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15 juillet 2009
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Criminal hypnotism at the Belle Époque :
The path traced by Jean-Martin Charcot
and Georges Gilles de la Tourette
Julien Bogousslavsky , Olivier Walusinski, Denis Veyrunes
Living his writings :
the example of neurologist Georges Gilles de la Tourette
(version complète pdf)
Living His Writings:
The Example of Neurologist G. Gilles de la Tourette
 Walusinski O, Duncan G. Movement Disorders in press
G. Gilles de la Tourette interne de JM. Charcot
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.

gilles de la tourette et charcot
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.
gilles de la tourette
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).
la progres illustre
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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Traité clinique et thérapeutique de l'hystérie d'après l'enseignement de La Salpêtrière1895
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La nécrologie La Presse Médicale 4 juin 1904
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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
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