Charcot and hallucinations: A study in insight and blindness.

Abstract

Jean-Martin Charcot (1825-1893) showed little interest in mental disorders, the domain of nineteenth-century alienists. But hallucinations are not confined to the field of psychiatry, and Charcot, who had once tested the hallucinogenic effects of hashish in his youth, went on to describe hallucinations in the course of various neurological conditions as just another semiological element. Most of his or his disciples' writings on hallucinations can be found in his work on hysteria. Hallucinations and delusions were part of "grand hysteria" and occurred at the end of the attack (third or fourth phase). Hypnosis or chemical agents could also induce hallucinations. Charcot and his disciples did not go so far as to emphasize the importance of hallucinations when they evoked past trauma, especially sexual trauma. Charcot's materialistic orientation led him and his disciples-especially D. M. Bourneville (1840-1909), G. Gilles de la Tourette (1857-1904), and the neurologist and artist P. Richer (1849-1833)-to seek hysteria in artistic representations of "possessed women" and in the visions of nuns and mystics. Finally, Charcot recognized the importance of hallucinations in neurological semiology, by means of precise and relevant observations scattered throughout his work. Preoccupied with linking hysteria to neurology, Charcot only scratched the surface of the possible significance of hallucinations in this context, paving the way for the work of his students Pierre Janet (1859-1947) and Sigmund Freud (1856-1939).