text:
The discovery of the unconscious: The history and evolution of dynamic psychiatry, HF Ellenberger
Mesmer, animal magnetism, Charcot, France, Salpetriere, magnetic treatment, the patient, Pierre Janet, Nancy School, Johann Joseph Gassner, Germany, Abbe Faria, Alexandre Bertrand, psychological phenomena, state of Baden, scientific study, Bergasse, Marquis de Lafayette, Gassner, Bishop of Constance, patient, The Discovery of the Unconscious, Blanche Wittmann, Jules Janet, magnetism, Puysegur, Vienna, magnetic influences
The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry Henri F. Ellenberger (1970) Chapter Two: The Emergence of Dynamic Psychiatry The emergence of dynamic psychiatry can be traced to the year 1775, to a clash between the physician Mesmer and the exorcist Gassner. Gassner, an immensely successful and popular healer, personified the forces of tradition. He had mastered an age-old technique that he applied in the name of the established religion, but the spirit of the times was against him. Mesmer, a son of the "Enlightenment," had new ideas, new techniques, and great hopes for the future. He was instrumental in defeating Gassner and believed that the time was propitious for the onset of the
Scientific Revolution
that he had in mind. However, the overthrow of a declining tradition does not in itself inaugurate a new one. Mesmer's theories were rejected, the organization he had founded was short-lived, and his therapeutic techniques were modified by his disciples. Nonetheless, he had provided the decisive impulse toward the elaboration of dynamic psychiatry, even though it would be a century before the findings of his disciples were to he integrated into the official corpus of neuropsychiatry by Charcot and his contemporaries. Gassner and Mesmer In the first months of 1775, crowds of people, rich and poor, noblemen and peasants, including among them patients of all kinds, swarmed to the small town of Ellwangen, in Wurttemberg, to see Father Johann Joseph Gassner, one of the most famous healers of all time. He exorcized patients in the presence of Catholic and Protestant church authorities, physicians, noblemen of all ranks, members of the bourgeoisie, and sceptics as well as believers. His every word and gesture and those of his patients were recorded by a notary public, and the official records were signed by the distinguished eyewitnesses. Gassner himself was a modest country priest; but once he had donned his ceremonial garments, had taken his seat, and had the patient kneeling before him, astonishing things would take place. Numerous collections of official records have survived, as well as accounts given by eyewitnesses. Among the latter was an Abbe Bourgeois, from whose narrative we borrow the following details: The first patients were two nuns who had been forced to leave their community on account of convulsive fits. Gassner told the first one to kneel before him, asked her briefly about her name, her illness, and whether she agreed that anything he would order should happen. She agreed. Gassner then pronounced solemnly in Latin: "If there be anything preternatural about this disease, I order in the
name of Jesus
that it manifest itself immediately." The patient started at once to have convulsions. According to Gassner, this was proof that the convulsions were caused by an evil spirit and not by a natural illness, and he now proceeded to demonstrate that he had power over the demon, whom he ordered in Latin to produce convulsions in various parts of the patient's body; he called forth in turn the exterior manifestations of grief, silliness, scrupulosity, anger, and so on, and even the appearance of death. All his orders were punctually executed. It now seemed logical that, once a demon had been tamed to that point, it should be relatively easy to expel him, which Gassner did. He then proceeded in the same manner with the second nun. After the seance had ended, Abbe Bourgeois asked her whether it had been very painful; she answered that she had only a vague memory of what had happened and that she had not suffered much. Gassner then treated a third patient, a high-born lady who had previously been afflicted with melancholia. Gassner called forth the melancholia and explained to the lady what she was to do in order to overcome it in case she was troubled by it again. Who was the man whose almost miraculous healings attracted such crowds? The life history of Johann Joseph Gassner (1727-1779) is not well known. Among biographical accounts, one, by Sierke, is strongly prejudiced against him; another, by Zimmermann, is better documented but is biased in his favor; both are based mainly on contemporary pamphlets, not on archive material. Gassner was born in Braz, a village of indigent peasants in Vorarlberg, a mountainous province of western Austria. He was ordained into the priesthood in 1750, and beginning in 1758 carried out his ministry in Klosterle, a small village in eastern Switzerland. A few years later, according to Zimmermann, he began to suffer from violent headaches, dizziness, and other disturbances that became worse whenever he began celebrating the Mass, preaching, or hearing confession. This particular detail led him to suspect that "the Evil One" might be at work; he resorted to the Church's exorcism, prayers, and his troubles eventually disappeared. He then began to exorcise sick people within his parish, apparently with much success, since patients started to come to him from all the neighboring districts. In 1774 his fame was increased after he had cured a high-horn lady, the Countess Maria Bernardine von Wolfegg. In the same year Gassner wrote a booklet in which he explained the principles of his healing method. He distinguished two kinds of illnesses: natural ones, that belonged to the realm of the physician, and preternatural ones, that he classified into three categories: circumsessio (an imitation of a natural illness, caused by the devil) ; obsessio (the effect of sorcery) ; and possessio (overt diabolical possession), the least frequent of them. In all of these cases Gassner first told the patient that faith in the name of Jesus was an essential prerequisite to heing healed and asked his consent for the use of exorcismus probativus (trial exorcism). He then solemnly entreated the demon to make manifest the symptoms of the disease; if the symptoms were produced, Gassner considered it proven that the disease was caused by the devil and proceeded to exorcize him. But if no symptoms appeared, he sent the patient to a doctor. In that manner he felt his position to be unimpeachable, both from the viewpoint of Catholic orthodoxy and from that of medicine.
Because of his sudden fame, Gassner received invitations from various places; including Constance, where he performed cures by exorcism without apparently succeeding in gaining the favor of Cardinal Roth, Bishop of Constance. But he found a powerful protector in the Prince Bishop of Regensburg, Count Fugger, who appointed him to an honorary office al his own court. Gassner thus took up residence in the old churchtown of E'llwangen and lived there between November 1774 and June 1775. During this period he reached the peak of his activities; patients thronged to Ellwangen, and a storm of polemics raged around him. Dozens of pamphlets were published, either for or against him, in Germany, Austria, Switzerland, and even in France. Gassner had the support of some ecclesiastical protectors in addition to that of the masses and of those who hoped to be cured by him. (His enemies added that he was particularly popular with the innkeepers and carriage drivers, who largely benefited from the fad.) One of his admirers was the celebrated Zurich pastor Lavater. Among his adversaries were the Catholic theologian Sterzinger, the Protestant theologian Semmler, and most of the representatives of the Enlightenment. Rumors were circulated that cases of possession were sure to occur wherever Gassner's visit was announced; imitators, among them even peasants and children, began exorcizing with his method. In Vienna, animated controversies took place, both for and against him. Why was there such an outburst of passion? This can be better understood by looking at the situation in Europe in 1775. Politically, Europe had begun to leave behind the old feudal organization to move toward the development of national states. In contrast with unified nations such as France and England, Germany, under the nominal sovereignty of the Emperor, was an inextricable conglomerate of more than three hundred states of all sizes. Most of continental Europe was under the domination of the Austrian monarchy, which ruled not only over Austria proper but also over a dozen subjected nations. Vienna, an artistic and scientific center of the first order, was the seat of its brilliant court. A strong and rigid system of hereditary social classes prevailed everywhere: nobility, bourgeoisie, peasantry, and laborers, each class having its subclasses. "The Church had a firm grip on the lower and middle classes. But Europe had come under the spell of a new philosophy, the Enlightenment, which proclaimed the primacy of Reason over ignorance, superstition, and blind tradition. Under the guidance of Reason, mankind was expected to proceed along a path of uninterrupted progress toward a future of universal happiness. In
Western Europe
the Enlightenment had developed radical tendencies that were to materialize later in the American and French revolutions. 'The remainder of Europe was ruled by "enlightened despotism," a compromise between the principles of Enlightenment and the interests of the
ruling classes
. Maria Theresa of Austria, Frederick II of Prussia, and Catherine the Great of' Russia were the typical representatives of that system. In the Church, too, "enlightened" tendencies were gaining ground: the order of Jesuits was taken as scapegoat and abolished in 1773. The notorious witch hunts and processes had not yet completely disappeared (one of the last executions was to be that of Anna Goldi in Glarus, Switzerland, in 1782), but everything related to demons, possession, or exorcism was shunned. n view of this atmosphere, it becomes understandable why so much opposition arose against Gassner, and also why even his most faithful protectors were forced into positions of extreme caution. The Prince Bishop of Regensburg ordered an inquiry that took place in June 1775, after which Gassner was advised to reduce his activity and to exorcize only patients who had been sent to him by their respective church ministers. The University of Ingolstadt delegated a commission with representatives from its four faculties to make an inquiry. This inquiry was held on May 27, 1775, in Regensburg and had a rather favorable outcome. The Imperial Court in Vienna also took an active interest in the matter. In Munich the Prince-Elector Max Joseph of Bavaria also appointed an inquiry commission. This commission invited Dr. Mesmer, who claimed to have discovered a new principle called animal magnetism and who had just returned from a journey along the Rhine and to Constance, where he was said to have performed marvelous cures. Mesmer arrived in Munich, and, on November 23, 1775, gave demonstrations during which he elicited in patients the appearance and disappearance of various symptoms, even of convulsions, simply by a touch of his finger. Father Kennedy, the Secretary of the Academy, was suffering from convulsions, and Mesmer showed that he was able to bring them forth in him and dispel them at will. On the following day, in the presence of court members and members of the Academy, he provoked attacks in an epileptic and claimed that he was able to cure the patient through animal magnetism. In effect this amounted to Gassner's procedure, without involving the use of exorcism. Mesmer declared that Gassner was undoubtedly an honest man, but that he was curing his patients through animal magnetism without being aware of it. We can imagine that, upon hearing of Mesmer's report, Gassner must have felt somewhat like Moses when the Egyptian wizards reproduced his miracles in the Pharaoh's presence. But unlike Moses, Gassner had not been permitted to witness Mesmer's performance or to reply to his report. Meanwhile, the Imperial Court, which was decidedly not favorably disposed toward Gassner, had asked the Prince Bishop of Regensburg to dismiss him, and he was sent to the small community of Pondorf. In Rome, Pope Pius VI (Giovanni Angelo Braschi) had ordered an investigation into Gassner's activities. In the decree that followed, it was stated that while exorcism was a common and salutary practice of the Church, it was to he performed with discretion and with strict adherence to the prescriptions of the Roman ritual. Gassner died in Pondorf on April 4, 1779. His tombstone bore a lengthy inscription in Latin, describing him as the most celebrated exorcist of his time. No one ever questioned Gassner's absolute piety, his lack of pretentions, and his unselfishness. Unfortunately for him, he had come too late, and the controversies that had been raging around him had a much more important object: the struggle between the new Enlightenment and the forces of tradition. Gassner's downfall prepared the way for a healing method that retained no ties with religion and satisfied the requirements of an "enlightened" era. Curing the sick is not enough; one must cure them with methods accepted by the community. 2
Franz Anton Mesmer (1734-1815) The fateful turning point from exorcism to dynamic psychotherapy was thus reached in 1775 by Franz Anton Mesmer, who has been at times compared to Columbus. Both Columbus and Mesmer discovered a new world, both remained in error for the remainder of their lives about the real nature of their discoveries, and both died bitterly disappointed men. Another point of similarity is the imperfect knowledge we have of the details of their lives. None of Mesmer's disciples seems to have been interested in the story of his master's life. The first to inquire about it was Justinus Kerner, who traveled to Meersburg, where Mesmer had died, and gathered firsthand documents and information about him. Recently, the research done by Tischner, Schurer-Waldheim, Bittel, Wohleb, Milt, and Vinchon has shed some light on several periods of Mesmer's life, about which, however, large gaps still remain. Franz Anton Mesmer was born on May 23, 1734, in Iznang, a small village on the German shore of Lake Constance, the third of nine children. His father was a game warden in the service of the Prince Bishop of Constance. Nothing is known of Franz Anton's childhood and youth; the first recorded fact of his life states that in 1752, at the age of 18, he was registered at the Jesuit Theological School in Dillingen. In 1754, Mesmer registered at the Jesuit University of Ingolstadt for his third year in theology. His activities and whereabouts during the years 1754 to 1759 are not known. It is likely that he spent them studying philosophy. He registered as a law student in Vienna in 1759 and changed to medicine the following year. Mesmer completed his medical studies in Vienna, where his dissertation on the influence of planets on human diseases won him his degree in 1766, at the age of thirty-three. Mesmer's scholastic career was remarkable in several regards. It was certainly not unusual for the Church to notice an intelligent and diligent boy, and to provide him with the possibility of studying in ecclesiastical schools with a view toward a future clerical vocation. One of his brothers, Johann, later became a priest in a nearby community, and this is obviously how Franz Anton also began his studies. However it is most unlikely that the Church or his family continued supporting him when he changed from theology to philosophy, then to law, and finally from law to medicine. It is more probable that he found rich protectors, as he did in later periods of his life. lie might also have been associated with secret societies. In 1767 the young doctor married a wealthy widow of noble descent, Maria Anna von Posch, and established himself in Vienna as a physician. A refined man of the world and a patron of the arts, he lived on a splendid estate of which Leopold Mozart said: "The garden is incomparable, with its avenues and statues, a theater, a birdhouse, a dove-cot, and a belvedere on the summit."' Friends who visited the house included the musicians Gluck, Haydn, and the Mozart family. (Wolfgang Amadeus Mozart's earliest opera, Bastien and Bastienne, had its first performance in Mesmer's private theater.) Mesmer was one of the first to play the glass harmonica, a new musical instrument that had been perfected in America by Benjamin Franklin. During the years 1773 to 1774, Mesmer treated in his own home a twenty-seven-year-old patient, Fraulein Oesterlin, who was afflicted with no less than fifteen seemingly severe symptoms. He studied the quasi-astronomical periodicity of her crises and became able to predict their recurrence. He then endeavored to modify their course. It had just become known that some English physicians were treating certain diseases with magnets, and it occurred to Mesmer to provoke an "artificial tide" in his patient. After making her swallow a preparation containing iron, he attached three specially conceived magnets to her body, one on her stomach, the two others on her legs. The patient soon began to feel extraordinary streams of a mysterious fluid running downward through her body, and all her evils were swept away for several hours. This happened, Mesmer reported, on July 28, 1774, a historical date."' He understood that these effects on the patient could not possibly be caused by the magnets alone, but must issue from an "essentially different agent," that is, that these magnetic streams in his patient were produced by a fluid accumulated in his own person, which he called animal magnetism. The magnet was but an auxiliary means of reinforcing that animal magnetism and giving it a direction. Mesmer was forty years old when he made this discovery. He was to devote the rest of his life to its elaboration and to present it to the world. As a result of this new method, Fraulein Oesterlin improved so greatly that she was able to marry Mesmer's stepson and become a healthy wife and mother. But the first disappointments were not long in coming. Father Hell, the astronomer who had provided Mesmer with magnets, claimed that the discovery was his, while Mesmer's medical friends strongly disapproved of his new research trend. Notwithstanding, Mesmer must have at that time become somewhat of a celebrity, because in June 1775, Baron Horeczky de Horka, a Hungarian nobleman, invited him to his castle in Rohow, Slovakia. The Baron was suffering from nervous spasms, which had persisted despite the efforts of Vienna's foremost physicians. Mesmer's stay in Rohow lasted about two weeks, of which an account was written by the Baron's house teacher Seyfert, who served as Mesmer's interpreter and, assuming that he was a quack, observed him keenly in order to unmask him. Shortly after Mesmer's arrival, several of the castle's inhabitants began to feel pains or peculiar sensations in their bodies as soon as they came near him. Even the skeptical Seyfert noticed that he was seized with an invincible sleepiness when Mesmer
played music
. It was not long before he became thoroughly convinced of Mesmer's extraordinary powers. He saw how Mesmer could elicit morbid symptoms in people around him, particularly in those whom he had magnetized. A lady who was singing lost her voice as soon as Mesmer touched her hand and recovered it when he made a gesture with his finger. As they were sitting together, Seyfert saw that Mesmer was able to influence people sitting in another room simply by pointing to their images reflected in a mirror, even though these people could see him neither directly nor indirectly in the mirror. At another time, when two musicians were playing the horn, Mesmer touched one of the instruments; immediately, a group of people-who could not see him-began to have symptoms that disappeared when Mesmer removed his hand. Meanwhile, the rumor had spread that an 3
extraordinary healer had arrived at Rohow, and patients came from all the neighboring areas to see him. Mesmer magnetized many of them, while sending others to see their own doctors. On the sixth evening, Mesmer announced that the Baron would have a crisis on the following morning-which actually happened. The crisis was unusually violent, and it was reported that the fever increased or decreased according to whether Mesmer came closer to the patient or drew away from him. A second, less violent crisis occurred a few days later, but the Baron found the treatment too drastic and Mesmer left Rohow, though not without healing, at the last minute, a peasant who had suddenly lost his hearing six weeks before. Seyfert also relates his talks with Mesmer, who admitted that Gassner possessed magnetism to an extraordinary degree and that his own powers were not as great, wherefore he had to reinforce it by certain means. Seyfert had reasons to believe that Mesmer did so by wearing magnets on his body and by keeping them in his bed. The following month, July 1775, Mesmer traveled to the shores of Lake Constance, his homeland, where he performed several sensational cures closely following in Gassner's footsteps. His stay in Rohow had apparently convinced him that he was able to outdo Gassner. As we have seen, this glorious period of Mesmer's life culminated in his being called to Munich by the Prince-Elector, his demonstration of his own magnetic powers, his testimony about Gassner, and his nomination as a member of the Bavarian Academy of Sciences. When he returned to Vienna at the end of 1775, Mesmer must have been sure that his grandiose discovery would bring him lasting fame. But the Viennese medical world was still indifferent or even hostile. Mesmer took several patients into his own home. One of them, Maria-Theresia Paradis, the eighteen-year-old daughter of a wealthy and influential
civil servant
, had been blind since the age of three and one-half. According to a biographer, she had been given the most refined education with the help of specially devised instruments, such as embossed maps to teach her geography, and Kempelen, the famous maker of automatons, had built her a printing machine with which she was able to write. She moved around gracefully, could dance and perform needlework-but her greatest talent was music, which gained her the special attention and protection of the Empress Maria Theresa. Vienna's foremost physicians had treated her for many years without results (she had even received more than three thousand electric discharges). But after a series of magnetic sessions with Mesmer, she declared that she was seeing. Her first visual perception was that of Mesmer; she found that the human nose had a strange, even frightening shape and expressed fear that it might hurt her eyes. tier sight was gradually restored-or, this is what she said and what Mesmer announced-and her family expressed great delight. But her previous physicians denied the reality of the cure. A medical commission emphasized that the patient claimed to see only when Mesmer was present. An acute conflict arose between Mesmer and the Paradis family; the patient lost her sight for good. She returned home and pursued her career as a blind musician. Mesmer suggested that her cure was neither in her nor in her family's interest: she would have lost her fame as a blind musician, and perhaps also the generous financial support of the Empress. Soon afterward, in the latter part of the year 1777, Mesmer left Vienna. The reasons for his departure are unknown; his enemies later contended that he had been forced to leave. It had been assumed that he was disturbed by his failure in the case of Maria-Theresia Paradis and by the hostility of his colleagues. It may also be that the young patient had developed a strong attachment for him, and Mesmer a similarly strong attachment for her. (It is noteworthy that his wife remained in Vienna; he never saw her again.) But the true reason lies perhaps in Mesmer's oversensitive and unstable character, in his psychopathology. According to his own account, Mesmer had undergone a depressive period. He despaired of ever finding the truth. He would walk in the woods, talking to the trees, and for three months tried to think without the help of words. Gradually, he recovered his peace of mind and his self confidence, and came to visualize the world in a completely new aspect. He now felt that it was his mission to make his great discovery known to the world. He left for Paris and arrived there in February 1778. The atmosphere that Mesmer found in Paris was quite different from the one he had left in Vienna. The Austrian Empire was a stable state with an energetic government, a proficient administration, a watchful police. Paris was no less a cultural center than Vienna, but life there was strangely restless. Under a weak king and a frivolous queen the government was unstable and the financial situation catastrophic; enormous sums of money were engulfed in graft, speculation, and gambling. The ideas of Enlightenment developed a radical and antireligious tendency. The nobility was clinging obstinately to its exorbitant privileges, but paradoxically was showing a remarkable trend toward philanthropy and disinterested public service. In a disastrous war against England, France had lost India and Canada; now, partly out of feelings of revenge, the public was enthusiastic about the American War of Independence. There was, especially in Paris, a general tendency toward
Mass Hysteria
; the public went from one craze to another. It seems that Mesmer's fame had preceded him to Paris, where at that time a peculiar interest prevailed for distinguished foreigners. Mesmer was forty-three years of age, a tall, sturdy, handsome man whose imposing personality and worldly manners gained him easy access into French society, despite his strong German accent. For reasons not known, he soon parted with his first associate, the French surgeon Le Roux, and began magnetizing patients in a private residence in Creteil. He then settled in a private mansion on the Place Vendome, where he received patients from the highest social circles and magnetized them for large fees. He was extremely eager to form contacts with representatives of the scientific bodies: Academie des Sciences, Societe Royale de Medecine, Faculte de Medecine. He gained at least one influential disciple in Dr. D'Eslon, private physician to the Count d'Artois, one of the King's brothers. Mesmer supplemented his efforts with publications written by himself and by D'Eslon. 4
In the meantime his practice had gradually increased. Before leaving Vienna, he had dispensed with the use of magnets and electricity as auxiliary means. In 1780 or 1781, having more patients than he was able to treat individually, he inaugurated a collective treatment, the baquet, which will be discussed later. Two of his clients showed him strong personal devotion: Nicolas Bergasse, a skillful lawyer with keen philosophical interests, who was politically active and the banker Kornmann, whose young child Mesmer treated for a severe eye disease. Mesmer's system, as he expounded it in 27 points in the year 1779, can be summarized in four basic principles. (1) A subtle physical fluid fills the universe and forms a connecting medium between man, the earth, and the heavenly bodies, and also between man and man. (2) Disease originates from the unequal distribution of this fluid in the human body; recovery is achieved when the equilibrium is restored. (3) With the help of certain techniques, this fluid can be channeled, stored, and conveyed to other persons. (4) In this manner, "crises" can be provoked in patients and diseases cured. It is fairly easy to distinguish the various elements in what Mesmer and his disciples called the doctrine. The first and most immediate one was Mesmer's intuition of being the bearer of a mysterious fluid, animal magnetism, which he had noticed in himself for the first time when treating Fraulein Oesterlin. Mesmer described how he was able to provoke the appearance of symptoms in patients by his physical presence or by his gestures; he also reported that when he approached a man who was undergoing a bloodletting, the blood began flowing in a different direction. According to Mesmer, every human being possesses a certain amount of animal magnetism: Gassner possessed it to a very high degree, Mesmer had it somewhat less, and the sick have less than the healthy. An analogy could be drawn between this theory and the Polynesian concept of "mana," a universal, impersonal energy that can be stored in persons, objects, or places, and can be detected only through its objective effects. The second element of the doctrine was the physical theories that were supposed to explain the nature and action of animal magnetism. Being a son of the Enlightenment, Mesmer was seeking a "rational" explanation and rejected any kind of mystical theory. On the other hand, since psychology w as almost nonexistent at that time, he was naturally led to think of a physical concept, of something in the form of Newton's universal gravitation or of electricity. In his medical dissertation, Mesmer had already described a universal fluid pervading the cosmos, which he had named gravitatio universalis. Through this phenomenon, the influence of the sun, moon, and planets on the human body could be explained, as well as the periodical manifestations of certain diseases. He later called this fluid general agent. It was believed to exist in several forms: one was the influence of the magnet, another was electricity, and another was animal magnetism. This physical part of the doctrine was undoubtedly its weakest point and always remained unclear in Mesmer's mind because he was not a good systematizer. A third element of Mesmer's system was the analogies given by the contemporary discoveries in the field of electricity. Mesmer imagined his fluid as having poles, streams, discharges, conductors, isolators, and accumulators. His baquet, an instrument that was supposed to concentrate the fluid, was an imitation of the recently invented Leyden jar. He also taught that there was a positive and a negative fluid that neutralized each otheran assumption that was never accepted by his disciples. The fourth element of the doctrine was the theory of crises, obviously derived from Gassner's practice. Gassner believed the crisis to be the evidence of possession as well as the first step in the procedure of exorcism. For Mesmer, the crisis was the artificially procured evidence of the disease and the means to its cure. Crises, he said, were specific: in an asthmatic it would be an attack of asthma and in an epileptic it would be an epileptic fit. When the patient was repeatedly provoked, these crises became less and less severe. Eventually they disappeared, and this meant recovery. These basic ingredients that Mesmer tried to synthesize in his doctrine led to his famous aphorism: "There is only one illness and one healing." No medication or therapeutic procedure ever cured a patient by itself; cures were achieved only through the effect of magnetism, although physicians had not been aware of it. Animal magnetism would now furnish mankind with a universal means of curing and preventing all illnesses, thus "bringing medicine to its highest point of perfection." Mesmer's egocentricity led him to expect that medical schools would accept a theory that would cancel all that had been discovered since Hippocrates, and would cause the
medical profession
to become superfluous. Not surprisingly, the type of therapy performed by Mesmer was as repugnant to contemporary medicine as contemporary medicine was to him. Mesmer used no medication other than magnetic water. He would sit in front of his patient with his knees touching the patient's knees, pressing the patient's thumbs in his hands, looking fixedly into his eyes, then touching his hypochondria and making passes over his limbs. Many patients felt peculiar sensations or fell into crises. This was supposed to bring forth the cure. Mesmer's collective method was still more extraordinary. An English physician, John Grieve, who was in Paris in May 1784, described in a letter his visit to Mesmer's house, noting that there were never less than two hundred patients at one time: I was in his home the other day and was witness to his method of operating. In the middle of the room is placed a vessel of about a foot and a half high which is called here a baquet. It is so large that twenty people can easily sit round it; near the edge of the lid which covers it, there are holes pierced corresponding to the number of persons who are to surround it; into these holes are introduced iron rods, bent at right angles outwards, and of different heights, so as to answer to the part of the body to which they are to be applied. Besides these rods, there is a rope which communicates between the baquet and one of the patients, and from him is carried to another, and so on the whole round. The most sensible effects are produced on the approach of Mesmer, who is said to convey the fluid by certain motions of his hands or eyes, without touching the person. I have talked with several who have witnessed these effects, who have convulsions occasioned and removed by a movement of the hand. . . 5
The entire setting was intended to increase the magnetic influences: large mirrors reflected the fluid, which was conveyed by musical sounds emanating from magnetized instruments. Mesmer himself sometimes played on his glassharmonica, an instrument that many people found to be shattering. The patients sat in silence. After a while some of them would experience peculiar bodily feelings, and the few who fell into crises were handled by Mesmer and his assistants in the chambre des crises (crisis room). Sometimes a wave of crises spread from one patient to another. An even more extraordinary procedure was that of the magnetized tree, a kind of collective outdoor therapy for the poor. Such therapeutic procedures seemed so extravagant that few physicians could escape from feeling that Mesmer was a quack. Professional resentment must have been increased by Mesmer's growing success and by the fabulous fees he demanded from his noble and wealthy patients. In the middle of 1782, Mesmer seems to have understood that he had reached an impasse. For five years he had worked toward having his discovery acknowledged by the scientific societies, which he would then have sold at great profit to the French government so that he could apply and teach his method in a public hospital. But he was further than ever from his goal. In July 1782 he left for a sojourn in Spa-a health resort in what is today Belgium-with his devoted friends Bergasse and Kornmann. According to Bergasse's account, Mesmer received a letter stating that D'Eslon, pretending to replace him, had opened a practice of animal magnetism. Mesmer was dismayed and furious at the "traitor" and visualized his own ruin. He was sure that after having stolen his secret, D'Eslon would also steal his clientele. The lawyer Bergasse and the financier Kornmann then formulated a new plan: they would organize a subscription to raise a large sum of money in order to buy Mesmer's discovery. The subscribers would be given possession of the "secret" and would be organized into a society that would educate students and spread Mesmer's teaching. The project was a huge success. In spite of the enormous account of money demanded from the subscribers, they were found. Among them were the most illustrious names of the city and the court, names belonging to the most ancient aristocratic families such as Noailles, Montesquieu, and the Marquis de Lafayette, as well as prominent magistrates, lawyers, and physicians. The Bailli des Barres of the Order of Malta was to introduce magnetism to the Knights on the island. However, growing difficulties arose between Mesrner and his disciples. Bergasse later published a documented account about these arduous negotiations of 1783 and 1784, which-if all the details were true-shows Mesmer as a fundamentally egocentric and suspicious man, moody, despotic, greedy, and at times even dishonest. Nevertheless, the society (called Societe de1'Harmonie) -a strange mixture of business enterprise, private school, and masonic lodge-was launched and flourished. Branches were founded in other French cities and towns. It secured a large fortune for Mesmer, in addition to his earnings from his magnetic practices. The society also published an epitome of Mesmer's doctrine and transformed what had been one man's secret into the common knowledge of an enthusiastic group. Mesmer's despotism was often resented by his disciples, but animal magnetism was now an established institution in France, and it developed swiftly. The interest of the public, which had been focused on the American War of Independence and the peace treaty with England, was now released and turned toward Mesmer. The year 1784 was as fateful for Mesrner as 1776 had been for Gassner: he encountered a peak of success, agitation, and then a rapid downfall. In March 1784, as a result of the agitation around Mesmer, the King appointed a commission of inquiry consisting of members of the Academie des Sciences and the Academic de Medecine, and another commission consisting of members of the Societe Royale. These commissions comprised the foremost scientists of their day: the astronomer Bailly, the chemist Lavoisier, the physician Guillotin, and the American ambassador Benjamin Franklin. The program of experiments had been devised by Lavoisier and was a model of the application of the experimental method. The litigious point was not whether Mesmer cured his patients but rather his contention to have discovered a new physical fluid. The commissions' conclusion was that no evidence could be found of the physical existence of a "magnetic fluid." Possible therapeutic effects were not denied, but were ascribed to "imagination." A supplementary and secret report was drafted for the King and pointed to the dangers resulting from the erotic attraction of the magnetized female patient to her male magnetizer. One of the commissioners, Jussieu, disassociated himself from his colleagues and wrote a report suggesting that there certainly was an unknown efficient agent at work, probably "animal heat." Mesmer was indignant because the commissioners had not come to him with their inquiries, but had gone to the "traitor" D'Eslon. Later, however, this circumstance proved fortunate for Mesmer: when the Public Ministry, on the basis of the commissioners' report, decided to prohibit the practice of animal magnetism, Bergasse succeeded in his efforts to have the interdiction lifted by Parliament-the highest judicial instance-on a legal technicality: the commissioners' report concerned D'Eslon's, not Mesmer's practice. In any event, the reports do not seem to have seriously harmed the development of the magnetic movement. The Societe de I'Harmonie developed its activities and similar societies were founded in various French cities. Simultaneously, however, the movement experienced an unprecedented number of setbacks: Mesmer was abundantly ridiculed in cartoons, popular songs, and satirical plays. There was the unfortunate episode involving Court de Cebelin, a celebrated scholar who published an enthusiastic pamphlet about Mesmer after having been "cured" by him, whereupon he suffered a relapse and died in Mesmer's own home. But public agitation was diverted from Mesmer a few months later by the new themes of Count Allesandrodi Cagliostro (Giuseppe Balsamo) and the scandal of the "Queen's necklace." Far more serious, as far as Mesmer was concerned, were the criticisms leveled against him by scientists and scholars. An anonymous author published a book, L'anti-magnetisme, in which he traced in an objective manner the sources of Mesmer's doctrine and showed the connection between his healing method and that of Gassner. Another author, Thouret, published an even more thorough study, taking 6
Mesmer's 27 propositions one by one and showing that each of them had already been stated in much the same terms by authors such as Paracelsus, Van Helmont and Goclenius, and above all by Mead and Maxwell. Thouret concluded that Mesmer's theory, far from being a novelty, was an ancient system that had been given up for almost one century. Mesmer denied ever having read any of those authors (it had not yet become fashionable to call such sources by the name of "precursors"). Physicists, for their part, would not hear of the so-called magnetic fluid. A physician and physicist by the name of Marat declared that animal magnetism had no claim to being a physical theory. Still worse from Mesmer's point of view was the fact that he had hardly begun to unveil his doctrine when his disciples rebelled. They found it vague and incoherent, even though D'Eslon had already given some clear and limpid formulations of it. A Comite d'instruction was appointed to publish the doctrine in a form acceptable to the students. Bergasse, who was playing a prominent role in the society, had found in Mesmerism the basis for a new world philosophy and expounded his theory in a work titled ""Theory of the World and of Organized Beings." It was published in limited numbers, and, in order to give it the aspect of a secret knowledge, 115 key words were replaced by symbols so that the uninitiated were unable to understand it. But this publication aroused Mesmer's wrath, and, following a sharp polemic between the two men, Bergasse left the society. Meanwhile, many members had become disillusioned and they, too, defected. Worse perhaps, from Mesmers' viewpoint, was that one of his most faithful disciples, Puysegur, of whom we shall speak later, though proclaiming his loyalty to Mesmer's teaching, discovered magnetic sleep, which was to give a new direction to the movement. Another setback of a more personal nature was an incident that occurred on Good Friday (April 16, 1784) at the Concert Spirituel du Careme in the presence of the
Royal Court
and the elite of Parisian society. A blind young musician had arrived from Vienna to play the harpsicord--Maria-Theresia Paradis. Grimm reported that "all eyes turned toward Mesmer who had been unwise enough to come to the concert. He was well aware of being the center of attention and suffered one of the worst humiliations of his life." His enemies promptly revived the old story that Mesmer had pretended to cure her but it was proven that he failed. Maria-Theresia spent the following six months in France, and her presence in Paris must have been very disturbing to Mesmer. In August of that year the Societe de 1'Harmonie in Lyons invited him to demonstrate his skill in the presence of
Prince Henry
of Prussia (a brother of King Frederick II) . To his own consternation and to the dismay of his disciples, he failed utterly. It is likely that Mesmer reacted to those events as he had done in 1777: by falling into a depression and taking to flight. In fact, Mesmer disappeared from Paris, having probably left at the beginning of 1785. His whereabouts were unknown to his disciples. Rumors circulated that he was living in England under an assumed name. The movement he had founded was developing more and more in the direction given it by Puysegur. Mesmer's activities during the following twenty years are largely unknown. Only part of his wanderings through Switzerland, Germany, France, and Austria have been traced. It has been found that when he returned to Vienna in 1793, he was expelled as being politically suspect, and that, in 1794, his name was linked with an obscure political plot. He went to Switzerland, where he acquired Swiss citizenship, and settled in Frauenfeld, a small town near Lake Constance. He had lost part of his fortune but was still sufficiently wealthy to live as a man of leisure for the remainder of his life, in the style of a rich aristocrat. Recent research has revealed testimonies of people who knew him during that time. They describe him as a man of refined worldly manners, but as proud and egocentric, showing no interest in other people's ideas. He resented the world that had not accepted his discovery, the physicians who had rejected him, and his disciples who had distorted his teachings. By that time Mesmer was so completely forgotten that most of his disciples did not even know that he was still alive. Wolfart, a German physician, finally went to visit him in 1812. A Romanticist and patriot, Wolfart was surprised that Mesmer expressed himself exclusively in French--in the manner of the old German aristocracy. He published a German translation of Mesmer's last book, which contained not only the ultimate outline of his system but also a collection of his opinions on a great variety of subjects: education, social life, public festivities, taxes, and prisons. Unfortunately, most of the papers that Mesmer entrusted to Wolfart were lost. Wolfart was so careless that, when publishing Mesmer's book, he gave his Christian name as Friedrich instead of Franz. One or two years before his death, Mesmer moved to Meersburg, on the shores of Lake Constance, and died there on March 5, 1815--a few miles from his birthplace. When Justinus Kerner visited Meersburg in 1854, he heard wondrous stories from old people who had known the great man. He was told that when Mesmer went to the island of Mainau, flocks of birds would fly toward him, following him wherever he walked, and settling around him when he sat down. Mesmer, they added, had a pet canary in an open cage in his room. Every morning the bird would fly to his master, perch on his head, and wake him with his song. He would keep him company during his breakfast, sometimes dropping lumps of sugar into his cup. With a slight stroke of his hand, Mesmer would put the bird to sleep or wake it up. One morning the bird remained in its cage: Mesmer had died during the night. The canary sang and ate no more, and a few days later he was found dead in his cage. What was the true personality of this man, who, in his homeland, had left the reputation of being a wizard? We cannot obtain a satisfactory answer; too much about him is unknown. We know nothing of his childhood nor of his emotional life, aside from his unhappy marriage. On the basis of existing documents, several pictures can be drawn: The first and best-known picture is given by his French disciples, especially by Bergasse in his lengthy account filled with bitter resentment, written after Mesmer had expelled him from the movement. In these accounts Mesmer is shown as a man dominated by the fixed idea that he had made an epoch-making discovery that the world ought to accept immediately, even before it could be fully revealed. He wanted to keep his secret to himself as long as he pleased and to make it known only when it became convenient for him. His doctrine of animal magnetism, however, should remain his permanent and exclusive 7
property; no one was allowed to add, modify, of subtract anything without his permission. He demanded absolute devotion from his disciples, although he did not feel the need to reciprocate by showing them gratitude, and he broke with anyone who manifested independent ideas. Mesmer felt as though he was
living in a world
of enemies who were continually trying to steal, distort, or suppress his discovery. He took indifference for hostility and contradiction for persecution. This picture of Mesmer is perhaps not very different from that of several other great scientists. It is (in Jung's terms) the typical syndrome of "psychological inflation" and must be considered a secondary development superimposed on a more basic personality structure. Mesmer felt a mysterious power within himself, which was demonstrated by his sensational healings and by the strange occurrences at the castle of Rohow. But in addition to these probably temporary occurrences, he possessed to a high degree a "personal magnetism"-a compelling mixture of charm and authority. He was unequaled in the art of convincing people and obtaining great favors from them. This may also explain the mystery of his social climbing in an era of impermeable class differentiation and his ability to deal with princes and aristocrats on a basis of equality. The fluctuations of his personal magnetism were perhaps subordinated to certain more basic psychopathological features: a morbid oversensitivity, moodiness, and alternating elations and depressions. During his periods of success he showed a restless, almost hypomanic, activity. It seems that he expressed at times what might be called paranoiac delusions of grandeur. (A Swiss physician, Egg, relates that Mesmer had told him in 1804 that running water was magnetized because he, Mesmer, had magnetized the sun twenty years before.) But he was also subject to sudden fits of discouragement. Mesmer described the abnormal condition he suffered from at the end of 1776. It is quite possible that something similar occurred in 1785. Both these episodes were perhaps associated with his feelings that his magnetic powers were exhausted. With his uncanny powers, Mesmer is closer to the ancient magician than to the twentieth-century psychotherapist. His victory over Gassner reminds one more of a contest between rival Alaskan shamans than of a modern psychiatric controversy. However, his doctrine contained the seeds of several basic tenets of modern psychiatry: A magnetizer, Mesmer proclaimed, is the therapeutic agent of his cures: his power lies in himself. To make healing possible, he must first establish a rapport, that is a kind of "tuning in," with his patient. Healing occurs through crisesmanifestations of latent diseases produced artificially by the magnetizer so that he may control them. It is better to produce several, steadily weaker ones than one severe crisis. In collective treatment the magnetizer should control the reactions of the patients on one another. Mesmer grouped his disciples into a society in which physicians and lay magnetizers were on an equal footing. Its members, who had made heavy financial sacrifices, learned his doctrine, discussed the results of their therapeutic work, and maintained the unity of the movement. It is an open question as to whether Mesmer was a precursor of dynamic psychiatry or its actual founder. Any pioneer is always the successor of previous ones and the precursor of others. There is no doubt, however, that the development of modern dynamic psychiatry can be traced to Mesmer's animal magnetism, and that posterity has been remarkably ungrateful to him. Puysegur and the New Magnetism There always comes a time when the creation emancipates itself from the creator and takes its independent course of life. Mesmer had hardly begun to unveil his doctrine when one of his most faithful disciples, the Marquis de Puysegur, made a discovery that was to give a new course to the evolution of magnetism. In the opinion of certain historians, this discovery equals or even exceeds the importance of Mesmer's own work. Charles Richet has said "the name of Puysegur must be put on the same rank as that of Mesmer.... Mesmer is no doubt the initiator of magnetism, but not its true founder." Without Puysegur, he adds, magnetism would have been short-lived and would have left only the memory of a transient psychic epidemic around the baquet. Among Mesmer's most enthusiastic disciples were the three brothers De Puysegur, who belonged to one of the most illustrious families of the French nobility. In the course of the centuries, the family had given France many prominent men, particularly in the military field. Their family belonged to that branch of the French aristocracy that was active in philanthropic affairs. All three brothers became Mesmer's students and played a role in the history of animal magnetism. The youngest brother, Viscount Jacques Maxime de Chastenet de Puysegur (1755-1848), gained his reputation on the parade grounds in Bayonne: an officer, apparently stricken with apoplexy, had fallen to the ground. The Viscount magnetized him on the spot and healed him in the presence of all the troops. He is said to have been subsequently placed in charge of the treatment of the sick soldiers in his regiment. The second brother, Antoine-Hyacinthe, called the Count de Chastenet (1752-1809), was a naval officer who had made investigations about the Guanches of the Canary Islands and brought some of their mummies back to Paris. It was he who introduced animal magnetism into Saint-Domingue, the rich and prosperous French slave colony. The white masters soon swarmed around the baquets, and the Negro slaves demanded and obtained a baquet for their own use. The oldest brother, Amand-Marie-Jacques de Chastenet, Marquis de Puysegur (1751-1825), an artillery officer who had distinguished himself at the siege of Gibraltar and taken part at an official mission to Russia, divided his time between his military life and his castle in Buzancy near Soissons, where he owned the immense property of his ancestors. As did many of his aristocratic contemporaries, he kept a cabinet de physique, where he tried various experiments with electricity. Sceptical at first about Mesmerism, he was converted to it by his brother Antoine-Hyacinthe and began to give individual and collective treatments on his estate. 8
One of his first patients was Victor Race, a young peasant of twenty-three, whose family had been in the service of the Puysegur family for several generations. Victor, who was suffering from a mild respiratory disease, was easily magnetized and, in that state, showed a very peculiar crisis. There were no convulsions, no disorderly movements, as was the case with other patients; rather, he fell into a strange kind of sleep in which he seemed to be more awake and aware than in his normal waking state. He spoke aloud, answered questions, and displayed a far brighter mind than in his normal condition. The Marquis, singing inaudibly to himself, noticed that the young man would sing the same songs aloud. Victor had no memory of the crisis once it had passed. Intrigued, Puysegur produced this type of crisis again in Victor and tried it successfully on several other subjects. Once they were in that state, they were able to diagnose their own diseases, foresee its course of evolution (which Puysegur called the pressensation), and prescribe the treatments. The number of his patients became so great that Puysegur soon organized a collective treatment. The public square of the small village of Buzancy, surrounded by thatched cottages and trees, was not far from the majestic castle of the Puysegurs. In the center of that square stood a large, beautiful old elm tree, at the foot of which a spring poured forth its limpid waters. The peasants would sit on the surrounding stone benches. Ropes were hung in the tree's main branches and around its trunk, and the patients wound ends of the rope around the ailing parts of their bodies. The operation started with the patients' forming a chain, holding one another by the thumbs_ They began to feel the fluid circulate among them to varying degrees. After a while, the master ordered the chain to be broken and the patients to rub their hands. He then chose a few of them and, touching them with his iron rod, put them into "perfect crisis." These subjects, now called physicians, diagnosed diseases and prescribed treatment. To "disenchant" them (that is, to wake them from their magnetic sleep), Puysegur ordered them to kiss the tree, whereupon they awoke, remembering nothing of what had happened. These treatments were carried out in the presence of curious and enthusiastic onlookers. It was reported that within little more than one month, 62 of the 300 patients had been cured of various ailments. The new type of treatment introduced by Puysegur thus included two different manifestations: the first was the "perfect crisis" itself with its appearance of a waking state, its elective relationship with the magnetizer whose commands the subject executed, and the amnesia that followed it. The analogy of that magnetic sleep with natural somnambulism was soon recognized, hence the name "artificial somnambulism." (Only much later was Braid to give this condition its present name, "hypnosis.") The second aspect was the "lucidity" displayed by certain patients, that is, their capacity to diagnose diseases, predict their courses, and prescribe treatments for themselves as well as for others with whom they were placed in rapport. Puysegur soon learned from Victor himself of another psychotherapeutic use of the perfect crisis. At that time, Victor was very concerned about a quarrel he had with his sister. He would never have dared talk about it to anyone; but when in magnetic sleep, he felt free to confide in the Marquis, who suggested to Victor to look after his own interests and to find a satisfactory solution. Victor then actually took steps to rectify his situation. The role played by Victor Race in the history of magnetism deserves special attention. Not only was he one of Puysegur's first patients, and the very first to fall into the perfect crisis--of which he became the prototype--but it was from him that the Marquis learned fundamental principles. At the beginning of 1785, Puysegur took Victor to Paris where he used him for demonstrations. Twice he showed him to Mesmer, whose reaction is not known. A worsening occurred in Victor's condition, who explained during magnetic sleep that it resulted from his being exhibited to curious and often incredulous people. Puysegur thus learned that magnetism should be used only for therapeutic purposes and not for experimentation and demonstrations. Furthermore, while experimenting with Victor, Puysegur realized the vanity of Mesmer's teaching of the physical fluid and understood that the real agent in the cure was the magnetizer's will. The effect of Puysegur's discoveries was considerable. The wonderful cures of Buzancy were imitated elsewhere. From remote villages came idyllic stories of peasants and servants healed at the foot of magnetized trees by philanthropic counts and marquises. But above all, the new kind of magnetic treatment introduced by Puysegur spread swiftly, much to Mesmer's displeasure who contended that magnetic sleep was but one of the many forms of crises, and he firmly upheld his doctrine of the physical fluid, although many of his disciples defected. From that day on a slowly growing rift occurred between the orthodox Mesmerists who clung to the crisis and the fluid theory, and the followers of Puysegur who concentrated their attention on artificial somnambulism, adopting a psychological theory, and eventually simplifying the technique of mesmerization. In August 1785, Puysegur was ordered to take command of his artillery regiment stationed in Strasbourg. The local Masonic society had asked him to teach the principles of animal magnetism to its members. Puysegur gave a course, which he concluded with the following words: I believe in the existence within myself of a power. From this belief derives my will to exert it. The entire doctrine of Animal Magnetism is contained in the two words: Believe and want. I believe that I have the power to set into action the vital principle of my fellow-men; I want to make use of it; this is all my science and all my means. Believe and want, Sirs, and you will do as much as I. 9
In Strasbourg, Puysegur organized the Societe Harmonique des Amis Reunis, whose aim it was to train magnetizers and to set up centers for magnetic treatment. By 1789 it counted more than two hundred members including the elite of Alsacian aristocracy, who pledged to give their treatments gratuitously, to write accurate reports of all their experiences, and to submit them to the society. Under its supervision a number of treatment centers were set up throughout Alsace. The activity of the Strasbourg society is of particular interest because, unlike other French centers, it published
annual reports
listing the cures with short case histories including the names of the practitioner and the patient, and the nature of illness. Collective treatments were no longer mentioned, either in the form of the baquet or in the form of the magnetized tree. It would seem that theoretical considerations played an unimportant role in the society's activities. There is no way of knowing how the movement would have developed had it not been abruptly interrupted by the Revolution in 1789. The Societe de l'Harmonie and all its branches disappeared. The peasants, instead of sitting at the foot of magnetized trees, gathered around "liberty trees" to listen to revolutionary speeches. Many of Mesmer's aristocratic disciples emigrated; others perished on the scaffold, as did several former members of the Royal Commissions: Bailly, Lavoisier, and his opponent Thouret. Bergasse narrowly escaped the guillotine and later became a mystical philosopher and a close friend of Czar Alexander. When Malta was taken by Bonaparte and subsequently by the English, the Mesmerian Knights were expelled. In Saint-Domingue, magnetism degenerated into a psychic epidemic among the Negro slaves, increasing their agitation, and the French domination ended in a blood bath. Later Mesmer boasted that the new republic--now called Haiti--owed its independence to him. The Marquis de Puysegur spent two years in prison, after which he was able to recover his castle, become the Mayor of Soissons, write literary works, and take up once again his research on magnetism. He investigated the hypothesis that severe
mental illness
might be a type of somnambulic distortion and that some day magnetism might be used in hospitals to cure the insane. He undertook the treatment of a twelve-year-old boy, Alexandre Hebert, who was at times seized with terrific fits of frenzied fury. The Marquis spent six months with the boy, leaving him neither day nor night, thus anticipating the later attempts at a psychotherapy of severe psychosis. After Napoleon's overthrow, a new generation of magnetizers, who had not known Mesmer, saw in Puysegur their respected patriarch, and it was hardly noticed that the term "mesmerizing" actually meant using the procedure inaugurated by Puysegur. Returning to Buzancy in April 1818, the sixty-seven-year-old Marquis learned that Victor Race, who was now fiftyeight years of age, was severely ill and continually talking about him. Puysegur went to see Victor and magnetized him in the same thatched cottage in which he had done it for the first time thirty-four years earlier. He was struck by the fact that Victor, in his magnetic sleep, remembered every detail of his previous somnambulic life. Victor's health improved, and the Marquis returned to Paris. Victor, the dean of French somnambules, died shortly thereafter and was buried in the cemetery at Buzancy. The Marquis ordered an inscription to be put on his tombstone. On May 29, 1825, Charles X was solemnly crowned at Reims in a celebration performed according to an archaic ritual. Puysegur, the descendant of one of the oldest French families, dwelt for the duration of the coronation in one of the ceremonial tents that had been pitched on the public square. Due probably to the high humidity, the seventy-four-year-old aristocrat became severely ill and was taken back to his castle at Buzancy, where he soon died, leaving the reputation of a thoroughly honest and generous, if somewhat uncritical man. With his innate respect for rank and primacy, he had always proclaimed himself Mesmer's respectful disciple and never tried to supersede him in any way. His name gradually fell into oblivion; his writings became scarce. Charles Richet rediscovered Puysegur in 1884 and showed that most of what his illustrious contemporaries believed to have discovered in the field of hypnosis was already contained in Puysegur's writings. Today, Buzancy is a charming little village amidst forests and fertile fields and meadows. The castle of the old and powerful Puysegur family has almost entirely disappeared. The centuries-old elm tree survived until 1940; the Societe des Amis de Mesmer was about to shoot a film of Mesmer's life, an episode of which centered around this tree, when a storm uprooted it. The farmers rushed to gather its pieces; some farmers took pieces of its bark which they carefully kept, ascribing to them certain prophylactic or curative properties. The spring continues to pour forth its waters at the same place and it is believed to have certain marvelous virtues. The tomb of Victor Race in the small village cemetery has disappeared, and his descendants, who have been traced to the present day, are quite unaware of their ancestor's historical role. The peaceful little church contains the graves of several of the Puysegurs, including that of Amand-Marie-Jacques de Chastenet, Marquis de Puysegur, one of the great forgotten contributors to the history of the psychological sciences. The Diffusion of Mesmerism The Mesmerist movement was very young and inexperienced when it lost its leader in 1785. However, it went on, slowly developing along new lines. The early magnetists did much therapeutic work and published good observations. But the strange phenomena of magnetic sleep overexcited their imaginations and turned their minds toward the search for the extraordinary. In 1787, Petetin in Lyons published the story of a hysterical woman who fell into a cataleptic state in which her sensory functions were displaced to the epigastrium, that is, she could see and hear only through her epigastrium. In Germany, although he had been known there and had made demonstrations from as early as 1775 to 1776, Mesmer's name later became attached to the new magnetism inaugurated by Puysegur. In 1786, the Margrave Karl Friedrich of Baden sent a delegation to the Mesmerist Society in Strasbourg and introduced animal magnetism into his states. In 1787, Professor Bockmann, a physicist from Karlsruhe, founded the Archiv fur Magnetismus and Somnambulismus. The extraordinary states of magnetic lucidity were used to try to obtain preternatural revelations. Much was made of the case of a twenty-three-year-old young lady living in the small 10
town of Rastadt (state of Baden), who, in magnetic sleep, explained the mysteries of the human soul, of the seven degrees of magnetic sleep, of Nature, and even of God and the Trinity. After the temporary arrest caused by the Revolution, the development of animal magnetism took a different course in France and in Germany. In France, as we have seen, magnetism was taken up again around 1805 by Puysegur, who published several works on it. Together with those of Mesmer, they were considered for at least one generation as the great classics on the subject. But, beginning around 1812, new men were introducing new concepts and new methods into the study of magnetism. There was first the conspicuous Abbe Faria, a Portuguese priest who claimed to have come from India and to be a Brahmin. He opened a public course on lucid sleep in Paris in 1813 in which he criticized the theory of the physical fluid as well as that of the rapport and contended that the essential process of magnetization was due less to the magnetizer than to the subject. He further taught that certain types of individuals were susceptible to magnetization and called them natural epoptes. His technique consisted in seating his patients in comfortable chairs and having them fixate his open and raised hand, after which he commanded in a loud voice: "Sleep!" The subjects then fell into magnetic sleep. While they were in that state, he produced visions in them as well as posthypnotic suggestions. Unfortunately for Faria, he was handicapped by his poor French and (according to Noizet) became the victim of the practical joke of an actor who had come to one of his sessions with the intention of ridiculing him, after which Faria became the laughingstock of Paris. His name survived mainly because Alexandre Dumas used it for a character in his novel The Count of Monte Cristo. Janet has shown that it was Faria, who, via Noizet and Liebeault, was the true ancestor of the Nancy School. Deleuze met with success where Faria had failed, and the revival of magnetism in France is usually ascribed to him. He too gave a public course and published a clear and well-organized textbook. Deleuze stated that the era of "prodigious healings" had gone with Mesmer and Puysegur, and that the period of the elaborate and codified technique had set in. He also noted that the old quarrel between the "fluidists" (who believed in Mesmer's physical fluid), the "animists" (who believed in psychological phenomena), and the intermediate theory (held by those who believed in the physical fluid's being directed by the will) was a thing of the past; the practitioners had come into their own. He gave excellent descriptions of the phenomena occurring during artificial somnambulism, was sceptical about alleged preternatural manifestations, and warned against the various dangers inherent in magnetic treatment. If Deleuze was predominantly a clinician and an empiricist, Alexandre Bertrand, who had a dual training as a physician and as an engineer, approached the phenomena of animal magnetism with a view toward exploring them in a scientific and experimental manner. Janet, who held Bertrand's work in the highest esteem, considered him to be the true initiator of the scientific study of hypnosis. Noizet, an officer in the French army, who had watched Faria's demonstrations, relates how he became acquainted in 1819 with Bertrand, who had started his research on magnetism, and how he convinced Bertrand of the fallacy of the fluid theory. They became friends, and both sent manuscripts to a competition proposed by the Berlin Academy; but the manuscripts were returned. Bertrand revised his in the form of his Traite, whereas it took Noizet thirty-five years to publish his in a limited edition. Noizet's teaching was to be taken over by Liebeault, and in this manner, Faria's technique eventually became the general method applied by the Nancy School. Both Bertrand and Noizet emphasized the fact that the human mind conceives of thoughts and reasonings of which we are not aware and which can be recognized only through the effects they produce. Among the French students of magnetism, there were also men such as Charpignon, Teste, Gauthier, Lafontaine, Despine, Dupotet, Durand (de Gros), and others who deserve the highest credit, although they are largely forgotten today. Janet protested against the name of "precursors," which has been disdainfully given to them. These men, he said (as well as Puysegur and the early Mesmerists), were the actual founders of the science of hypnotism; they had described all its phenomena right from the start and nothing substantial had been added during the
nineteenth century
. These men had understood, for example, that the rapport was the central phenomenon in magnetism and somnambulism and that its influence extended far beyond the actual seance. Posthypnotic suggestions had already been described in 1787 and were well known to Faria and Bertrand. The reciprocal influence between the patient and the magnetizer was soon included in the concept of rapport. Early magnetizers warned against the danger inherent in the powerful interpersonal attraction issuing from the rapport, although they knew that this influence also had its limitations. Tardif de Montrevel emphasized in 1785 that the subject in magnetic sleep was well able to resist any immoral commands that an unscrupulous magnetizer might give. They investigated the vicissitudes of individual treatments, explained how to start and terminate them and warned of the dangers of too frequent seances and of too prolonged treatment. They also investigated various types of "magnetic" conditions including cases of dual personality. The influence of mind over body and the possibility of curing many organic diseases through magnetism were a matter of course for them. They often met with one another in work groups and carefully recorded a journal of their treatments. In spite of all their merits, the wide experience they had gathered, their scrupulous honesty and the rational approach of the best among them, these men failed to promote the cause of magnetism. They made desperate and fruitless efforts to have magnetism acknowledged by the scientific authorities: the successive commissions appointed by the Academie des Sciences always concluded their investigations with a rejection. Janet pointed out that most of them, instead of applying themselves to the study of the most elementary manifestations of magnetic sleep, fancied that they could demonstrate the validity of their doctrine by extraordinary phenomena. Moreover, not only were most of them laymen, but they chose uneducated, sensitive subjects, set them in trances and had them diagnose diseases and prescribe treatments. This was an illegal
practice of medicine
in the second degree, as it were, and it attracted the wrath of the medical profession. Finally, they were defenseless against a host of quacks who utilized the technique of magnetism for well-paying stage demonstrations, which sometimes resulted in psychic epidemics and brought magnetism into disrepute. The development of Mesmerism in Germany took on a distinctive character because, in contrast with France, German universities showed a lively interest in animal magnetism and it was adopted by the Romanticists and the philosophers of Nature. In 1812 the Prussian government appointed an official commission of inquiry whose reports, published in 1816, were favorable, whereupon the universities of Berlin and Bonn instituted chairs of Mesmerism. The German Mesmerists included men of high intellectual distinction such as Gmelin, Kluge, the brothers Hufeland, Kieser, Nasse, Passavant, and Wolfart, who, in 1811, founded the journal Asklapeion in which much space was devoted to magnetism. Wolfart traveled to Frauenfeld to visit Mesmer and brought back with him Mesmer's last unpublished book. As did their French colleagues, the German Mesmerists understood the fundamental role of rapport in the treatment but gave it a more philosophical interpretation. In his textbook Kluge wrote that magnetizer and patient formed a "magnetic circle," that is, a closed world of two individuals, which had to be protected from noise, light, and outward interference. Friedrich Hufeland compared the unit of magnetizer and patient to the relationship between the pregnant woman and the fetus, and taught that the magnetic treatment went through stages similar to those experienced by the fetus up to its birth--which corresponds to the end of the cure. The German Romanticists were interested in animal magnetism for two reasons: the first being the attraction of Mesmer's theory of a universal, physical "fluid." Romantic philosophers visualized the universe as a living organism endowed with a soul pervading the whole and connecting its parts. Mesmer's physical fluid--had its existence been demonstrated--would have furnished evidence of the Romantic conception. The second reason was Puysegur's discovery of magnetic somnambulism with its extra-lucid manifestations. Mesmer had already spoken of a "sixth sense" revealed in the sensitivity to the fluid; Puysegur had added that this sixth sense provided humans with an ability of describing distant events and predicting future happenings. The Romanticists now assumed that somnambulic lucidity would enable the human mind to establish communications with the World Soul. For those reasons, considerable attention was devoted to the phenomenology of magnetic somnambulism. Kluge, in his textbook on animal magnetism, distinguished six degrees of the magnetic state: (1) Waking state, with a sensation of increased warmth; (2) Half-sleep; (3) "Inner darkness," that is, sleep proper and insensitivity; (4) "Inner clarity," that is, consciousness within one's own body, extrasensory perception, vision through the epigastrium, and so forth; (5) "Selfcontemplation": the subject's ability to perceive with great accuracy the interior of his own body and that of those with whom he is put into rapport; (6) "Universal clarity": the removal of veils of time and space and the subject perceives things hidden in the past, the future, or at remote distances. Very few subjects, however, proved able to attain the last three stages and particularly the sixth one, and it was believed that it was a scientific and philosophical task of the highest importance to find one of those rare subjects and to work systematically with him. Thus, whereas the French were seeking extra-lucid somnambules as auxiliary subjects for medical practice, the Germans utilized them in an audacious attempt at experimental metaphysics. Among the extraordinary subjects who flourished in Germany during that time, none became as famous as Katharina Emmerich and Friedericke Hauffe. Katharina Emmerich (1774-1824), a poor peasant woman and former nun in Dulmen, Westphalia, had visions and bore the stigmata of the Passion. After having visited her, the poet Clemens Brentano decided to break with his former life, and appointed himself secretary to the Saint. He settled in Dulmen and lived there from 1819 until her death in 1824. In her cataleptic states, Katharina visioned Christ's Passion and suffered greatly. Every night she had dreams that followed one another in regular sequence according to the cycle of the liturgic year and that showed the life of Christ and of his Holy Mother. Brentano visited Katharina every morning and wrote down her dreams and visions as she dictated them to him. With this material, he compiled two books that were a great success. Notwithstanding the poet's embellishments, many people believed these revelations to be actual historical records. The other subject, Friedericke Hauffe (1801-1829), was not a saint but a seeress. She was made famous by the poetphysician Justinus Kerner and she, in turn, brought him great fame. In spite of their shortcomings, Kernels investigations of the seeress were a milestone in the history of dynamic psychiatry. Justinus Kerner (1786-1862) was the son of a modest civil servant in the state of Wurttemberg. In his delightful autobiography, he tells of his childhood in Ludwigsburg, a small town with a haunted house and the tower where Dr. Faust was said to have practiced black magic. Adjacent to his parents' home was the asylum for the insane, which he could see from his window. In his early childhood, he met the poet Schiller. At the age of twelve, he was cured of a nervous ailment by the magnetizer Gmelin and retained a lasting interest in the mysteries of the human mind. Some of Kerner's poems remain among the minor classics of German poetry. As a physician, he was first to describe a kind of food-poisoning today called botulism and supplemented his clinical observations with ingenious experiments on animals with the poisonous substance. In 1819 he was appointed city physician in the small town of Weinsberg, in Wurttemberg, where he remained until his death in 1862. The Kerner house, celebrated for the refined hospitality shown toward its visitors, soon became a little Mecca for poets, writers, philosophers, and people of all ranks and classes--including kings and princes. Kerner was a kind, generous, humorous, and learned man, a brilliant conversationalist, a lover of nature, animals, popular songs, and folklore, and had a keen interest in the mysterious and the occult. He was the first to make an inquiry about Mesmer's life and to collect relevant biographical documents. Among his patients he encountered cases of possession, which he called a demonic-magnetic disease. His therapy 12
in such cases was a curious mixture of exorcism and magnetism. In his attitude toward possession, magnetic somnambulism, and allegedly supranormal manifestations, Kerner was, according to his friend David Strauss, less credulous than it has been assumed. He looked upon such matters as a poet, wishing that they were true, but not firmly convinced of their verity. November 25, 1826, was a crucial date in Kerner's life: it marked his acquaintance with Friedericke Hauffe, who was brought to him in a condition near death. On April 6, 1827, he took her into his home, where she remained until shortly before her death in 1829. Her story, as told by Kerner, may be summarized as follows: Friedericke Hauffe. the daughter of a game-keeper, was born in the village of Prevorst in Wirttemberg. An uneducated person, she had read nothing but the Bible and a hymn hook. As a child, she already had visions and premonitions. At the age of nineteen. her parents engaged her to a man she did not love. That same day. a preacher whom she admired very much was buried. During his funeral service, she "died to the visible world" and her "inner life" began. Shortly after her wedding, she took sick, imagining that she was lying in bed with the preacher's corpse. She entered into a series of "magnetic circles," while her physical illnesses became more and more severe: she suffered from convulsions, catalepsy. hemorrhages, and fever for which neither physicians nor healers could find a remedy. She was finally brought to Kerner, emaciated, deadly pale, her eyes shining, and her face wrapped in a white cloth like that of a nun. Kerner first tried to treat her with the customary medical remedies, but noticed that every medication he gave her--even the smallest dose--brought about exactly the reverse of the anticipated reaction. He then resorted to "magnetic passes," whereupon the patient gradually improved. For the remainder of her stay in Weinsberg, Friedericke led a "bodiless life," that is, her
vital force
s were supposed to originate not from her organism but exclusively from her being magnetized at regular intervals, day after day. During a great part of the time, she found herself in a magnetic sleep in which, however, she was "more awake than anybody" and revealed her remarkable capacities as a "seeress." Kerner undertook a very thorough investigation of her, recording her sayings and making systematic experiments with the help and advice of a group of philosophers and theologians. None of the people who visited the "seeress" ever suspected her of being a fraud. Many were deeply impressed. The theologian David Strauss said that her features were delicate, noble, and illuminated, that she expressed herself slowly in a solemn, musical voice almost like in a recitative, and that she spoke the purest High German instead of the Swabian dialect commonly spoken by the people. Her voice was full of feeling when she gave advice and exhortation and told about the spiritual world. It is claimed that the "seeress" gave evidence of her ability to see distant events and foretell future happenings. Physical phenomena, for example, the spontaneous displacement of objects, were also said to occur in her presence. She received messages from disincarnate spirits about personal and general matters. Thus, she was able to bring revelations concerning the nature of man and about a system of "magnetic circles": there were seven "sun circles" and one "life circle." These were apparently symbolic representations of spiritual conditions. The "seeress" spoke frequently in an unknown language which Kerner and his friends found sonorous and magnificent. It was, she said, the original language of mankind, forgotten since the time of Jacob, but which could be recovered in certain circumstances. Since she spoke it fluently and translated it, some people around her became able to understand it. Unfortunately, Kerner did not compile its grammar and vocabulary but recorded only a few sentences such as: O pasqua non ti bjat handacadi? (Willst thou not give me thy hand, physician?) or Bona finto girro (The people must go). This language was written in a system of ciphers of which each one also represented a number. Friedericke constantly combined these and other numbers into a system of inner computation which ceaselessly and automatically went through her mind. Kerner, who had noticed the patient's oversensitivity to many things, undertook a
systematic study
of the action of various substances on her: minerals, plants, products of animal origin, as well as the influence of the sun, the moon. electricity, sounds. and music on her organism. In her magnetic trances, the "seeress" often prescribed medications which unfailingly cured her exactly when predicted. In one of her dreams, she devised an apparatus which she called a "nerve-tuner" (Nervenstimmer) and which Kerner built according to her instructions; it proved efficient. Cures by the "seeress" of several other people were also reported, but Kerner does not seem to have encouraged very much this aspect of her talents. The seeress aroused enormous interest in Germany. Philosophers such as Gorres, Baader, Schelling, G. von Schubert, Eschenmayer, and theologians such as David Strauss and Schleiermacher, came repeatedly to see her in Weinsberg and discussed her revelations quite seriously. Soon after her death, Justinus Kerner published a book, Die Seherin von Prevorst, compiling his clinical observations and experiments on the subject. To these was added a theoretical study by Adam Carl August von Eschenmayer. The book had a prodigious success in Germany, and has been republished several times; it was the first monograph devoted to an individual patient in the field of dynamic psychiatry. It has been alleged that Kerner and his associates were fooled by a hysterical woman, but there is no evidence that Friedericke was dishonest and no reason to believe that Kerner distorted or embellished her sayings. He obviously made great efforts to be objective, separating his observations from his experimentations and from the philosophical interpretations, which he left to Eschenmayer. But it did not occur to them that the mere fact of observing a subject with certain expectations might have an influence on the development of her symptoms. The Seeress of Prevorst is still valuable as the record of an involuntary experiment on the performances of the "mythopoetic" functions of the unconscious, when given time and under favorable circumstances. The interest raised by Kerner's observations of the "seeress" resulted in a flood of letters and reports concerning similar phenomena. Kerner and his friends published much of this material in the Blatter von Prevorst (1831-1839) and in the Magikon (1840-1853). These were probably the first periodicals devoted mainly to parapsychology. 13
During the last period of his life, Kerner lost his beloved wife and gradually became blind. He fell into a pronounced depression but remained creative all the while. As a pastime he used to make inkblots on a sheet of paper, fold it and elaborate the resulting figures, giving them fanciful shapes and writing verses under each of them. These pictures, he said, were ghosts and monsters to which he ascribed a place in Hades (the transitory home of the spirits). This book, published posthumously under the title Klecksographien, became a source of inspiration for Hermann Rorschach much later for his inkblot tests. As we shall see later, many Germans of the early nineteenth century were, like Kerner, deeply influenced by animal magnetism, but its influence declined rapidly after 1850 under the impact of positivism and scientific rationalism. Outside of France and Germany the development of Mesmerism was much slower. It met with strong and obstinate opposition in England until a breakthrough occurred between 1840 and 1850. A Manchester physician, James Braid, was much impressed by demonstrations given in November 1841 by the French magnetizer Lafontaine. Sceptical at first, he repeated Lafontaine's experiments and was soon convinced. He rejected the fluid theory and proposed a new one based on brain physiology; he adapted Faria's and Bertrand's old technique of fixating the hand by fixating a luminous object. Under the more suitable term "hypnotism," he made magnetism acceptable to certain medical circles, who came to ascribe to Braid himself the discovery of these phenomena. Unfortunately, he attempted to combine hypnotism with phrenology, which gave rise to much confusion. Independently of Braid, an English surgeon by the name of John Elliotson published a report about surgical operations that he had performed painlessly on patients who had been put into magnetic sleep. Elliotson complained that he met with violent opposition on the part of the Royal Medical and Chirurgical Society. Almost simultaneously another English surgeon, Esdaile, who was practicing in India, reported on 345 major surgical interventions that he had performed with the sole help of Mesmeric anesthesia, a technique he found easier to apply to Hindus than to English patients. He also used it as a general method of treatment. Some years later, he mentioned the existence of a Mesmeric disease, that is, an artificial but by no means slight condition in people who had become used to frequent magnetization. Soon thereafter the discovery of ether anesthesia made this technique obsolete. Magnetism also found followers in Scotland. An anonymous author reported a number of ingenious experiments and noted the peculiar attraction magnetized patients had for each other while under the influence of Mesmeric sleep. He also reported excellent therapeutic results with a patient put into magnetic sleep for ten days. Enthusiasm for Mesmerism was such that a psychic epidemic broke out in Edinburgh and other towns of Scotland in the year 1851. The introduction of magnetism into the United States occurred at an early date. We may mention incidentally that Lafayette, who had been one of Mesmer's aristocratic students, was asked by him to be his ambassador to
George Washington
. But the practical introduction of magnetism in
North America
took place mostly via New Orleans, which at that time was still a French city and where a flourishing Mesmeric society soon developed. In all other parts of the United States, the diffusion on magnetism was slow but it steadily increased after 1840. Among its adherents, two at least deserve special mention. One was Phineas Parkhurst Quimby (1802-1866), a young watchmaker. He understood that the real agent of the cure was suggestion and practiced a kind of "mind cure." One of his patients was later to become known under the name of Mary Baker Eddy (18211910), the founder of Christian Science. Another was Andrew Jackson Davis, a young man, who, having himself magnetized daily, dictated in his trance an enormous
Book of Revelation
s about the world of the spirit. The book was a great success and paved the way for the propagation of spiritism, which was soon to follow. It is remarkable how the history of Mesmerism went through a succession of positive and negative phases. The first phase was the grand years of Mesmer's activity in Paris from 1777 to 1785; the second took place after 1815 and in the early 1820's; the third one, beginning around 1840, culiminated in the 1850's. According to Janet, at least nine journals devoted to magnetism appeared in France from 1815 to 1850. Mesmerist societies held meetings and congresses, conferred prizes and awards, and on May 23, 1850, organized a grand celebration on the occasion of Mesmer's birthday, which included concerts, banquets, and speeches. But as Mesmer's disciples became more numerous, enthusiastic, and fanatic, the movement deviated more from its initial norm and fell into discredit: It mingled increasingly with
wild speculation
, occultism, and, at times, with quackery. At this point unexpected developments occurred, subsequent to the advent of spiritism. To follow these developments, we must turn to the United States of America. The Impact of Spiritism In the years 1840 to 1850 the United States was a vast but rapidly expanding country with an energetic if relatively small population of approximately 20 million inhabitants, the majority of whom were living in small "townships." The common man's average level of education was higher than in other countries, but there was no "educated upper class" to impose the pressure of a tradition and
cultural norms
. Every man claimed the right to think for himself and used this right with more vigor and freshness than intellectual discipline. Preachers and congregations often changed their beliefs, and religious sects were numerous. There was a general and permanent predisposition toward psychic epidemics, which arose unexpectedly, spread rapidly, and were accepted "almost to a man" in vast areas. Recent discoveries, for example, the telegraph, fired the imagination; nothing seemed too fantastic to be rejected without further examination. Thus, it happened that a seemingly trivial incident became the starting point for a psychological epidemic of unexpected amplitude--the rise and spread of Spiritism. 14
If contemporary reports are to be believed, the story started in 1847 when a man in Hydesville near Arcadia, New York, began to be bothered by mysterious noises occurring in his house at night and left the house to a farmer, John Fox, who occupied it with his wife and two daughters, aged fifteen and twelve. The disturbances persisted. On the evening of March 31, 1848, the knocking repeated the noises purposely made by one of the daughters and then--in the presence of neighbors-questions asked by the mother were answered in a rudimentary code; it was revealed that a man had been murdered in that house and buried in the cellar. Crowds of curious people flocked to the Fox house during the following days. Mrs. Fox and her daughters went visiting; the knocking followed them everywhere and communicated with them, purporting to be the "spirits" of deceased people. Mrs. Fox and her daughters soon commercialized their seances with the spirits, and they had many imitators. The contagion spread rapidly over the United States; the code system for communication with the spirits was perfected. Physical phenomena were reported in February 1850. For example, tables began to move during the sessions, loud and extraordinary noises were heard, and a fluid made itself visible. An impassionate controversy developed. There were spiritist groups, pamphlets, journals, and congresses. Many Mesmerists were among the first and most active supporters of the new movement. At the beginning of 1852 the wave of spiritism crossed the Atlantic, invading England and Germany. In April 1853 it swept over France, and soon reached all parts of the civilized world. Meanwhile, it had been discovered that the manifestations depended to a large extent on the personalities of the participants: some people prevented the "spirits" from appearing, others helped them, and a privileged few could serve as "mediums," or intermediaries between the living and the dead. Some mediums were able to write automatically, speak in a trance, and allegedly call forth the occurrence of physical phenomena. Around 1860 "spirits" began manifesting themselves visually during the seances, and in 1862 photographs purportedly taken of them as well as casts of their hands were shown. This was followed by the period of the extraordinary mediums: Florence Cook, Stainton Moses, Slade, Home, and others. It was said that, during Home's sittings, pianos were raised into the air, harps and accordions played without anyone touching them, and spirits were heard. Home was seen touching fire, and it was even reported that he once went out through a window and returned through the window in the next room, having "flown" out and in at the third-floor level Sir William Crookes, a well-known physicist, experimented with Home and Florence Cook; Crookes swore to have seen, in the latter's presence, the "materializations" of a beautiful woman who called herself Katie King. She let herself be photographed by Crookes and talked to him and his friends. The epidemic slowly receded, but many spiritist groups remained quite active. In Paris, Hippolyte Rivail, a former schoolteacher who had been a disciple of Pestalozzi in Switzerland, became a convert to spiritism, which he systematized in numerous works under the pseudonym Allan Kardec and to which he gave the form of an immensely successful lay religion. His Book of the Spirits became according to Janet, "a guide not only for the spiritists, but also for the spirits." The scientific study of these manifestations, which had been attempted in an uncritical manner by Crookes, Zollner, and others, was now undertaken more systematically by Charles Richet. A new science, that of parapsychology, gradually emerged. In England, Myers and Gurney founded in 1882 the Society for Psychical Research, which gathered a great amount of carefully selected data. A cautious investigator, Myers admitted the hypothesis of survival after death and of communication with the spirits of the deceased, while Flournoy, in Geneva, thought that these phenomena could be explained by subliminal perception and cryptomnesia. The advent of spiritism was an event of major importance in the history of dynamic psychiatry, because it indirectly provided psychologists and psychopathologists with new approaches to the mind. Automatic writing, one of the procedures introduced by the spiritists, was taken over by scientists as a method of exploring the unconscious. Chevreul, who had already in 1833 demonstrated that the movements of the divining rod and the pendulum were unconsciously directed by the performer's hidden thinking, took up his old experiments again with a view of providing a rational explanation of turning-tables. A new subject, the medium, became available for experimental psychological investigations, out of which evolved a new model of the human mind. Another incentive to the further development of dynamic psychiatry was the appearance of great professional hypnotizers who gave public sessions throughout Europe and who attracted large crowds to their spectacular performances. We have seen how Braid, in Manchester, came to experiment with hypnotism after having watched the magnetizer Lafontaine. Similarly, around 1880, several neurologists began to reconsider their attitudes toward hypnotism after seeing performances by Hansen in Germany and Donato in Belgium, France, and Italy. These new approaches to dynamic psychology led to a revival of interest in the ill-famed hypnotism and to its investigation by university physicians such as the physiologist Charles Richet. Two schools then arose and made their contributions to the newer dynamic psychiatry: the Nancy School and the Salpetriere School. The Nancy School In the period from 1860 to 1880, magnetism and hypnotism had fallen into such disrepute that a physician working with these methods would irretrievably have compromised his scientific career and lost his medical practice. Janet' 17 mentioned the strange story of a distinguished city practitioner who had secretly set up a hospital in a cottage in a neighboring village, where he kept a few patients on whom he performed interminable hypnotic treatments and investigations. Among the very few who dared hypnotize openly was Auguste Ambroise Liebeault (1823-1904), from whom the Nancy School was to originate. Liebeault was the twelfth child of a peasant family who was living in the province of Lorraine. Through hard work, he became a country doctor in Pont-Saint-Vincent, a village not far from Nancy. He proved to be a 15
remarkably successful practitioner, and within ten years his practice had earned him a small fortune. As a medical student, he had found an old book on magnetism and had successfully magnetized some patients. It is not known what made him decide to use this method after all the years in which it had been in such disfavor. Since his clients were reluctant, he offered them an alternative: he proposed to either treat them with magnetism gratuitously, or with "official" medicine for his usual fee. The number of patients who chose magnetism increased so rapidly that, four years later, Liebeault had an immense practice that brought him almost no income. He then decided to take a two-year leave from his professional life and retired to a house he had bought in Nancy, devoting all of his time to writing a book about his method. Hypnotic sleep, he taught, is identical with natural sleep, the sole difference being that the former is induced by suggestion, by concentrating the attention on the idea of sleep. This is also the reason why the subject remains in rapport with the hypnotizer. According to Janet, Liebeault's ideas were derived mainly from Noizet and Bertrand. (Curiously enough, Liebeault much later became a believer in the theory of the magnetic fluid, which he had rejected for most of his life.) But he was a better hypnotizer than writer; the story goes that in ten years only one copy of his book was sold. He then re-opened his medical practice, giving consultations from 7:00 A.M. until noon and taking only the fees that his patients voluntarily offered to pay. Van Renterghem, who visited Liebeault at the time of his belated fame, described him as a small, talkative, and vivacious man, with a wrinkled face, a dark complexion, and the appearance of a peasant. Liebeault, he said, received between twenty-five to forty patients every morning in an old shed with whitewashed walls and paved with large, flat stones. Every patient was treated publicly and with no concern for the surrounding noise. Liebeault hypnotized the patient by ordering him to look into his eyes, suggesting that he was getting increasingly sleepy. Once the patient was slightly hypnotized, Liebeault assured him that he was relieved of his symptoms. Most of his patients were poor people from the city and peasants from the neighborhood, whom he indiscriminately treated with the same method no matter what disease they suffered from--arthritis, ulcers, icterus, or
pulmonary tuberculosis
. For more than twenty years, Liebeault was considered by his medical colleagues to be a quack (because he hypnotized) and a fool (because he did not charge any fees). Rumors of his therapeutic miracles reached Bernheim, who decided to pay him a visit in 1882 and was converted to his ideas. It is a rare occurrence indeed that a renowned professor adopts a heretofore ill-reputed method from an old man who is said to be a quack and a fool. Bernheim publicly became Liebeault's admirer, pupil, and devoted friend, and introduced his methods in his university's medical hospital. Liebeault suddenly acquired fame as a great medical man; his book was rescued from oblivion and was widely read. Liebeault may be considered as the spiritual father of the Nancy School, but its actual leader was Hippolyte Bernheim (1840-1919). An Alsatian and a French patriot, Bernheim left his hospital and university positions in Strasbourg when it was annexed by the Germans in 1871, and was appointed in Nancy. The old Lorraine capital was pulsating with new life as a result of the arrival of numerous Alsatian refugees, the creation of a new university in 1872, and the flowering of a new school of decorative arts led by Emile Galle and Victor Prouve, which was to spread and become, around 1900, the "modern style." Bernheim, whose reputation was already established through his research on typhoid fever, as well as heart and pulmonary diseases, was appointed titular professor of internal medicine at the new university in 1879. Three years later, in 1882, he tried out and adopted Liebeault's hypnotic method, although he unlike his teacher utilized it only when he thought that he had a good chance of success. Van Renterghem described Bernheim as a short, blue-eyed man, who spoke in a soft voice but who had a very authoritarian way of handling his hospital ward and hypnotizing his patients. Bernheim taught that hypnosis was easier to induce in people accustomed to passive obedience such as old soldiers or factory workers, among whom he had his best therapeutic successes. He had poor results with people of the higher and wealthier classes. Bernheim revealed the existence of Liebeault's work to the medical world shortly after Charcot read his celebrated paper on hypnotism at the Academie des Sciences. This began an embittered struggle between the two men. In 1886, Bernheim published his textbook, which was a great success and made him the leader of the Nancy School. In opposition to Charcot, he proclaimed that hypnosis was not a pathological condition found only in hysterics, but it was the effect of "suggestion." He defined suggestibility as "the aptitude to transform an idea into an act," a feature that every human being possessed to a different degree. Hypnosis, he said, was a state of enforced suggestibility induced by suggestion. Bernheim currently used hypnotism to treat many organic diseases of the
nervous system
, rheumatism, gastrointestinal diseases, and menstrual disorders. He vehemently denied the validity of Charcot's theory of hysteria and claimed that the hysterical conditions, demonstrated in the Salpetriere were artifacts. As time went on Bernheim made less and less use of hypnotism, contending that the effects that could be obtained by this method were equally obtainable by suggestion in waking state, a procedure that the Nancy School now termed "psychotherapeutics." Bernheim, however, was an internist, not a psychiatrist, and he had no organized school around him. In its restricted sense the Nancy School consisted of a group of four men: Liebeault, Bernheim, the forensic medical expert Beaunis, and the lawyer Liegeois. The latter two were particularly preoccupied with the implications of suggestion in crime and criminal responsibility. In its wider sense the Nancy School was a loose group of psychiatrists who had adopted Bernheim's principles and methods. Among them were Albert Moll and Schrenck-Notzing in Germany, Krafft-Ebing in Austria, Bechterev in Russia, Milne Bramwell in England, Boris Sidis and Morton Prince in the United States, and a few others who deserve special mention. Otto Wetterstrand, a fashionable Swedish physician, lived in Stockholm in a large and sumptuous apartment with a succession of salons decorated with the finest rugs and furniture. He was a blond and blue-eyed man of middle height, wore a moustache, and had a tic of the eyelids. He saw between thirty and forty patients every afternoon and hypnotized them in the 16
presence of the others. He also had a private hospital staffed with nurses who were his former patients. He applied a method of treatment by prolonged hypnotic sleep and maintained his patients in this state between 8 and 12 days. His strange methods gave rise to a legend depicting him as an extraordinary modern wizard. He was the actual initiator of the method of prolonged continuous sleep--a technique that Otto Wolff modified in 1898 by substituting a medication, Trional, for hypnosis. In Holland, Frederik Van Eeden, better known as a prominent Dutch poet, made some audacious experiments with hypnosis. He attempted to teach French to a ten-year-old girl whom he had hypnotized, a language that she did not know in her waking state. He then transferred this knowledge from her sleeping state to her waking state so that, to her amazement, she found herself able to understand and speak some French. In 1887 he and Van Renterghem organized a psychotherapeutic clinic in Amsterdam that took the name of Institut Liebeault. In Switzerland, Auguste Forel, professor of psychiatry in Zurich and director of the Burgholzli mental hospital, visited Bernheim in 1887 and soon became one of the masters of hypnotism. Like Liebeault and Bernheim, he was very successful with the treatment of certain physical diseases. He organized an outpatient service of hypnotic therapy. His most original application of hypnotism was in the management of his mental hospital where the personnel, not the patients, were hypnotized. Forel hypnotized a number of male and female nurses, who volunteered, and suggested to them that their sleep in the wards for agitated patients would be sound in spite of the noise, but that they would waken as soon as a patient did something unusual or dangerous. It was said that this method was quite successful.
Sigmund Freud
was one of the many visitors to Nancy and spent a few weeks there with Bernheim and old Liebeault in 1889. He was impressed with Bernheim's contention that the posthypnotic amnesia was not as complete as was generally assumed. Through concentration and with the help of skillful questioning, Bernheim could bring the patient to remember what he had experienced under hypnosis. Around 1900, Bernheim was considered by many to be Europe's foremost psychotherapist; but ten years later he was almost forgotten. Other, supposedly more modern, men had risen to fame, particularly Dubois in Berne, who Bernheim said with bitterness, had "annexed" his discovery in 1871 (in the same sense as the Germans had "annexed" Alsace and Lorraine). After having been Liebeault's respectful disciple for years, Bernheim now obviously considered him as his precursor and himself as the true founder of psychotherapy. At least he had the comfort, shortly before his death, of seeing his native Alsace restored to France. Charcot and the Salpetriere School Contrary to the Nancy School, the Salpetriere School was strongly organized and headed by a powerful figure, that of the great teacher Jean-Martin Charcot (1835-1893), a neurologist who had come belatedly to the study of certain mental phenomena. During the years 1870-1893, Charcot was considered to be the greatest neurologist of his time. He was the consulting physician of kings and princes, and patients came to see him "from Samarkand and the West Indies." But fame had come to him after long years of incessant and obscure toil, and few of those who marveled at Charcot's extraordinary success realized that it was a belated one reached after many years of toil. No real biography of Charcot has been written as yet. Most accounts such as that by Guillain are based on necrologies and depict for the most part the Charcot of the brilliant years. Valuable memories have been recorded by his disciple Souques, and particularly by the Russian physician Lyubimov, who had been acquainted with Charcot for the last twenty years of his life. Charcot was born in Paris, the son of a carriage-builder who, it was said, made carriages of great beauty and who was reputed to be more of an artist than an artisan. Very little is known of Charcot's childhood and youth. It is said that he was a cold, silent, shy, and aloof young man who had a speech impediment. He wore a black moustache (the story goes that his first rich patient was referred to him on the condition that he shave off his moustache). As an interne (medical resident), the young Charcot was assigned for some time to the Salpetriere, an old hospital, which, at that time, was mainly a medical poorhouse for four or five thousand old women. Charcot realized that this hospital sheltered numerous patients with rare or unknown neurological diseases and would be a great source for clinical research. He kept this in mind while slowly pursuing his career as an anatomo-pathologist. As a young doctor he was asked by one of his teachers to be physician and companion to a rich banker traveling to Italy, which gave him an opportunity to become acquainted with Italy's artistic wealth. His medical career was rather slow and laborious. However, the turning point came in 1862, when, at the age of thirty-six, Charcot was appointed chief physician in one of the Salpetriere's largest sections and took up his old plans with feverish activity. Case histories were taken, autopsies performed, laboratories opened, while, at the same time, he began to acquire a team of devoted collaborators. He was inspired by Duchenne (de Boulogne), a neurologist of outstanding capacity who had no official position and whom Charcot called his Master in Neurology. Within the 8-year period from 1862 to 1870, Charcot made the discoveries that made him the foremost neurologist of his time. In 1870, Charcot assumed the supplementary charge of a special ward, which the hospital administration reserved for a fairly large number of women patients suffering from convulsions. Some were epileptics, others were hysterics who had learned to imitate epileptic crises. Charcot strove to discover means for distinguishing between hysterical and epileptic convulsions. He also began to investigate hysteria with the same method he used for organic neurological diseases, and, with his disciple Paul Richer, gave a description of the full-blown hysterical crisis (the grande hysterie). 17
In 1878, probably under the influence of Charles Richet, Charcot extended his interest to hypnotism, of which he undertook a purportedly scientific study (as he had done with hysteria), taking as his subjects several of the most gifted of his female hysterical patients. He found that these subjects developed the hypnotic condition through three successive stages: "lethargy," "catalepsy," and "somnambulism," each stage showing very definite and characteristic symptoms. Charcot read his findings to the Academie des Sciences at the beginning of 1882. It was, Janet said, a tour de force to have hypnotism accepted by the same Academie that had condemned it three times within the past century under the name of magnetism. This resounding paper gave hypnotism a new dignity, and the heretofore shunned subject once again became the topic of innumerable publications. Among Charcot's most spectacular achievements were the investigations on traumatic paralyses, which he conducted in 1884 and 1885. In his time paralyses were generally considered to result from lesions of the nervous system caused by an accident, although the existence of "psychic paralyses" had been postulated in England by B. C. Brodie in 1837 and by Russel Reynolds in 1869. But how could a purely psychological factor cause paralysis without the patient's awareness of that factor and excluding the possibility of simulations? Charcot had already analyzed the differences between organic and hysterical paralyses. In 1884 three men afflicted with a monoplegia of one arm following trauma were admitted to the Salpetriere. Charcot first demonstrated that the symptoms of that paralysis, while differing from those of organic paralyses, coincided exactly with the symptoms of hysterical paralyses. The second step was the experimental reproduction of similar paralyses under hypnosis. Charcot suggested to some hypnotized subjects that their arms would be paralyzed. The resulting hypnotic paralyses proved to have exactly the same symptoms as the spontaneous hysterical paralyses and the posttraumatic paralyses of the three male patients. Charcot was able to reproduce these paralyses step by step, and he also suggested their disappearance in the reverse order. The next step was a demonstration of the effect of the trauma. Charcot chose easily hypnotizable subjects and suggested to them that in their waking state, as soon as they were slapped on the back, their arm would become paralyzed. When awakened, the subjects showed the usual posthypnotic amnesia, and as soon as they were slapped on the back, they were instantly struck with a monoplegia of the arm of exactly the same type as the posttraumatic monoplegia. Finally, Charcot pointed out that in certain subjects living in a state of permanent somnambulism, hypnotic suggestion was not even necessary. They received the paralysis of the arm after being slapped on the back without special verbal suggestion. The mechanism of posttraumatic paralysis thus seemed to he demonstrated. Charcot assumed that the nervous shock following the trauma was a kind of hypnoid state analogous to hypnotism and therefore enabling the development of an autosuggestion of the individual. "I do not think that in any physiopathological experimental research it would often be possible to reproduce more accurately the condition which one has set oneself the task to study," Charcot concluded. Charcot placed the hysterical, posttraumatic, and hypnotic paralyses in the group of dynamic paralyses in contrast to organic paralyses resulting from a lesion of the nervous system. He gave a similar demonstration with regard to hysterical mutism and hysterical coxalgia. Here, too, he reproduced experimentally, by means of hypnotism, clinical pictures identical with the hysterical conditions. In 1892, Charcot distinguished "dynamic amnesia," in which lost memories can be recovered under hypnosis, from "organic amnesia" where this is impossible. In the last years of his life, Charcot realized that a vast realm existed between that of clear consciousness and that of organic brain physiology. His attention was drawn to faith healing, and in one of his last articles he stated that he had seen patients going to Lourdes and returning healed from their diseases. He tried to elucidate the mechanism of such cures and anticipated that an increased knowledge of the laws of "faith healing" would result in great therapeutic progresses. There are many descriptions and pictures of Charcot, but they pertain almost without exception to Charcot at his zenith around 1880 or the declining Charcot of the last years. The most lively ones were given by Leon Daudet, who had studied medicine at the Salpetriere and whose father, the novelist Alphonse Daudet, had been Charcot's intimate friend. Here is a condensed excerpt of Leon Daudet's Memoirs describing Charcot: Charcot was a small, stout. and vigorous man with a big head, a bull's neck, a low forehead, broad cheeks. The line of his mouth was hard and meditative. He was clean-shaven and kept his straight hair combed back. He somewhat resembled Napoleon and liked to cultivate this resemblance. His gait was heavy, his voice authoritative, somewhat low, often ironical and insisting, his expression extraordinarily fiery. A most learned man, he was familiar with the works of Dante, Shakespeare, and the great poets; he read English, German, Spanish, and Italian. He had a large library full of strange and unusual books. He was very humane; he showed a profound compassion for animals and forbade any mention of hunters and hunting in his presence. A more authoritarian man I have never known, nor one who could put such a despotic yoke on people around him. To realize this, one only had to see how he could, from his pulpit, throw a sweeping and suspicious glance at his students and hear him interrupt them with a brief, imperative word. He could not stand contradiction, however small. If someone dared contradict his theories, he became ferocious and mean and did all he could to wreck the career of the imprudent man unless he retracted and apologized. He could not stand stupidity. But his need for domination caused him to eliminate the more brilliant of his disciples, so that in the end he was surrounded by mediocre people. As a compensation, he maintained
social relations
hips with artists and poets and gave magnificent receptions. t was one of his favorite ideas that the share of dream-life in our waking state is much more than just "immense." Many references to Charcot can be found in the Diary of Edmond and Jules de Goncourt. These two brothers were known for their biting descriptions and seem to have been particularly antagonistic toward Charcot, whom they described as follows: 18
Charcot was an ambitious man, envious of any superiority, showing a ferocious resentment against those who declined invitations to his receptions, a despot at the university, hard with his patients to the point of telling them bluntly of their impending death but cowardly when he himself was ill. He was a tyrant with his children and compelled for instance his son Jean, who wanted to be a seafarer, to become a physician. As a scientist, Charcot was a mixture of genius and charlatan. Most unpleasant was his indiscretion in talking of his patients' confidential matters. The description given by the Russian physician Lyubimov is so vastly different that one can hardly believe it concerns the same person: Beside his extraordinary gift as a teacher, a scientist and an artist, Charcot was extremely humane, devoted to his patients and would not tolerate anything unkind being said about anyone in his presence. He was a poised and sensible man, very circumspect in his judgments, with a quick eye for distinguishing people's value. His family life was a harmonious and happy one; his wife, who was a widow with a daughter when he married her, helped him with his work and was active in
charitable organizations
. He gave great care to the education of his son Jean who had spontaneously chosen to be a physician and whose first scientific publications were a great joy for his father. He enjoyed the devotion of his students and of his patients, so that his patron saint's day, the Saint Martin, on November 11th, was celebrated with entertainments and rejoicing at the Salpetriere. One may wonder how Charcot gained the enormous prestige that he enjoyed in the years 1880 to 1890. Several reasons may be discerned. First, the Salpetriere was anything but an ordinary hospital. It was a city within a city in the seventeenth-century style, consisting of about 45 buildings with streets, squares, gardens, and an old and beautiful church. It was also a place of historical fame: Saint Vincent de Paul had carried out his charitable activities there. It had later been converted by Louis XIV into an asylum for beggars, prostitutes, and the insane, and was one of the places where the notorious September Massacres had taken place during the French Revolution and where Pinel had achieved his mental hospital reforms. It was also known from one episode in the classic novel Manon Lescaut by the Abbe Prevost. Its thousands of old women had inspired some of Baudelaire's poems. Before Charcot, the Salpetriere had been little known to
medical students
, and physicians did not relish the thought of being appointed there. Charcot was now credited with being the scientific wizard who had turned this historical place into a Temple of Science. That old-fashioned hospital with its antiquated buildings had no laboratories, no examination rooms, and no teaching facilities. With his iron will--and with the help of his political connections--Charcot built a treatment, research, and teaching unit. He had carefully chosen his collaborators; he installed consulting rooms for ophthalmology, otolaryngology, and so on, as well as laboratories and a photographic service. Later he added a museum for anatomo-pathology, an out-patient service where men were also admitted, and a large auditorium. Among Charcot's disciples were Bourneville, Pitres, Joffroy, Cotard, Gilles de la Tourette, Meige, Paul Richer, Souques, Pierre Marie, Raymond, Babinski. There is hardly one French neurologist of that time who had not been a student of Charcot. Charcot exerted an absolute domination on the school that was his creation. Each of his lectures was carefully recorded by students and published in one of the several medical journals he had founded. There came a time when no one could be appointed to the Paris medical faculty without his sanction. This patriotic feeling contributed to Charcot's fame: he and Pasteur were to the French a proof of France's scientific genius, challenging Germany's alleged scientific superiority. Charcot personified what the French call a prince de la science; he was not only a man of high scientific reputation, but also a powerful and wealthy man. Through his marriage with a rich widow and the extremely high fees that he charged his patients, he was able to lead the life of a member of the wealthy class. Aside from his villa in Neuilly, he had acquired in 1884 a splendid residence on the Boulevard Saint-Germain, which had been decorated according to his own plans. It was a kind of private museum with Renaissance furniture, stained-glass windows, tapestries, paintings, antiques, and rare books. He was himself an artist who did excellent drawings and was an expert in painting on china and enamel. He was a keen connoisseur of the history of art and was a master of French prose who had a great knowledge of French literature. Charcot also possessed a knowledge of English, German, and Italian, which was a rare accomplishment at that time. He displayed a particular admiration for Shakespeare, whom he often quoted in English, and for Dante, whom he quoted in Italian. Every Tuesday night he gave sumptuous receptions in his splendid home to the Tout-Paris of scientists, politicians, artists, and writers. He was known to be the physician and sometimes the confidant of kings and princes. Emperor Pedro II of Brazil, it was said, came to his home, played billiards with him, and attended his lectures at the Salpetriere. Charcot was a very influential figure in English medical circles. At an international congress that took place in London in 1881, his demonstration on the tabetic arthopathies was received with a storm of applause. He had many admirers in Germany, although he declined invitations to congresses in that country after the Franco-Prussian war of 1870 to 1871. In Vienna he was well acquainted with Meynert and Moritz Benedikt. Charcot was very popular in Russia, where he had been called several times as consultant physician to the Czar and his family. Russian physicians welcomed him because he relieved them from their strong dependence on German scientists. According to Guillain, he arranged an unofficial encounter between Gambetta and the Grand Duke Nikolai of Russia, from which the Franco-Russian alliance was to issue. Charcot traveled extensively; every year he made a carefully planned journey to a different European country, visiting the museums, making drawings, and writing travelogues. 19
Great as it was, Charcot's prestige was still enhanced by a halo of mystery that surrounded him. It had slowly grown after 1870 and reached its peak with his celebrated paper on hypnotism in 1882. He gained the reputation of being a great thaumaturgist. Instances of his quasi-miraculous cures are reported by Dr. Lyubimov: Many patients were brought to Charcot from all over the world, paralytics on stretchers or wearing complicated apparatuses. Charcot ordered the removal of those appliances and told the patients to walk. There was, for instance, a young lady who had been paralyzed for years. Charcot bade her stand up and walk, which she did under the astounded eyes of her parents and of the Mother Superior of the convent in which she had been staying. Another young lady was brought to Charcot with a paralysis of both legs. Charcot found no organic lesion; the consultation was not yet over when the patient stood up and walked back to the door where the cabman, who was waiting for her, took off his hat in amazement and crossed himself. In the eyes of the public, Charcot was the man who had explored the abysses of the human mind, hence his nickname "Napoleon of Neuroses." He had come to be identified with the discovery of hysteria, hypnotism, dual personality, catalepsy, and somnambulism. Strange things were said about his hold on the Salpetriere's hysterical young women and about happenings there. Jules Claretie relates that during a patients' ball at the Salpetriere, a gong was inadvertently sounded, whereupon many hysterical women instantaneously fell into catalepsy and kept the plastic poses in which they found themselves when the gong was sounded. Charcot was also the man whose searching gaze penetrated the depths of the past and who retrospectively interpreted works of art, giving modern neurological diagnoses of cripples represented by painters. He founded a journal, the Iconographie de la Salpetriere, followed by the Nouvelle Iconographie de la Salpetriere, which were probably the first journals to combine art and medicine. Charcot was also considered to have founded a scientific explanation for demoniacal possession, which, he assumed, was nothing but a form of hysteria. He also interpreted this condition retrospectively in works of art. He was known for his collection of rare old works on witchcraft and possession, some of which he had reprinted in a book series titled "The Diabolical Library." All these features contributed to the incomparable fascination exerted by Charcot's seances at the Salpetriere. Tuesday mornings were devoted to examining new, heretofore unseen patients in the presence of physicians and students. They enjoyed watching Charcot display his clinical acumen, and the assurance and swiftness with which he was able to disentangle the most complicated case histories to arrive at a diagnosis, even of rare diseases. But the greatest attraction were his solemn lectures given on Friday mornings, each of which had been prepared with the utmost care. Long before the beginning of the lectures, the large auditorium was filled to capacity with physicians, students, writers, and a curious crowd. The podium was always decorated with pictures and anatomical schemata pertaining to the day's lecture. His bearing reminding one of Napoleon or Dante, Charcot entered at 10 A.M., often accompanied by an illustrious foreign visitor and a group of assistants who sat in the first rows. Amidst the absolute silence of the audience, he started speaking in a low pitch and gradually raised his voice, giving sober explanations that he illustrated with skillful colored chalk drawings on the blackboard. With an inborn acting talent, he imitated the behavior, mimicry, gait, and voice of a patient afflicted with the disease he was talking about, after which the patient was brought in. The patient's entrance was sometimes also spectacular. When Charcot lectured on tremors, three or four women were introduced wearing hats with very long feathers. The trembling of the feathers allowed the audience to distinguish the specific characteristics of tremors in various diseases. The interrogation took the form of a dramatic dialogue between Charcot and the patient. Most spectacular were the lectures that he gave about hysteria and hypnotism. Another of Charcot's innovations was the use of photographic projections, a procedure that was unusual for medical teaching at the time. The lecture concluded with a discussion of the diagnosis and a recapitulation, stating the lecture's main points; both of which were models of lucidity and concision. It lasted two hours, but the audience never found it too long, even when the topic concerned rare organic brain diseases. Lyubimov points to the difference between Charcot's lectures and those of Meynert, which he had also attended in Vienna and which left him exhausted and confused, whereas he left Charcot's lectures with a feeling of exhilaration. It is easy to understand the spellbinding effect that Charcot's teaching exerted on laymen, on many physicians, and especially on foreign visitors such as Sigmund Freud, who spent four months at the Salpetriere during 1885 and 1886. Other visitors were more sceptical. The Belgian physician Delboeuf, whose interest in Charcot's work had brought him to Paris in the same period as Freud, was soon assailed by the strongest doubts when he saw how carelessly experiments with hysterical patients were carried out. On his return to Belgium, he published a strongly critical account of Charcot's methods. Those visitors who came to see Charcot in Paris for a short period, and were envious of him, were often unaware that he was surrounded by a host of powerful enemies. He was stamped as an atheist by the clergy and the Catholics (one of the reasons being that he had replaced the nuns at the Salpetriere by lay nurses), but some atheists found him too spiritual. He was publicly accused of charlatanism by the magnetists. He also had fierce enemies in political and society circles (as is obvious from the Diary of the Goncourt brothers). Among neurologists, some who had remained his admirers as long as he stayed on the solid ground of neuropathology deserted him when he shifted to the study of hypnotism and to spectacular experiments with hysterical patients. Lyubimov tells how the German neurologist Westphal expressed deep concern about the new turn taken by Charcot's research after he visited him in Paris. In America Charcot was attacked on the same grounds by Bucknill. Beard, who admitted that Charcot had made "serious mistakes," nonetheless respected him "as a man of genius and a man of honour." Charcot also had to wage a continuous battle against the Nancy School in which he was steadily losing ground to his opponents. Bernheim sarcastically proclaimed that among thousands of patients whom he had hypnotized, only one displayed the three stages described by Charcot--a woman who had spent three years at the Salpetriere. Charcot also met with 20
undying hatred on the part of some of his medical colleagues and particularly on the part of his former disciple Bouchard, an ambitious man twelve years his junior. Worse still, a few of his seemingly loyal disciples duped him by showing him more and more extraordinary manifestations that they rehearsed with patients and then demonstrated to him. It is true that many of his disciples never participated in such activities, but no one apparently dared warn him. He had been extremely cautious for a long time, but eventually La Rochefoucauld's maxim came to apply to him: "Deception always goes further than suspicion." According to Guillain, Charcot began to feel strong doubts toward the end of his life and was thinking of again taking up the entire study of hypnotism and hysteria, which death, however, prevented him from doing. A secret enemy, who was well acquainted with Charcot's medical condition and who for years sent him anonymous letters depicting his angina pectoris and announcing his impending death, most likely belonged to the medical circle around Charcot. The extreme opinions prevailing about Charcot, the fascination he exerted on the one hand, and the fierce enmities he had made on the other, made it difficult in his lifetime to form a true assessment of the value of his work. Contrary to expectations; the passing of time has not made this task much easier. It is therefore necessary to distinguish the various fields of his activity. First, it is often forgotten that Charcot, as an internist and anatomo-pathologist, made valuable contributions to the knowledge of pulmonary and kidney diseases, and that his lectures on diseases of oldage were for a long time a classic of what is now called geriatrics. Second, in neurology, which was his second career, he made outstanding discoveries upon which his lasting fame will undisputedly rest: delineation of disseminated sclerosis, amyotrophic lateral sclerosis ("Charcot's disease"), locomotor ataxia and its peculiar arthropathies ("Charcot's joints"), his work on cerebral and medullar localizations, and on aphasia. On the other hand, it is most difficult to evaluate objectively what could be called Charcot's "third career," that is, his exploration of hysteria and hypnotism. As happens with many scientists, he lost control of the new ideas that he had formulated and was carried away by the movement he had created. Pierre Janet has accurately described Charcot's methodological errors in that field. The first was his excessive concern with delineating specific disease entities, choosing as model types those cases that showed as many symptoms as possible; he assumed that the other cases were incomplete forms. This method having proved fruitful for neurology, Charcot took it for granted that the same would hold true for mental conditions as well. He thus gave arbitrary descriptions of the grande hysterie and the grand hypnotisme. A second error was to oversimplify the descriptions of these disease entities in order to make them more intelligible to his students. A third fatal error was Charcot's lack of interest in his patients' backgrounds and in the ward life of the Salpetriere. He hardly ever made rounds; he saw his patients in his hospital examination room while his collaborators, who had examined them, reported to him. Charcot never suspected that his patients were often visited and magnetized on the wards by incompetent people. Janet has shown that the alleged "three stages of hypnosis" were nothing but the result of training that Charcot's patients underwent at the hands of magnetizers. Seeing that the early history of magnetism and hypnotism was forgotten, Charcot-even more than Bernheim-believed that all that he found in his hypnotized patients were new discoveries. Another fact, which from the start distorted Charcot's investigations in dynamic psychiatry, was the peculiar collective spirit that pervaded the Salpetriere. This closed community sheltered not only crowds of old women, but comprised also special wards for hysterical patients, some of them young, pretty, and cunning: nothing could be more eminently propitious to the development of mental contagion. These women were the star attractions, utilized to demonstrate clinical cases to the students and also in Charcot's lectures, which were given in the presence of the Tout-Paris. Because of Charcot's paternalistic attitude and his despotic treatment of students, his staff never dared contradict him; they therefore showed him what they believed he wanted to see. After rehearsing the demonstrations, they showed the subjects to Charcot, who was careless enough to discuss their cases in the patients presence. A peculiar atmosphere of mutual suggestion developed between Charcot, his collaborators, and his patients, which would certainly be worthy of an accurate sociological analysis. Janet has pointed out that Charcot's descriptions of hysteria and hypnotism were based on a very limited number of patients. The prima donna, Blanche Wittmann, deserves more than an anecdotal mention. The role of patients in the elaboration of dynamic psychiatry has been all too neglected and would also be worthy of intensive investigation. Unfortunately, it is very difficult to gather relevant information in retrospect. We know nothing of Blanche Wittmann's origin and background prior to her admission to the ward for hysterical patients at the Salpetriere. According to Baudouin, she was young when she arrived there and rapidly became one of Charcot's most renowned subjects and was nicknamed la reine des hysteriques. She was often exhibited to demonstrate the "three stages of hypnosis," of which she was not only the type, but the prototype, according to Frederick Myers who had seen her. Baudouin states that she is the woman in full hysterical crisis, depicted between Charcot and Babinski in Brouillet's famous painting; she can also be recognized in several pictures in the Iconographie de la Salpetriere and elsewhere. She was authoritarian, capricious, and unpleasant toward the other patients as well as the personnel. For some unknown reason, Blanche Wittmann left the Salpetriere for some time and was admitted at the Hotel-Dieu, where she was investigated by Jules Janet, Pierre Janet's brother. After achieving the "first stage of hypnosis," that is, lethargy, Jules Janet modified the usual technique and saw the patient in a quite new condition. A new personality, that of Blanche II, emerged, showing herself as much more balanced than Blanche I. The new personality disclosed that she had been permanently present and conscious, hidden behind Blanche I. She was always aware of everything that occurred during the many demonstrations when Blanche I had acted out the "three stages of hypnosis" and was supposed to be unconscious. Myers noted 21
that "it is strange to reflect for how many years the dumbly raging Blanche II has thus assisted at experiments to which Blanche I submitted with easy complacence." Jules Janet kept Blanche Wittmann in her second state for several months and found that she was remarkably (and apparently lastingly) improved by his treatment. What later happened to Blanche Wittmann has been succinctly reported by Baudouin. She returned to the Salpetriere where she was given a job in the photography laboratory and later, when a laboratory of radiology was opened, she became employed there. She was still authoritarian and capricious, denied her past history, and became angry when asked about that period of her life. Since the dangers of radiology were not yet known, she became one of the first victims of the radiologist's cancer. Her last years were a calvary that she crossed without showing the least hysterical symptom. She had to suffer one amputation after another and died a martyr of science. It was, however, Charcot's third career, that contributed more than anything else to his contemporary fame. The writer T. de Wyzewa, in an obituary he wrote on Charcot, said that in a few centuries his neurological work might be forgotten, but that he would stand in the memory of mankind as one who had revealed to the world an unsuspected realm of the mind. It is because of that breakthrough, and not his own literary works (which have remained unpublished) that Charcot exerted a powerful influence on literature. As stated by de Monzie, he was the starting point of a whole tradition of psychiatrically oriented writers, such as Alphonse Daudet and his son Leon Daudet, Zola, Maupassant, Huysmans, Bourget, Claretie, and later Pirandello and Proust, not to speak of many authors of popular novels. Charcot himself was the model for a specific character in many novels and plays in the 1890's: the great scientist of world-renown impavidly pursuing his uncanny research in the abyss of the human mind. An American visitor who saw Charcot at the beginning of 1893 noticed that, while his intellectual strength was as lively as ever, his physical health was greatly shaken. He kept on working feverishly until August 15, 1893, when he left for a vacation with two of his favorite disciples, Debove and Strauss, intending to visit the Vezelay cathedral. He died unexpectedly in his hotel room the night of August 16, and was given a national funeral in Paris on August 19. In spite of the deluge of praise that was lavished on his memory, his fame soon waned. The publication of his complete works, which had been planned in fifteen volumes, was abandoned after volume IX had appeared in 1894. According to Lyubimov, Charcot had left a considerable amount of literary works: memoirs, illustrated travelogues, critical studies on philosophical and literary works, all of which he did not want published in his lifetime. Lyubimov adds that Charcot's true personality could not have been known before their publication. However, none of these writings has ever been printed. Charcot's son Jean (1867-1936), who had studied medicine to please his father, gave up this profession a few years later and became famous as a seafarer and explorer of the South Pole. Charcot's precious library was donated by his son to the Salpetriere and gradually fell into the most pitiful state of neglect, as well as did the Musee Charcot. The evil that men do lives after them; The good is oft interred with their bones. So it was with Charcot. It was not long before his glory was transformed into the stereotype of the despotic scientist whose belief in his own superiority blinded him into unleashing a psychic epidemic. One year after Charcot's death, Leon Daudet, who had been a medical student on his ward, published a satirical novel, Les Morticoles, which gave fictitious names to prominent physicians and ridiculed the Paris medical world. Charcot was depicted under the name of Foutange and Bernheim was called Boustibras. Faked hypnotical seances at the "Hopital-typhus" with "Rosalie" (portraying Blanche Wittmann) were described in a caricaturistic manner. Another malevolent account of Charcot's Salpetriere was later given by Axel Munthe in his autobiographic novel The Story of San Michele. Jules Bois, who was well-acquainted with Charcot, relates that during the last months of his life, the old man expressed his pessimism with regard to the future of his work, which he felt would not survive him for long. In fact, before ten years had elapsed after his death, Charcot was largely forgotten and disowned by most of his disciples. His successor, Raymond, while giving lip service to Charcot's work on neuroses, himself belonged to the organicist trend in neurology. One of Charcot's favorite disciples, Joseph Babinski, who had made himself known during Charcot's lifetime by his experiments in transferring hysterical symptoms with a magnet from one patient to another, now became the main protagonist of a
radical reaction
against Charcot's concept of hysteria. Hysteria, he claimed, was nothing but the result of suggestion, and it could be cured by "persuasion." The name "hysteria" itself was replaced by that of "pithiatisme," coined by Babinski. Guillain reports that when he was a resident at the Salpetriere in 1899, that is, six years after Charcot's death, there were still a few of Charcot's hysterical female patients who would, for a small remuneration, act out for the students the full-fledged attack of the grande hysterie. But hysterical patients eventually disappeared from the Salpetriere. As years went by, Charcot's neurological discoveries were taken for granted and his name became associated with a regrettable episode in the long history of the Salpetriere. In 1925, his centennial was celebrated in the Salpetriere with a strong emphasis on his neurological achievements and a few rapid apologies about the legere defaillance (the slight lapse), which his work on hysterical and hypnosis had been. Psychoanalysts, however, praised him in that regard as a precursor of Freud. In 1928 a group of Paris surrealists, in their endeavor to counteract all accepted ideas of their time, decided to celebrate the discovery of Charcot's hysteria, "the greatest poetical discovery of the end of the nineteenth century." 22
Several years later, the author of the present book, then a medical student at the Salpetriere, met a very old woman patient who had spent almost her entire life there and had known Charcot and his school. She kept talking to herself and had hallucinations during which she was hearing all these men speaking in turn. Those voices from the past, which had never been recorded but still resounded in the disturbed mind of that wretched old woman were all that survived of the glory that had been Charcot's Salpetriere. Conclusion We may now look back on the development of dynamic psychiatry from Mesmer to Charcot. There was little dynamic psychotherapy before Mesmer, aside from the largely obsolete, nonmedical practice of exorcism. Medical men had elaborated a theory of "imagination," that is, a "power of the mind" endowed with multiple and multiform--sometimes extraordinary-manifestations (among which spontaneous somnambulism attracted
special interest
). Mesmer developed what he believed to be a scientific theory and a universal medical therapy. He aimed at provoking "crises," which were supposed to have diagnostic value and to be the weapon for the cure. His main discovery was that of the "rapport" between magnetizer and patient. Puysegur replaced the pseudo-physical theory of the "fluid" with the insight that unknown psychological forces were at work. His great clinical discovery was that of "magnetic sleep," or "artificial somnambulism," that is, a condition similar to spontaneous somnambulism, with the difference that it could be induced and stopped at will and utilized for the exploration of unknown psychic functions as well as for therapy. The concept of rapport was elaborated and now regarded as a psychological phenomenon and the channel for the psychotherapeutic action. The great wave of spiritism in the nineteenth century resulted in the discovery of new approaches to the conscious mind, such as automatic writing. Besides "artificial somnambulism," a new condition, the mediumnistic trance, was explored. Charcot pointed to the existence of unconscious "fixed ideas" as nuclei of certain neuroses, a concept that was to be developed by Janet and Freud. Thus, prior to those two great pioneers lay a whole century of dynamic psychiatry, during which a considerable amount of investigation had been carried out, even though it was not completely systematized. This first dynamic psychiatry will be the subject of the next chapter. 23
HF Ellenberger
The Discovery of the Unconscious: The History and Evolution of Dynamic Psychiatry
HF Ellenberger
Hugh McPherson
Fri Aug 31 06:56:53 2007
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