Acting out in the asylum

BIOGRAPHY: ANNE HAVERTY reviews Medical Muses: Hysteria in Nineteenth Century Paris By Asti Hustvedt Bloomsbury, 372pp

BIOGRAPHY: ANNE HAVERTYreviews Medical Muses: Hysteria in Nineteenth Century ParisBy Asti Hustvedt Bloomsbury, 372pp. £16.99

IN THE PARIS of the later 19th century the humble 13th arrondissement was home to a small group of unlikely celebrities. Crowds – artists, writers and socialites prominent among them – flocked to see these comely young women perform their weekly shows. But the theatre was a hospital, the Salpêtrière, the performers were not actors but patients, and the impressario was the famous self-styled neurologist Jean-Martin Charcot.

The Salpêtrière was both a conventional asylum and a refuge for women unwanted by society or who themselves were unable to cope with it – the disabled or deficient in one way or another, homeless, single and pregnant, or simply old and poor, but all of them liable to an inexplicable illness of women known as hysteria. We may know of it in our time as the hospital Diana, princess of Wales was brought to, with what seems like pathetic irony, after that car crash in the Alma tunnel.

More than a century ago, the Salpêtrière was an ignominious place to fetch up in for the staff nearly as much as for the inmates, so it was surprising that the talented and ambitious Dr Charcot should choose to become its chief physician. An acolyte of his, Sigmund Freud, said later that Charcot was inspired by “the wilderness of paralyses, spasms and convulsions” he saw there.

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Charcot was a man of his time. This was the age of scientific positivism, and he was determined to classify and explain the origins of the weird but intriguing and often spectacular symptoms of hysteria. The intermittent and apparently random set of symptoms, which included tremors and theatrical poses, flailing limbs and paralyses, fantasies, wilful starvation and self-mutilation, were not symptoms of insanity he said, nor of the peculiarly complex and volatile female physiology – the very word hysteria has a uterine etymology – but had an organic origin in the nervous system.

He wrote articles and books on the subject and gave inspiring lectures in which he acted out the symptoms he had observed in his subjects; to use the word “patients” seems inappropriate, as restoring them to health wasn’t the issue for him. Charcot saw his role as one of observation, categorisation and demystification. Using his resident and generally compliant hysterics, he gave public demonstrations, which became hugely popular, of how a hysterical episode could be initiated and then arrested using what he named “ovarian compression”. The dubious technique of ovarian compression was a tacit reversion to the theory of uterine instability as a cause of hysteria, but Charcot wasn’t a man who worried about inconsistencies.

In his time too the new art of photography was flourishing, and photographers came to photograph his celebrated demonstrations. Their images of young women in emotional trances were published and widely circulated across Europe. Hysteria itself became fashionable. Paris was for a time established as “the hysteria capital of the world”. “We are all hysterics,” said Guy de Maupassant.

Naturally, much of the interest was focused on Charcot’s subjects. Asti Hustvedt concentrates on the three who would become the stars of the Salpêtrière because they were the most attractive and possibly the most compliant. They were Blanche, known as the Queen of Hysterics; Augustine, who continues to be something of an icon because she was highly photogenic; and Geneviève. They all had childhoods and backgrounds awful enough to incite hysteria – which may be more than anything a form of escape – one would think, without having to look for any other reason.

Blanche’s father was violent; her mother was a frail woman unable to cope with her work as a washerwoman. She saw five of her siblings die of convulsions. She herself suffered convulsions that left her intermittently deaf and mute. At 13 she was sent to work for a furrier who molested and beat her. Soon after, she ran away and returned to her mother, to whom she was close; then her mother died. For want of anywhere else to go she returned to the furrier and was regularly raped over a period of months. She arrived in the Salpêtrière at the age of 18, suffering from convulsions and losses of consciousness.

Augustine was fostered in early infancy and returned to her parents in Paris only when she was 12. By then she had been brutally molested by the husband of a friend. Almost immediately her mother betrayed her by effectively selling her to her employer, who was also her lover. He raped the child by threatening her with a razor. A few days later she suffered her first hysterical convulsions. When she became promiscuous and the convulsions worsened, her mother brought her to the Salpêtrière.

Geneviève’s story was one of loss. An orphan brought up in a foundling hospital, fostered with several different families and always sent back to the orphanage before very long, the catalyst in her own view for her hysteria was the death at 14 of the boy she was in love with. Her case is perhaps the most fascinating and most mysterious because her symptoms – crucifixion poses, stigmata and ecstasies – mirrored those of the saint or mystic of tradition and to her were real, while to Charcot and his disciples they were satisfying proof that saints and mystics could be reclassified as hysterics.

All three were women of independent character. Blanche often rebelled against Charcot’s control. Augustine finally escaped from it disguised as a man. Geneviève liked to leave periodically to walk the byways of France on solitary pilgrimages.

Yet what emerges most vividly perhaps from Hustvedt’s account is an image of the Salpêtrière as a haven. When their symptoms abated the women could work there in what was virtually a village, with its own workshops, cafe, boulangerie, épicerie, tabac and even marchand de vin. Whatever can be said about Charcot and the collusion of his patients in his demonstrations, his rule was benign and empathetic and run on scientific methods. It was always a kind of home for a vulnerable woman to return to.

The whole experiment raises fascinating questions about the myriad of illnesses that can be lumped under the umbrella of “hysteria”, down to our own time. We can claim to be no wiser than Charcot finally about phenomena such as anorexia and self-harm. Even he was reduced to Hamlet’s comment that “there are more things in heaven and earth, Horatio . . .”

Hustvedt provides a meticulously researched investigation. If only she had let herself go a little . . . And I would have thought that Charcot’s influence on Freud deserved a chapter.


Anne Haverty is a novelist and poet. Her most recent novel, The Free And Easy, is published by Vintage