Epilepsy and hysteria : creating or dissolving boundaries

D.P. FABER

Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool L69 7ZA, United Kingdom

 

The question addressed is : do hysteria and epilepsy throw light on the relationship between neurology and psychiatry in the nineteenth century, particularly in France ? The status of the pathologies with regard to their differing signs and how these relate to each other is described. In the case of epilepsy the prognosis for sufferers was often madness. Partly for this reason the care of epileptics was in the hands of the alienists. Lanteri-Laura (1980) also pointed out that the semeiology of  délires  and hallucinations preceded that of neurology. The latter specialization developed notably through the work of J.M. Charcot (1825-1893) in France. Institutional arrangements at the Salpêtrière hospital in Paris helped to prolong the view that epilepsy was in the same class as madness, until the sane and insane epileptics were separated in 1867, and Charcot, the neurologist took over the responsibility of the former. The presence of hysteric patients in various sections for epileptics added to the confusioon that existed in the diagnosis of these two pathologies. Hysteria was noted for its protean nature and mimicry of neurological disorders. Various relationships between hysteria and epilepsy were proposed, and it was observed that patients could suffer from both. In his description of an attack of hysteria major or  hystero-épilepsie  (the usual term), Charcot proposed a  période épileptique . He believed that neuropathology and psychiatry were related, and perhaps he could justify this by his clinical observations. When H. Landouzy proposed in 1846 twenty-three criteria for facilitating a differential diagnosis, he was, in fact, formulating two distinctive syndromes. It could still be argued that their dividing line did not create a boundary between neurology and psychiatry, but rather that continued diagnostic confusion testifies that hysteria was the bridge between the two specializations.

 

 

Panel 1B   (Evolution and Dissolution)
Tuesday, 14 September 1999
11.40

The Neurosciences and Psychiatry: Crossing the Boundaries

Joint Congress of the European Association for the History of Psychiatry (EAHP), the European Club for the History of Neurology (ECHN), and the International Society for the History of the Neurosciences (ISHN)

Zurich and Lausanne, Switzerland, 13-18 September 1999