Jean-Martin Charcot and the Use of Hypnosis (2026)
Martin Catala
Department of Neurology, Assistance Publique – Hôpitaux de Paris, Sorbonne – Université, Paris, France
Correspondence: martin.catala@upmc.fr
Keywords: history of neurology, Salpêtrière, hysteria, hypnosis, pithiatism
Jean-Martin Charcot (1825–1893) was undoubtedly one of the leading figures of the French school of neurology in the 19th century. After obtaining his high school final examination in letters, he enrolled in medical school at the end of 1843. He was appointed externe in December 1846, then interne provisoire (resident in the complementary list) in December 1847, and finally interne des hôpitaux de Paris (hospital resident) in December 1848. He defended his inaugural thesis in 1853, focusing on a rheumatological condition now known as rheumatoid arthritis. He subsequently advanced in his medical career, holding positions as chef de clinique (clinic chief) (1853-1855), médecin des hôpitaux (physician of the hospitals) (1856), chief of department in the hospice of la Salpêtrière (1862), and professeur agrégé (associated professor) (1860), before becoming the holder of the chair of pathological anatomy (1873-1881) and, finally, the chair for the clinic of the diseases of the nervous system created for him in 1882 by Léon Gambetta (1838-1882).
I cannot present all of Charcot’s areas of interest here, so I will focus my work on hysteria and hypnosis. It is likely that Charcot became interested in hysteria early in his career through his contact with Pierre Briquet (1796-1881) or Pierre Adolphe Piorry (1794-1879). However, it was in 1870, with the closure of the Sainte-Laure building at la Salpêtrière, that Charcot took charge of epileptic and hysterical patients classified as non-insane.
The first mention of Charcot’s use of hypnosis dates to 1878. Charcot had been conducting lectures at the Salpêtrière hospice since 1866. In the 1878–1879 season, he began his teaching on Sunday, November 10, at 9:30 a.m. He presented cases of hysterical female patients and demonstrated the phenomenon known as transfer[1] (Charcot, 1878a). This phenomenon was discovered by chance by Marie-Ernest Gellé (1834–1923): applying either a metal or a magnet to an area that had lost sensation; after a variable period, the examiner would observe the return of sensation on the original side and the loss of that same sensation in the contralateral region. At the end of the lesson, Charcot added: “To conclude, I present to you another hysterical patient, in whom we induced a contracture of the right lower limb using a particular artifice…” (Charcot, 1878a, p.1074). And Charcot revealed the solution the following week, on Sunday, November 17 (Charcot, 1878b, p.1076-1077): “It is time to share my little secret with you: it is quite simple, and, following my example, you will be able to do the same—for I certainly do not suppose you attribute any supernatural power to me. The method works with all hysterics. One need only gaze fixedly at a hysteric to induce that special state of induced lethargy, that unconscious state of muscular relaxation and insensitivity, of which you are now witnessing the effects.” Paul Richer (1849–1933), then an intern under Jean-Martin Charcot, noted that the method used in this context had been developed by James Braid (1795-1860) of Manchester and subsequently applied by Eugène Azam (1822-1899), Paul Broca (1824-1880), Ernest-Charles Lasègue (1816-1883), Ernest Mesnet (1825-1898), and others. As it is well known by our readers, James Braid published his methods under the name neurypnology in 1843, a term that later became hypnosis. However, it is regrettable that Richer failed to mention three cases: Laurent Cerise (1807-1849) published a case of improvement obtained by hypnosis in a hysterical patient (even though he remains very cautious regarding the role of the treatment) (Cerise 1843), the case managed by the student Royer in Piorry’s department at the old Pitié Hospital (Lafon, 1848, p. 92), and the work of Paul Jean-Baptiste Desveaux in the department directed by Charles Lasègue (1816-1883) (Desveaux, 1867).
Several methods were used to induce this hypnosis. Désiré Magloire Bourneville (1840-1909) and Paul Regnard (1850-1927) described the initial procedures employed in the ward (Bourneville & Regnard, 1879-1880):
- Holding the subject’s thumbs between one’s fingers while gazing fixedly at them,
- Pressing one’s thumbs against the subject’s eyeballs after closing their eyelids,
- Seating the subject on a chair and holding an object before their eyes,
- Placing one’s hand upon the subject’s head.
Later, sounds (giant tuning fork, tam-tam) and light were also used (Regnard, 1887).
Charcot (1882) described three states induced by hypnosis in hysterics: catalepsy (the subject maintains the postures imposed by the examiner), lethargy (the subject loses strength in the limbs, which fall back heavily), and somnambulism (the subject presents an appearance similar to the previous state, but joint rigidity is present).
The Charcot school opposed the Nancy school, ostensibly by maintaining that hypnotism worked only on hysterics. In reality, the matter is not quite so simple. Bourneville and Regnard (1879–1880) wrote: “…there are few women who cannot be hypnotized; there are even some men for whom the process is extremely easy. But one proceeds more quickly and reliably by choosing a hysteric.” Georges Gilles de la Tourette (1857-1904) clarified (Gilles de la Tourette, 1889, p. 56): “… he [Charcot] never even wrote that only hysterics were hypnotizable. He simply confined himself to studying hypnotism in hysterics alone.”
Thus, the situation regarding this point is not one of such conflict. However, a crucial distinction is that Charcot viewed hysteria as a disease of the cerebral cortex, in contrast to the Nancy hypothesis, which attributed a role to suggestion. In his lecture on Tuesday, May 1, 1888, Charcot stated (Charcot, 1892, p. 281): “It is in the seat of psychic operations, in the cerebral cortex, in other words, that the phenomenon evidently takes place.” Some contemporary medical historians have mistakenly believed that Charcot’s use of the term “psychic” implied he regarded hysteria as a psychiatric condition. We can see that this is not the case and that Charcot maintained the condition had a cortical origin.
After Charcot’s death, Joseph Babinski (1857-1932), one of his closest pupils, radically changed his views on hysteria; he abandoned the idea of a neurological disease and instead adopted the hypothesis of suggestion. He even proposed a neologism, “pithiatism” (curable through persuasion), to define the disorder (Babinski, 1934, pp 457-464). Others were more severe toward Charcot, suggesting that he had been too naive and was manipulated by his patients (Avril, 1933, p. 2; Besançon, 1948, p. 89).
[1] Transfer refers to the sudden shifting of an hysterical physical symptom, such as paralysis, from one side of a patient’s body to the exact corresponding location on the opposite side.
References
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