1 The Web of Meaning
On 18 April 1883, the headline of the French newspaper Le Figaro read, in bold capitals, âHAMMING IT UPâ (âCABOTINAGEâ). Below followed a damning attack on the famous neuropathologist, Professor Jean-Martin Charcot (1825â1893). Here and in other articles, columnist FĂ©lix Platel likened Charcot to the fashionable German opera composer, Richard Wagner, claiming that Charcot:
Wagner was famous for championing the Gesamtkunstwerk, or total art work, in which all of the senses were simultaneously assaulted by different elements of performance: sound, music, voice, acting, lighting, spectacle, and design.2 Charcot and his acolytes warned against the potential ill effects of such intense neuro-affective stimulation, claiming that it could bring on hysteria or other diseases. France had, moreover, been defeated by Germany, 1870â1871, making the popularity of Wagnerâs work highly problematic for nationalists like Charcot and Platel. To call Charcot a Wagnerian was, therefore, to call him âa wogâ and a histrionic ham, an actor rather than a doctorâor more precisely, to classify him as a director and dramaturg, rather than an objective scientist.
Platelâs insulting but revealing account serves as a frame for my discussion of Charcot. The reading offered above also offers, in condensed form, an example of my approach to the topic. Anthropologist Clifford Geertz christened this âthick description,â whereby concepts drawn from a social milieu may be read against each other to reveal the complex meanings which lie embedded within commonplace terms. Geertzâs first examples of thick description were indeed theatrical scenarios. According to Geertz, the aim of thick description was to determine the difference between a reflexive act such as spasmodic contracture of the eyelid, versus the communicative act of winking which resembles this otherwise meaningless pathological action, each of which have different nuances and significance.3 Robert Darnton employed Geertzâs concept in his now classic examination of how the staged execution of cats by eighteenth century apprentices was a remarkably complex symbolic act, having social consequences whilst remaining within the realm of fiction and the symbolic. It is in the space between fiction and action, between gesture and its contextual force, that I deploy thick description to bring out such contradictions and paradoxes within Charcotâs rhetoric.
Although Charcot rarely wrote about the theatrical practices of his day, his work is redolent with theatrical concepts. This was part of Charcotâs genius: to deploy a fundamentally choreographic analysis of the body to diagnose neurological illnesses, and derivations of this remain at the heart of neurology today. This was also Charcotâs Achilles heel, drawing him into uncertain territory. Charcot conceived his approach in the final years prior to the invention of cinema. His close collaborators Paul Richer and Albert Londe indeed produced proto-cinematic stop-motion analyses of the moving body.4 Nor did Charcot himself have access to X-rays, though X-ray technology was also pioneered at the SalpĂȘtriĂšre immediately after Charcotâs death. In the context of this paucity of bio-imaging technologies, Charcotâs recourse to models of theatrical spectatorship and visual caricature (the exaggeration of bodily form to highlight diagnostic detail) was inspired. Charcot was, however, then faced with the problem of differentiating between illness and the mere performance of illness; between outward theatrical display and essence, which in turn implicitly raised the question of whether illness was itself a kind of performance. If this was the case, how does the neurologist remain aloof from fictional performance, or is the neurologist a flawed ballet master, a Svengali, or Wagnerian dramaturg, who fosters the very diseases he seeks to diagnose? These questions are implicit in the criticism which Platel offers. My aim in what follows is to show how such uncertainties came into play within the writings of Charcot and his followers, and to sketch some of the consequences.
This relationship between theatre and medicine was paradoxicalâone might say dialecticalânot only because theatre and medicine are usually seen as discrete practices. The chief feature of Charcotâs career was to make distinctions between things, not simply between the actor and the diseased individual, but between diseases. Charcot experimented with many treatments, but there were few effective therapies for major neurological illness during the late nineteenth century. What Charcot excelled at was the differential identification of disease and the isolation of the tissues or processes which lay at the root cause of illnesses. Charcotâs exceptional work on the description of illness types laid the foundations of neurology as we know it, but was at the time a novel discipline. Only by naming can one begin to search for causes and solutions. Even so, Charcot himself was, at the level of aesthetics, thoroughly imbricated in the practices and phenomena from which he sought to distance himself.
Ironically, these uncertainties at the heart of Charcotâs discourse contributed to his renown. Critics, artists, and theatre-makers exploited the confusions which this implicitly Wagnerian aesthetic offered. The writings of LĂ©on Daudet and Axel Munthe, together with plays produced under the aegis of the horror theatre of the Grand Guignol, are particularly notable as they were authored in part by Charcotâs former students. At the Guignol and in the work of Munthe and Daudet, a Charcot-figure is depicted as a diseased performer or histrionic actor within the staging or mise en scĂšne which that character had forged for his own medical practice. Platelâs critique is developed in more detail in these and other accounts. By contrast, Charcotâs former students and art historians Richer and Henry Meige sought to locate a realm within which healthy performance could be readily identified. They concluded that the aesthetic ideals embodied within Ancient Greek athletics provided the most reliable model for spectatorship of the healthy moving body, and championed such sportive events in opposition to those of the aesthetic avant-garde, the Grand Guignol, and of illness itself. This antimony within Charcotâs own circle between the dramatization of highly innervating, sensorially shocking events by Daudet, Munthe, and the Guignolâs Alfred Binet and AndrĂ© de Lorde, versus the measured Greek athletics of Richer and Meige, illustrates the fraught nature of the rapprochement between theatre and medicine which Charcot strove to maintain during his lifetime.
In his lectures and writings, Charcot developed a way of presenting his patients in the lecture theatre and in his publications that not only suited, but paradoxically echoed, the symptoms of his subjects. He nevertheless attempted to maintain a distinction between the performance of medical knowledge in the lectures, as opposed to the pathological performativity of his patients themselves. The instability of this opposition is the subject of this text as a whole. The focus of the first two sections of this book (Chaps. 2â7) is fin de siĂšcle neurology itself: a discourse which describes and pathologizes physical acts. The first section describes the frames, contexts, and evocative sitesâincluding the SalpĂȘtriĂšre and its texts, all of which acted as stages for these eventsâwherein neurology was performed (Chaps. 2â5). In the second section I move to pathological performance itself, drawing especially on Richerâs Ătudes cliniques sur la grande hystĂ©rie (1881; 1885) and the Iconographie photographique de la SalpĂȘtriĂšre (1875â1880), the latter of which is considered here less as a collection of static images than as a flip-book representation of performance itself (Chaps. 6 and 7). The closing section reveals how the theatricality of Charcotâs practice was critiqued in three main sources authored by former students of Charcot, namely Daudet and Munthe (Chap. 8), and Binetâs collaboration with de Lorde as part of the ThĂ©Ăątre du Grand Guignol (Chap. 9). Here the inversions hinted at within Charcotâs practice erupt in horrifying narratives of the doctor as patient.
As a work of thick description, my sources consist primarily of the works of the Charcot school from the 1870s through to 1925, when a flurry of eulogies and biographies was issued to mark the centenary of Charcotâs birth. Unpublished archival works have also been sparingly used. Key biographies include that authored by Charcotâs former student Paul Peugniez as well as Georges Guillainâs study of 1959.5 Although Guillain never met Charcot, he interned with Charcotâs students Fulgence Raymond, Pierre Marie, and Achilles Souques, as well as encountering former patients when he came to occupy Charcotâs professorial chair at the SalpĂȘtriĂšre, 1925â1948. Guillainâs work is treated here as a primary source, as far as discourse and imagery is concerned.
Charcotâs own output was prolific and varied. It was anthologized several times, whilst scholar Christopher Goetz has added to this material by republishing some of Charcotâs Tuesday lectures.6 The most extensive collection of Charcotâs writings includes not only the first nine volumes of the Oeuvres complĂštes which was edited by his associate DĂ©sirĂ© Bourneville, but also the Hospice de la SalpĂȘtriĂšre series (Oeuvres complĂštes, volumes ten and eleven) which was collated by Charcotâs secretary Georges Guinon. These texts are sometimes put together with Charcotâs Leçons du mardi, edited by his students Emery Blin and Henri Colin, and Charcotâs son Jean-Baptiste (Oeuvres complĂštes, volumes twelve and thirteen). Collectively, they make up a thirteen volume set, although the binding of such serialized publications was not always consistent in the late nineteenth century.7
As demonstrated within the Oeuvres complĂštes, Charcotâs work was a collaborative effort, in which his concepts were transcribed and edited by students, assistants, and secretaries, before further revision at the hands of the master. Of Charcotâs famous lectures, his leading pupil Georges Gilles de la Tourette recalled that, âHe never gave a lesson without first preparing it in long hand, documenting it to excess. Upon leaving the amphitheatre ⊠he said to one of his students: âHere are my notes, write them out,ââ whilst in other cases Charcot stated that he âwrote it entirely myselfââhardly necessary if Touretteâs description of Charcotâs notes was an accurate one.8 Whilst the precise give and take between Charcotâs lecture scripts and subsequent notation varied somewhat, the work of Charcotâs associates and supporters can be identified as that of a broadly unified school.
Charcotâs work, then, was inseparable from that of his acolytes. I draw here particularly upon the work of Paul Richer, Henry Meige, Alfred Binet, and Max Nordau. Richer and Meige both served as professors of ar...