- Hysteria and hypnotism became a favourite
topic of studies in the fin de siècle
neurology that emerged from the school organized
at La Salpêtrière by Jean-Martin
Charcot, where he had arrived in 1861. Georges
Gilles de la Tourette started working with
Charcot in 1884, and probably remained his most
faithful pupil, even after his mentor's death in
1893. This collaboration was particularly
intense on "criminal hypnotism", an issue where
Hippolyte Bernheim and his colleagues from the
Nancy school challenged the positions taken by
La Salpêtrière. Bernheim claimed
that hypnotism was not a diagnostic feature of
hysteria, and that there were real-life examples
of murders suggested under hypnosis, while
hypnosis susceptibility was identified to
hysteria by Charcot and Gilles de la Tourette,
who saw rape as the only crime associated with
hypnotism.
-
- The quarrel was particularly virulent during
a series of famous criminal cases which took
place between 1888 and 1890. At the time, it was
considered that La Salpêtrière had
succeeded over Nancy, since the role of
hypnotism was discarded during these famous
trials. However, the theories of Charcot and
Gilles de la Tourette were also damaged by the
fight, and this probably triggered the
conceptual evolution, which led to Joseph
Babinski's revision of hysteria in 1901. Gilles
de la Tourette's strong and public interest in
hypnotism nearly cost him life, since in 1893, a
young woman who claimed to have been hypnotized
against her will shot him in the head at his own
home. It was subsequently shown that hypnotism
has nothing to do with it, and the delusional
woman escaped a trial, being interned at
Sainte-Anne for mental disturbance. Ironically,
his victim may have been partly responsible,
since he had been one of the strongest proponent
of placing mentally-ill criminals in asylums
instead of prison.
-
- La Salpêtrière is a place
where, in the middle of the nineteenth century,
nervous system diseases started to be organized
into what would become modern times neurology.
Jean-Martin Charcot was the driving force of
this evolution, after he started his work in
that hospital on 13 November, 1861. Soon, he
became surrounded by pupils and colleagues, who
formed what became known as La
Salpêtrière school. These included
Victor Cornil, Charles Bouchard, Charles
Féré, Paul Richer, Fulgence
Raymond, Pierre Marie, Henri Meige and many
others, among whom Joseph Babinski and Paul
Sollier were said to be his most gifted
followers (1). Georges Gilles de la Tourette
belonged to the closest group of Charcot's
pupils, after he started his work with him in
1884 as an interne, becoming his chef de
clinique in 1887 and his personal secretary in
1892 (fig. 1). While Gilles de la Tourette's
name is now specifically associated with the
disease that bears it, at the time, his best
recognized activity clearly was in the
management of hysterics and hypnotism (2).
- Hysteria and hypnotism in Charcot's
circle
-
- In neurology, the second half of the
nineteenth century was dominated by the study of
two diseases, tabes and hysteria. Probably with
the suggestion of his interne
Désiré-Magloire Bourneville (3),
Charcot's interest in hysteria developed mainly
after 1870, when he became in charge of the
Delasiauve service, where mainly epileptics and
hysterics were admitted (4). This interest also
developed within a general public fascination
for "animal magnetism" and "mesmerization" (fig.
2), often leading to occult practices and
charlatanism, which had gained a considerable
place after Franz Anton Mesmer studies at the
end of the eighteenth century. Distorsions also
involved the medical milieu, as shown by the
experiments of Jules Bernard Luys (5), when they
became set up by his chef de clinique
Gérard Encausse, also known as "mage
Papus" in his parallel, successful, activity of
occult practices in secret societies. Charcot
considered hysteria as a "neurosis" with an
organic basis, but with no demonstrable cerebral
damage, and where a "dynamic lesion" of the
brain was responsible for the "stigmatas"
(sensory dysfunction, hyperexcitability, visual
field narrowing), i.e. permanent clinical
features, in patients who were also prone to
paroxysmal fits (grandes crises
d'hystérie) (6). The "dynamic lesion" was
emphasized by Charcot in order to explain the
organicity of hysteria in the absence of a
morphological lesion. However, Charcot's views
on hysteria evolved over time, frequently in a
contradictory way (7), and shortly before his
death in 1893, he had started to introduce
psychological considerations, which had already
been mentioned by Bénédict
Augustin Morel, Charles Lasègue and Jules
Falret in the early 1880s (3). For him, "trauma"
became a critical factor, which acted both as a
triggering factor and as a mental representation
after an often prolonged latency phase, a
concept which was at the origin of the first
ideas developed on hysteria by Freud and Breuer
in the 1890s (7).
-
- Probably influenced by Charles Richet's work
on "provoked somnambulism" in 1875 (8), Charcot
started to use hypnosis with hysterics in 1878,
and his ideas were summarized in Richer's book
on "hystero-epilepsy" in 1881, where hysteria
and epilepsy were both considered as organic
neuroses with no visible brain lesion (9).
Charcot and his school considered the ability to
be hypnotized as a clinical feature of hysteria,
and they repeatedly used this phenomenon in
public demonstrations, which became popular
shows among an intellectual, non-medical,
cenacle (10). For the Salpêtrière
school members, susceptibility to hypnotism was
synonymous with disease, i.e. hysteria, although
they later recognized, during a prolonged
quarrel with Hippolyte Bernheim and the Nancy
school (11), that grand hypnotisme (in
hysterics) should be differentiated from petit
hypnotisme, which corresponded to hypnosis of
ordinary people (6). Soon during these
controversies, medical-legal aspects appeared,
addressing whether hypnosis could or could not
influence certain people to commit reprehensible
or criminal acts. Charcot himself took firm
positions against this hypothesis (12), but in
this issue, this was Gilles de la Tourette, who
always remained faithful to Charcot's ideas, who
played the most critical role.
-
- Charcot's faithful disciple : Georges
Gilles de la Tourette
-
- Georges Albert Édouard Brutus Gilles
de la Tourette (2, 13, 14) was born on 30
October, 1857, in Saint-Gervais nearby
Châtellerault, before starting his medical
studies at 16 years in Poitiers. After going to
Paris in 1876, he became interne provisoire in
1881 and interne titulaire in 1882, working with
Charcot in 1884 and with Paul Brouardel, a
medical-legal expert, in 1885, before his
doctorate thesis on gait disorders in 1886.
After his appointment as Charcot's chef de
clinique in 1887, his career closely followed
the one of his mentor until his death in 1893
(the "black year", since Gilles de la Tourette
also lost his 5-year-old son from meningitis).
In 1892, he was candidate to the
agrégation professorship contest, along
with his predecessor as Charcot's chef de
clinique Babinski, both of them being rejected
after Bouchard, the president of the jury and
former interne of Charcot, organized an intrigue
to eliminate his former master's
protégés in favour of his own
candidates. But contrary to Babinski, Gilles de
la Tourette was again candidate and was accepted
as professor a couple of years later (15). His
scientific production is now dominated by his
1885 report on incordination motrice
accompagnée d'écholalie et de
coprolalie (16), named by Charcot tic convulsif,
and which subsequently became identified as
Gilles de la Tourette's disease. His interests
were not limited to medicine, but included
history and literature, as shown by works on
Théophraste Renaudot and theatre. When
addressing hypnotism and hysteria, he also
studied ancient historic reports, such as the
cases of the "possessed nuns" at Loudun in 1634
(17). In 1888, he founded the Nouvelle
Iconographie de la Salpêtrière with
Albert Londe and Richer, and in 1900, with the
help of Bourneville, he was appointed chief
physician of the Exposition Universelle. Gilles
de la Tourette was jovial and emotional, and
Freud described him as an "authentic meridional"
(2), while he had no origin in Southern France.
During the last months of the century, he
started to show a disturbed behaviour (fig. 3),
which worsened and necessitated that he left
Paris for Switzerland with his family and
Charcot's son Jean-Baptiste, who had him
admitted on 28 May, 1901, to the Lausanne
psychiatric hospital in Cery, using a deceiving
trick (Jean-Baptiste told him that a famous
patient was waiting in Cery to be examined by
him). He was never to leave this hospital, being
deprived of all his civil rights in 1902, before
he died on 22 May, 1904. Diagnosis was tertiary
syphilis, with general paresis, ironically a
disease for which he had claimed, along with
Charcot, that no relationship existed with
syphilis.
 - Hypnotism and crime
-
- The medical-legal interest of Gilles de la
Tourette had developed under his training with
Brouardel (who authored with Charcot the preface
of his pupil's 1887 book on medical-legal
aspects of hypnotism) (18) were not limited to
hysteria and hypnotism, but also included topics
such as abortion and political murder (he made a
report on the anarchist murderer Ravachol) (2).
Besides, he made an important statement on the
necessity to admit mentally disturbed criminals
to asylums rather than to prison. In this field,
his friendship with the journalist and writer
Georges Montorgueil was important in
facilitating public awareness, as shown in 1894
with Dr. Lafitte case, when Gilles de la
Tourette and his friend the journalist Georges
Montorgueil supported in the newspaper
L'Éclair the practitioner who had been
accused of illegal abortion on a young woman
(2).
-
- In 1887, Gilles de la Tourette published his
major work on hypnotism and its medical-legal
aspects (18), dedicated to Charcot and
Brouardel, who had authored the preface. He was
faithful to his mentors' ideas on susceptibility
to hypnotism as a feature of hysteria, and on
the fact that most crimes could not be committed
under hypnosis, except certain rapes (but it was
the victim who was hypnotized) and possibly
thefts. According to him, there were three
states of grand hypnotisme: lethargy, catalepsy,
and somnambulism, plus certain initial states
(lucid lethargy, fascination, and charm state)
(pp.103-109). While the hypnotized subjects
could be called "automatons", they kept a
conscious state, which made them unable to
perform acts which would go against their inner
nature. On the other hand, they could be
submitted to certain reprehensible acts, such as
rape, mainly while in the lethargic state, in
which muscle relaxation is compatible with the
forfeit ("a rag at the mercy of the first
by-comer", p. 491). To support his views, Gilles
de la Tourette quoted several famous rape cases,
include the case of Marguerite A… in 1858,
the Castellan case in 1865, the Lévy case
in 1878, and the Maria F… case of Ladame in
1881. He vehemently criticized assumptions by
Hippolyte Bernheim and Jules Liégeois
from the Nancy school (19) that other crimes
(with the exception of rare cases of theft)
could have been committed by innocents
malevolently hypnotized. For him,
Liégeois' hypnotic experiments with fake
weapons (20) were biased and artefactual, and
did not support a significant role of hypnotism
in real life crimes. Gilles de la Tourette also
complained of the current fashion of charlatan
esoteric practices using hypnosis, advising that
hypnotism be reserved to medical use in a small
number of specific patients (i.e. hysterics). A
major, public, debate occurred in 1888 on the
occasion of the Affaire Chambige, when the
22-year-old Henri Chambige was found wounded
beside the naked corpse of the older Madeleine
Grille, a well-respected married woman: Bernheim
sustained that the woman had been hypnotized,
raped and killed by Chambige, who subsequently
attempted suicide, but much controversies
arouse, and even the famous magistrate Gabriel
Tarde claimed that "this is love, which is
hypnosis!" (21). Two years later, Charcot
published in the non-medical American magazine
"Forum of New York" an article on "hypnotism and
crime", in which he re-affirmed that the only
crime associated with hypnosis was rape (22),
while Gilles de la Tourette published between
1891 and 1895 his opus magnum on hysteria "as
tought at La Salpêtrière school"
(6), the proofs of which Charcot was correcting
on the trip to the Morvan region with Isidore
Straus and Georges-Maurice Debove, during which
he died.
-
- Against Nancy
-
- The most animated and public controversy
between the Salpêtrière and Nancy
schools took place in 1889-1890 on the occasion
of the Eyraud-Bompard case ("Gouffé's
trunk"), which was summarized in a book the
following year by the forensic expert A.
Lacassagne (23). The story fascinated the press
and the public (fig. 4). In short, after having
been lured by a young woman, Gabrielle Bompard,
the bailiff Gouffé had come to her
apartment, where Gabrielle managed to have him
sit on a chaise longue, behind which her lover
Michel Eyraud had hidden a hanging system, which
he could operate from behind a curtain. During
preliminaries, Gabrielle sat on Gouffé's
knees and as if in play, she slipped the belt of
her red peignoir around his neck and attached it
to the prepared swivel. Eyraud just had to pull
on the other end of the cord system, hanging
Gouffé who died within two minutes. The
murder was a flop, since no money could be found
on the bailiff or at his office, and the
murderers left Paris for Lyons the next day with
a huge trunk, which Gabrielle had bought in
London, containing the victim. They abandoned
the corpse nearby Lyons and destroyed the trunk,
before flying away. After several months of
investigations, Gabrielle finally gave herself
up, while Eyraud was arrested later. The
inappropriate, childish, indifferent, and
seducing behaviour of Gabrielle was immediately
observed, and brought by her lawyer, the issue
arouse that she had been hypnotized by Eyraud
all along during the murder and its preparation
(24). Bernheim supported that hypothesis (19),
which was reinforced by the fact that Jules
Voisins hypnotized Gabrielle several times in
jail. Because of a broken leg, Bernheim could
not attend the trial and was replaced by
Liégeois, who put forward his own
experiments of suggested murder during hypnotism
using fake weapons (20). However, his arguments
were demolished by Brouardel, Gilbert Ballet,
and Auguste Alexandre Motet, who closely
followed the Salpêtrière views that
except rape, no crime &endash; in particular
murder- could be the consequence of hypnotism.
They concluded that Gabrielle had no mental
disease, but was an incomplete being with a
total halt of development of moral sense,
contrasting with good intellectual development.
Eyraud was guillotined, and Gabrielle was
sentenced to twenty years. In 1891, Gilles de la
Tourette published a famous Épilogue,
followed by a correspondence between him and
Bernheim (25), in which he fully supported the
conclusions of the trial after the report by
Brouardel and colleagues. However, this
"victory" was not without collateral damage for
La Salpêtrière school. Private
letters from Charcot to Gilles de la Tourette
show that the former was considerably
disquietened by the controversy, which had
considerably altered the image of medical
hypnotism, according to him: "I am very anxious.
Bernheim did not know and I have the proofs of
your épilogue. Did he change his mind,
and what to do (…)?" (2). Two years later,
Gilles de la Tourette remembered that his mentor
was deeply affected by the fact that as a
result, he believed that hypnotism had been
damaged for at least ten years (2).
-
- In his Épilogue (25), Gilles de la
Tourette criticized Liégeois hypnotic
experiments of suggested murders with fake
weapons (20). However, it is striking that a few
years before, he had done similar experiments in
the La Salpêtrière laboratory,
which he reported in detail in his 1887 book on
hypnotism (18): H.E…, an hysteric patient
from the service was told under somnambulism to
shoot an interne (Mr. B…) when she would
have waken up, because he was not treating her
well. She was given a ruler, while told that
this was a gun, which she refused to give back
after being put awake ("she would kill the
person who would try to take it from her"). When
Mr. B… came in, she waited until he was
close enough and "shot" him, subsequently
explaining in cold blood that this was normal,
since his treatment for her was poor. Gilles de
la Tourette continued with the even more famous
case of Blanche Wittman, the celebrated hysteric
patient fainting in Babinski's arms in front
Charcot in the 1887 painting by Brouillet, and
who stayed at La Salpêtrière
between 1879 and 1893, before going to work at
Marie Curie's laboratory. Gilles de la Tourette
put her under lethargy with a gong noise and
under somnambulism with a friction on the
vertex. The experiment took place in front of a
rather large audience, which included the
theatre play author Jules Clarétie.
Blanche was told to poison Mr. G… just
because this was an order. After waking up, when
Mr. G… came in, she proposed him some beer,
in which Gilles de la Tourette had shown to her
that he had introduced some "poison", when she
was under hypnosis. She used some manipulative
words to have Mr. G… drink, and even
accepted to be kissed by him as an
"exchange"…After the "death" of Mr.
G…, Blanche never admitted the poisoning
during a fictitious investigation, and Gilles de
la Tourette concluded that Blanche had shown
"all feminine seductions, in such a natural way,
that a non-informed person would certainly have
been deceived". These case reports illustrate
the inner contradictions of La
Salpêtrière school in the
controversy with Nancy. Nevertheless, Gilles de
la Tourette himself evolved little on that issue
after Charcot's death, and several years later
he sill mentioned that he did not accept the
Nancy views on murders committed under hypnotism
(2).
-
- The ambiguous, sexually-flavoured,
communication between the
Salpêtrière doctors and their
hysteric patients is well shown by the "kiss"
episode, and it should be seen in the
perspective of the time, when the notion that
hysteric women were seducers was building up.
While susceptibility to hypnosis was emphasized
as a constitutive feature of hysteria, the
concept was simultaneously somewhat inverted,
with the issue of men being put under influence
(i.e. "hypnotized") by seducing, manipulative,
women. Gouffé's trunk case was a good
example in highlighting Gabrielle Bompard's
childish, apparently irrational but in fact
emotionally and sexually manipulative,
behaviour, so that she was even depicted as a
"cold monster" (26).
 - Criminal hypnotism at home?
-
- Gilles de la Tourette also experienced in
his private life the consequences of the
particular atmosphere which surrounded hypnotism
at the Belle Époque, since on 6 December,
1893, he was shot &endash;for real- at his home
in Paris by Rose Kamper-Lecoq, a 29-year-old
former patient from La Salpêtrière
and Sainte-Anne, who later claimed that she had
been hypnotized at distance (2, 13). Gilles de
la Tourette had just published a newspaper
interview with Montorgueil against the
unwarranted use of hypnotism and
"mesmerization", and this may have been a
trigger to the assault (14). Rose asked him for
some money, claiming that she was without
resources, because hypnotism sessions had
altered her will, and shot him when he refused.
There were three shots, with only the first one
reaching its target, fortunately for Gilles de
la Tourette with only a superficial occipital
wound, so that the same evening, he was even
able to write to Montorgueil about the event
(fig. 5). The patient did not try to escape, and
was quietly sitting in the waiting room when
people arrived. The story was reported in detail
by Georges Guinon in "Le Progrès
Médical", because rumors of an attempted
murder under hypnotism were spreading, while the
investigation report clearly showed that
interpretative delusional thoughts were the
reason of the act (27). The patient indeed
claimed that she "knew" that Gilles de la
Tourette was in love with her, and that previous
hypnotism sessions had transformed her in
annihilating her will, allowing a new spirit,
now in herself, to force her to kill him. She
also pretended to be in communication with the
czar, and had already threatened other famous
people in Paris. Brouardel, Ballet, and later
Jules Falret declared her insane with "fixed
ideas", and she later attacked a nurse with a
fork. For this reason, and contrary to what has
been previously reported (14), there was never a
trial, and the patient spent several years in
mental hospitals, while the association with
hypnotism and the assault was definitively
discarded.
- The path initiated and followed by Charcot
on hysteria and hypnotism at La
Salpêtrière was faithfully followed
by Gilles de la Tourette. However, Gilles de la
Tourette stopped working less than eight years
after his mentor's death, and we do not know
whether his evolution on that topic would have
been different with time. Other close pupils of
Charcot, such as Féré or Alfred
Binet, distanced themselves from an
intransigeant position on the Nancy-
Salpêtrière controversy (3, 24).
This was also the case of Babinski, who in 1891
was still giving a "pure Charcot"- type of
lecture on hysteria and hypnotism at La
Salpêtrière (28), before seriously
revising his views in the process which would
lead to the concept of pithiatism ten years
later (29).
-
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-
La
maladie de Gilles de la Tourette
- GE Gilles de la Tourette La
maladie des tics convulsifs (pdf)
- Contribution
à l'étude des bâillements
hystériques Nouvelle Iconographie de La
Salpêtrière1890
- Traité
clinique et thérapeutique de
l'hystérie d'après l'enseignement
de La Salpêtrière1895
- Gilles
de la Tourette par P. Legendre pdf
- Attentat
contre Gilles de la Tourette 07/12/1893
- La
nécrologie La Presse Médicale 4
juin 1904
- La
nécrologie Nouvelle Iconographie de la
Salpêtrière 1904
- The forgotten
face of Gilles de la Tourette: practitioner,
expert, and victim of criminal hypnotism at the
Belle Époque Bogousslavsky J
Walusinski O
- Criminal
hypnotism at the Belle Époque : The path
traced by Jean-Martin Charcot and Georges Gilles
de la Tourette Bogousslavsky J Walusinski O
Veyrunes D
- Correspondance
inédite de G. Gilles de la Tourette, sa
maladie fatale Walusinski O. Duncan G
- Correspondance
inédite de G. Gilles de la Tourette avec
JM. Charcot et G. Montorgueil Walusinski O.
Duncan G
- Vivre ses
écrits, l'exemple de G. Gilles de la
Tourette Walusinski O. Duncan G
- G.
Gilles de la Tourette 1857-1904 in
english
- L'état
mental de Froufrou G. Gilles de la Tourette
1892
- Mademoiselle
Bottard par G. Gilles de la Tourette
1898
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