Invention of Hysteria: Charcot and the Photographic Iconography of the Salpetriere (review)

"What the hysterics of the Salpêtrière could exhibit with their bodies betokens an extraordinary complicity between patients and doctors, a relationship of desires, gazes, and knowledge. This relationship is interrogated here" (p. xi). With this, Georges Didi-Huberman opens his work on the rediscovery of hysteria by Jean-Martin Charcot, founder of neurology and a major influence on Freud. Although the book was first published in France in 1982, we still cannot avoid the book's poignant reflections on the history of medical diagnosis and the doctor-patient relationship. For in the shadow thrown by this book, there are still questions worth asking. They are not about how far we have come, which is evident, but what we have overlooked or refused to admit along the way. In effect, where do epistemological issues intrude upon medical science, and how within medical practice can we fail to recognize that meaning is an applied value? That these issues then had about them an erotic and sexual significance, hysteria being predominantly a "woman's" disorder treated by men in a large institution where control presided over cure or release to excess, reveals something else about late-19th-century medicine at the Salpêtrière: its exclusionary function and its theatrical context—the latter, I suggest, still not having left us, however radically its terms have altered. In another sense, this work is as much a study of a transitional moment in medical analysis—when the search for the biophysical "lesion" turned to the characterization of a psychological "disorder"—as a study of the limitations of that analysis and the critical need to understand its cultural and technological context; the advent of photography legitimated Charcot's work with a cutting irony that Didi-Huberman captures from the start. The visual identification of the "seat of the illness," along with all its lexical derivations, deprives the patient of an essential indeterminacy—the individual uniqueness she desperately searches for through her symptoms, and, if called on, her appearances at Charcot's Tuesday lectures. There is little hope for a way out, however efficiently the patient satisfies her doctor's expectations in terms of symptom type or kind, and the resulting constriction of space, both internal and external, even perhaps of hope, cannot mask a violation, which, for Didi-Huberman, turned to "hatred."

The medical science we know, or wish we knew, seems far afield here. But then the title of this book, with its stress on invention, carries the point throughout with a vivacity often lacking in other historical works. For Didi-Huberman, the argument evolves not only through the eye and his analysis of the photographic oeuvre on hysteria, but in response to how poignantly that oeuvre touched him. Indeed, it is difficult at times not to recoil from the therapies inflicted on these women by their doctors, whether performed to alleviate suffering or in pursuit of a specialized bit of knowledge.

Here again I take the author's tack and style as a strategic difference that distances him from the kind of "confirmation" that the photograph provided then, and which in our visual culture also raises the stakes to a critical breaking point, where voices such as Artaud's and Bataille's resonate, especially in regard to the hysterical body, the body dispossessed of itself. Here is a retrospective examination of "Charcot and the Photographic Iconography of the Salpêtrière," as the subtitle to the book terms it—yes, of course, but this retrospection, intense, sustained and supple, approaches us without the usual cautions, laying bare an invidious passion that the hysteric's cry, at last, contravenes: the theatricalization of a diagnosis, the staging of the body of disease.

Structured in two sections—"Spectacular Evidence" and "Charming Augustine," referring to Charcot's prize hysteric, whose photos in extremis would later captivate the surrealists—the work concludes with important appendices of source...