Popular Science Monthly/Volume 17/June 1880/Hysteria and Demonism II
A STUDY IN MORBID PSYCHOLOGY.
By CHARLES RICHET.
THE word anæsthesia signifies absence of sensibility. In order to comprehend the significance of this symptom, it is important to present a few summary notions relative to sensibility and the sense of touch. The skin of man, like that of all animals, is furnished with innumerable nerves which are sensitive to the most trifling exciting cause, so that, if we touch ever so lightly any point on the skin, the shock communicated to the sensitive nerves of that organ is transmitted to the brain, and provokes there a sensation and a perception. Several modes of sensibility in the skin have been distinguished. Thus by the tactual sensibility we perceive the contact of objects; but this is not all there is of the sense of touch, for at the same time with the contact we are able to feel the temperature and consistency of foreign objects. There is also a sensibility belonging to the muscles. When we make a motion—that of closing the hand, for example—we are not only aware of the effort we make to move the fingers and shut up the hand, but we also know that the movement is executed. Everything takes place as if the muscles were sensible, and each of the muscular contractions actually provokes a sensation. We should also distinguish between tactual and muscular sensibility and the sensibility to pain. When the skin is burned, or cut, or torn, the violent shock suffered by the nerves gives rise to a particular sensation, of which we have all had more or less experience, and which is called pain. The word is so clear and the thing so common that no other definition than the word itself is needed.
Some extremely curious observations may be made with patients who are wholly anæsthetic. We may prick them, pinch them, burn them, without their feeling the slightest pain. They do not perceive the contact of the objects that wound them. An experiment which always creates astonishment in persons who are not acquainted with medical practice is, to bandage the eyes of a patient, and scratch along her arm from place to place with a fine needle without her receiving the least intimation from her senses that she is wounded.
Anæsthesia is sometimes general and equally marked on the right and left sides, sometimes limited to a particular region of the body, as the forehead, the chest, or the forearm. Partial anæsthesia may occur even with patients who are only a little hysterical. If we seek to measure the sensibility of the different regions by pricking the skin lightly with a pin, we will often find a small zone of skin that is insensible. The Inquisitors of the sixteenth century had no other way of proceeding than this when they sought for the claw of the devil, only that, instead of touching the skin with pins, they made the executioner stick skewers of iron into all parts of the body. If the accused did not jump with pain at every implantation of the iron, they immediately declared that the devil had put his grip on her. The stigma of Satan was one of the most certain evidences of witchcraft. According to the most precise tokens of the exorcists, the devil's mark had the shape of a hare's paw.
Hysteric anæsthesia is often seated on only one side of the body; the affection in this form is called hemianæsthesia. The insensibility is so exactly limited to one side, that it is enough to go two or three millimetres to the right or left of the middle line of the body to establish the fact of the presence of sensibility or of its absence.
Although many researches have been made to discover the causes of this derangement of the nervous system, no satisfactory solution of the question has been reached yet. It seems to be proved that no material organic injury is connected with hysteria. The nerves of the affected side have the same appearance as the nerves of the healthy side; the marrow and the brains show no swelling, no hæmorrhage. We have not in this case a disease in which any disorder in the structure of the organ can explain how its function is perverted. What further causes us to believe that it would be wrong to look for an organic hurt where there is only a dynamical perversion is, that hemianæsthesias, after having lasted for even four or five years, will sometimes disappear all at once without any appreciable cause of cure, and leave no traces. As we have said, hysteric patients have an uncertain and changing disposition. Their maladies are likewise capricious and fantastical, and will come on without known cause, and disappear in the same way. An insignificant emotion, hardly perceptible, is sometimes enough to dissipate a of several years' standing. I knew a case of this kind, in which an hysterical patient had been paralyzed for four years, so that she was not able to speak, or eat, or drink, and had to be fed by putting food into her mouth. One evening she spoke out all at once, and said she could eat without being helped. Her sudden cure was unexplainable. Analogous cases, when they take place in the Pyrenees, pass for supernatural and divine manifestations. We judge otherwise in Paris, and see in them only the irregular effects of a disease which is imperfectly understood, the singular and complex nature of which science has not yet unraveled.
Some very strange phenomena have been observed in hysterical patients. It appears to be proved that they can remain a very long time without taking food and without drinking; at the same time, the secretions seem to be suspended, so that, under certain conditions not yet well determined, there takes place an almost complete cessation of the chemical operations of life, such as does not occur in other persons till the moment of death. "Nature," says M. Charcot, "seems to have a special provision for hysterical persons." The most surprising circumstance is that, although the attack be extremely violent and the alimentation most deficient and poor, the affected persons preserve their plumpness and the usual appearance of health. These facts are certainly not supernatural, though they have not been explained. It is right, then, to be on the guard against seeing in this prolonged abstinence, as they assumed to do in the case of Louise Lateau, a kind of miraculous divine protection. It is also necessary to beware against the simulations which many patients habitually attempt. It would be puzzling to say why they do this unless it be that they lie for the sake of lying, for the mere pleasure of propagating an error, even when that error is not to their profit. Some of the so-called demoniacs in former centuries indulged this curious fancy of making believe that they lived without food. Wier, one of the few persons who ventured to defend good sense against the universal folly of his age, tells how, in 1574, he exposed the tricks of a little beggar, who was probably hysterical, named Barbara, who made herself pass for a prodigy, and pretended not to eat or drink. He took the little mendicant home with him, watched her carefully with the aid of his wife and servant, and so fully laid bare her deceptions that she was compelled to confess, not that she had been playing tricks, but that Wier had cured her.
Wier was not the only person who, even in the sixteenth century, protested against the abuse of the belief in the supernatural. Several educated physicians would not allow themselves to be blinded by the ruling prejudices, and referred nervous affections and convulsions to their true cause, hysteria, which they then called suffocation of the womb, instead of to the devil. It would, however, have been rash for them to deny the action of demons, and they were, therefore, reticent in expression, and used well-rounded phrases to disguise the boldness of their doctrine. "I have seen," says Houlier, "two daughters of a president of one of the Parliaments of France, subject to be taken with such fits of laughing that it was impossible to stop them, either by fright or by threats and scolding." "In suffocations of the womb," says a learned man of the sixteenth century, "incidents frequently occur which cause physicians of little experience to think that it is a case of enchantment or of something extraordinary and supernatural." They had also observed incidents of catalepsy and of burial alive in hysteria, but were very careful against ascribing them to the machinations of the devil.
The efforts of physicians to cure hysteric anæsthesia have only recently been attended with any success. A happy discovery, revealing a series of real but improbable facts, has led to the introduction of salutary modifications in the therapeutics of hysteria. Twenty-five years ago, M. Burq affirmed that the application to the skin of certain metals, as gold, silver, copper, or zinc, would cure neuralgias, headaches, and paralyses, but no one thought of making a scientific verification of his novel assertion. M. Burq passed out of notice, but continued to maintain that the treatment of nervous diseases with metals would lead to marvelous cures. lie might, however, have preached in the desert till the end of his days, had it not occurred to M. Charcot to make a test of some of his experiments. He found that M. Burq's representations were correct, at least in part. Though the application of metals gives only moderate results in many nervous diseases, it is nevertheless true that in hysteria, and particularly in anæsthetic hysteria, it is attended with singular modifications in the symptoms. The application of pieces of gold or silver or other metal upon the insensible region is sufficient to produce a complete restoration of sensibility in the course of a few hours. Some patients are cured with gold, others with silver, others with zinc or copper. This process of treatment, which consists in the application of pieces of metal to the skin, is called metallotherapy.
Strange as these facts may appear, they have been verified too many times in France and other countries to permit us to call them in question. Additional researches have disclosed the manner in which the metals act when they are applied to the skin. It is by the development of feeble electric currents in consequence of the contact of the metal with the moist and salty skin. The currents, although they have not enough intensity to be felt, are strong enough to modify the condition of the sensory nerves, cause anæsthesia to disappear, and reëstablish sensibility. Experiments made directly for that object have established the probability of this theory.
Magnets, which may be compared to very feeble electric currents, exert an action on the skin very like that of metals. The phenomena are very clear; but, instead of curing anaesthesia, magnets transfer it, causing it to disappear from one side and pass to the other side. If, for example, we apply a magnet to a patient insensible on the right side, at the end of half an hour the right side will have become sensible while the left side will have lost its sensibility, showing that the disease, instead of disappearing, has been carried over from one side to the other. Does not this facility with which the morbid spot may be moved exclude every hypothesis of a deep material lesion of the nervous centers? The facts of metallotherapy and magnetotherapy are of great interest in physiology as well as in clinics; but the exposition of them is very dry, and even this short glance at them may seem too long. I pass to the description of symptoms which we might call demoniacal, and which constitute the grand attack of hystero-epilepsy.
It would be hard to imagine a more terrible spectacle than that of one of these demoniac fits. The body pulsates with tremors and violent shocks. The muscles are contracted, so tense that we might believe them to be on the point of bursting. Great bounds, frightful cries and bowlings, confused vociferations, indescribable contortions which we would not have supposed a human creature capable of making—such is the hideous picture which the hysterical patient presents when she is seized with an attack. After one has witnessed a scene of this character, he will be less astonished that the simple credulity of the men of the middle ages made them see in the phenomena the intervention of evil spirits, and that they supposed that only the devil could provoke such a furious exasperation of all the forces of the body.
As we study more closely the attacks of epileptic hysteria, we perceive that, in the face of this violent appearance of disorder, the disease has its regular, distinct periods. Nothing is at hazard. Every symptom, however unordered it may seem, appears in its turn with a surprising regularity, we might almost say punctuality. M. Charcot and his pupils have shown that the demoniac fits embrace three well-characterized periods.
The first period is analogous to the attack of epilepsy proper. An abrupt loss of consciousness takes place. The patient falls to the floor; her muscles contract, stiffen; her face turns blue; the features are wrought into a horrible grimace; the arms bend; the hands clinch; in a few instants afterward the muscles quiver with convulsive tremblings, which at first grow more marked, then become weaker and weaker. At last, the muscles, exhausted by the long and violent strain, relax, and a deep, stupid sleep succeeds the convulsive spell.
This lasts only for a little while, and then begins the second period, which M. Charcot calls the period of clownism, because it recalls the curious attitudes and contortions of the clowns in the circus. At this stage the patient executes prodigious bounds; the body, bent into the arc of a circle, rests on the bed only by the head and feet; the face is disfigured, sometimes terribly so, and the twisted features give it a hideous expression; and at times the whole body will bound up, then fall heavily upon the bed. "The patient goes into a fury against herself," says M. P. Richer, describing one of the attacks; "she tries to scratch her face, to tear her hair, she utters pitiful cries, she hits her breast with her fist so hard that the attendants have to interpose a cushion; she springs at the persons who are around her, tries to bite them, and, if she can not get at them, tears everything within her reach, the bedclothes, her own clothes, bellows like a calf, strikes the bed with her head and her fists as if she could never get enough of it; she jumps up, throws her arms around, bends her legs up and kicks them out again, shakes her head back and forth uttering hoarse cries all the time, or, if she sits down, twists her body around from one side to the other, and keeps her arms moving."
Not less surprising than the violence of the attack is the ease with which it can be stopped. All the excess ceases at once on simply compressing the abdomen. The demoniac spell originates apparently in the ovary, for, on pressing the hand on the abdomen precisely at the point that answers to the ovary, the rage immediately ceases. The poor demoniac, restored to herself, casts an astonished look at the persons around her, as if she does not understand why they are there, for she was alone when she was seized, and has been unconscious since. She keeps her consciousness as long as the ovary is compressed, and is able to put the clothes in order, to talk, laugh, and enjoy herself cheerfully with her associates; but, if the compression is relaxed a little, the attack begins again with all its original force, to cease again if the ovary is compressed anew. By a coarse but intelligible comparison, the working of this pressure may be likened to the action of a faucet on the flow of water in a pipe. The flow ceases when the valve is turned off, to begin again as soon as it is turned on. The patients at the Salpêtrière understand the relation so well that, when one of them is attacked, the others straightway go to her bed and press on her abdomen, for several hours if it is necessary, till the fit is over. The attack is marked by a complete absence of mind. The intellectual life is entirely suspended, but is resumed at the end of the fit, just as if nothing had taken place. If a remark has been begun and is interrupted, it is resumed on recovery at the point where it was interrupted.
We call these attacks indifferently demoniac fits or fits of hystero-epilepsy, because it was believed for a long time that demons were the real living agents that provoked the terrible morbid phenomena. The symptoms are the same, and it is only necessary to read the description of the demoniac attacks of the past to recognize their identity in all points with the hystero-epileptic fits of the present. Esprit de Bosrager, a Capuchin father, who was charged with the exorcising of the nuns of Louviers, tells pertinently to this point: "On the day of Pentecost (1644), the same Dagon (this was the name of the devil that possessed Sister Marie du Saint Esprit) kept up for four good hours the greatest rebellion that could be imagined to prevent the girl from communicating, and during all this time he made her suffer extraordinary convulsions, threw her to the ground several times, forced her to make a hundred leaps, a hundred courses round the church, made her push at people, strike them, and throw them down . . . . Oh, what astonishing motions! what wonderful contortions! what furious rolling, sometimes into a ball, sometimes into horrible shapes! What numerous and rude convulsions in such delicate creatures, and with so frequent repetition and reënforcement! I should have to be persuaded very much, I assure you, before I would believe that sensible and judicious men would make all those convulsions pass for disease and all those wonderful movements and rollings for juggler's tricks. But what ought to convince every human mind as by a demonstration, what admits of no reply, and what all the famous doctors have acknowledged, is this: that it is quite impossible that convulsions, and such terrible ones, should come naturally by disease, should last so long, should return so frequently, should not leave lassitude after they had passed, and, finally, that they should not destroy the subject."
With all respect to the brave Capuchin, these spells of demonomania are a veritable disease. We are able to class the symptoms, distinguish the phases, the beginning, the middle, and the end, and we can affirm that the "wonderful rollings" of Sister Marie de Louviers belong to the second period of the hystero-epileptic fit.
The strange acrobatic attitudes which characterized the preceding phase are not observed in the third period. The limbs are no longer cast about in every way, in obedience to the exaggerated excitation of the spinal marrow. Cerebral life, which has been suspended since the beginning of the attack, has returned, and consciousness has, at least partially, appeared again. Now, hallucinations of every kind arise, sometimes gay, sometimes sad, sometimes amorous, sometimes religious or ecstatic. Whenever any image rises in the mind, the movements of the limbs, the expression of the face, the general attitude of the body, respond at once to its character. These poses, these passional attitudes, have a vivacity, a vigor of expression, that can not be found anywhere else. The most skillful actor would never be competent to represent fear, menace, anger, with as much truthfulness and power as these poor hysterical girls, whose demeanor is influenced by the agitations of a raving and changeable delirium. One crosses her arms and raises her eyes to heaven in an attitude of religious admiration, as if she saw the clouds opening to show her the saints or God. Another talks in tender words to her little girl, from whom she has been separated for a long time. Another sees monstrous animals, lizards with red snouts and blood-shot eyes, or enormous bats, and her features express unspeakable horror. Generally there are two types of delirium, gay and melancholy, answering to corresponding forms of hallucination. The two frequently appear in combination, taking each other's place with marvelous rapidity. M.——, says M. Paul Richer, "is with Ernest at a pleasure-party in a restaurant near Paris, where the tables are set under trellises adorned with flowers and climbing plants. At the right is a negress surrounded with strong-armed black men who are tattooed, and entirely naked, who seize her by the hair and are about to scalp her. The blood runs in streams over the face of the unfortunate woman, who utters lamentable cries, and calls for help. On the left is a very different spectacle: Ernest has a throng of friends who accompany other young women. All the personages have no other clothing than a broad, red girdle, except Ernest, who wears a Spanish costume. They sit at the table, eat oysters, drink of a white wine, sing, and laugh." Each patient generally has a form of delirium peculiar to herself, so that the different attacks in the same subject always bear a resemblance to one another. The same personages appear, the same scenes are repeated in all the attacks. The order in which the hallucinations come on does not vary, and one who has witnessed a few attacks suffered by the same patient can always judge when the end of the fit is near from the nature of these hallucinations. With one, it is indicated by a flourish of military music; with another, by the noise of a railroad-train; with another, by the appearance of monstrous animals—vipers, crows, frogs, rats. The regularity of these mad deliria is indeed surprising. Listening to the vociferations, the bowlings of the sufferers, it would seem as if chance alone directed the horrible drama. In reality, all is foreordained, regulated. The tumult goes on with the mathematical precision of a well-adjusted clock.
Fantastic as the delirium of the patients during their attack may appear, it always has a cause and occasion. The hallucinations of a demoniac resemble the real episodes of her life, particularly the one which has had the most influence in the development of her malady. It is true, as we have already said, that the principal cause of hysteria is hereditary predisposition; still, an accident is needed, an exterior provocation for the first nervous crisis, some event which may be grave or light, to determine the outbreak of a malady which has been brooding for a long time. This event is often a fright, a violent emotion, some grief, a disillusion. Then, in the attacks of delirium, the things and persons that were the occasion of the emotion—fright, grief—reappear as hallucinations. This influence of what has happened in the past establishes an important difference between the delirium of the insane and that of persons suffering from hysteria. The visions of the insane, whatever they may be, generally have no immediate relation to anterior events, while the form of delirium in hysteria is nearly always determined by an incident which has formerly played an important part in the life of the patient. The visions of beasts and monsters are common to all delirium. They appear whenever a fever has deranged the cerebral functions, and are the generally recognized marks of alcoholic delirium.
The period of delirium which indicates the ending of the attack is sometimes quite short. More often it is prolonged for several hours, and not rarely it persists for some days. The cerebral functions have been deeply troubled, and they return very slowly to their normal condition. It is, however, hardly proper to use this expression to describe the intelligence of the hysterical patients as it is observed during the intervals between their fits. Intelligence, it is true, is not extinguished; the memory, the keystone of the intellectual arch, is preserved; but the other faculties are singularly perverted. We can gain a good idea of their condition by studying the manners and the conversation of the demoniacs in the Salpêtrière. They pass the day in continual laughing at things that have nothing laughable in them—at the servant-maid who passes by, for example, at a badly made bed, at a bird that perches near the window, at a badly fastened bonnet. The same causes will as readily provoke tears. Interminable conversations are always going on, recriminations, with indignation drowned in a flood of words. With all this is combined an unceasing movement which has no real object and can not be explained. The woman must put flowers on the bolster of her bed, a ribbon in her hair, she must decorate herself with gewgaws; and the busy carefulness in these little matters contrasts with the negligence and disorder of the general keeping; a patient whose hat is adorned with ribbons will go out barefooted into the court. Odd ideas prevail, and absurd antipathies and sympathies. Hysterical patients demand, more than anything else, that other persons shall be occupied wholly with them, interested in their petty passions, that they take part in their likes and dislikes, that they admire their intelligence or their dress. They tell improbable stories, lie boldly, and are not disconcerted in the least when they are convicted of the lie. Deprived of all moral sense, they obey only because they have no alternative. No feeling of modesty or false shame restrains them; they tell their adventures to any one that comes, provided they are pleased with him, and will talk with men as freely as if they were of their own sex. Nothing embarrasses these female Diogeneses; they have an answer for everything, ask the most indiscreet questions, and tell the truth bluntly to every one. They are not deficient in self-love, and are indignant if one does not appear to be occupied with them. They never hold the same opinion long, and will pass from one sentiment to another with marvelous rapidity. No idea, no reasoning can hold them or persuade them. Their mind wanders from spot to spot without the power to settle itself, and it is as hard to fix the attention of an hysterical person upon a precise idea as it is by reasoning to induce a bird which is hopping about to stop and fix itself on a branch.
These unfortunate creatures are wholly deficient in good sense, and commit all manner of follies when left to themselves. It is necessary to be fully aware of this fact to understand why they are confined in an asylum for the insane; for when we question them, when we converse with them, we do not discover that total perversion of intelligence which we make out so easily with regard to most insane persons. We should have to see them in their working life, that is, in the midst of the exterior world, subjected to the exciting influences of every kind with which it abounds, to comprehend to what extravagances, not to use a stronger term, they will abandon themselves when no restraint hinders them. Sometimes, though rarely, they commit crimes. Most frequently they forge strings of fables to delude justice. One will cut herself with scissors, and pretend that some one has hurt her; another will feign pregnancy in order to make some one whom she hardly knows marry her; another is a kleptomaniac, and when she is in a shop steals everything within her reach, to accuse the first person that comes along of having committed the theft.
No description can be as valuable to convey an understanding of the nature of the disorders of the intelligence which hysteria causes as the simple story of a patient who has long been known at the Salpêtrière under the name of G——, and who is distinguished for the eccentricity of her disposition, as well as for the violence of the convulsions from which she suffers. G—— was born at Loudun on the 2d of January, 1843; was abandoned by her mother and put among the foundlings; after having passed her early years in an asylum, she was sent to the country. When fourteen years old she was courted by a young man named Camille, but at the end of a year her affianced died of a brain-fever. She was shut up during the funeral, to prevent a scene, but got out of the window, ran to the cemetery, and wanted to throw herself into the grave. She was confined again, but went to the cemetery in the night, calling on her lover and wishing to dig up his body. She was afterward seized with a nervous fit, during which she appeared to be dead, and continued for about twenty-four hours in a complete lethargy. After two years more of residence in the asylum she seemed to have nearly recovered; then, at seventeen years of age, she took a situation as chambermaid at Poitiers. Her nervous attacks returned in a few weeks; she pretended to be pregnant, was believed, and was sent to the hospital to be confined. The deception was soon exposed, but her attacks had assumed a graver form; she was indomitable and rebellious to all discipline, and was sent to an insane asylum. While the physician was treating her with belladonna, she hid her daily doses of pills for ten days, and then took them all at once. They nearly killed her, but she recovered. She maimed her chest with a pair of scissors, and could not tell why she had done it. She ran away from the hospital and went to Paris, but was attacked again and sent back. She was transferred to the insane asylum at Toulouse, but escaped from there and returned to Paris, walking all the way, if her story is to be believed, dressed in the uniform of the asylum, sleeping in the woods, undressing herself to wash her linen, living on bread which she asked for at the farmhouses, and being three months on the road. She made up her mind, under the pressure of hunger, to beg in spite of her pride, saying that our Lord had asked for alms, and she could do what he had done. She was arrested at a railroad-station for tearing down the placards from the walls. She was taken back to the Salpêtrière, where she gave birth to a daughter in 1867. She escaped in 1870, and became an attendant in the hospital of St. Antoine, but gave way to violence in a dispute with a nun, and was discharged. She started to go to see her daughter in Burgundy after the armistice was signed, but was detained by the Prussians, returned to Paris, and went back to the Salpêtrière. At one time, having read in the papers the stories about the miraculous Louise Lateau, she desired to go to Belgium to visit "her sister." She was attacked with a fit on the way, and met with adventures in Brussels which prevented her making her visit. She finally returned to the Salpêtrière in 1877, and has been there ever since. She suffers from frequent demoniac attacks, but is generally quite docile and reasonable in a certain measure, ready to tell, to any one who will listen to it, her long and improbable history.
The story of G—— will be read with more interest, if we are able to realize that two hundred and fifty years ago she would have been exorcised, or condemned as a witch and burned alive.