be separated.
springs.
For instance,
cause
we
cause of
if
consider
all
they are.
It will
has
failed.
know no
better
its
his-
Charcot's stigma
276
of Hysteria
But the stigma has another meaning, which is pracIt is a mere means of diagnosis.
Now, anesthesia
tical.
It
in the past
one of those
acci-
It
means
he
me
that he has
hysterical amaurosis.
even
if
do not believe
Very
you seek on
little
say
remain
for
must
in practice
which
but that
is
it is
symptom
of
Hysterical Stigmata
We
Suggestibility
277
r61e of stigmata.
n
Anesthesia pleased the physicians, because this symptom is in some manner intermediate between physical
mental state
theses
had long
;
was a hysterical
was the fashion to write
that there
felt
you know
that
on the character of
it
hystericals.
There were
curious and striking, but of course somewhat excepOur poor patients were not lucky.
tional, features.
gentler,
"A common
278
of Hysteria
veterate and incessant need of unceasingly lying, without reason, solely for the sake of lying, and this not
only in words, but also in action, by a kind of parade
in which the imagination plays the principal part, gives
birth to the most inconceivable incidents and sometimes
Do
take
seriously.
and often
So
false-
of hysteria.
No
still
many
physicians
doubt falsehood
who
exists
in
falsehood.
especially,
woman
it is
has had
all
her
that
life
is,
an extravagant need of falsehood, above all, of falsehood by letters. Her greatest happiness consists in
she sends to an indevising amorous correspondence
dividual, man or woman, marvellous letters in which
;
love
wonderful
is
answers paste
that
it
always takes.
respondence for
it ended before the assizes
to
The gentleman
and she goes on with the cormonths or years. What is sad is that
restante,
be published.
Falsehood is, in
my opinion, one of the mental accidents of the neurosis, one of the deliriums that the
hysterical may have in a very serious or in an attenuated
degree, just as she may have
that is to say, ambulatory fits.
somnambulisms or fugues
But it is very well known
Hysterical Stigmata
279
Suggestibility
made
all of
fugues.
accident of falsehood.
It
exaggerated.
the end, patients were trained to present
Legrand du Saulle was convinced that
in their hair
at length
their bedsteads;
We
it.
Formerly,
all
hystericals
tied to
it.
psychological disturbances.
In reality, the great mental stigma that modern studies
have brought into evidence is the mental phenomenon
No
of suggestion.
portance given to
Babinski,
is
doubt I begin to think that the imit, in particular in the last works of
it
is
certain
is
suggestion is
mata of the hysterical state. But it is necessary to
define this phenomenon exactly, to give a distinct
meaning to the word, because physicians are in the
habit of using
it
comprising under
in
this
nomena.
It is
of suggestion;
very well.
means you
please,
phenomena
You
mind
cause
of the
through sensa-
tions, signs,
there
280
of Hysteria
itself in
him
as
it
usually
speak to
If I
be able to dwell a
am
little
my journey. The
I
see
are
and
the
words I speak, I
dim,
always
images
I
to
know
always
speak
myself.
very well that I am
to call to
mind a few
particulars of
falls,
and
in reality, I
do not see
them.
But don't be
be aware of
it,
afraid,
for
happen
It is quite different
The
who
Hysterical Stigmata
Suggestibility
281
words; their
we
hears.
If
tation
that
question them, they tell us without hesithey see Niagara before them, and the
spectacle has so
to efface the
much
intensity that
normal vision
it
seems completely
surround
them.
first,
still
and perceptions.
They seem
to
make a
complete journey
over the bridge,
Thus such a
may have
subject
acquired the habit of convulsions or
contractures of the limbs when he sees an electric apparatus or is touched with a magnet. These patients
have shakes
in their
burns or refrigerations or
when they
Alas,
what
is left
of the big
282
of Hysteria
breath, indicated
passes of the
ject ?
manifest
tain ideas
awaken
will
cer-
is
very
This
is
pills of
mica
in
many
circumstances.
We
somnam-
bulisms, a system of images, each of which has different muscular or visceral properties (see the figure i
first lecture). With the normal man, these systems,
which are always very numerous, stop one another and
do not develop. In suggestion, each idea seems to
in the
develop to the
maximum,
to give all
it
contains in the
way of images, muscular movements, and visceral phenomena. This complete development of all the elements
contained in an idea
phenomenon.
But, you may
is
an
say, this
Hysterical Stigmata
Suggestibility
283
them as
us do when we try
It is what all of
some
for then the idea brings about
work,
perform
material movements of our limbs. The thought of
looking for a book causes me really to look for it. This
living as possible.
to
is
all
attention,
semble of
in us
by
all
weak by
itself,
to
make
it
grow.
You
know
no
effort
of strength
from
There
is
On
his personality.
realize the
As
He seems to be very
conscious of them while they are being executed.
Very often he executes them without knowing it, quite
In this connection, it is very important
subconsciously.
tions as soon as they are ended.
little
to
jects
of this
all
the
by a regard
to their
284
wilders,
of Hysteria
to execute
any
foolish act in
Bear
this definition
launched
too
in
many
authors,
into
these
psychological
precipitately
merely remarked
nomenon.
penetrates into
This
there.
who
mind;
is
the
the
mind
childish.
the
of
As
subject,
and stops
have so often
tried to
We
astonishment at the phenomenon of suggestion, it is bewe think it offers something abnormal and excep-
cause
tional.
are not
filled all
very well
how
from what
me
in
is
to distinguish
not.
what
is
what
They know
suggestion in
them
not
Their minds
not understand
I said?"
it
if
that,
am
please.
Hysterical Stigmata
Suggestibility
285
word "suggestion"
As the
precision of meaning.
ordinary psychological terms, memory, association of
all
Ill
likely to
confound
phenomenon, you
is
will
this
remark; namely,
no longer a commonplace and constant
consequence
that suggestion
of
it
first
great characteristics:
ment
ideas.
second,
Both
it is
286
It is necessary, in
the
first
of Hysteria
an idea
suggestible subjects.
from the
first,
through suggestion
Suggestion requires,
confess that
to people of
Hysterical Stigmata
health does not exist.
Suggestibility
287
It
man.
We
men
speak of
pathological
or
medically appreciable. If
(a kind that is numerous,
state to
him
that there
is
dog
where he
is sitting,
he
will
nomena which
the
mechanism
which
is
very different.
These
facts
On
288
of Hysteria
had no
difficulty in demonstrating numerous and evident traces of mental disease more or less grave, such
We
find
anesthesias, attacks, paralyses, fixed ideas.
in the past of such persons all sorts of neuropathic
accidents,
persistent
They have an
no confidence
me; and
yet
cinations all
minds, that
it
demands,
power, minds
now demonstrated
affirmations
relatively sane.
that
it
contradictory?
A symptom may
symptom.
not belong to
all
dis-
it is
the sign of a
Hysterical Stigmata
289
Suggestibility
It
which unites
in a
is
a particular disease
is
it is,
above
all,
the
sign of hysteria.
the
all
of all
you
will find
aside
the
old
subjects
somnambulists.
\ hypnotic
Do
lj
not forget, in
was
fact, that
first
it is
described.
in the
Now,
li
first
is
same
no need
Then,
suggestibility has
in individuals
notized.
There
who were
you must
first
290
Hysteria
or,
recognizing that he
is
hysterical.
For
my
part, I
who was
have
not
kept for some time both the accidents and the mental
dispositions that characterize this neurosis, recover
at that moment, suggestions no
and
these
subjects bear themselves in
longer take,
normal individuals. This
to
like
suggestions
regard
completely.
Well,
these
who
will
Hysterical Stigmata
291
Suggestibility
In
certain
it
is
a very
rest, of
periods
or
in
that which has
health, in certain somnambulisms,
been wrongly called the second state of Felida, we have
changeable malady.
of
in
a state of depression,
I described, long
together with all the other accidents.
ago, those women who are suggestible only three days
woman
its
nowadays.
One
patient
left
preceded
it,
do not
its
hesitate to assure
same
neurosis.
will
292
In a word,
my
of Hysteria
definite.
Suggestion
phenomenon
it
is
presents
a precise and
itself
experi-
and,
inversely, all
later, this
We
have
still
LECTURE XIV
THE HYSTERICAL STIGMATA THE RETRACTION OF THE FIELD OF CONSCIOUSNESS
THE COMMON STIGMATA
Other proper
The
hysterical
Absent-mindedness
stigmata
contraction of voluntary
movements
Subconscious-
The
Alternation
Transfers and equivalences
Personal percepelementary phenomena of consciousness
tion
The field of consciousness
Conscious synthesis
ness
7/5 variations
conscious-
ness
of
incom-
of attract-
The
ing attention
Lapses of the mental functions
weakness of attention
Emotional disturbances
Troubles
The incapacity
The lowering of the mental
of the will
of beginning or of stopping
level
protestations
by presenting
to
many
terical
We
disease
by
I confine
this single
myself to
phenomenon.
remarking
that, in the
Only
propose to
you
to divide
293
them
into
my
two
mind.
classes.
294
of Hysteria
proper;
they have the same properties as suggestion itself.
They are phenomena that exist in hysteria, but scarcely
any other
exist in
disease.
The
No doubt,
themselves
they present
among hystericals, and often
in a high degree, but they do not exist solely among
common
these patients,
to
from
to the
common
we
neurosis
the mind.
Suggestion,
an idea
it
let
of an idea in the
mind
We
of the subject.
cannot con-
them
the patients.
I should like to put in the first rank of these phenomena a very singular disposition of mind, for which we
namely, a
dis-
The
to
position to indifference,
abstraction,
aggerated absent-mindedness.
paying attention to something,
what
am
quite ex-
to
295
Hysterical Stigmata
While
while
other
phenomena,
am
paying
from
though
first.
When
they speak
room.
all
tell
them
They
forget
their
secrets
before
them with
would
indifference.
When
it
on
an
astonishing
impossibilities, contradictions,
ignorance.
do not reach
Objections,
their
minds
in the least.
The same
limitation
a time.
first.
The
first
disturbance with
was observed
many
girls is their
time.
mental.
This
fact
Here
is
in their
move-
may
incapacity to do,
even be
"
et
seq.
161.
"The
296
of Hysteria
make
make
same
movement.
do something
else.
a special appearance to
all
By the side of the positive phenomenon, consisting in the development of the somnambulic
idea, in convulsions, in persistent emotions, there was
their accidents.
place.
One would
forget
ill,
all
that
in their
in another state,
in another state.
of effort,
which
surprised us.
The
the
1
A. Pick,
"
Ueber
die
Sogenannte
'Conscience
Musculaire/"
The
297
Hysterical Stigmata
unknown
to themselves.
domain
you express do
they remain in that
If the ideas
it
if
will result in
medium-
mindedness
is
of suggestion
ness
it
is
gestion,
which
is
it
precisely the
development of an
is
idea,
indif-
Lastly,
itself
is
a stigma peculiar
298
to hysteria.
First of
individual.
Normal
say,
is
always a
all,
of Hysteria
it
as
consciousness,
in the
normal
philosophers
surrounded by
who
on the
stretch.
No
symptom
I wish to describe to
you
is
not inattention
mind.
So I make
it
a stigma
stigmata
and
still
better.
equivalences.
know
whose
that, to succeed,
fist
was
contractured.
passively in every
You
way;
then,
when
which
move
The
been a
move
little
299
Hysterical Stigmata
This work
is
marvellous;
freely in every
happy
later in despair.
fist,
which was
venture because
which
it
having no notion
me by
the circumstances in
namely, in a quite
na'ive
patient,
of the
operator or herself
hand.
You know
struck
it
occurred
that
the
result
is
During a certain period, from 1875 to 1890, this phenomenon, which is called transfer, was very much sought
after and often provoked artificially.
It was said to
be brought about by the mechanical action of certain
substances.
Thus
the
power of provoking
transfers.
To
cure a paralysis
bed
was
paralysis
then found to disappear on that side and to become
localized on the left side.
When the magnet was withdrawn, the paralysis reappeared on the right side, and,
of the right side, a big
after
several
oscillations
Other substances
electric current
of
this
in the
The
kind,
it
vanished.
had similar
effects,
and transferred
300
of Hysteria
You remember
was
much
studied
very
phenomenon
by Burcq
and Dumontpallier, who ascribed to it very odd laws.
Some physicians said they had found the means to make
of sensibility as well as those of motion.
that this
the oscillations either slow or rapid, to fix the disturbance on one side or the other, etc. Others went even
further; they invented the change of the colour sensations, which were transformed into their complementary
The
colours.
patients,
after
after
has no
Lastly,
for absurd-
limits,
of the
passed into the second, and, after a few osdisappeared. It became a convenient thera-
first
cillations,
peutic process.
No doubt there are in all this
Many
many
childish errors.
phenomena
of suggestion
phenomenon
In
my
to the other
It
is
of transfer
little
to the operator,
The
301
Hysterical Stigmata
assert.
victory.
all,
the
Then
to soon reappear.
same accident
presented
very likely
twelve
is
incoercible
first.
dif-
girl of
which had
vomitings,
making her
more
and she no
but, from that
eat with
longer vomits.
This seems
all
right,
moment,
this girl,
till
becomes impossible
observed.
five
fine
examples of
them.
But other
be observed.
One
3<D2
of Hysteria
terious processes,
now walk
When
freely,
He
but he
abdominal contractures.
could
months.
and replaced by
on indefinitely.
be equivalent and to have the
phenomena
The
of
amaurosis.
accidents seem to
And
so
localized in
some place or
other.
If
you understand
see
will
left
side
that the
is
but a
No
instability,
to
move
in its
ensemble
first.
This
The
is
303
Hysterical Stigmata
gestion,
to hysteria that I
last of the
stigmata peculiar
II
Can we summarize
and
absent-mindedness,
general idea that will enable us to conceive the essential
character which manifests itself in these mental troubles ?
be serviceable.
You
will find
it
my work on the
and in my book on
in
1901.
When we
things.
feel
in
a pain, I
can analyze
in the following
manner.
In the
first
place,
304
of Hysteria
compared
FIG. 21.
cular sense;
perception.
lamps kindle here and there. This is what is designated by the isolated words, "sensation of pain,"
"sensation of vision," "sensation of motion."
In the
f
,
T", when
it
is
The
pletely represented
It
contains a
new
305
Hysterical Stigmata
The
question here
is
my whole person it is
the union of present sensations different from the little
sensation considered, from all past impressions, from
of the idea of personality, of
It is the notion
the imagination of future phenomena.
of my body, of my capacities, of my name, of my social
world
it is
an ensemble
It is
a world of
two things
into
that
If
system
little,
we
new
dared, and
"I"
it is
we should
is
first
just
line
been
of our
simply
secondly, a reunion, a synthesis of
all
these elementary
306
notion of personality.
assimilation that
It
we can
of Hysteria
is
truly say,
"I
feel."
I formerly
proposed
new
character
is
This figure is, of course, quite theoretical, for it supposes an absurd thing; namely, that a man becomes
at
a given
moment
all
sonality,
conscious
of,
consciousness, contribute,
of well-being or discomfort, but are not clearly perceived by his personality. A part only of these elementary sensations gives rise to complete and personal
perception.
What
is
the
number
of those elementary
phenomena
Of how many ele-
The
307
Hysterical Stigmata
complete consciousness?
This
is
what
proposed to
call the
problem
by analogy, as you see, with the extent of the visual
field.
This problem is not clearly resolved, and psychologists have proposed very different figures.
ness,
The
is
individuals
and
mind.
their states of
much
An
with
orchestral
when
asleep, dreams,
ecstasy, have,
on the contrary, in
crisis of
on
this
of our mental
state.
Their
development
gestion,
control.
which
we
called
suggestibility.
Sugalways said, depends on the absence of
But control is nothing but the struggle, the
it
is
opposing
one
is
another.
The second
characteristic,
308
of Hysteria
exaggerated absent-mindedness, that abstraction bringall the blanks of consciousness, is but another
ing on
aspect of the
same phenomenon.
Our schema
who cannot
Let
see, at
A'
A'
4-
FIG. 22.
Schema
of absent-mindedness.
such as V, V,
He
will
The
Hysterical Stigmata
309
noises.
forgetting
sensations, as T, T',
mindedness.
field of consciousness becomes
The patient can no longer
more contracted.
more
than
two
elementary sensations at once.
perceive
reserves
this small share of perhe
Of necessity too,
ception for the sensations which seem to him, whether
right or wrong, the most important, the sensations
To have consciousness of what
of sight and hearing.
is seen or heard is of paramount necessity, and he
neglects to perceive the tactile and muscular sensations,
thinking he can do without them (Figure 23). At the
outset, he might perhaps still turn to them and take
them into his field of personal perception, at least for
still
a moment;
bad
more
There
tics.
,but,
serious,
habits.
one now)
is
pinches his
he can no longer
is
feel consciously.
310
of Hysteria
You may
easily
T'
T"
M'
M"
V'
V"
T'
-t-
T'
*-
FIG. 23.
Schema
sums up the
is
last
because the
phenomenon, that of
field of
alternations.
It
that
by attracting
The
311
Hysterical Stigmata
increases
becomes momentarily
so
much
that
the subject
we have observed
blind, a thing
continues,
am therefore
side
patients' thinking
to
summarizes the
preceding stigmata, and we may say that their fundamental mental state is characterized by a special moral
weakness, consisting in
the
lack of
power, on the
them
to his
personality.
Ill
be connected
no longer seems
The hysteric malady
It
to
me
is
not
It
absolutely isolated, like other mental disturbances.
is a special form, which constitutes a part of a much more
considerable group, and which is more or less distinguished from the other diseases belonging to this group.
The patients we consider are first and above all neuropaths,
individuals
weakened;
312
of Hysteria
The
direction.
result
is
that,
besides the
properly
ances, at
belong to
all
into
neuropathic individuals.
the enumeration
of
these
We cannot enter
disturbances,
which,
the
title
common
of
These subjects
feel
veil.
They
and
"
I,
p. 264.
The
he
313
Hysterical Stigmata
excitation,
and
You
what
and
love.
These
same
time, plaintive and
patients
kinds of eccenagitated, they will commit all
tricities, because eccentricity excites them and draws
attention to them.
They must needs attract attensee
will
tion
an
to
be, at
themselves,
interest in
all,
will result
love
the
in
order that
people
may
take
them.
of being praised
In
my
opinion
it
has always
all, it is
acter to hysteria.
It
sometimes
it is
exists in
a very high
by no means a stigma
peculiar to this malady; it exists as well in the psychasthenic. The amorous manias of doubters and of
patients laboring under obsessions, their mania of
jealousy, their need of attracting attention to themselves,
314
of Hysteria
laziness
them and
stigma.
The same
found
alterations are
are weakened.
The
subjects,
in the feelings,
who seem
They
which
so emotional,
are indifferent
lent, are
not just
that
is
them up.
You
an unfortunate event.
Lastly, the disturbances of their will are well known.
patients no longer will or rather they can no longer
The
They can no
do anything.
longer
"Ndvroses
et
Id&s
fixes," I, p. 109.
The
minds
to sleep,
315
Hysterical Stigmata
and,
in
their
many
Of course, it is especially
become difficult and, for a long
time, the patients go on with old actions, without being
able to stop, before they enter a state in which they no
longer do anything.
will
new
This incapacity
attention,
and
of
this
incapacity of stopping
when
it
it
been stopped at the outset. We begin to dream bewe wish to do so, reverie is so pleasant. We
to
eat sparingly in order to be thin, to have a
begin
cause
precipice,
No
and the
doubt you
declivity
is
with
all
is
phenomena
of abulia
to their
316
of Hysteria
So we
may
a depression, a lowering
to us the following stigmata
of the mental level, which takes the special form of a
:
LECTURE XV
GENERAL DEFINITIONS
The positive
of the typical symptoms of hysteria
and negative phenomena in somnambulism with amnesia,
in agitations with paralyses and anesthesias
The general
Review
Their congruency
and
of
Definitions of hysteria
The need
Psychological definitions
as a disease
Definitions of hysteria
Discussion of these defi-
by suggestion
ideas, without relation
Fixed
nitions
The
of the accident
to the
medical form
unknown
to the patient
The conditions of suggestion
as
a
mental
form of
Hysteria
depression, characterized by
the contraction of the field of personal consciousness and
a tendency
to the dissociation
system of ideas
The laws
and functions
of localization
and
emancipation of the
The
diffi-
anterior
weakening
of the junction,
emotion
IN these
I
lectures
hysteria,
symptoms
all
the
that
of
know
well.
to
3i 8
of Hysteria
We
Allow me,
first,
to
remind you
in a
somnambulism
We
have
studied it
its simple and typical form of monoideic somnambulism, then in its more complete forms
of fugues, of polyideic somnambulisms, of artificial
somnambulisms. You remember that we have always
recognized in it the exaggerated development of an idea,
under
system of thoughts,
ing not only on the somnambulic period, but even, in remarkable cases, on the whole of the idea and of the feeling.
When
the
General Definitions
and give
rise
to tics
and choreas
319
of various kinds.
same
r61e as the
we came
is
When
amnesias of somnambulism.
tics,
we saw
of pains,
the
and
same
of hal-
more
exaggerated degree.
It
is
it
is
Sur-
The
functions.
these organs.
There
;
320
of Hysteria
teria
sciousness, alternation,
This
is
suffice
us in prac-
tice.
dices
Unfortunately, the
tent;
it
is
still
very
human mind
is
feel
seems to
me
that
give definitions
it is
on
in
formulas
passed
in
review.
Though Lasegue
my
little
book on
and
General Definitions
321
We
n
I
am wrong
and observing
matters,
evolved
is
to
you
their
abundance, which,
These
in these
have
definitions
though
of a physician, or
hope that he
if
he
him?
He must
were
it
I do not exagindispensable.
of the
three-fourths
you that, nowadays,
definitions of hysteria are nearly identical.
which, in medicine,
is
gerate in telling
there
if
these authors
had
322
of Hysteria
and replace
their
of
the last
recommend to you
book of M. Jose
Ingenieros,
published
at
and
am
Charcot used to say that hysteria is an entirely psyThis opinion was discussed at his time.
chic malady.
There were
and
some remainders
still
genital theories;
there were
some attempts
Bastian's book,
is
in
very courageous.
1
Charlton Bastian,
Paralysis," 1893.
"
Dr.
He had
General Definitions
323
encephalon.
That there
no truth
is
should not
dare assert
of the matter,
and
But now,
difficulties begin.
chological disturbance
is
it
Of what kind
a question?
We
of psy-
should
On
this point,
the
work
of a
nite patience
and penetration,
all
edifice
324
of Hysteria
identical with
tics of idiots, is to
it
clinical descrip-
to believe, to
confound
it
important to distinguish
The
first
it
it is
all,
nowadays the
and that it is
well.
porary works
is
of
Charcot, studying
the paralyses, had shown that the disease is not produced by a real accident, but by the idea of this accident.
idea that the wheel passed over his legs. This remark
is easy to generalize.
There are such kinds of fixed
There
at school.
General Definitions
325
made on
normal man.
They seem
and
more deeply
about motor and visceral
to penetrate
to bring
modifications.
by
MM.
"What
characterizes
this
many phenomena
So it may be said
of hysteria turn
on
common
conceptions
Moebius
this character.
in 1888,
all
words, quite
similar definitions.
"when
in the
said
it
much might be
said
on those cures
through persuasion.
It is
absolutely the
This
326
of Hysteria
it
by
all
number
of con-
temporary conceptions.
Ill
to the
"
ibility.
one of the
scientific
to the suggest-
useful.
work
It is
that
had already
think them insuffi-
However,
discussed
dicted,
and
first
In the
first
more just
hysteria
is
summarizes
It is
the accidents seem to be brought about by ideas.
not quite exact that we always observe these ideas.
In a few cases
repeated
General Definitions
The
327
seems
is
all hysterical
M. Bernheim, "The
just as
he conceives
This
is
to
it."
->
come back
to a kind of
crises of sleep
accidents."
to
"You
contemptuous
Now,
of them.
there are
many
I say that
it."
hystericals
who do
not
them.
They become
anesthetic,
paralytic,
it.
anorexic,
Clinical
it,
do not admit
beforehand.
328
is
and
If these patients
of Hysteria
it
very frequent
One has
somnambulism and
it is
be well
fixed ideas
I acknowl-
should
not at
of its laws.
all
than
is
think of
it
I should like to present, in the second place, an argument which is still weak, but the importance of which
grow more and more. It relates to the physiological and psychological laws of hysterical accidents,
laws of which we are ignorant, and of which the subjects
are ignorant like us. When we see a crowd of accidents evolve according to these laws, which we painfully
describe, we cannot say that they are due to autowill
suggestion.
I remind
of
somnambulisms, which,
This amnesia
the feelings connected with it.
lost
and
all
the
remembrances
apparently
disappears
on
all
are restored
when
same somnambulism.
and
of all that
is
con-
General Definitions
329
my
contrary idea, that of being obsessed by their remembrance like the psychasthenics.
The more
more
have
In
walk, the function of the movements of the hand.
this case, you will tell me, the paralysis might very well
be brought about by an idea, since the popular idea
coincides with the very limits of the paralysis. This is
true in general, simply because the popular ideas are
The
true.
much
tions
disturbances of speech
hemiplegy?
How
is it
vision
Why
are
Why
accompanied with
there
cases
of
are the
right-sided
hemianopsia?
monocular
turbances of accommodation?
Why
If
you pass on
to con-
330
tractures,
do you
of Hysteria
am
convinced, for
my
has
These
defini-
tions
sense.
that,
with hystericals,
the
action that
is
answer that
it is
it is
this special
constitutes hysteria,
say,
if
if it is
true, that
definition certain
I asked for.
new
General Definitions
331
;
IV
You
you
absent-mindedconsciousness.
field of
When
thing else?
power
If
Why
that
it
this
retraction
it
which
range
mine.
They
into
are
definitions,
in
my
is
observed in
many
all
the functional
paralyses.
Was
332
"The
accidents in 1889?
of Hysteria
name
of
hypnoid
states,
phenomenon
to
Breuer and
what depth
this dis-
sociation reaches.
tias
me
to indicate to
is
MM.
We
motor functions.
must remember
that, in hysteria,
subsist
with
their systematization.
the
personality,
system of grouping
of the different functions around the same personality.
What
is
emancipated
dissolved
I maintain
to
is
this
day
that,
if
hysteria
is
a mental
malady,
it
and
is
I will take
the dissociation
and functions
and emancipation
and a tendency
to
is
not for
me
to understand
what
General Definitions
333
The
difficulty
we meet
How
ization.
bears on
with, then,
is
a difficulty of
local-
with a third,
turns into a
is
it
it
somnambulism ?
of definition.
The
starting-point of hysteria
is
is
the
same
as that of
There are some operations that are easy for all kinds of
reasons, first, because they are simple and only require
in
which
this
334
nervous tension
itarily
is
seem
of Hysteria
which the
vital forces
to
that,
re-
through a
Even
in
ized
this
by
likely, in
emotion
is
character-
emotion, there
is
Very
a great expense of nervous
strength
set,
causes.
If hereditarily predisposed,
The
to intoxication, fatigue,
vous tension,
all
is
exists in
With
were, an autotomy.
Consciousness, which is no
able
to
too
longer
perform
complex operations, gives
some
of
them.
There
is, it is true, a general enup
as
it
General Definitions
335
No
doubt, in a certain
ization
is
number
An
idea sug-
but which
of psychological automatism.
it,
nostrils
tic of blowing
because he had a scab in
weak and
some reason or
disturbed.
Many
other, has
remained
of our patients
become
336
dumb
after
clined to
of Hysteria
an emotion, but they were formerly instammer, their speech was quite insufficient.
This remark
very numerous
a
disease
of any kind
hysteria:
associated
cases of
lesion
of
the
is
localized.
symptoms
of organic
to
professional
and
social
paralyses.
Finally, fifth law:
We
fact,
activity at
moment
of a great emotion.
physiological laws that cause the
the
subject.
General Definitions
337
study of hysteria.
definitions;
of general
discussions,
which
the
researches
of
experimental
psychology, so brilliantly represented, I think you will
not have lost too much time in trying to understand a
psychology,
barbarous language.
For
my
INDEX
Aphasia,
swelling of, among pheof respiration, 263-264.
Abdomen,
nomena
Absent-mindedness,
311; rhythm
and, 254.
Abulia, 315.
296, 309Cheyne-Stokes
172,
of
distinction
209;
hysterical
between
motor, 218-219.
Aphonia, 317.
Asphyxia, hysterical, 247-248.
Aspiration, tics of, 266.
Astasia-abasia, 177-181, 217.
Astruc, 14.
Accommodation, spasm
206-207,
of,
3 2 9of, 260.
Aerophagia, phenomenon
Alimentation, hysterical disturbances
of, 227 ff.; tics of, 264-269.
Azam,
Allochiria, 183.
72-74;
somnambulism, 124-125.
sentation of, 70-77.
Anesthesia, hysteric, in motor disturbances, 124-126; description of
150-158;
in
paralyses,
of,
work
by, 322.
difference
personality, 85.
Benedict, 331.
Bernheim,
165;
Binet, 4.
163-164.
of,
230;
definition of
hysteric,
three
243-244-
defi-
of, 244.
cases of,
186-187.
Bloch, apparatus devised by, 350.
Blocq, form of hysterical paralysis
pointed out by, 177.
Blood, vomiting of, 268-269.
'
Borel, 186.
Bourru, 83.
Brachet, 15, 320.
Breuer, 4, 331, 332.
Brewster, experiment
339
of,
192-193.
Index
340
quoted on hysteric
fits,
102.
Bristow, 205.
Broca, 215.
Brodie,
English physician,
15-16,
140, 176; work of, on local neraffections, 131.
Bulimia, 264-265.
quoted on
anesthesia and muscular weakness,
Burcq,
167,
300;
236,
epileptic
fits
Brissaud, 4.
vous
between
difference
99;
and,
Coprolalia, 225.
Coriat, H., paper by, 55.
Coulson, 131.
Courtney, Dr. J. M., paper by, cited,
58-59-
183-
Burot, 83.
Dana, Dr.,
cited, 66.
Danilewsky, works
Cartaz, on hysterical dumbness, 210,
214.
Catalepsy,
form
of
somnambulism
called, 33.
I3
140,
249.
Chairou, 249.
Charcot, T. M.,
1.
of,
3, 4, 12,
144,
IS
1.
16-17, 20-21,
53. 161-162,
ing fugues, 60
on motor agitations,
121,122; helicopode and helcopode
sonalities of, 74 ;
gaits of, 146, 174; case of hysterical dumbness studied by, 211; the
anesthesia of,
273-276;
definition
Chorea of Sydenham,
227
ff.
"Dissociation
Prince's, 67.
of,
252-254.
123.
Double
hypothesis
phenomenon
concerning,
136-137;
of anesthesia in, 273-
of,
210.
Dumbness,
274.
theories concerning,
98-
hysterical, 209-215.
Dumontpallier, 282, 300.
Dutil, 165.
Dyschromatopsia, 204.
Index
34i
167;
Grasset, 4, 324.
Gull, W.,
228.
described
anorexy
by,
Gurney, 331.
210.
205-207.
See Vision.
nambulisms, 32-37,
59-60;
somlack-
84-85.
on
Fits,
94
ff.;
false
theories
Flees,
for eye-testing,
190-192.
See Fugues.
Flights.
Flourens, 249.
Forel, 4.
Gelle, 220.
on
hysterical hemi-
anopsia, 200-201.
gaits, 146,
174.
Hemianesthesia, 153-154.
Hemiplefjy,
hysteric,
nopsia
Huchard,
176.
Hufeland,
15.
of,
317-
321; various definitions of, 321326; discussion of definitions, 326332; author's formula of, 332.
Hysterogenic points, 98-99, 113.
Index
342
Lasegue,
Idea.
Incapacity,
124-125;
phenomena
161,
131,
171-172,
of,
314.
Lebreton, 205.
"Lecons
du
Mardi,"
Charcot's,
219.
of, in tics,
examination
168,
anorexy described
in
of,
of,
M
Mabille, case of Louis Vivet published by, 83.
MacNish, Dr.,
Jaccoud, form of hysterical paralysis
pointed out by, 177.
James, William, cited, 175.
Janet, Jules, 162, 165.
Jaws, spasms of, 265.
Jolly, F., 188, 331.
67, 68.
Macropsia, 207.
Malebranche, 291.
Marceline, the case of, 87-91.
Marie, Dr. Pierre, 4, 209.
3*4-
"Mental
Janet's, 303.
Merycism, 266.
of, 205.
of
Hystericals,"
4.
Kussmaul, 210.
Kuttner, patient
of blood, 268.
Mesnet,
State
of,
with vomiting
religious,
"Lady
of
MacNish," story
of,
68-
somnambulism,"
74.
Landolt, 186.
Monoplegy, 144.
Montgeron, Carre de, 134, 210.
Morax, 206.
Mosso, 249, 254.
Index
Motor disturbances
of limbs, 117-
119.
Pomme,
14.
85-
Ptyalism, 266.
2OI.
(Esophagus,
Pitres, 4.
Polydipsia, 265.
Polyopy, 207.
Polypnoea, respiration in cases of,
2SS-25 6 257-258.
Polyuria, 265.
N
Narrowing
343
spasms of
of,
the,
140.
243-
244, 266.
Reflexes,
Ophthalmoplegy, 205-206.
Oppenheim,
defini-
absence of modification
of,
160-
162.
Regnard, 192.
Pachon, works
Page, W., 176.
of,
249.
Paget, 131.
Paralyses, hysteric, 138-139; causes
varieties of (hemiof, 140-142;
plegy,
paraplegy,
monoplegy,
paralyses of the trunk), 142-144;
diagnosis of, 145-150; difference
between organic paralyses and,
146; systematic, 178; of digestive organs in disturbances of
alimentation,
tory, 246
ff.
phenomenon
254-257;
anesthesia
243-244
respiradiaphragm,
of the
in,
of
273-274.
Paraplegy, 143.
Ambroise, 14.
Parinaud, 186, 192, 193, 206, 207.
Pawlof, 237.
See Double
Personalities, double.
Pare',
Regurgitation, 266.
Reproduction of hysteric accidents,
110-115.
paralRespiration, tics of, 245 ff.
alternating seeysis of, 246 ff.
saw, 255.
Retraction of field of consciousness,
;
of,
314.
Revillod, 210.
on double
personality, 78.
Roux,
personalities.
Photophobia, 205.
Pick, A., 295-296, 331.
Index
the most
270 ff.
important mental stigma of hys-
teria, 292.
Sauvage, 14.
Suggestibility,
"Multiple Personality"
B.,
279
2 79> 33
ff.
distinct
phenomenon
meaning
of,
description of principal
facts of, 279-281; difference be>
by, 67.
Sigh, the hysterical, 259.
Simulation,
perpetual,
so-called,
286.
277-278.
Sitieirgia, 229.
Sitiophobia, 229.
Sleep, fits of, examined as an accident of hysteria, 104-109.
Somnambulisms,
illustrative
26-32;
analogy between fugues and, 5459; differences between fugues
illusand, 59-61
polyideic, 61
trative cases, 61-64; emancipation of feelings and emotions in,
;
Subconsciousness,
296-297.
mental
Suggestion,
of,
phenomenon
of,
of,
123.
Taine, on double
personality, 78.
Tardieu, 277.
Taste, disturbances of sense of, 183.
Tics, 119-123; characteristics of,
123-128; hysteric anesthesia in,
124-126; of speech, 224-225; of
inspiration, 259; expiratory, 260264; complex phenomena of, 262264; of perpetual spitting and
salivation, 265 of eructation, 266.
Todd, study of traumatic neuroses
;
by, 140.
of,
182-183.
Tourette, Gilles de la, 4, 199, 224,
237; work of, cited, 248.
Tours, Moreau de, 7.
Transfers, 298-300.
Tremors, phenomenon of, in hysteria, 129-131.
Vascular
V
reflexes, 160.
of
monocular
and
binocular, 193-195;
narrowing
of the visual field,
195-201;
disturbances in movements of the
eyes, 205-207.
Index
Vivet, Louis, case illustrating
345
article by,
239-240, 241
Word-blindness, 219.
Word-deafness, 219-2*1.
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