Parable for Our Time

September/October 2006 Historically Speaking 29 Parable for Our Time Roger L. Williams In 1821 Dr. Ulysse Trélat (1795-1879), a pioneer in the profession called psychiatry today, began a practice in general medicine. As a medical student , he had acquired a special interest in mental illness during courses taught by Dominique Esquirol, the eminent disciple of Philippe Pinel. In 1840 Trélat won an appointment to the Salpêtrière, a hospice for elderly women with a section reserved for alienated women. The appointment provided for sustained observation, research, and publication as he occupied Pinel's former apartment within the institution . At the outset of this new practice, Trélat quite understood that some categories of madness were the result of organic lesions and thus probably incurable . Consequently, his interests veered toward cases that appeared to be personality disorders—individuals evidently rational and lucid most of the time, but seemingly mad on only one subject. This suggested the possibility of cures through psychological or moral treatment if conducted compassionately and humanely. He called this category of mental illness lafolie lucide to emphasize its partial character. At some unspecified date in the 1840s Trélat was called for temporary service at Bicêtre during an absence of Dr. François Leuret, a congenial fellow psychiatrist. He saw in the division reserved for male lunatics a patient identified as Monsieur O., who had discovered the principle of perpetual motion . A tall man of strong constitution, his various experiments and subsequent inventions had brought financial ruin to his family before his confinement at Bicêtre. Trélat, believing that a tendency to madness was inherited, found in Monsieur O.'s record that his father had been deemed très exalté, a fanatic. Monsieur O. had found that there was no need to use ordinary movers to turn a wheel indefinitely. One could turn a wheel with flowing water, but he had found that a wheel turned in stagnant water as well. To every objection that Trélat raised to that notion , Monsieur O. responded with an unshakable conviction, finally insisting: "Permit to say, Doctor, that I recognize your complete competence in medicine , but in mechanics I cannot accord you the same infallibility." Trélat had to admit the truth of that observation. At that time, the house rules at Bicêtre permitted a physician to escort a patient outside the institution if the mission was to promote a cure. Trélat knew and liked François Arago, the director of the Observatory of Paris. He called on Arago at the Observatory to inquire whether Arago would be willing to help cure this sick man in Bicêtre. Arago answered that he would do everything that was needed. The following morning Trélat again explained to Monsieur O., and very firmly, the impossibility of perpetual motion, only to be deflected again by the same assertion of incompetence. Would Monsieur O. accept the judgment, Trélat asked, from someone whose authority was beyond doubt? And did he recognize Arago as such an authority? After several moments of reflection, Monsieur O. gave clear and repeated assertions that he would agree with the enlightened opinion of Arago. With this encouragement, Trélat led Monsieur O. to the Observatory the next day. They arrived just as Arago—accompanied by Alexander von Humboldt, his colleague and friend—was reaching his apartment following his astronomy lecture in the amphitheater. Thus it happened that this demented and impoverished man was received by two of the most eminent European scientists of that day. He gave no sign of feeling either awkward or out of place at this meeting, no matter that he had only two pieces of string for shoelaces. The ambience was perfectly civil. Arago listened at length and in quiet patience as Monsieur O. explained his demonstration of perpetual motion. At the end, Arago asserted that there could be no movement without a mover. "Look for that mover in the moving air, in water current, in the tension of a spring, or in the change of volume of a body. But you will never make a wheel turn in stagnant water. You have wanted my opinion on the...