At the Hospital 'La Salpêtrière'
A Clinical Lecture of Doctor Charcot
by Sofya Niron [a.k.a. Sofya Kovalevskaya]

translated from the Russian by Joan Spicci with Ivana Cerna
©2002 Joan Spicci Saberhagen


What a surprise. I certainly didn't expect to meet a Russian lady in the role of Dr. Luys's hypnotic 'subject' in Paris. Where, oh where has fate taken our countryman.

"What's this about a Russian lady, that Dr. Luys spoke of?" I ask Dr. Berillon on the way home.

Dr. Berillon knows her well and he told me her whole sorrowful tale.

More than fifteen years ago a lone Russian lady came to study in Paris. She began to attend lectures in the medical academy, but she studied haphazardly, without a plan, without prior preparation. Her parents had died and left her a small fortune, which she used to live on in Paris. But her life here turned out unhappily. For some reason she didn't join the circle of Russian students. French students were haughty, derisive. Only with one of them, G-r, she, for some reason, became close, for what reason -- God knows. She was a pure-blooded Russian girl according to her tastes and habits. He certainly was a genuine Parisian, with an innate esteem for luxury and comfort and, at the same time, a boulevardier, to the core. Well, it seems, what could they have in common? But they got together. He didn't love her at all and, after having helped her spend her small capital, not only did he grow cool towards her, but even came to hate her. She loved him passionately, undyingly, with a kind of hardness and obstinacy.

He betrayed her constantly. She shadowed him, watched for him at night on the streets. He drove her away, even hit her, and moved to another apartment in order to be rid of her. Nothing helped. She became a legend among the whole Latin quarter. This went on for years. She was penniless. How, by what means, she survived -- only God knows. Once some relatives showed up and offered to take her back to Russia. She refused, preferring to endure both hardships, and hunger, just so she wouldn't have to leave Paris, she wouldn't have to go away from him.

Meanwhile, he was unlucky in life. He didn't pursue a career, he didn't acquire a position, his health deteriorated. Youth was gone and approaching his fortieth year, he found himself, just as she, un dé cavé [a disgraced person], without a fixed means to live now, and no hope for the future. So they again got together.

She developed some kind of a nervous disorder. They admitted her to Salpêtrière. Charcot found her illness very interesting and began to experiment on her with hypnotism. At this time hypnotism had just come into vogue. She proved to have a surprising susceptibility to it. Now her superficial friend realized that he might derive a benefit from his unfortunate friend. She became a professional subject of hypnotism and he, her friend, became her manager, her impresario.

But what a difference between her and the usual somnambulant! The usual somnambulant are all fools, coarse, ignorant. They are collected from the lowest tiers of society. It is impossible to trust them. She certainly is an intelligent, educated woman, at one time attending a medical course. And besides she is Russian, and now all Russians are in vogue in Paris.

This somnambulant is pure treasure. It stands to reason, she will not foretell the future and will not tell fortunes with cards as her friends do at fairs. No, Dr G-r invented a more profitable and far more scientific method. He brings his traveling companion to all the well know professors engaged in hypnotism, and, from a love of science, proposes that they carry out experiments on her, of course, without pay. And he presents her to each professor exactly in the specialty in which that professor is interested.

The doctors habitually are left delighted by the intelligence, and quickness of the patient, gifted with the highest degree of susceptibility to hypnotism. The great Charcot himself announced that he had never dealt with such an intelligent 'subject' as she. Having secured recommendations and the patronage of the great maîtres [master], it wasn't difficult to obtain invitations to private hypnotism seances which now are in great demand in Parisian society and at which they pay the 'subject' up to 500 francs per evening. They say, the business of this little couple goes so well that Dr G-r not only no longer runs away from his beloved, but just the opposite -- for days he took her to the mayor, so that he might legally tie the marriage knot on this his useful little union. Well, this is the kind of unexpected result hypnotism can sometimes bring about.


"I advise you not to go to the seance at Dr Luys's tomorrow. It certainly will be unpleasant for you to see your countrywoman in such a degrading role. Besides, from what I know of them, I am convinced that right from the very beginning the couple will devise some kind of exploitation of their acquaintance with you." Dr. Berillon told me. He himself relates honestly and seriously to the question of hypnotism and that is why he sustains an almost personal hatred for everyone, who wishes to make a farce out of it.

Actually, no matter how interesting it would have been for me to see my 'famous countrywoman' and to draw comparative parallels between Russian and French somnambulants, never the less, I decided to decline the invitation of Luys -- especially since on this very day there was the prospect of going to the clinical lectures of Charcot at La Salpêtrière.

Salpêtrière is the largest hospital for women in all Paris. The personnel at Salpêtrière, counting patients and staff, approaches five or six thousand -- a whole city. At Salpêtrière there is a department for those suffering from cancer and another for the incurables, -- a kind of almshouse. But the main contingent of the patients is drawn from the nervous, the hysterical and the mad.

Unwillingly you experience a strange feeling, as you walk one area after another, ward after ward, and all around you, you see the yellowish-pallor, the nervous motion, the surprisingly asymmetric faces which characterizes this family of patients.

Recently so much has been written and spoken about Salpêtrière that there is one name, Charcot, that arouses its own kind of sentiments. Charcot is the sovereign in the kingdom of neurosis. Everyone here relates to him with reverence, bordering on servility. And his appearance actually is as imposing as a general's. There was no appeal to informality, to familiarity, which I noticed at Luys's. Charcot is stingy with words, and his words must be caught as they fly by. And I doubt that anyone of the patients got it into his head to call him mon gros [my fat one], no matter which of the three stages of hypnotic sleep opened by Charcot she found herself in. Interns present to him their reports on patients with such a servile manner that unwittingly the words came to mind: ATTENTION! I myself saw how terribly, excessively embarrassed and disoriented one intern became when Charcot gave him some kind of disapproving reprimand. If Luys were in Charcot's place, the intern, probably, would not only not be embarrassed, but even, for all I know, he might enter into a squabble with the professor.

Today's lecture is conducted strictly as a preparation for a large public lecture, which Charcot is giving in a few days in a great auditorium. Today they are admitting only a select few. Consequently, I imagine myself in the situation of becoming acquainted, so to say, with the behind the scenes preparations of a great master. Sometime ago accusations against Charcot appeared in print from a number of different sources claiming that in his clinical lectures he presents all the same patients, who are exposed beforehand to a complete course of education in hypnotism at Salpêtrière. Therefore now he has begun to adhere to a different system -- to vary as much as possible the selection of his live medical assistants. That just now is what is going on, namely the sorting of patients: each intern presents those patients having been entrusted to his care, who seem to him for some reason or other interesting in their medical condition, and from a number of these Charcot selects some on whom he confers the honor of serving as living illustrations of his theories. All these patients await their turns in a room that isn't very large. We have gathered along the sides of the room, as one by one the patients are brought to the professor.

This examination leaves an extremely painful impression. Probably, in the majority of various clinics affairs are conducted precisely in this manner. But being very much unaccustomed, it is difficult to watch all this chair à expérimentation médicale [meat for medical experimentation; cannon fodder] and that is precisely the way Charcot relates to all these women patients, as if they are medical specimens and nothing more. He associates with them extremely unceremoniously. It never crosses his mind that they might have feelings. He examines, he taps at them, he parades their ailments for the view of students as indifferently and unfeelingly as if he did this on a mannequin. And there and then, aloud, to their face, presents a diagnosis and frequently announces very highly unfortunate prognoses for them. He is not troubled that this is how they obtain their own personal verdict. All these patients, it seems, are not paid. To them these appearances are to pay for the medical advise given them.

Today the majority of the examined patients represent very severe forms of local lesions of the nervous system. Some of them are not able to remain standing. They are pushed in chairs and at the time of the examinations they are supported on both sides, otherwise they would fall. One patient especially is in a terrible state. She understands everything. Her intellectual ability is not weakened at all, but all the motor nerves have gone out of control. They are not paralyzed -- they function, but in the entire locomotive system a kind of tangle has occurred. So, for example, the patient wants to extend her hand, in order to take a glass, but in place of this she suddenly sticks out her tongue or her leg tries to go up.

"You must take this glass with your hand, and not with your leg or tongue. Try, try again," Charcot screams at her.

The patient, obviously, recognizes better than anyone the absurdity of her motions. She blushes, becomes confused, she visibly makes an incredible effort to carry out the order, but convulsions pulling at different parts of the body are the only result. This is absurd. The absurdity is not her actions, but that the stupid students see in this something very comical and burst out laughing. The patient is even more confused, apparently, just on the point of crying. But instead she suddenly begins to laugh loudly, indeed very loudly, irrepressibly, so that the examination comes to a halt, and they lead her out of the room.

In comes another patient, quite an old woman, also having kept all her mental ability, but having lost all feeling in her legs. The whole lower part of her torso seems dead. Now the region of her pelvis also is beginning to fade, but her mind is completely functioning, completely reasonable. She certainly still very much wants to live. Looking at this unfortunate old woman one unwillingly remembers the terrible story from 'A Thousand and One Nights' in which a sorceress has changed a man completely into a stone post, with the exception of his head which sees everything, hears everything, feels everything. Our patient not only understands everything, but she speaks quite cleverly, intelligently. She narrates the history of her illness -- at the beginning only a slight fading in the feet was felt, exactly as if small insects were running. Then she completely stopped feeling that she had feet, as if they had been cut off, but above her knees. In her hips she still had feeling, and then this terrible growing numbness rising always higher and higher.

She was born in the South of France and carried on a small business in one of the provincial towns. She very naively relates, how rumors reached her of a famous doctor in Paris, who surely could cure her, and how she decided to abandon her home and sell her business so that she might move to Paris.

"It shouldn't have bothered you much, old woman: your business was doing poorly," Charcot rudely says to her. "You only had to pack your trunk and leave."


The very strongest impression on me was made by a mother and her son. She was a milliner by trade, still a young woman, very pleasant in appearance. Her little one was about ten years old. He was skinny, pale and when he was calm, his little face was very likable and intelligent. However, the trouble is that he is rarely calm. After every two or three minutes his whole body begins to shudder and to produce these terrible grimaces, so that it is impossible to watch him. He has la chorée [chorea, St. Vidus's dance] -- as it seems, this illness is called.

"Did you try hypnotic suggestion on him?" asks Charcot of his attending assistant.

The intern reports that he has tried, but no suggestions helped.

"In that case this illness of his is hereditary," Charcot decides, "in their family there were probably similar kinds of illnesses. Did you ask about this?"

"I asked, but the mother is certain, that there weren't any." The intern reports hesitantly, as it would be regrettable for him to have to report a fact contradictory to the assumptions expressed by the professor.

"Probably you interrogated her in insufficient detail!" Charcot impatiently retorts. "They always forget which illnesses were in their family," he explains to the listeners. He begins to question the mother of the sick little boy.

She has such a healthy, blooming appearance that there is no reason to suspect that she passed to her son the rudiments of this terrible illness.

"Your husband is probably frequently ill?" asks or rather claims Charcot.

"Oh, no, he is wonderfully healthy. I never saw him ill."

"He probably is old, much older than you?"

"Oh, no, he and I are of the same age."

"But is it true, in this case, that your husband is also the natural father of your child?" rudely asks Charcot, and in his voice you hear irritation.

The students in deference to the professor begin to snicker.

"Oh, monsieur! " Is the only answer the completely confused mother can find.

"Eh, bien voyons, cherons ailleurs," [Well, we will search elsewhere.] continues Charcot, but quite a bit softer, as evidently he is somewhat ashamed of his outburst. Every one of the questions lead to nothing. It turned out that not only the father and mother are both completely healthy, but besides this ill child, they have two completely healthy children. That's not all, their parents, all four, are still alive. Despite being in their declining years, they also enjoy perfect health. However Charcot is not discouraged.

"Let's turn to the uncles and aunts," he says calmly. "You must try to recall, madame, if there were any eccentrics in your family. Did any of them immigrate to America? How many brothers and sisters do you have? What was their fate?"

The young woman has retained until now an imperturbable calm, but at this point she is reminded of her sister. She begins to become confused and to stammer. Charcot, noticing that he had finally seized on some kind of sensitive point, intensifies the pressure. At last the poor woman has been forced to acknowledge that indeed her sister was qui a mal tourné [someone who had taken an evil path]. That the family completely renounced her. And no one even knew where she was or what had happened to her.

"Ah, je le savais bien!" [I just knew it!] Charcot shouts in a triumphant voice. "I am prepared to wager, that the first signs of that illness, which you now observe in this child, were manifested in this sister." He continues, turning to the audience . . "I would not be surprised if it turned out that this sister, whose residence is unknown to the family, is at this very minute somewhere in a lunatic asylum."

What a pity, the correctness of this proposition can't be verified, but Charcot is content with it and orders the child taken away. He is so certain of the infallibility of his hypothesis, that he doesn't even take the trouble to ask questions, if there hadn't been some peculiar shock in the patient's life. Under what conditions he was raised. Or if he was pushed too hard in his studies -- and so on. Heredity -- that terrible, categorical verdict -- explains everything in the opinion of today's doctors. Any further discussion becomes unnecessary.

"Isn't there some way to help him?" The mother asks timidly.

"Oh, no, madame, for hereditary illness nothing can be done."

She receives the merciless answer.

The sight of all these patients, their convulsions, and twitching, but chiefly the sound of their voices and their terrible, convulsive way of speaking had such an effect on me, that I asked my companion to leave --not to wait to the end of the lecture.

Passing through one of the corridors, we once again saw that same mother and son. The poor woman stood leaning against the windowsill, crying bitterly. She, obviously, didn't want to resign herself to the verdict of science and reconcile herself to the thought that her son was a logical victim of heredity.

The child stands there. Clearly he feels sorry for his mother. He instinctively recognizes he is to blame for her tears. He caresses her and constantly shuddering he keeps repeating: "Don't cry, mama, I beg you, don't cry. I'll try not to make faces any more. Only don't cry."

It's no wonder that unaccustomed as I am to such scenes, this lecture made such a strong impression on me. Even Dr. Berillon, who by now ought to have been used to this, evidently came away with a depressing impression of everything he'd seen and heard.

At first we walked in silence along the banks of the Seine, both of us deep in unhappy thought. Finally, Berillon burst out with a whole flood of curses against hypnotism, against doctors, against patients, against neuroses, in a word, against everything that made up the essence and core of his life.

"How terrible is our profession," he says. "Every minute something happens to convince me that we know nothing, we can do nothing, that we are as powerless and helpless as children. That we all, to a man, are all charlatans and only charlatans. And worst of all in our work, you don't know who to trust. The patients lie. Every doctor has his own skates. [every doctor has his own way of doing things] There, for example, is Charcot, a famous man, no doubt about it. But he has only two things: hypnotism and heredity. As to his own patients, they mean nothing to him. Let us assume, he is right nine times, but on the tenth even he manages to garble the facts. I ask humbly, well, how can one understand all this muddle. Where does scientific truth end and where does swindling begin? Hypnotism is undoubtedly a great discovery, but believe it or not there are times when the very word hypnotism drives me out of my wits."

"But why don't you quit this work, stop devoting yourself to hypnotism?" I ask.

"Oh, I surely will stop, absolutely stop," he answers. "I will earn 150,000 francs (you know, it's no lie, this isn't so much) and then I will go south, away from this terrible Paris, where it is always cold." Berillon is a native of the south, and this year it is particularly cold in Paris. Despite the fact that it is July, at this moment we both are freezing.

He continues, "Here there isn't one single healthy person. I will settle in the country. I will not marry for money, as everyone does in France. I will choose for myself a stout, healthy woman -- even better, a peasant. And my children will grow up healthy in the country, where they won't have to think about heredity."

Saying this, Dr. Berillon, the skinny little fellow, with poor color in his cheeks, with rapture fills his sunken chest with the air of Champs-Elysées (the part of Paris we had reached without noticing, while conversing), as if he were already anticipating the future bliss, waiting for him in rural stillness, far from hypnotism, hypnotists, and the hypnotized.


Sofya Niron

Paris, 21 July 1888