One of the most fascinating areas of research for Leaving Van Gogh was the treatment of mental illness in 19th-century France. Since the novel is set in 1890, it’s natural that I came across the titanic figure of that era, Dr. Jean-Martin Charcot. I even wrote him into LVG by having Dr. Gachet attend one of Charcot’s famous Tuesday Lectures. So Asti Hustvedt’s Medical Muses was a must-read for me, and a hugely satisfying one.
Charcot was one of the founders of modern neurology, and a pioneer in the discovery of the neurological causes of abnormal behavior or illness: for instance, what we call “Lou Gehrig’s disease” is sometimes still known as “Charcot’s disease” in France. But Hustvedt focuses here on Charcot’s work on hysteria, which at the turn of the century was held responsible for a number of mysterious symptoms like partial anaesthesias, paralysis, even the appearance of stigmata — none of which had a discernible organic cause.
This would be interesting, though abstract, if it weren’t that Charcot’s work at the famous women’s hospital of the Salpêtrière was carefully documented in records both verbal and visual — yes, there were photographs. Thus two of Charcot’s patients, Blanche Wittman and Augustine Gleize, became quite famous in their day. Hustvedt focuses on Blanche, Augustine, and a third woman, Geneviève Legrand, as a way of examining the fascinating, complicated, multi-layered phenomenon of hysteria.
OK, are you ready? Let’s do the sex part first. One of the key characteristics of hysteria, as defined by Charcot and his followers, was that the sufferers had attacks in the course of which they were not themselves, and sexual reverie was a frequent component. The patients at the hospital were all women, and many of them had suffered sexual abuse before arriving at the hospital. The photographs of the patients that illustrate various stages of the hysterical attack are often suggestive. The doctors, naturally, were all men.
Then let’s think about the theatrical element, especially involving hypnosis. An hysterical woman who had lost the use of her left arm — for no clear physical reason — might be hypnotized. When it was found that she could use that arm under hypnosis, it became clear that her paralysis was generated by her psyche. Imagine this fact being demonstrated in a theater, before an audience of physicians and journalists. Imagine hypnotized patients being pierced with pins and feeling no pain, or submitting to post-hypnotic suggestions.
Now look at women, and women’s undefinable complaints. Poor women, mad women, unclassifiable women, women who had sexual urges outside the marital framework. Hustvedt even brings religion into the mix, since her third case study, Geneviève, was deeply religious. (There’s a remarkable chronological connection with the flourishing of hysteria and the cult of Lourdes.)
That’s a pretty combustible mixture. Hustvedt’s careful research and scholarly writing style tames it all, while the way she frames the narrative in the lives of these three women puts a personal face on many of the issues. The hysteria diagnosis went out of fashion shortly after Charcot’s death in 1893 but as Hustvedt points out, doctors are still puzzled by a variety of complaints — chronic fatigue syndrome, Gulf War syndrome to name only two — that cause suffering without being attributable to physical causes. We now have medications that can alleviate suffering but sometimes we don’t even know how or why they work. Not that different, perhaps, from 1890?