Mad Travelers: Reflections on the Reality of Transient Mental Illnesses

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Mad Travelers : Reflections On the Reality of Transient Mental Illnesses Hacking, Ian. University of Virginia Press 0813918235 9780813918235 9780585120942 English Fugue (Psychology)--Case studies, Tissié, Philippe,--1852-1925, Social psychiatry, Niche (Ecology) 1998 RC553.F83H33 1998eb 616.85/232 Fugue (Psychology)--Case studies, Tissié, Philippe,--1852-1925, Social psychiatry, Niche (Ecology)

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Mad Travelers Reflections on the Reality of Transient Mental Illnesses

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Page - Barbour Lectures for 1997

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Mad Travelers Reflections on the Reality of Transient Mental Illnesses Ian Hacking UNIVERSITY PRESS OF VIRGINIA CHARLOTTESVILLE AND LONDON

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THE UNIVERSITY PRESS OF VIRGINIA © 1998 by the Rector and Visitors of the University of Virginia All rights reserved Printed in the United States of America First published 1998 The paper used in this publication meets the minimum requirements of the American National Standard for Information Sciences Permanence of Paper for Printed Library Materials, ANSI Z39.48-1984. Library of Congress Cataloging-in-Publication Data Hacking, Ian. Mad travelers: reflections on the reality of transient mental illnesses/Ian Hacking. p. cm. "Page-Barbour lectures for 1997" CIP t.p. verso. Includes bibliographical references and index. ISBN 0-8139-1823-5 (cloth: alk. paper) 1. Fugue (Psychology) Case studies. 2. Tissié, Philippe. 1852-1925. 3. Social psychiatry. 4. Niche (Ecology) I. Title. RC553.F83H33 1998 98-20894 616.85'232 dc21 CIP Frontispiece: Dr. Phillipe Tissié hypnotizing Albert in the presence of Professor Azam. From Foveau de Courmelles (1890).

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For Chloe

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Contents Acknowledgments

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Introduction

1

1 The First Fugueur

7

2 Hysteria or Epilepsy?

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3 Niches

51

4 Five Questions, Five Answers

80

Supplements 1 What Ailed Albert?

103

2 The Wandering Jew

113

3 Wandertrieb in Germany

125

Documents 1 Albert's Tale (1872 May 1886)

135

2 Albert Observed (June 1886 February 1887)

149

3 Dreams (May 1887 September 1889)

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4 A Pathogenic Dream (1892)

185

5 Experiments (1888, 1893)

187

6 Epilogue (1907)

192

Notes

195

Bibliography

223

Index

235

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Illustrations Dr. Phillipe Tissié hypnotizing Albert in the presence of Professor Azam Frontispiece Fig. 1. Four photographs of Albert in different states

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Fig. 2. Two photographs of Albert, awake and hypnotized 161 Map 1. Albert's longest journeys

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Map 2. The Bordeaux region

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Acknowledgments I have to thank the Hannah Foundation for the History of Medicine for a grant that supported André LeBlanc's research in Bordeaux, and which covered incidental expenses. We received help from many individuals in Bordeaux itself. Mme Avisseau and Mme Prax, Sous-directrices of the Archives Départmentales de la Gironde, and Olivier Renou, the archivist who helped locate, among other things, the birth certificate of our key patient. M. Savoyac and Dr. Daniel Roy, who helped clear some research paths. Three journalists from Sud-Ouest, the principal Bordeaux newspaper: Michèle "Mimi" Sporny, Anne-Céline Auché, and especially Dominique Richard who wrote up our research for a long article which, in turn, paved the way to more contacts. M. Michel Rateau, historiangenealogist-heraldist. Cristophe Dabitche and Mark Eagersall, whose cheerful ambivalence toward their city gave me a better sense of it. The helpful librarians at the Bibliothèque de Médecine et de Pharmacie, Université de Bordeaux, and the Bibliothèque Municipale de Bordeaux. I also thank Alexander Furrer for his help obtaining materials in the Zentralbibliothek, Zürich. I discussed some of these topics at a seminar in the University of Toronto and in the Eidgenössische Technische Hochschule, Zürich, and in talks at McGill University, the University of California at Los Angeles, the University of British Columbia, Memorial University, Newfoundland, and the University of Calgary. Two early accounts of this work have appeared, one in History of Psychiatry 7 (1996): 425-49 and the other, a talk at the Whitney Humanities Center, Yale University, in Modernism/Modernity 3, 2 (1996): 31-43. It was, however, the Page-Barbour Lecture Committee at the University of Virginia, under the leadership of Allan Megill, who provided the incentive to bring all this material together and a wonderful audience to criticize it. These lectures were given in February 1997. The fourth lecture is a

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rational reconstruction of the answers I tried to give in Virginia, and which I presented, in March in a more organized form to an audience that had not asked the questions but was generous with more as a MillerCom lecture at the University of Illinois, organized by Andrew Pickering. I am grateful to André Gombay for help in proofreading French and to Vincent Gullin, who located the 1907 newspaper story that completes my epilogue. Thanks again to everyone, but especially to André LeBlanc.

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Introduction These lectures tell about a forgotten epidemic of insanity inaugurated by a mad gas fitter and his doctor, an energetic pioneer in physical education. I intend this story to speak for itself, both as fact and as a parable about mental illness and psychiatry. The strange events that I describe prompt some reflections on transient mental illnesses. Readers who are more keen on theory than adventures may want some advance notice of the use that I make of the story. By a ''transient mental illness" I mean an illness that appears at a time, in a place, and later fades away. It may spread from place to place and reappear from time to time. It may be selective for social class or gender, preferring poor women or rich men. I do not mean that it comes and goes in this or that patient, but that this type of madness exists only at certain times and places. The most famous candidate for a transient mental illness is hysteria, or at any rate its florid French manifestations toward the end of the nineteenth century. Cynics would offer multiple personality today as another transient mental illness and go on to compose a list of other disorders that will prove transient chronic fatigue syndrome, anorexia, intermittent explosive disorder, or whatever they choose to criticize. Transient mental illnesses provoke banal debates about whether they are "real" or "socially constructed." We need richer tools with which to think than reality or social construction. My theoretical ambitions in these lectures were modest. I did not want to understand reality. I wanted to provide a framework in which to understand the very possibility of transient mental illnesses. The most important contribution here is the metaphor of an ecological niche within which mental illnesses thrive. Such niches require a number of vectors. I emphasize four. One, inevitably, is medical. The illness should

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fit into a larger framework of diagnosis, a taxonomy of illness. The most interesting vector is cultural polarity: the illness should be situated between two elements of contemporary culture, one romantic and virtuous, the other vicious and tending to crime. What counts as crime or as virtue is itself a characteristic of the larger society, and the virtues are not fixed for all time: prudence, a virtue for the Protestant bourgeoisie of early modern Europe, had been mere weakness in the feudal era. Then we need a vector of observability, that the disorder should be visible as disorder, as suffering, as something to escape. Finally something more familiar: the illness, despite the pain it produces, should also provide some release that is not available elsewhere in the culture in which it thrives. The lectures are rich in historical anecdote and curious details. But they are not mere stories. They lay out, by an example, the power of the concept of an ecological niche for a transient mental illness. I take for granted that a mental illness something that counts as madness within a society requires both victims and experts. We call these patients and clinicians, but in Lecture 3 I give an example from Greek myths where we have madness, the afflicted, and the experts, though we hesitate to speak of patients and clinicians in any modern sense. The idea of madness is more cross-cultural than the categories of late twentieth-century medicine. Since both victims and experts play such an important part, Lecture 1 tells a great deal about the first victim and the first doctor in an epidemic of mad travelers that broke out in 1887. The book comes in several parts. There are four Lectures. The first three tell a detailed story, and the fourth discusses matters arising: it reflects on the reality of transient mental illnesses. One cannot, in a set of lectures, include all the rather astonishing historical asides that arise in a true story. Many incidents are relegated to the Notes. They do give references, of course, but they are an integral part of the Lectures, providing a reservoir of information and anecdote that confirms, for me, the simpler statements in the Lectures themselves. There were also some odds and ends. Three Supplements examine other matters arising. Finally there are some translated Documents relating to my star patient and his doctor. Some readers will begin with the Documents, others with the Lectures. It would be by no means foolish to begin with the Notes. Soon after giving the lectures, I found myself rebelling at a curious

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strand in the intellectual life of our times. There is a macabre fascination with the relationship between long-dead lunatics and their long-dead doctors, a fascination that blurs fact and fiction. Pat Barker's trilogy Regeneration, The Eye in the Door, and The Ghost Road won the Booker Prize for the third volume, although the first is the best. Its focus is the interaction between William Rivers, anthropologist and doctor of shell shock, and the poet Siegfried Sassoon; many another doctor (Henry Head) and writer (Wilfred Owen, Robert Graves) get cameo parts, although the star patient is, I think, fictional. Margaret Atwood's Alias Grace is about the relationship between a mad servant girl who co-murdered her bosses a century and a half ago and the young doctor who goes to study her in the asylum to which she has been consigned. The young woman is historical, and so are the Ontario institutions and doctors, although here it is the star doctor who appears to be fictional. These are novels. They deploy the past using recent psychiatric obsessions. Throughout Barker's books post-traumatic stress disorder does the work, though we get some multiple personality in the third volume. In Atwood multiple personality is a permanent question mark; did Grace do the killings in a second personality, or was that personality fabricated not by the good young New England doctor who speaks with her every day but by Jeremiah the peddler who is playing the role of a psychic investigator by the time the quasi-denouement occurs? There is much more fiction, most of it quite tiresome, in which the dead lunatic and the doctor go about their business, but I have just mentioned the very best of novels from 1995 and 1996. Equally striking is the writing of cultural history that parallels Barker and Atwood. None is more notable than the work that has Daniel Paul Schreber as star patient and Paul Emil Flechsig as star doctor, with Sigmund Freud as star kibitzer. Schreber, appointed as president or chief justice of the Saxon Supreme Court, was a paranoid schizophrenic who wrote memoirs of himself in an insane asylum. Elias Canetti's Crowds and Power (1978) used these writings to make an amazing comparison between the private madness of Schreber and the public madness of Hitler. Both, Canetti thought, were driven by an insane sense of the potential of power. Canetti was theoretical. More recently there has been so much detailed examination of the life and times of Schreber that I am inclined to say that we know "everything" about him, especially thanks

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to the passionate research of William Niederland, The Schreber Case: Psychoanalytic Profile of a Paranoid Personality (1984), and Zvi Lothane, In Defense of Schreber: Soul Murder and Psychiatry (1992). Thanks to plenteous photographs obtained by Lothane, we even know what everyone in the Schreber story looked like. Louis Sass, in The Paradoxes of Delusion: Wittgenstein, Schreber, and the Schizophrenic Mind (1995), has used Schreber to understand schizophrenia from within, to see the schizophrenic as solipsist, and thereby to comprehend Wittgenstein's battle with solipsism, if not with schizophrenia itself. And let us not forget that Thomas Bernhard's one-sentence novella, Wittgenstein's Nephew, was a tour de force using just the themes that Sass took up. Bernhard, superb artist, was not quite writing about our Ludwig Wittgenstein, and certainly not about Schreber, but there in the book is the solipsist in the garden of the Viennese asylum, Wittgenstein's nephew, looking at the sun. Sass took Schreber inward. Eric Santner's My Own Private Germany: Daniel Paul Schreber's Secret History of Modernity (1996) goes so far inside that it uncovers, in the mad mind of Schreber, the modern world and the makings of the German disaster. I read most of these works after lecturing about a bicycling physician and his patient, a demented gas fitter who obsessively and uncontrollably takes off for days or months or years, often walking 40 miles a day, losing his papers, his identity, but not his demand to go, go, go. So I found this obsession with mad individuals and their doctors quite unnerving. What kind of understanding do we strive for, in the fact and fiction of madness? What type of escape is this, in which we pretend to understand our world in terms of dead lunatics and their equally dead and possibly equally mad doctors? I even saw a dreadful symmetry. Barker, in fiction, doing the truly famous doctor and patient; Atwood, in fiction, doing the truly obscure doctor and patient. Canetti through Santner writing fact, not fiction, about the now famous patient Schreber and his doctors, in order to tell a story about the whole of the modern world, plus Hitler and Wittgenstein. And I, in miniature, doing a factual account of a truly obscure patient and equally obscure doctor. The symmetry, of course, is that the Canadian authors, whether in fiction or in fact, prefer to write about obscure provincials. But what are we all doing? Are we engaged in more than voyeurism? It was only when I turned back to read some new histories of psychiatry, or of branches of that discipline, that I could put my discomfort aside. For

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the histories of medicine to which by chance I turned had so little to say about the patients, the real people. We desperately need the great narrative scope of the old French case histories, even of Freud himself, to get a glimpse of how our fellow men and women break up, in a time and at a place. The novelists give us the sense of the time and the place in which madness is both intelligible and yet insane. That too is done by the historical work of Lothane and Niederland and the larger placings, albeit with agendas, of Sass or Santner. According to Karl Jaspers, Schreber's written-down thoughts were absolutely impermeable, unintelligible, the perfect exemplar of how madness cannot be accessed. But by now they are, in a way, all too intelligible. They are invested not with too few meanings but too many. That is a real danger, to forget we are talking about the mad judge Schreber, who, even after he got better and went home, then got worse and died in an asylum. We can get so close, and so inside, that we lose just as much touch with the patient as do those historians of psychiatry. The novelists provide a better model, for they give us suffering and comedy and avoid profundity. One reader of my story wanted more history of the politics of psychiatry, for example, and how it fitted into nineteenth-century French politics. Instead I added more about buildings, more about the sense of being in provincial, closed-in Bordeaux, where Albert went mad. I am no novelist, but I hope to have invited the reader into the mean dark streets of a town that suffocates under its own pride or into the spacious cloister of the hospital where my compulsive walker found a safe place. I talk more about my doctor's enthusiasm for cycling than the latest news from Paris. I came to realize that I was less a voyeur than a companion, and that this was the right experience with which to frame the theoretical questions and concepts which, at another level, are the topic of these lectures.

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1 The First Fugueur It all began "one morning last July when we noticed a young man of twenty-six crying in his bed in Dr. Pitres's ward. He had just come from a long journey on foot and was exhausted, but that was not the cause of his tears. He wept because he could not prevent himself from departing on a trip when the need took him; he deserted family, work, and daily life to walk as fast as he could, straight ahead, sometimes doing 70 kilometers a day on foot, until in the end he would be arrested for vagrancy and thrown in prison." 1 Thus begins our story in a ward in the ancient Bordeaux hospital of Saint-André.2 The young man's name was Albert; he was an occasional employee of the local gas company, and the first fugueur. He became notorious for his extraordinary expeditions to Algeria, Moscow, Constantinople. He traveled obsessively, bewitched, often without identity papers and sometimes without identity, not knowing who he was or why he travelled, and knowing only where he was going next. When he "came to" he had little recollection of where he had been, but under hypnosis he would recall lost weekends or lost years. Medical reports of Albert set off a small epidemic of compulsive mad voyagers whose epicenter was Bordeaux, but which soon spread to Paris, all

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France, Italy, and, later, Germany and Russia. Fugue became a medical disorder in its own right, with earthy labels like Wandertrieb and suitably Latinate or Greek-sounding ones such as automatisme ambulatoire, determinismo ambulatorio, dromomania, and poriomanie. Fugues, that is to say strange and unexpected trips, often in states of obscured consciousness, have been known forever, but only in 1887, with the publication of a thesis for the degree of doctor of medicine, did mad travel become a specific, diagnosable type of insanity. Albert's strange tale is one of picaresque adventure and bitter pathos, but why tell it now? Because we are besieged by mental illnesses, more neurotic than psychotic, and we wonder which of them are affectations, cultural artifacts, clinician-enhanced, or copycat syndromes, and which ones are, as we briefly and obscurely put it, real. We are profoundly confused about an entire group of mental disorders, feeling that their symptoms are both nurtured and natural, both moral and neurological. Is PMS, premenstrual syndrome, a disorder or something that a predominantly male profession of psychiatrists has written into its nosology to deal with irritable and irritating female patients? Fidgety children have been with us forever; then came hyperactivity; next, attention deficit; at present attention deficit hyperactivity disorder, for which the steroid Ritalin is prescribed. Is that a real mental disorder? Or is it an artifact of psychiatry demanded by a culture that wants to medicalize every annoyance that troubles parents, teachers, bus drivers, and all the other powers that be? Anorexia and bulimia cause immense distress to patients and their families. The suffering is manifest, but are we talking about behavior that is produced by stereotypes of female beauty, combined with a way of rebelling against parents, or are we talking about a "real mental disorder"? Is multiple personality disorder, now named dissociative identity disorder, "a true psychiatric entity and a true disorder" afflicting perhaps 5 percent of college students and also 5 percent of admissions to any acute care adult psychiatric in-patient unit? 3 Or is it a a self-indulgent way to express genuine and profound unease that has been cultivated by clinicians and the media, but which has no medical content at all? Are we to take seriously antisocial personality disorder or intermittent explosive disorder, blaming a good deal of violent crime on these psychiatric entities? Or are we to see these as part of the apparatus of forensics by which

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justice and medicine conspire to define and control the criminal element, all the while burying systemic poverty as a critical ingredient in crime? It is not only what used to be called neuroses whose reality is called in question. Schizophrenia, or rather "the group of schizophrenias," was first named in Switzerland in the first decade of the twentieth century. It was long a popular diagnosis. Yet it has been withering away. Not only have the symptoms been ameliorated by several generations of psychotropic drugs, but the proportion of actual diagnoses has declined markedly in a large number of medical jurisdictions. Most psychiatrists who try to help schizophrenics speak of it as a dreadful disorder that strikes young adults (among others) and destroys not only the patients but their families and friends. Yet it has been repeatedly argued that there is no such entity, that it is a "scientific delusion." 4 Symptoms aplenty, yes, but different congeries of symptoms in different decades of this century, with no determinate medical entity from which they emanate. I happen not to be a skeptic about schizophrenia. My focus in these lectures is not on psychoses but on those disorders that were once called neuroses. That group of medical entities may be about to explode. The New York Times Tuesday "Science Times" of 4 February 1997 bore the headline, "Quirks, Oddities May Be Illnesses." The occasion was a new book, Shadow Syndromes, featuring subclinical autism, depression, and the like.5 People exhibit shadow syndromes when they satisfy part of a checklist for a disorder but not enough to diagnose that disorder; on the other hand, there is ''clinically significant distress or dysfunction." Such proposals do not come from a lone psychiatrist and his coauthor. Plenty of support for the new diagnoses is cited by the newspaper, which includes favorable comments by, among others, Robert Spitzer, who directed the teams that produced the successive official diagnostic manuals of the American Psychiatric Association the Diagnostic and Statistical Manual, DSM III (1980), DSM III-R (1987), and DSM IV (1994). A new form of the reality question arises. Many people are, to use some of the popular adjectives mentioned by the Times, "weird," "odd ducks," and "nerdy." Some of us were uncoordinated in sports as children and were, or are, not very good at making new friends. Are we suffering from an illness (a real illness!), in this case subclinical autism? With multiple personality, some skeptics urge that unhappy people have evolved symptoms in concert

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with their doctors and the media. With shadow syndromes, there is no question (yet) of doctors or media cultivating loners and ball-fumblers; that behavior is real enough, as we inveterate lonesome ball-fumblers know to our cost, but are we to be conceptualized as ill? Above all, are we to be treated as ill by the experts, with their array of medications, therapy, and bills? I do not predict a quick answer to that question. Passions run high about old questions and will run high about new ones. Ideologies are intense. In play are feminism, Marxism, and scientism; psychiatry and antipsychiatry. Lobbying is vigorous, whether in the committees that settle the approved entries for official diagnostic manuals or in groups of patients and their families that try to take some control over their problems. Lurking behind these activities, sometimes sedate, sometimes frenzied, is a nagging question. What counts as evidence that a psychiatric disorder is legitimate, natural, real, an entity in its own right? Ludwig Wittgenstein said that in psychology there are experimental methods and conceptual confusion. 6 We have more than that for the mental illnesses. We have the clinical methods of medicine, psychiatry, psychology; we have the innumerable variants of and deviations from psychoanalysis; we have systems of self-help, group help, and counselors including priests and gurus; we have the statistical methods of epidemiology and population genetics; we have the experimental methods of biochemistry, neurology, pathology, and molecular biology; we have the theoretical modeling of cognitive science; and we have conceptual confusion. Perhaps all our problems will be erased when we have enough objective scientific knowledge. I have another view. We do have a limitless reservoir of ignorance, but we also have conceptual confusions that new knowledge seldom helps relieve. There are a number of reasons for this, but I am especially impressed by the way that scientific knowledge about ourselves the mere belief system changes how we think of ourselves, the possibilities that are open to us, the kinds of people that we take ourselves and our fellows to be. Knowledge interacts with us and with a larger body of practice and ordinary life. This generates socially permissible combinations of symptoms and disease entities. We often express our malaise about this phenomenon, which we do not correctly identify, by asking whether certain disorders or their manifestations are real. The first chapter of my recent book about multiple personality was

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titled "Is It Real?" "I am not going to answer that question," I wrote; "I hope that no one who reads this book will end up wanting to ask exactly that question." 7 Vain hope! Time and again people have taken me aside and quietly asked what I actually believe: Is multiple personality real or not? There is, to be sure, a special skepticism about multiples. My interrogators tend to hope that I will side with the angels (or rather, whichever side they believe the angels to be on). They hope I will say that there definitely is such an illness, whose symptoms I describe with great precision and with such a depth of sympathy. Or they hope that I will say that there is no such illness, that the phenomena I describe so ironically are part of a "social construction." Or the disorder is "iatrogenic" caused by doctors or, ingeniously, "doxogenic" caused by a belief system cultivated by therapists and the media.8 People are not going to stop using the word real or its co-workers such as true in connection with controversial mental problems. Reasons for this range from finance to responsibility, from semantic theory to scientific metaphysics. Health insurance should pay only for real mental illnesses, right? Responsibility is the crux. We have a profoundly moral attitude to disease. If something is a real disease, you are not responsible for it or are responsible only insofar as you engaged in vice that brought on the disease. Sex, drink, and idleness are typical vices. But if you need costly hip-replacement surgery because you continued playing boyhood games such as basketball into middle age, you are not blamed or held responsible; this is because in our world continued youthful activity is a virtue. In the case of mental illness, responsibility may be diminished or removed altogether if the illness is a real one. And the names for real illnesses have objective, individuated referents; scientific metaphysics and popular science alike demand that the referent is biochemical, neurological, organic, something localized in the body that could in principle be isolated in the laboratory. But these are matters for Lecture 4. Analytic philosophers like myself are trained to make distinctions and clarify ideas. We like to think that this helps to remove confusion. I believe that most important conceptual difficulties are rather unyielding. This is because they result from some fundamental incoherence in the underlying organization of our ideas ideas that we will not give up partly because they are essential to the ways in which we do think. Reality and responsibility like reference, science, and the body are

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rather grand examples of organizing concepts. No amount of analysis makes deep confusion evaporate; no amount of heated debate boils it off. But there are things we can do. One is to examine in some detail a manageable example in which many of the ingredients of the confusion are plainly on view. Enter Albert. Enter the fugue epidemic of the 1890s. It is elegantly constrained. We know exactly where and when the diagnosis of fugue begins, and we can watch it peter out. Here we have one diagnosis that is extinct and yet, in certain respects, curiously up-to-date. It resembles recent epidemics in that it is important only at a time, in a locale, it has a vogue, spreads, decays, and the world passes on to next year's affliction. I ought to say that my example is not entirely antiquarian. Dissociative fugue is a diagnosis in the handbooks of the 1990s, in the manuals of both the American Psychiatric Association and of the World Health Organization. 9 Even there hangs a tale, for especially in America fugue is a grandfathered diagnosis. That is to say, it is kept on the books partly because it has been on the books, and also for certain reasons of political rhetoric that I mention in Lecture 4. The diagnosis is never or almost never made and yet is listed as a possible diagnosis as if it were a bit like measles, and very much like depersonalization disorder, which you can just "have." After I have told you enough about cases of fugue, you will begin to feel torn. Yes, you will be inclined to say, these people did suffer from a "true psychiatric disorder" (perhaps more than one). The doctors of the day used a diagnosis that did fit their cases; fugue was a viable entity. Yet at the same time the phenomenon is steeped in the social circumstances of the day. We are tempted to say that whatever ailed these patients (and they were ailing!), the manifestations, the marks of their illness, were entirely socially conditioned. Here, then, is my method: I tell you a true story about a disorder of which you have never heard. It is a sufficiently gripping story that you will attend to it and take in its salient features very quickly. Yet you will realize that this more or less "dead" disorder is a vignette of a type of problem that vexes us today. Why take an old case rather than a present one? Because partisan reactions will not arise immediately; when they begin to surface, you may reflect on why they do appear for so dusty and obscure a chain of events long ago, about which we ought to be indifferent. Fugue is a happy choice because it is just plain interesting in its own right fascinating to me, and I hope to you, in part because travel has

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become so integral a part of the learned world. Throughout this century the Page-Barbour Lectures have invited travelers from afar to tell Virginians, if not of wonders, at least of "some fresh aspect or aspects of the department of thought," as the deed of trust puts it. Each person in the audience takes for granted that a vacation may, and often will, involve a trip. Albert's own trips are so striking that I sketch a few of them here. Albert's own account, as taken down by his doctor, is the first of the documents that follow the lectures. Fugue itself conveniently illustrates many social facets of mental illness that are by now rather old hat. It is highly gender-specific. It is class-specific. It is directly involved with systems of social control, and I do not mean abstractions about power and knowledge. I mean the police and the military. One is hard-pressed to say who has the greater role in defining, in realizing, the disorder as a correct diagnosis the class of patients or the class of physicians. Fugue is closely connected to the late nineteenth-century mental illness that has, in the past two decades, attracted most attention by cultural historians: hysteria. That standing conundrum, hypnotism, plays its role in fugue. There is a preenactment of one of today's embarrassments for affluent cities, the homeless. Anti-Semitism rears its conventional head, for who is the archetypal fugueur but the Wandering Jew? I take up that issue in Supplement 2. These matters strike familiar chords, albeit in somewhat novel arrangements. I prefer to emphasize another idea. It uses as metaphor a notion that became fashionable in another field some time ago: the ecological niche. We are struck by the phenomenon that some types of mental illness and some arrangements of symptoms are central at some times and places and absent in others, even in the history of one fairly continuous culture. These are the ones that I call transient, not in the sense that they come and go in the life of a single person, but that they exist only at a time and a place. I argue that one fruitful idea for understanding transient mental illness is the ecological niche, not just social, not just medical, not just coming from the patient, not just from the doctors, but from the concatenation of an extraordinarily large number of diverse types of elements which for a moment provide a stable home for certain types of manifestation of illness. Now, however, I ask you to be content with an introductory story about a young gas fitter of Bordeaux. We first hear of him in a thesis with an unusually romantic title: Les Aliénés voyageurs. 10 We may fear already that the

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author, the by no means young medical student Philippe Tissié (1852-1935), liked a good yarn. Tissié would not pass as your average intern in any hospital, at any time. When he first set eyes on Albert he was thirty-three years old. He had been orphaned at fourteen, had worked twelve hours a night as a bookkeeper's clerk at a Toulouse railway station. 11 During the day he took music classes at the local conservatory. When he turned sixteen he moved up to a day job as a delivery man, all the while going to night school. After providing for the education of two younger sisters by savings from such menial work, he got his big break when on his twenty-third birthday he shipped out of Bordeaux on a steamer, the Niger, on the Bordeaux-Senegal run.12 He worked as a supercargo's clerk.13 The ship's doctor took a shine to him and after a couple of years urged him to apply for a post as underlibrarian to the medical faculty in Bordeaux. He got the job, completed his baccalauréat in the sciences, and by 1886 finally had fulfilled all qualifications for the medical degree except his thesis. He was working in the ward of Albert Pitres, a hotshot neurologist who had been a student of Charcot's in Paris, and who in 1881 had become professor in Bordeaux at the age of thirty-three, the age when Tissié was still completing his studies. In 1886 Pitres was giving lectures on hypnotism and hysteria, and it was no surprise that Albert was assigned to his ward. So Albert was there for Philippe Tissié to describe in his thesis. But so were a great many other patients. About sixty were assigned to a ward. Tissié did not choose Albert by chance. The man and his doctor were made for each other, opposite but parallel. Opposite: Albert was barely lettered, able to read, but he could hardly write. Tissié was always at his letters, even as an adolescent doing full-time menial jobs. Where Albert was the victim of impulse and uncontrollable drives, Tissié was a model of goal-directed planning and achievement. But parallel: Tissié, like Albert, was always close to movement, keeping books at night in the train station, that center of all movement, or delivering, or on the good ship Niger whose very name is redolent of colonial travel and adventure in darkest Africa. There is more to it than that. The only thing I know about Tissié's boyhood is that early on he heard of the latest wonder, the vélocipède, "the wonderful invention that needs neither a horse nor a carriage." One day in the early sixties the great Léotard came through town on his way to Toulouse: Léotard, the man-bird, the greatest trapeze artist of the day, and a pioneer of

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cycling (and, yes, the man after whom that athletic garment, the leotard, is named). All the children turned out to watch him whiz by. Tissié recalled how "he went so quickly, on two great wheels, I heard the grinding of metal and wood. I had seen a vélocipède!" His father had the local wheelwright make a wooden tricycle for his son, and the cycle remained a love of Tissié's life and a part of his profession later on. 14 When Albert came to Tissié's notice in 1886, the bicycle had just become the middle-class sporting instrument of choice; indeed, in France cycling was the very first popular, that is, nonaristocratic, sport.15 A few dates sum up the story. In the early 1880s the Safety bicycle became generally available the prototype of the modern bicycle with two equalsized wheels and driven by pedals and a chain. The free wheel was invented in 1881. The first long-running magazine devoted to the sport, Le Sport Vélocipédique, commenced in 1880.16 In 1881 a national federation of cycling clubs was established, Union Vélocipédique de France. There had been racetracks for horses forever. In 1884 the first track for (human) runners was built in Paris. The first velodrome preceded it, in Paris, in 1879. Montpellier built one in 1885, and Bordeaux immediately followed. There had been long-distance cycle races for quite some time: Paris-Rouen on 7 November 1869. The Paris-Bordeaux race did not begin until 1891, but it was established as the first of the "classiques": one-day road races on the professional cycling calendar. In that year inflatable rubber tires came on the market in France. In January 1890 the Touring Club de France was founded for cyclists. By the end of the decade it had 73,000 subscribers, thirty volumes in the series Sites et Monuments de France, and numerous manuals rating local hotels and mechanics. When you think of Bordeaux, you think of wine, and perhaps of a town that has just overcome its ruination, the phylloxera louse that destroyed the vines. That began in 1863 but had been solved by Albert's time, thanks to grafting the old vines onto California stock. If you are learned, you recall that just as Albert was checking into the hospital, Emile Durkheim was moving to Bordeaux to begin the course of lectures that would invent modern sociology. But you did not know that Bordeaux was the absolute center of activity for the first popular French sport. Albert's doctor soon became the official doctor of the Véloce-Club de Bordeaux, and he was writing columns for its magazine, Le Véloce-Sport, which were collected into a Cyclists' Guide for

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Training, Racing, and Tourism. 17 He was one of the architects of the Bordeaux-Paris race, and there he is, in charge, in the photograph at the starting line. And apparently he scandalized his colleagues and the good citizens of Bordeaux by making house calls on a bicycle.18 I fancy that my newfound friend was the first physician in the world who pedaled on his rounds. I shall spare you Tissié's later history as a leader in physical education, a rather astonishing story but one far too complicated for us. Physical education was one battleground for the reformation of France, its youth, its education, its glory. Those who like simplification may find that those on one side Tissié's happened to be Dreyfusards. We who have nothing to do with France, or physical education, or a long-dead scandal, have inherited the wind in the form of the Olympic Games, pushed by Coubertin and other anti-Dreyfusards over the anguished protests of men like Tissié, who did not much like competitive sport on the English model and who favored rational and moderate exercise, aerobics, Swedish gymnastics, cycling, and long walks. But all that, except for the long walks, is quite another story. Histories of French physical education are a bit bemused when they come to Tissié's medical thesis; they suppose that Tissié studied Albert precisely because the man was able to travel such prodigious distances on foot, a veritable instance of training to excess.19 The historians of physical education have lost touch with Tissié's psychiatric practice. Historians of medicine, on the other hand, have now amply described the political schisms that divided the French medical profession, French alienists in particular, and French society in general. In Rewriting the Soul I observe how useful multiple personality was for those doctors who were anticlerical and ill disposed to the idea of a unitary immortal transcendental metaphysical (etc.) soul. Those same doctors were usually positivist, in the strong and proper French sense of the word, derived from Auguste Comte, who invented it; that is, opposed to theory in favor of experiment and observation, opposed to invisible entities, opposed to what they called metaphysics, and opposed even to the idea of causation, preferring a rather Humean notion of constant conjunction and in general being much impressed by the Scottish idea of the association of ideas as a guide to psychology. In addition, the doctors who figure in the story of multiple personality were mostly republican, that is, deeply opposed to any restoration of the monarchy. Republicanism, positivism, and anticlericalism usually went hand in hand.

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Historians of medicine have not yet, however, sufficiently connected this trio of attitudes to other aspects of French life, for example, physical education. The great physical education movements were rich in political significance. Thus in January 1890 a Ligue Nationale pour l'Education Physique was founded in Paris by the anarchist communard Paschal Grousset, who having been exiled in England was determined on his return to introduce competitive sports in a systematic way for the improvement of French youths. 20 Only a couple of months later in 1890 Tissié founded the Ligue Girondin pour l'Education Physique. Gironde is the department in which Bordeaux is situated. Was Tissié's league a provincial society analogous to the national one but smaller? Not at all. It was the only significant provincial society for gymnastics in France, and in many ways it played a greater part in French physical education than the national league. Tissié is now lauded in physical education circles as a pioneer of regionalism, which has become an important theme in late twentieth-century France. He was far more than that. He detested statism, centralism, Jacobinism, Napoleon, and most things that came from Paris. Girondin did not just denote a region, La Gironde. It meant politics. Tissié's Girondin League was founded early in 1890. Now 1889 was the centenary of the Revolution, the year of the great World's Fair in Paris, the year the Eiffel Tower was constructed. Soon afterward Bordeaux began to build what is still its own tallest monument, the Monument to the Girondins.21 The Girondins: that was the name later given to the club of men who clustered around Brissot, and who in 1789 stood for change with moderation. Many of its members were from the Bordeaux region. The Girondins lost out to Robespierre and the radical Jacobin club. In one of the most dramatized scenes of the Terror, some twenty went to the guillotine. Thus the erection of this rather astonishing monument, glowing in the green of weathered copper, surrounded by les chevaux des Girondins steeds galloping through spouting water was commenced in 1894 as a memorial to moderation and provincial integrity, against the folly of the capital. The year 1889, the centennial of the Revolution, was by no means tranquil. In the spring the populist General Boulanger was generally supposed to be about to march on the Elysée, the presidential residence, in order to abolish the Third Republic and establish a popular dictatorship that would consult the people with occasional plebiscites.22 The coup d'état did not take place, but it is still widely believed to have been a very near thing. I do not wish to dwell

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on political history, but we should see Tissié, founding the Ligue Girondin, as engaged in a deeply political act, whose meaning was plain for all to see. It meant the independent moderation which was part of the self-image of Bordeaux. Moderation ran to all things. When Tissié's professor, Albert Pitres, published his treatise on hypnotism and hysteria, one of his students reviewed the book. "The hysteria of the Saint-André Hospital is," wrote the disciple, "in comparison to the grande hystérie of the Salpêtrière [Charcot's hospital in Paris] a petite hystérie." 23 The same goes for the political views of the members of the medical profession who concern us. The great positivism, republicanism, and anticlericalism of their Parisian colleagues was reproduced, in Bordeaux, as a modest positivism, a moderate republicanism, a gentle anticlericalism. Albert, employee of gas companies, was not involved in these grand schemes. His fantasies were of faraway places; I doubt that he noticed what engaged his own doctor, let alone the political upheavals and battles going on in France. Before saying more about him, I should first enter a caveat. The interest in Albert is not about what really happened in the course of his life, or what was the cause of his curious behavior. He matters to my story because he is the first in a line of fugueurs. He and his doctors establish, in a hyperbolic way, the possibility of fugue as a diagnosis in its own right. Everything I am about to describe could be fantasy. Everything could be what in the trade is called folie à deux, half madness, half folly, produced by the interaction of doctor and patient. Such folly could still inaugurate an epidemic. And folly it may be, for after a brief account of Albert's parental antecedents, Tissié launched into a bizarre tale. Worse, although the tale was told in Albert's own voice, as if he were reciting it on the couch, we know that nearly all the facts were obtained from Albert under suggestion and hypnosis, perhaps the least reliable sources of testimony known to the human race. Document 1 below is Tissié's first report of Albert's travels. We read what are supposed to be Albert's words, yet Albert must have spoken with an extremely heavy Gascon accent, now the preserve of great-grandfathers. Hypnotism is suspicious, but we have, nevertheless, some controls. Quite a number of doctors had a go at Albert. That is not in itself a ground for verisimilitude, but one may be impressed by a figure in the French military

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establishment. Men from the medical corps, especially one just promoted to the most important French military hospital, Val de Grâce, and well trained in the detection of malingering, ought to have some skepticism in their bones. Such a one, Emile Duponchel, had been garrisoned in Bordeaux before his promotion and helped debrief Albert. He describes how Albert ''is easily hypnotizable and readily submits to suggestions. In hypnotic sleep he recalls a certain number of details of his adventurous life, which had been forgotten during his waking state. It was thus that we were able, little by little also by writing to French consuls abroad and by consulting the civil and military authorities at home to reconstitute with commendable patience and by means of indubitable external proofs, the successive episodes of his romantic existence." 24 There is a drawing of Albert in Tissié's thesis. There are four photographs from Pitres's textbook of 1891. These show Albert in four states: two normal, front and side, then hypnotized, and then fugueur (fig. 1). Beware, however, for I suspect that these photographs may have been taken at one sitting, perhaps even in the photographer's studio.25 These shots show how Albert was supposed to look in each of his states. It was urged in many quarters that photography introduced true objectivity into science. No longer did we have to rely on artist's impressions or verbal reports. Caveat emptor! Louis Vivet, the very first multiple personality in history that is, with more than two distinct and diagnosed personalities was photographed in some ten supposedly distinct personality states, representing different stages of his life, but the photos were taken in at most two sittings, and mere changes in posture represent hypnotic suggestion.26 Jean-Albert Dadas was born on 10 May 1860, son of Romain Dadas and Marie Dumeur.27 Marie died of pneumonia at age fifty, in 1877. Albert always remained devoted to her memory, in a sentimental, or even maudlin, way.28 The men in the family worked for gas companies. The father Romain had once had a little money but lost or squandered it. He died of softening of the brain at age sixty-one, in 1881. Father Dadas was first of all a hypochondriac you had only to tell him he looked poorly and he would go home to bed, complaining of pains. As he aged, "he devoted himself, in excess, to the pleasures of sex; he frequently left home; then he became senile. Symptoms of general paralysis." Very probably he was syphilitic. One son had gone up in the world and managed a gas factory in the Midi, but he died of meningitis

Page 20 Fig. 1. Four photographs of Albert in different states by F. Panajou, director of photography at the Bordeaux Faculty of Medicine. From Pitres (1891), vol. 2. Top: In his normal state. Bottom left: At the end of an attack of "ambulatory automatism." Bottom right: When hypnotized.

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at the age of thirty-five. A second, also hypochondriac, worked in town, once again for the gas company, but suffered from headaches. He died in 1892. Albert's sister was in good health, married to another gas worker. These were solid artisans, respectable, seldom without work when they needed it, loyal to their employer who in turn took patronal responsibility for their welfare. Albert fell from a tree at age eight and had a concussion, with vomiting and subsequent migraine. From the very start we can read this story as a case of childhood head injury, but let me first tell it Tissié's way. Albert was apprenticed to a manufacturer of gas equipment at the age of twelve. He worked well and then disappeared. His brother found him in a nearby town helping a traveling umbrella salesman. Tapped on the shoulder, he acted as if he were awaking from a deep sleep, groggy and confused, astonished to find himself where he was, carting umbrellas. Then began a standard pattern. He was given 100 francs to obtain coke for the gas company and woke up on the train with a ticket to Paris. How much was 100 francs? When young Tissié worked nights in the train station, he was paid 30 francs a month; when he was underlibrarian for the medical faculty, his annual salary was 1,200 francs. So 100 francs was real money, but not a lot of money. At any rate, Albert was found sleeping on a bench at the Gare d'Orléans in Paris, kept in custody for a fortnight, and then sent back to his family. But his employer wanted the 100 francs from his family, so Albert stopped en route and worked in domestic service for some months, saving up before he returned home. That was how it went. Overhearing a place-name, Albert felt compelled to set out. At some point he was astonished at where he had got to, often destitute, sometimes arrested. He tried to find work, did odd jobs, scrounged, and managed to get home, often under conditions of terrible hardship. Thus once someone spoke of Marseille; when he got there, people talked of Africa, so he took ship for Algeria, where he had numerous adventures and, in some desperate place, was counseled by a Zouave to go home. He obtained tips for trifling services, implored a ship's captain, and went back to France, scrubbing pots in the galley. He arrived in Aix at harvesttime, was arrested in the fields as a transient agricultural laborer without papers, and did a month's forced labor. His major trips began when he voluntarily enlisted in the 127th Infantry

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Regiment, where he served as a cook. He encouraged a chance-met childhood friend to join up, but the friend was posted to the 16th Dragoons. Since the two chums could not billet together, both deserted, and then Albert led the march through bitterest winter, Belgium, Holland. Very early on the friend died from cold, hunger, but especially exhaustion. Extensive wandering in Germany, to Nuremburg, then down the Danube. By Linz, Albert had lost his papers and was imprisoned for eight days. The prison doctor saw he was very ill and had him released. On to Vienna where he got work in the gas factory and yes, we have letters from the manager to prove it. After some more travel he learned of a general amnesty for French deserters and made his way home. Although besieged by headaches and diarrhea, he soon headed out again. One is struck, in reading these tales of flight, how easy it was to get around Europe a century ago, even if travel was not without its perils. Albert's standard modus operandi was, when he found himself in a strange place, to report to the French consul, who would give him just enough to get home on the train, fourth class. Albert would then hear a chance place-name, leading him to head in the opposite direction. He also begged from Frenchmen in foreign parts. Students would take up a collection for him, a village populated by descendants of émigré Huguenots was always kind to Frenchmen, and there was sometimes a Societé Française to give him some pennies and a loaf of bread. His greatest flight began with his politely taking his uniform and military equipment to the police office in Mons and then heading east Prague, Berlin, Posen, Moscow. En route, passing through East Prussia, he was attacked by a vicious dog while begging at a manor owned by a Frenchman. The scars were permanent; in the short run the owner paid for two weeks in the hospital. In Moscow a superintendent of police said, "I know who you are!" much to Albert's delight. Except he was arrested as a known nihilist, in the great sweep following the assassination of the czar, 13 March 1881. He spent three months in prison with all the other nihilists. The prisoners were separated into three groups, one to be hung, one to Siberia, and the rest to be walked out of Russia, to Turkey. The story of the exodus at least in Tissié's hands is truly vivid, the Cossack guards, the accompanying Gypsies, "unbelievably filthy," who are starving and who copulate on the fields with the other deportees for a scrap of bread or sip of brandy. Albert is chaste,

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despite valiant attempts at seduction to cheer the lad up, after which he satisfies himself "in his usual way." I did not mention that according to the case report, by the time he was twenty-six, Albert had had sexual intercourse only three times in his life, the first time in Vienna, but that he was an "inveterate masturbator." He made it to Constantinople, where an ever-obliging French consul gave him the funds to get to Vienna, where he went to work once again with the gas company. Fantasy? The fixed points, the consul, the former employer, certain French people who helped him, were confirmed. The arrest, the forced march from Moscow to the border? Well, anyone who read the newspapers would have known about the police rounding up nihilists, even the proportions that were executed, sent to Siberia, or exiled. Albert did not need to go to Moscow to overhear this story. He had learned to read in the army and preferred to read reports of distant parts of the world. The events in Moscow were the talk of Europe, so he could have composed his adventure entirely in his head. I confess I believe him; certainly the skeptical Duponchel did. There is plenty more bizarre detail on this trip, but the upshot was that Albert finally reported back to his regiment and was found guilty of desertion. He was sentenced to three years hard labor in Algeria. He worked well, but the shaving of his head caused him unbearable pain; he spent much of the time in the hospital. He was released from the army for good conduct and because he had a damaged eardrum. He returned to Bordeaux to work for the gas company, fell in love, became engaged . . . and disappeared on 18 June 1885. He turned up early in September in Verdun, having no idea what had happened during that time. His girlfriend had meanwhile had the sense to tell him never to speak to her again. On 9 December he was given a sort of welfare ticket home and on 17 January 1886 entered Saint-André. He was transferred to Pitres's ward on 24 February. The next day, when Pitres and his assistants went to examine him, he had disappeared . . . but he now spent most of his time in hospices until his return to Bordeaux, 3 May 1886. What was Albert like? I plunge into speculations about Albert and what ailed him in Supplement 1. For the present let us content ourselves with the simplest facts. In his normal state, at home, in the factory, or as a cook in the army, he was a good worker, timid, respectful, shy with women. He never drank and when he was on a fugue had a particular hostility to alcohol. At

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home he would have a regular and uneventful life. Then would come about three days of severe headaches, anxiety, sweats, insomnia, masturbation five or six times a night, and then he would set out. Usually a fugue was not exactly unplanned. He would get a little money together and some identity papers. At the last moment he would drink several glasses of water or stop at a bar and order a couple of glasses of barley water (orgéat) or some other soft drink. Then off he would go. Over and over again he would lose his identity papers. 29 It is hard not to think that he sometimes wanted to lose his identity. Yet late in his journeys he knew perfectly well who he was and how to get help. Overall, there is a curious mixed quality to his trips. There is no doubt that he got into a terrible state before taking off, and it can truly be said that the need to go overpowered him. Nevertheless he had very variable states of consciousness on the road, sometimes making quite deliberate choices. His reaction when the fate of the nihilists was being decided: Great, the czar will send me to Siberia, beyond my wildest dreams! His nocturnal masturbation fantasies often involved a woman he had seen during the day, with a picture of the two of them setting out on a great trip together. This man hated the fact that his "imperious need to travel," as Tissié called it, prevented him from living a normal life. But he also wanted to travel and from childhood had been fascinated by stories of faraway places. People did not notice Albert much on his travels. Even though he slept rough, he was very clean, taking care to wash in streams and scraping the mud off his shoes. When he "came to," he usually would have no idea of how he had arrived where he was. Later, he might have a general idea of where he had been, with some casual and to my mind rather suspicious touristic details about the sights on the way, but no memory for any specific happenings, such as the dog bite. "How did you get that mark on your arm?" "Oh, I suppose I have had it all my life." "No, it is a bite." "A bite? Me bitten by a dog?"

Then the memory would seep in, usually, it seems, when he was hypnotized. Albert had many of the then standard symptoms of hysteria. When he was

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first interviewed, his tongue felt no pain, to the extent that a needle could be pushed through it without hurting. He had a restricted field of vision, a standard sign of hysteria in those days. He had regions of the skin which were hypersensitive and others that were completely insensitive. There is more to tell about Albert yes, he did marry, in July 1887, and had a daughter, Marguerite-Gabrielle. They lived in Paris. His wife died of tuberculosis. The daughter was adopted by a family of market gardeners. Albert visited her regularly but continued to go on fugues. He always wanted to go north. In 1901 he was in Berlin, where he was (according to Tissié) recognized as "le voyageur de Tissié" and given assistance to get back to Tissié, who by that time had moved from Bordeaux to a smaller town in the Southwest, Pau. He stayed with the doctor for some time. 30 He died on or about 28 November 1907. Tissié wrote a sad epilogue which takes us up to 7 December 1907. Marguerite-Gabrielle, aged fifteen and a half, is looking at a notice board that posts job opportunities. A woman comes up and offers her a job as a dressmaker. Next day, overjoyed, she puts on her best frock and sets out for work, and meets the stranger. A prostitute watching the scene says, "She'll be gone in two days." She is about to be abducted into the white slave trade. Document 6 is a newspaper report of these events. I end this lecture not with Albert but with more about Bordeaux. It was not only bicycle city but also double consciousness city. For it was here that the first of the new wave of French multiples began. But I need to be more precise, for a moment. Strictly multiple personality, in the sense of more than two personalities, was first noticed about a year before Albert checked into Saint-André Hospital. I mentioned Louis Vivet. The first descriptions of this man as a multiple, with more than two personalities, appeared in print in 1885, and the expression "multiple personality" was introduced into English expressly to describe Louis Vivet. There was however a long history of people with two alternating personalities often called double consciousness. The first modern instance of this phenomenon was spotted in Bordeaux. Her name was Félida. I like to quote Pierre Janet's lectures at Harvard in 1906: "She is a very remarkable personage who has played a rather important part in the history of ideas. . . . But for Félida it is not certain that there would be a professorship of psychology at the Collège de France and that I should be here speaking to you of the mental state of hystericals."31 The first public statement about Félida as a case of double consciousness

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was at a meeting of the Bordeaux Society of Medicine and Surgery, 14 January 1876, although the speaker, Eugène Azam, had first encountered her during early experiments with hypnotism some eighteen years earlier. Azam was a thoroughgoing provincial, a loyal Bordelais and Gascon, a distinguished bourgeois doctor. Naturally Tissié came to know Azam, even if Azam was of an altogether different social class than the self-made Tissié. 32 Azam refers to Albert with great interest and favors an account in terms of double consciousness. Azam thought that Albert was more intelligent in his second state of "total somnambulism" than in his ordinary waking state.33 A popular book on hypnotism, published in 1890, has a long account of Albert, mostly abstracted from Tissié. It includes an engraving of "Dr. Tissié hypnotizing Albert in the presence of Professor Azam" (see frontispiece). An English translation of the book was published in London in 1890 and in Philadelphia in 1891, with snippets from the more sensational parts of Tissié's thesis.34 Two points must be emphasized here. Albert was never hypnotized (so far as we can tell) until some months after he entered Saint-André. He did not come from the culture of hypnotism in which so many hysterics and certainly multiples found themselves. He joined it. Second, Tissié to some extent did come to assimilate Albert to multiplicity, but only after he had published his medical thesis. Later he occasionally thought of Albert as having two states, taking the terminology of "first" and "second" from Azam.35 In this way Albert came to be compared to cases of double consciousness. Tissié continued his reporting of Albert in a book titled Dreams Freud referred to Tissié's book on nine different occasions in The Interpretation of Dreams, but only in rather general terms. Tissié came to believe that Albert's fugues often were initiated by dreams, and he developed a surprising mode of dream therapy.36 In my opinion, Albert was substantially influenced by Tissié's therapy, but that is only opinion. I speculate about Albert in Supplement 1 and examine the dangers of hypnotic influence. But in these lectures proper I do not wish to become too fixated on that one patient, paradigm though he was. Let us stand back and notice a few general points. First, as I confirm in Lecture 2, Albert did initiate an epidemic of fugues, or better, Tissié initiated an epidemic of diagnoses of fugues. Second, it has been observed in the past twenty years that about nine out of ten people suffering from multiple personality, or dissociative identity disorder, are women. That has prompted the odd question, where are the male multiples? (One

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canvassed answer is, in jail.) In fin-de-siècle France it was also true that about nine out of ten multiples were women. But after Albert there was an easy answer to the question, where are the male multiples? On the road. But the fugueur was no average man on the road. He was sober, clean, respectable, a member of the working poor, by no means permanently destitute. An artisan, a delivery man, a clerk, a small shopkeeper, not to be confused with the broad mass of tramps and vagrants whom the French population in the 1880s came increasingly to see as a fundamental social problem. The fugueur was not from the middle classes. But he was urban or had a trade. There are almost no reports of peasant or farmer fugueurs. We have been led, very largely by the example of Michel Foucault, to ask whether madness is a mirror of sanity; in Foucault's exceptional case, to ask if madness, as conceived during the Enlightenment, is not a mirror of the Age of Reason and an essential part of that arrangement of ideas. I resist the suggestion that fugue is an essential part of anything grand. But it does reflect something: the age of tourism. Tissié saw that himself. His last comment when Albert was still alive, published in 1901, describes Albert in exactly those terms, as suffering from "pathological tourism." Make no mistake about it. This is the era of popular tourism, epitomized in the Englishspeaking world by the company that ran the business of touring Europe and the Levant for many years: Thomas Cook and Son. We are not talking about the grand tours of British aristocrats, county landowners, or American figures in the novels of Henry James. I refer to tourism for the masses. Cook began by hiring railway coaches to take evangelicals to temperance meetings. In the second half of the nineteenth century, Cook's tourists, as they were called, were everywhere. We are talking about seven million tickets a year by the end of the century. And these tourists, though they had to pay, were as classless as the English were capable of being. 37 There were many smaller travel agents, more German than French. Tourism was expanding in the south of France, but more in the direction of Nice and Caens than Bordeaux or Biarritz. The great era of building popular tourist hotels was in full swing. You can chart the expansion of Switzerland as a destination simply by the hotels completed year by year and yes, in 1882, the year of the biggest spurt in hotel construction in Switzerland, Albert found a friend who talked about Switzerland, filling Albert with an obsession to go there, which he did. Travel was not only for Cook's tourists. Travel was rebellion, poetry.

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Flaubert's orientalism, trips to Egypt, Salammbô. Baudelaire and the flâneur, the intensely curious stroller, the traveler untroubled by time, who notices everything. 38 Baudelaire penned some of his fantasies from a Bordelais balcony and embarked from the port of Bordeaux itself.39 Can we see Arthur Rimbaud (1854-1891) as fugueur? Mad? Yes, or so some would say. Traveler? Par excellence. But mad traveler? He did himself often speak of fugue, meaning the word in its ordinary sense, "flight." His flights took him to places even more exotic than Albert's, even to the heart of Ethiopia, and they took place about the same time as Albert's fugues. In "Sea Breeze," an early poem by Stéphane Mallarmé (1842-1898), the poet exhorts himself to take flight, "Fuir! là-bas fuir!" and concludes, "Je partirai" (I will leave).40 Jules Verne (1828-1905) captured the minds of whole generations with his trips to the center of the earth, to the moon, to the bottom of the sea, and (when Albert was thirteen years old) around the world in eighty days. This is the golden era of travel journalism, Robert Louis Stevenson with a donkey in the Cévennes or describing the new vineyards of Napa and Sonoma, whose rootstock was the savior of the ancient but infected grapes of Bordeaux.41 There is Mark Twain at one end of travel writing and Karl Baedeker at the other. Not that they were separate. When I wanted old Baedekers of northern France and Germany from the library at the University of California in Berkeley, I was told to look for them in the Mark Twain collection of the Bancroft Library; yes, Samuel Clemens had them in his pocket. To tell the truth, I have no proof that Albert did not travel with French-language Baedekers in his pocket.42 Popular tourism was one part of the ecological niche in which a new type of mental disorder, and behavior, was able to locate itself. And what better doctor to recognize it than the great advocate of outdoor exercise, the man who, opposed to fancy gymnastic equipment and fancy athletic tracks, said that the whole of France is an exercise track, a piste du cirque? I must emphasize that tourism is only one part of the niche. In Albert's day travel had its darker side, the vagrancy scare, described in Lecture 3. I said that Albert fascinates some of us because travel has become part of the learned life and of middle-class life in general. But more than tourism hovers in the background. The "voyage" is our metaphor for self-discovery. Michel Montaigne mayor of Bordeaux, 1581-85 created the genre that we call the essay, but he also, in a small way, contributed to another genre,

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the travel diary. Montaigne was a driven traveler, seeking out health, or at least relief from the crippling pain of gallstones, but his journey to Rome via Austria and Switzerland in 1580-81 is recorded in minute detail. 43 He was by no means happy to learn, while in Rome, where he had been made a citizen in the course of his five months' stay, that he had been elected mayor at home and was thereby enjoined to take up residence there. Travel, for Montaigne, was not exactly flight, but it was escape, a way stage between one set of Essays and the next. The idea of life as a journey was cemented for the English reader by Pilgrim's Progress. The reader of German will invoke Goethe in Italy. Montaigne, Bunyan, Goethe: these are not just accounts of travel but epigones for their respective cultures. The trip is a manyfaceted symbol for our moral consciousness, sometimes positive, but also negative, as in that great amorality play, contemporary mass tourism, whose destination is 10 percent cathedrals, 20 percent eating, and 70 percent shopping. The ship of fools; the cruise ship. Thomas Mann's Death in Venice: see it as ''a splendid parable on the demonic and unsettling aspects of tourism."44 What did the world of travel look like? In the introduction to Rewriting the Soul I mentioned seeing "a handsome poster of a rainy Paris street" that reminded me that we all know what the world of double consciousness looked like it looked like the "world of the impressionists." In the spring of 1998 there was an exhibition in Paris, gloriously represented by Juliet Wilson-Bareau's catalogue Manet, Monet, and the Gare SaintLazare (New Haven: Yale Univ. Press, 1998). Paris saw the Saint-Lazare railroad station as the center of Europe. Located at the Place de l'Europe, it was spanned by a triumph of engineering, the Pont de l'Europe. The streets that radiate from it bear names dear to Albert: rue de Constantinople, rue de Vienne, rue de Moscou. It was here that the impressionists congregated. Gustave Caillebotte's "Paris Street, Rainy Day" the poster that I saw in a café portrays the intersection of the rue de Lisbon and rue de Moscou. His family owned much land near the Place de l'Europe, and some of his most famous paintings depict the Pont de l'Europe itself. Edouard Manet lived at 4 rue de SaintPétersburg from 1872. His stunning "The Railway" (often called "the Gare Saint-Lazare") is painted from rue de Rome. After 1878 Claude Monet (whom Caillebotte supported) had his home on the rue d'Edimbourg, just off the rue de Rome. Monet painted twelve impressionist classics of trains

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inside the Gare Saint-Lazare. Emile Zola declared: "That is where painting is today. . . . Our artists have to find the poetry in train-stations" (Wilson-Barreau, p. 105). The impressionist exhibition of 1877 was, in effect, about railways, the station, the Europe bridge, and the Europe quarter generally. Hence we know exactly what the world of travel looked like at the time that Albert began his astounding trips. And Caillebotte's painting of Monet on a dirt road, used as the cover of this book, could be a portrait of Albert's alter ego. Albert's obsessive and uncontrollable journeys were systematically pointless, less a voyage of self-discovery than an attempt to eliminate self. In Lecture 2 I describe how they inaugurated an epidemic of mad travel and use that as a peg on which to hang issues about the reality of mental illness. You can read Albert in so many other ways precisely because travel signifies so much in the whole of Western civilization, from the Odyssey to outer space, with much else, including John Bunyan's soul, packed in between. Yet for all these important excursions, let us not lose sight of our main topic, the reality of mental illness. Tissié himself, furious at the way in which military tribunals had treated Albert, without taking notice of medical advice, had this to say: "When we consider the damaged life led by this poor lad and the number of times in which he had business with the law, which led regularly to prison, we cannot help protesting against the arrogant and criminal incompetence of the magistrate who exclaimed: `What need have we of the help of the physician in order to appreciate the disorders of the mind? If madness is evident, everyone can recognize it by its extravagances or its fits of rage; if there is a doubt, a doubt exists equally for the doctor!'" 45 "That," wrote Tissié at the end of his study, "is the moral that we would like to draw from our thesis." He was rejecting a very old text indeed, a forensic treatise of 1830.46 We now take for granted that courts of law do need expert medical testimony, although in the back of our minds there still lurks, I suspect, a certain longing for that simple jurisprudential doctrine of 1830 deep in our hearts, we know what madness is! But we have moved on. Today the issue is not expert witnesses but the relationship between what they tell us and the way in which their patients become ill. We have not got clear in our minds, yet, the interaction between expert knowledge and the behavior of troubled people. That is the underlying theme that we must pursue.

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2 Hysteria or Epilepsy? How can a form of mental illness emerge, take hold, become an obsession in some place and time, and then, perhaps, fade away? I am leading you through an example. First, a single patient. In this lecture, a plethora. How could Albert and his doctors have started a veritable cascade of fugueurs, or at any rate of fugue diagnoses? This is not just a question about fugue but an exemplar for thinking about a whole group of mental illnesses, past and present. I need to document the outbreak, but that is the stuff of notes. There was a pretty pattern of national spheres of influence. In 1887 Bordeaux. In 1888 Paris. Soon, many regions of France and northern Italy. Then, a decade later, in 1898, a German physician, observing the French work, exclaims, where are the German fugues? Where is the German research? His countrymen rally round. Within five years the number of published German studies of fugue swells, and there is even a survey article so that other German doctors can catch up. That is only the beginning. Russia follows suit. 1 The contours of German fugue are different from those in France. The niche for fugue not only was found later in Germany than in France but also made use of a slightly different medical, social, and military context that I describe in Supplement 3. More interesting to us is that fugue did not "take"

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in America. We have something like an experiment, not a controlled one, to be sure, but a living example of how fugue became a common diagnosis in some milieus and was rejected by others. First I need to describe the dynamics of the outbreak of fugue in the heartland, in France itself. I have talked about 1887. In this lecture it is 1888-95, a jumble of competing cases that in seven years culminates in a synthesis. I talked about Bordeaux, the provincial capital, superbly bourgeois, self-confident, and, for all its sunny southern exposure, dark. Now we go to the metropolis. An epidemic may exist in the provinces, but an epidemic of diagnoses needs support from the center. Paris obliged. It did more than that. It created a controversy which unexpectedly went to the heart of mental illness, as then conceived. But now I have a problem. The great debate makes very little sense in today's terms. Yet without this debate, fugue would have been a mere curiosity instead of a cutting-edge disorder. That is my problem. I must create, in a few brush strokes, a profound disagreement over what ailed those mad travelers of long ago. I hope that when I have done so, you will see striking resemblances to current debates. The two great but mysterious mental pathologies of the day were hysteria and epilepsy. Bordeaux said that fugue was a hysterical condition. Paris said that it was latent epilepsy. Peacemakers said that some fugues are hysterical while others are epileptic. This issue, once burning, has been extinguished to the point where we find it hard to make sense of. Yet it was part of the environment that enabled fugue diagnoses to thrive. Hysteria does not even exist as a possible diagnosis today, while our understanding of epilepsy has been radically changed ever since the advent of the electroencephalograph. Yet these two maladies, both bearing Greek labels and named in ancient times, were two comparable puzzles confronting French psychiatry in 1887. 2 The greatest neurologist of all, Jean-Martin Charcot, at the Salpêtrière Hospital in Paris, would sometimes speak, in a way that seems nonsensical to us, of hystero-epilepsy. Both hysteria and epilepsy have been so intensely studied by historians of medicine and culture that I want to say as little as possible about both.3 I need to remind you of just two relevant facts, one about hysteria and one about epilepsy. First, male hysteria. Hysteria was by its very name a woman's complaint, exhibited in the other sex, if at all, only by effeminate men. Charcot legitimated the hysteria diagnosis for burly laborers. One suggests unkindly that

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this was a power grab. Women's doctors, gynecologists and obstetricians as we would now call them, used to own hysteria, named after the womb itself. Charcot wanted to study hysteria as a branch of neurology. What better way to wrest the illness from wombdoctors than to produce a raft of male hysterics? But Charcot was by no means an equal opportunity employer when it came to hysteria. Yes, men and women could both be hysterics. The predisposing cause in both cases was heredity, generously understood. There was a nineteenth-century program of research into degeneracy, analogous to, although of course far sketchier than, our contemporary program of finding genetic bases for mental and physical illness. The predisposing causes of hysteria in men and women were hereditary, or, more crudely, bad stock, but the occasioning causes were by no means the same. Moral causes could incite hysteria in women, but in men, unless the disorder appeared when the patient was very young, physical trauma, or shock, was the main predisposing cause, alongside poisoning, either industrial or alcoholic. A further difficulty for us, in understanding Charcot, is that the most common use today of the word trauma has to do with a wound to the psyche. Charcot still used the word in the old sense of physical injury. He had gone so far as to use it to refer to shock, but the shock had to have a purely physical (or chemical) cause. The extraordinary transition from the idea of physical trauma to the idea of psychical trauma was happening all around Charcot, in part because of his own contributions, but he himself never made that step. 4 Thus Charcot would not diagnose hysteria in a mature man unless it had appeared in his youth or there had been some physical trauma, a railway accident or lead poisoning, for example. Now let us turn to latent epilepsy. Epilepsy had meant being susceptible to seizures, grand mal. During the middle of the nineteenth century there arose a new conjecture. Epilepsy was a condition of the brain that was not always manifested by classic seizures. In the late 1850s the young English physician and journalist Hughlings Jackson wrote an essay about epilepsy and syphilis. He wanted to change the way we thought about epilepsy, generalizing the concept and including many instances of sudden change in mood or behavior. For example, falling into an apparent rage for no cause. He thought that his idea preserved the original meaning of the Greek epilepsia: "taking hold of, a something seizing the subject as though that `something'

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were outside himself." Thus began the reconceptualization of epilepsy. 5 Hughlings Jackson also had gone on to characterize a distinct form of epilepsy, to be called Jacksonian epilepsy, and also not identified by grand mal seizures. He was one of the few contemporaries whom Charcot acknowledged in lectures, almost fulsomely. In France, Bénédict-Auguste Morel had made similar suggestions.6 Hughlings Jackson had a truly exceptional clinical sensibility, recognized as master by that other great clinical neurologist, Charcot. In fact a 1991 study of epileptic amnesia and fugue searched the literature for a combination of the best phenomenological description of epileptic fugue and known local brain damage determined post-mortem. The authors fixed on a report by Hughlings Jackson published in 1888.7 Not many contributions to clinical and pathological medicine have a shelf life of 103 years. One began to speak of latent epilepsy. Patients did not have seizures of any of the ordinary sorts. Instead there would be other unusual events in the troubled person's life which were described as "psychological equivalents" of seizures or as "epileptic equivalents." Since some epileptics wander in a dazed state after an attack, might not there be fugues of a purely epileptic origin? The connection between an equivalent and a seizure was one of analogy. For example, if the event involved some sort of forgetting, perhaps amounting to amnesia, this would be compared to the amnesia or twilight period of an epileptic after an attack. If there was vertigo or the incident was preceded by headaches, that was relevant. If there was bedwetting, if there had been scarlet fever or childhood head injury, all that was confirmation of an underlying epileptic condition. A sudden fugue might fit into this picture. There were etiological conjectures in abundance, for example, an alleged strong connection between parental alcoholism and inherited epilepsy the alcoholic parent had latent epilepsy. Also there was a widespread belief that after an attack many epileptics were liable to commit violent crimes of which they later had no memory and for which in law they could not be held responsible. This was a dire threat to society, analogous to the fear that hysterics in a state of somnambulism or simply hypnotized could become criminals, even assassins. Degeneracy was deeply implicated in both hysteria and epilepsy. Doctors,

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novelists, and the population at large imagined that when hysteria showed in one generation, epilepsy might show in the next, exemplifying the terrible prospect of racial degeneration. Hence the puzzling concept of hystéro-épilepsie. Confronting a disturbed patient, one looked exhaustively into the health and attitudes of the relatives. The military doctor Duponchel, briefly summarizing Tissié's observation of Albert Dadas, laconically wrote "hériditaire" at the start. Tissié began his own summary of the case with the words, "Albert is an héréditaire." They meant that Albert inherited a disposition to mental instability from his father, the hypochondriac who died of senility, paresis, and softening of the brain. I hope these rather recondite remarks will suffice for me to lay out before you an extraordinary confrontation. In 1887, when Tissié published Les Aliénés voyageurs, Charcot, aged sixty-five, was just passing the peak of his influence. From the worldhistorical point of view, his most famous student, Sigmund Freud, had been in Paris on a scholarship two years earlier and was busy translating Charcot into German. Eugen Bleuler studied with Charcot shortly before Freud. In addition to his foreign students, Charcot was still producing a generation of French disciples, although he had antagonists aplenty, and some of his own favorite students, such as Joseph Babinski, were later to betray his memory. In his amazing Tuesday lectures, or performances, Charcot would exhibit one or more patients and develop their cases and their symptoms before the admiring eyes of a crowd. One Tuesday, 31 January 1888, he presented a mad traveler, albeit a far less ambitious wanderer than Albert. "Mén" was a thirty-seven-year-old delivery man for a company that sold and repaired brass art objects, such as candelabra. 8 He also delivered bills and collected payments. He had his first flight on 15 May 1887, when he was thirty-six. On a second and more dramatic trip in July, he was calling for some goods when he made a complicated trip through Paris, found himself on the train with no money and an inadequate ticket, and then jumped into the Seine to avoid being charged. It did not work. The ticket inspector came to the railway infirmary, where he had been taken after he was rescued. After another fugue on 27 August, he went to the Salpêtrière. You might expect that Charcot, the great advocate of male hysteria, would say that Mén was a hysteric. No. There was no record of any shock or injury in his recent history; otherwise he was simply too old for an outbreak of hysteria. Charcot

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was of the opinion that "this man's illness is epileptic in origin. I will use the expression ambulatory automatism based on descriptions that I made in the past of patients who walk about automatically and do not show any external signs that their walking is unconscious." 9 Charcot rejected the alternatives.10 One consideration clinched the case: medication. We use the same type of reasoning today. Is a person depressed or manic-depressive (bipolar disorder)? If the condition responds well to a substance such as Prozac, she is probably depressed, while if she gets better when taking lithium, it is more likely to be bipolar disorder. In those days there was at most one specific drug in psychiatry, potassium bromide for epilepsy (chloral was also used widely but less specifically). Bromides were administered with great abandon despite the side effects. One hospital in London used two and one half tons of potassium bromide in a year.11 French medical journals had advertisements for innumerable patent medicines using bromides. For example, le sirop de Henry Mure was a patent medicine for "épilepsie hystérie névroses." A one-teaspoon dose of this substance (of "pureté chimique absolue et au dosage mathématique du sel employé") contained 2 grams of potassium bromide in bitter orange syrup. Two grams was a standard daily dose.12 Charcot on Mén: ''If the man's flights are equivalent to epileptic seizures, then I can treat him." Charcot prescribed cyclical dosages of 4 grams the first week, 5 grams the next, and 7 grams the third week, and then back to 4. "You must never in your life," he said to the patient, "stop taking bromides." All went well for fourteen months, but the medicine left Mén weak and tired, so the dosage was reduced to one gram daily and then in September 1888 suspended entirely. On 18 January he took off again, with a substantial sum of his employer's funds in hand 900 francs nine months' salary for Tissié when he was a sublibrarian in Bordeaux. Eight days later Mén reached the naval port of Brest, without having any idea how he got there. But he had spent 200 francs. Scared that he would have another attack, he sought protection from a policeman. He told his story and even showed a letter from Dr. Charcot. The constable said, in effect, "Oh yeah?" and arrested him for vagrancy. A magistrate assumed that the 700 francs still in Mén's possession were stolen. Six days later, after confusing telegrams from his employer in Paris, the wretched man was released. Charcot declared that such individuals should be identified, and that they should always carry an

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official certificate, signed by a doctor and bearing an official stamp. 13 Thus wanderers would be able to distinguish themselves from vagabonds and extricate themselves from their predicaments. Charcot discussed these developments on 12 February 1889.14 He confidently ended his second demonstration of Mén with the words: "This is plainly a special variety of epilepsy. Thanks to the bromide treatment, we have already helped him, and I hope that by the use of the same medication I shall continue to be of service to him."15 Charcot never did (it seems) tell his public what happened to Mén. That was left to a medical student and not one of Charcot's own!16 Georges Sous records that despite substantial increases in the dosage of potassium bromide, Mén had three more major fugues, starting on 14 December 1889. There were also minor ones, when he would come to in a strange place, with a complete blackout for the previous few hours. The last known fugue took place on 30 June 1890. Despite vigorous inquiries by the police, he was never seen again. Regardless of his unfortunate disappearance, Mén became a new, metropolitan, and epileptic paradigm alongside Albert, the hysterical and provincial paradigm. The word paradigm has been much overused since Thomas Kuhn popularized it in The Structure of Scientific Revolutions. What I mean here is that these two cases were the first and standard examples upon which later work in the field was modeled. That is one of the two meanings of the word upon which Kuhn himself settled.17 I do not mean that either Mén or Albert was your typical epileptic or hysterical fugueur. Both were too perfect or too exceptional to be typical. I mean only that they were the foremost reference points for subsequent diagnoses. Duponchel, the military doctor who wrote about Albert, signaled the split between the two paradigms soon after Charcot's first presentation of Mén. After describing both Albert and another military fugueur, he said that "alongside ambulatory automatism, we need to distinguish what by analogy I would like to call déterminisme ambulatoire."18 This name did not catch on in France, but it became standard in Italy as determinismo ambulatorio, naming hysterical rather than epileptic fugue.19 And what did Charcot think of Albert? Not much. He was an original. He was totally different from the epileptic Mén.20 Two paradigms ensured a competition, very roughly between the Charcotians and the anti-Charcotians such as Pitres, although out of respect for

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the Master, hostility was veiled. Controversy ensures publicity. In this case it made people think about fugue or automatism. But there is a far more important point here. The niche for fugue as a diagnosis is built of diverse ingredients that I call vectors, since they point in different directions. In Lecture 1, I spoke of virtuous tourism, and in the third I talk about vicious vagrancy, a pair of elements in the environment that jointly were hospitable to fugue. But there are factors of a very different kind. The easiest way to make sense of a new form of madness is to lodge it within an existing taxonomy. That means it must be a subordinate disorder, falling under a superordinate disorder. There were two candidates for superordinate disorder: hysteria and epilepsy. In his final contributions to philosophy, Thomas Kuhn argued that a scientific revolution occurs when an existing taxonomy of natural kinds must be broken up in order to accommodate a new kind of thing. Conversely, you don't need a revolution if the new kind of thing fits within the established order. 21 The epilepsy-hysteria debate provided publicity for the new diagnosis. It also ensured that no matter who won, fugue could be accepted into the established taxonomy of mental illness without any need for revolution. That was not good for fugue in the long run. When hysteria left the scene as a superordinate disorder, it carried all its subordinates with it. The shattering of a genus (hysteria) can eliminate the species (hysterical fugue). I feel quite uncomfortable at this point. Mén and Albert Dadas were real people. The medical profession used them as paradigms. I use them as exemplars to think with. But what about the men themselves? They are dead, there is nothing we can do, and it would be sheer sentimentality to sorrow for them. But these are not happy lives. I do worry about how even the long-ago dead become pawns for psychiatric talk. When they were relatively prosperous, they usually have left a substantial paper trail behind them. We know an enormous amount about Freud's patients, such as Dora. We know about their lives after Freud; they are by no means happy lives, but we know these individuals as people. We can find out about them because they were rich, well connected, even if, for example, the Wolfman lost his incredible Russian estates after the revolution. Breuer's Anna O., namely Bertha Pappenheim, merited a 1952 German postage stamp honoring her pioneer work as social worker activist and feminist, particularly dedicated to poor, exploited Jewish women in Germany. But Mén and Albert Dadas pass from sight, and

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we know almost nothing about their helpmeets or their children. We know that Albert's wife died young of tuberculosis, and we believe that his daughter, thinking she was getting a good job as a dressmaker, was abducted to become a prostitute. We have hints of such disasters, but what was it like to be a good woman married to Albert? I am unhappy about using such hapless depersonalized individuals as paradigms. But such they were. That said, let us look more closely at the controversy arising from the two paradigms. Less than a month after Charcot's second lecture, two doctors from the Charité Hospital in Paris presented a fugue and a carefully argued statement against a diagnosis of epilepsy; the title was "A Case of Hysteria with Ambulatory Automatism and Trembling." 22 "Ambulatory automatism is usually attributed to epilepsy," they wrote. Note how quickly things are going. The very term ambulatory automatism is hardly one year old, as is Charcot's diagnosis of latent epilepsy. Yet already the connection is "usual." In July, Jules Voisin, no friend of Charcot's, reported a fugueur with double personality. The gender rule applies here: doubles tend to be female. She was a thirty-six-year-old charwoman, mother of eight, of whom five were alive and not one of them had ever had a convulsion. Ancestral history way back was diligently searched no trace of epilepsy. The woman was a classic case of hysteria: she was anesthetic over half of her body. She had repeated headaches and attacks of trembling during her sleep. Ambulatory automatism, doubled personality; she was cured by hypnotism. This was critical. Epileptics did not respond to hypnotism. There were a dozen more symptoms of hysteria. Voisin stated: "The case is interesting from many points of view, but I wish to draw the attention of the society to the phenomenon of fugue, of ambulatory automatism. Cases of unconscious fugues are not rare in science, and the majority are classed as latent epilepsy. I believe that a large number of them ought to be considered as cases of doubled personality in hysterics. This observation is a striking case."23 Note the "not rare," the "majority." A disorder that had barely begun to be diagnosed was already regarded as commonplace. Voisin continued the defense of hysterical fugue in a speech to the Congrés de Médecine Mentale on 6 August. The long title conveys the message. "Unconscious Fugues in Hysterics. Ambulatory Automatism. Differential Diagnosis between These Fugues and Epileptic Fugues." Voisin reported five cases of unconscious fugues in hysterics. By way of making peace with Charcot, he maintained

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that there could be two distinct types of fugue, one hysterical and one epileptic. But he favored hysteria. A person who was dispositionally epileptic could experience purely hysterical fugues! All five fugues took place in something analogous to what Azam called the second state. All were treated successfully by hypnotism. 24 All this was happening in 1889, the year of the Universal Exposition and the Eiffel Tower, commemorating the centennial of the Revolution. These were politically troubled times, as I reminded you in Lecture 1 (especially note 22, which says a few words about the coup d'état that was anticipated in mid-1888). But 1889 was also a year of selfcongratulation. Paris was full of congresses. The mental medicine congress, at which Jules Voisin (and also Tissié) spoke, ran 4-10 August. The First International Congress for Hypnotism and Therapy was 8-12 August, somewhat as an adjunct to the Congress for Physiological Psychology. William James, who was there, reported that "everyone seemed to think that the original Salpêtrière [viz., Charcotian] doctrine of hypnotism, as a definite pathological condition with its three stages and somatic causes, was a thing of the past."25 When it comes to solemn proceedings, James is the man to read. "The most striking feature of the discussions was, perhaps, their tendency to slope off to some one or other of those shady horizons with which the name `psychic research' is now associated." And people had a good time: "The congress wound up on Saturday night with a feast of other things than reason and a flow of something besides soul on the platform of the Eiffel Tower." The assembly was an international Who's Who of psychology, hysteria, and hypnotism, but Charcot was not present.26 At the hypnotism congress there was the obligatory tour of the famous Salpêtrière, but August Voisin's ward was on show, not that of Charcot. Voisin claimed to hypnotize one in ten psychotics and ameliorate their condition; the procedures were more those of Hippolyte Bernheim from Nancy, rather than of Paris and Charcot. In short, Charcot's reign was rapidly coming to an end, not over the minor issue of fugue but over the major one of the nature of hysteria, of hypnotism, and their interrelation. Tissié published in 1887, Charcot in 1888, and the first debates took place in 1889. After that it was a free-for-all, with numerous cases pouring in, enriched with rhetoric. Here is an example. One of Jules Voisin's students presented nine cases, all known to Voisin.27 The first in this list was none

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other than the juvenile delinquent and petty offender Louis Vivet, whom I have called the first truly multiple personality. Voisin had been proud to present Vivet as a male multiple in 1885. In 1889, after fugue had become a medical entity, Louis Vivet acquired a new property, retroactively, so to speak. He was a fugueur. Why? Because Voisin and his student needed to establish the legitimacy of hysterical fugue. Vivet was a useful ally, because he had been so intensely reported by many investigators. 28 He was known to be a hysteric treated by hypnotism. He was a fugueur. Ergo: fugueurs could be hysterics rather than epileptics.29 Voisin's student again urged differential diagnosis. The efficacy of hypnotism and the uselessness of bromides were part of the argument. Incidentally, only one of the nine patients did anything "wrong" he absconded with 32 francs while in his state of fugue (he was acquitted on grounds of nonresponsibility).30 Doctors, then as now, cannot help liking some patients and detesting others. Voisin's student went further, urging that hysterics were basically attractive people with a problem. But epileptics given to sudden impulses were described in a somber, indeed sordid, light. Latent epileptics who experience sudden attacks "are filthy and lewd, they exhibit their genitals, urinate in a salon, at the theater or in a church, make shocking gestures, or at least are found naked in the staircase, in the courtyard of their home, or in the street."31 We are told of the man in the train compartment who emptied his pockets, took off his hat, put his watch into it, urinated on the knees of an eight-year-old girl, and sat down, astonished, as he came to, at the anger of his traveling companions. That is the model for the epileptic fugueur! The epileptics are horrid, crazy. The hysterical fugueur is not like that at all. By implication Charcot's own example from the Tuesday lectures a thoroughly decent type must be a male hysteric, not an epileptic. That thesis was defended on 21 July 1890. Three days later it was the turn of Georges Sous, the student who told us of Mén's final disappearance. Although he showed that Charcot's treatment failed, he was faithful to Charcot's model.32 We are not shown the epileptic orduriers but instead learn the sad story (for example) of a thirty-two-year-old mechanic who from time to time left his workshop, doors and windows open, and disappeared for two or three days. On the last occasion he took a boat from Le Havre to Trouville and was arrested outside the estate of Thiers, then president of the Republic.

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The most interesting new case that Sous contributes is a splendid example of epilepsy a small shopkeeper with a long history of seizures, good response to bromides, and the occasional fugue. The message: epileptics who travel impulsively are nice people, as, indeed, was Charcot's Mén himself. Both these theses use the same rhetoric: Disorder X rightly bears a stigma; you wouldn't want to have anything to do with a person afflicted with X. But disorder Y is a misfortune that happens to basically decent souls. You would not want to diagnose someone you like as X (choose X = hysteria or X = epilepsy, depending on which side you are on.) What excellent medical rhetoric! This is a good moment to direct our attention to a more cultivated milieu. 33 I have insisted that in my large roster of cases, the patients are usually workingmen, fairly solid citizens, regularly employed if poorly paid. But there are of course counterexamples. So let me tell you about Emile, a Paris lawyer aged thirty-three. Here is a new social class, and even the venue in which we learn about him is new. My sources tend to be medical meetings, conferences, the toils of graduate students completing their medical degrees and where André LeBlanc has done the work, the actual records of lunatic asylums. But now we go to a highbrow location, the Academy of Moral Sciences, in its meeting of 20 January 1890. A long abstract of the lecture was printed the next day in the Bulletin Médical. An editorial note stated that this was published "according to the wishes expressed, we believe, by one of the most eminent members of that society [viz., Paul Janet, uncle of Pierre], who is well informed about this case of ambulatory automatism and doubling of the personality. This initiative, by one of the masters of modern philosophy, . . . and the reception of the audience . . . testify to the importance that more and more philosophers attach to knowledge of certain facts in nervous pathology."34 The title was anti-Charcotian: "Ambulatory Automatism in a Hysteric." Emile "presents all the manifest signs of hysteria." He was "almost instantaneously hypnotizable" he had only to be asked to fixate on a point in space or to hear a sharp sound (the clap of a hand), and he would fall into hypnotic sleep. He even went into a trance when he caught himself looking into the mirror in a café by the Bourse. It was perhaps not too surprising that every once in a while he lost his memory. "A new life, a new memory, a new me,

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begins. He walks, takes the train, makes visits, buys things, gambles, etc." Some of the events in Emile's second state were not altogether unrelated to events in his normal state. Thus he visited his stepfather, with whom he had a fight, before changing state on 23 September 1888. He returned to his normal state in the middle of October. Meanwhile he had for example visited one of his uncles, a bishop. There he had broken furniture and torn up books and even manuscripts. He also incurred 500 francs of debts during his peregrinations, which led to a charge of swindling. Since no one knew exactly where he was, he was tried and convicted in absentia. The decision was reversed once medical evidence had been heard. 35 He did it again, and also stole a small sum of money, and was again apprehended. Two well-known expert witnesses made a favorable deposition. The charge was dismissed. In the first incident the man recalled, under hypnosis, that he had borrowed 500 francs to gamble, and he described in detail the games he had played and how he had lost. The second incident furnished even more compelling evidence of the power of hypnosis (and hence of the hysterical nature of the case). Emile knew he had, before he lost consciousness in his normal state, a wallet containing 226 francs. It disappeared during his second state. He had no idea where or how. Six months later, under hypnosis, he recalled the hotel in which he had left it. Awakened, he was told to write to that hotel, and next day he received the wallet in the mail. Here we find what was to become the central criterion for hysterical fugue: amnesia for or confused memory about the trip, which could be resolved under hypnosis.36 Emile may not be new to you. The physician and public health official who read the paper to the Academy of Sciences was Professor Adrien Proust, father of Marcel. Henri Ellenberger, that exemplary and encyclopedic student of the history of dissociation, mentions "idle talk in Madame Verdurin's salon" about a double personality and writes, "It is noteworthy that this very story had been published by Marcel Proust's father, Adrien Proust, as a significant psychopathological case."37 That may be pushing things, because ambulatory automatism, the very point (and title) of Dr. Proust's report, is not mentioned by his son, and the disorder had virtually disappeared in France by the time Le Temps retrouvé was published. Marcel Proust's Dr. Cottard, "with the delicacy which reveals the man of distinction," is changing the course of conversation from a disagreeable

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subject. He "relates in more philosophical terms than most physicians can command" how the trauma of a fire had changed Mme Verdurin's footman into a new man, with new handwriting and an intolerable character which led to his being dismissed. Then, as they moved from the dining room to the Venetian smoking room, "Cottard told us that he had witnessed actual doublings of the personality, giving as example the case of one of his patients whom he amiably offers to bring to see me, in whose case Cottard has merely to touch his temples to usher him into a second life in which he remembers nothing of the other, so much so that, a very honest man in this one, he had actually been arrested several times for thefts committed in the other during which he had been nothing less than a disgraceful scamp." 38 Is this the specific story of Emile, reported in 1890 by Adrien Proust? Or is it more of an amalgam? No matter. Emile himself is not a prototypical fugueur because he was of the middle classes, a lawyer. And in his fugue he was dishonest, a swindler. The prototypical fugueur was an honest craftsman, artisan, clerk, or regularly employed laborer or a conscript. He was not your Paris lawyer, nor was he a tramp. In his fugue state he never stole, and if he did, it was out of absentmindedness or out of necessity, a piece of food.39 To return to hysteria-epilepsy: new cases on both sides kept on appearing. Bordeaux did its bit. The second volume of Pitres's Lectures on Hysteria has ample discussions of fugue and includes the four photographs of Albert shown in figure 1.40 One of many theses about fugue written under Pitres's direction begins: "During our stay at the Faculty of Medicine of Bordeaux, we had the opportunity to examine, in the outpatient clinic attached to Dr. Pitres's ward, a good number of patients who complained of a problem which, if not grave, was at least deeply troubling to them. They were, they said, taken by an overpowering desire to walk, and off they went, in spite of themselves, abandoning everything in order to satisfy this need."41 Then come eighteen cases, including a little more on the travails of poor Albert but many new examples, classified as epileptic, hysterical, and neurasthenic. That is 1892, in Bordeaux. Charcot died in 1893. One no longer had to tremble in Paris for fear of the Master. It was time to take stock. By 1894 there were enough fugues on record for there to be a major survey article. Forty cases were summarized. The list was far from complete and at the same time included cases that could only have been put in for the sake of bolstering the epilepsy family of diagnoses at the expense of the hysteria family.42 Next year

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came two attempts at synthesis. The field had become mature: only established fields have survey articles and syntheses. Not surprisingly, one synthesis came from Bordeaux, the other from Paris. The metropolitan one became canonical. Two years after Charcot's death, the successor in his chair, Fulgence Raymond, gave his measured summing up of the state of play. 43 But first the less systematic events in Bordeaux. In that medical milieu the proliferation of fugues and the resulting distinction between fugue episode and cause prompted new nomenclature. Ambulatory automatism should not be seen as a disorder in its own right: It is "a morbid episode of variable causation, whose relation to the great neuroses is now well understood."44 Sometimes it is an epileptic equivalent and sometimes a hysteric equivalent. The hysterical fugueur is overcome by unknown compulsions and behaves very much as if he had received a hypnotic suggestion. He is to be treated by hypnotism, while the epileptic fugueur responds to bromides. But then there are other patients who engage in impulsive vagrancy without the symptoms of either hysteria or epilepsy.45 Members of this new class of nonhysterical, nonepileptic fugueurs were sometimes tagged with the American label of neurasthenia. Etienne Régis was an increasingly close associate of Pitres. He devised yet another name for our disorder: dromomanie.46 One suspects that Tissié, the physical education enthusiast, had a hand in this coinage; dromo is a Greek stem signifying a racecourse. By dromomania Régis meant a nervous disposition, a state in which one had a compulsive drive toward taking flight. The fugue became the episode, and dromomania became the disorder of impulsive fugue, covering not only hysterical and epileptic fugues but also people who did not fit either label but were, to use the imported American diagnosis, neurasthenic. The name was preferred (wrote Régis) over automatisme ambulatoire, because there was no commitment to the idea of automatism, to amnesia, to change in identity, or to confusion about identity. To our eyes it was not so much a specific disorder as a group of complaints with distinct etiologies. Whereas hysteria and epilepsy had an element of theory behind them, dromomania was purely descriptive. This to some extent destroyed the taxonomic structure that I mentioned earlier, but there was an organizing principle: degeneracy. Dromomania, a generalized fugue-for-all-seasons, was absorbed into the larger degeneracy program that I describe in Lecture 3. But why insist on a single named disorder, dromomania? In part for legal

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reasons. There was seldom any way of telling what ailed a fugueur. The hysteria-epilepsy debates were inconclusive. But it did not much matter whether a fugue was purely psychogenic (hysterical) or epileptic or even if it was the consequence of brain injury. If the fugueur did something wrong, like inadvertently going on a fugue with his employer's money or, worse, deserting from the army, there was a diagnosis at hand that could exculpate him. The upshot of this approach appeared in a book Régis published jointly with Pitres in 1902 titled Obsessions and Compulsions. 47 To return to Paris, Charcot had not denied that there are hysterical fugues; he thought only that they were rare and of little interest. He wanted neurological bases for mental disorder, and epilepsy, including latent epilepsy, was fixed on as the neurological basis of fugue. Conversely those in the other camp did not deny that there were epileptic fugues. They maintained only that there were a great many hysterical fugues. In his magisterial lecture of 1895, Fulgence Raymond surveyed the published cases. He expressed fulsome respect for his predecessor but insisted that even a manifest epileptic could suffer from hysterical fugues. A man can have two diseases at once, and if he is hysterical, his traveling problem should be treated by hypnosis, not bromides. Raymond had his own cases.48 The central figure of the lecture was P., a man of thirtyone who made one flight, of which he had no memory afterward. When one looks at the story, as Raymond says, the man had cause to escape. His wife was away in Paris, he had drunk too much, not gone home, slept with a woman he did not know, and headed off from Nancy to Brussels, staying at worse and worse accommodations until his money ran out. He left home on 3 February; on the eleventh he was found sleeping in the snow in a suburb of the Belgian capital. We may add that P. had always solved his problems by traveling. To begin with, altogether reasonably: at seventeen this Frenchman had left his home in Lorraine so as not to be conscripted into the German army. He had signed on for a voyage of exploration to South America but could not go because of injury. He then spent two years in Gabon under Brazza. He married at twenty-four; his wife soon left him, upon which his family prevented him from joining the Foreign Legion. He remarried at twenty-six and settled down as an employee of the Compagnie de l'Est, working in the Paris railway station. He was still writing up his experiences in Gabon, which were

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published in installments by the Société de Géographie. Travel and escape were deeply inscribed on his soul. Raymond had some trouble getting P. to undergo hypnosis (''doubtless because he is from Nancy" a dig from Paris at Bernheim's school in Nancy), but after a series of unplanned but suggestive incidents, the man recovered the memories of the trip and was declared to be a hysteric. Raymond then used him as his own paradigm of hysterical fugue. Raymond confidently defined fugue and stated criteria for distinguishing among epileptic, hysterical, and what he called psychasthénique fugue. The third category, using a term invented by Pierre Janet, does not seriously involve amnesia. The fugueur remembers where he has been, pretty well. He has an irresistible desire to travel without any loss of consciousness or any of the usual stigmata of hysteria. He is typically a degenerate. A fugue, Raymond stated, is characterized by three features. (1) There is an irresistible compulsion to travel or in fact perform any other enduring unmotivated act. Thus every type of automatism was, for the nonce, drawn into the fugue classification. (2) The act is accomplished intelligently, in a regular and apparently normal way, without violence. (3) Afterward there is no memory of the act at all. In distinguishing hysteria, epilepsy, and psychasthenia, one must attend to factor 3, the degree of amnesia. Amnesia implies either epilepsy or hysteria, as opposed to psychasthenia. Moreover, in the case of hysterical fugues, memories can usually be recovered by hypnosis or suggestion. But that is not the key difference. When one is sure that the fugue is not psychasthenic and thus is epileptic or hysterical, one proceeds to "the degree of intelligence and coordination of the acts, which separates fugues properly called, that is hysterical phenomena, from, in my opinion, the procursive deliria of epilepsy." 49 "Procursive" referred to the aimless wandering that sometimes follows an epileptic fit. Raymond did not say it, but Charcot's Mén was not an instance of procursive aimless walking around in circles! Raymond was claiming, or rather on Tissié's behalf reclaiming, the core concept of fugue for hysterics. He succeeded. As long as hysteria remained a viable diagnosis (not long!), it was accepted that there were both epileptic and hysterical fugues, with the hysterical ones predominating.50 As for treatment: fugues of an epileptic nature were to be treated by chemical means. Hysterical fugueurs should be given hypnotic therapy. That is true whether or not the patient is also an epileptic, for suggestion and

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hypnosis are the surest road to amelioration. As for psychasthenic flights, various kinds of moral persuasion are in order. One must try to remove some idée fixe, but neither hypnosis nor drugs are appropriate for the result of inherited degeneracy. I expect that William James got a copy of Janet's account of Raymond's lecture from Janet himself. He certainly used it in 1896, when he gave the Lowell Lectures at Harvard. The topic was "Exceptional Mental States." There he took ambulatory automatism as the name of virtually any sort of exceptional mental state or aberrant behavior that involved some amnesia including multiple personality. 51 In these lectures ambulatory automatism became what psychiatrists call a superordinate disorder, grouping other disorders under it. James seems to have been trying out the idea, flying a kite: He never published these lectures, and he did not continue to use ambulatory automatism as an organizing concept for variations of the personality. I have led you through an outbreak of fugues, a controversy about their nature, and its temporary resolution. The medical debate is important to the fugue diagnosis. It made the topic interesting to doctors. I suggest that such a polarization of professionals helped a new mental illness to establish itself. It is also important that the polarization went within established taxonomies. There was no need for a Kuhnian scientific revolution, a transformation in "natural kinds," in this case, kinds of mental illness. I dwelled on a second element in Lecture 1: mass tourism, of which our fugueurs are parodies. Tourism was deemed to be good, a positive activity. It was supposed to be both romantic and intellectually rewarding, witness Baedeker's improving guides or the Touring Club de France with its thirty volumes of Sites and Monuments. It was supposed to be healthy, what with the Touring Club de France with its 73,000 paid-up tourists on bicycles or the new Alpinism. That was part of the niche in which fugue located itself. But there was a darker side to travel, an especially French obsession with vagrancy. Our doctors were keen to insist that their fugueurs were not vagrants and provided them with documents to prove it. But this dark side, as I explain in Lecture 3, is also part of the niche for fugue. There I suggest that one of the features of a new mental illness is that it embeds itself in a two-headed way in a culture. The simplest way is that there are two versions "of the same thing," one held to be virtuous and one held to be vicious, between which the illness insinuates itself, as fugue lives between tourism

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and vagrancy. That is too simple, but I suggest that at least there is something approved and something disapproved between which transient forms of madness insert themselves. Thus in Lecture 1 I gave you the cheerful, healthy, hearty, wholesome side, and in Lecture 3 I give you the gloomy side, full of hapless tramps and policemen. But here I conclude by repeating another theme: the bodily expression of male powerlessness. That is a phrase I adapted from the description of nineteenth-century hysteria as "the bodily expression of female powerlessness." 52 Male as opposed to female? Yes, of course. An American neurologist lecturing on fugue said in 1907 that "early in my investigations I was struck by the enormous preponderance of men. In the very considerable number of reported cases, I have found only two women. . . . Why no ambulatory automatism in women? . . . It is quite natural that a hysterical woman should not go off on a long and complicated journey but, for her attack, should have one of the `regular' manifestations of the disease."53 Quite natural! More accurately, a man in a daze with shabby clothes and little money could travel for days, quite safely, until he was arrested by the vigilant police, but a woman simply could not do that, then or now. I have been struck less by the gender difference than by the matter of class and occupation. It is something more specific than not being prosperous, not being of the middle classes. When I review my fugueurs I see that the paradigms are a gas fitter and a delivery man. Raymond's latter-day paradigm was a clerk in a railway station. I find small shopkeepers, carpenters, mirror makers, tailors, cobblers. They have had some education but usually were sent out to work, at least as apprentices, between the ages of twelve and fifteen. Typically urban, virtually no peasants or farmers.54 But also not day laborers or factory hands. These are men with a certain amount of, if not autonomy, at least freedom from immediate supervision. Albert is sent on various missions, to buy coke or to install a gas jet in a workshop making women's clothes. We must be cautious about selection effects. Could there have been an equal proportion of middle-class fugueurs who do not show up in the medical records? That is possible, but the presence of Proust's Emile shows that the prosperous hysterical fugueur was not automatically excluded from medical publications. I suspect that the selection effect actually goes the other way, excluding not the rich but the destitute. You must have a home in order

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to be a fugueur. Look at the very definition of dissociative fugue in place today in the diagnostic manuals (as quoted in note 9 of Lecture 1). A fugueur is someone who leaves home or place of work . . . so you must have a home or place of work. That is equally implied in Pitres's more metaphorical 1891 description of the fugueur: "Swearing by all the gods never again to quit his Penates, he returns home but sooner or later a new attack provokes a new escapade." The fugueur has to have household gods and hence a household. It follows that we will seldom see true members of the underclasses showing up as fugueurs, unless they are there because of their intrinsic medical interest. Once again I think of Louis Vivet, reclassified as a fugueur but singled out for study because of the multiplicity of his personalities. Thus I do not minimize the possibility of selection effects, that we are simply not seeing many fugueurs who were merely jailed as tramps and then moved on. There is nevertheless a distinct class of prototypical fugueurs, all drawn from very similar social backgrounds. Such men have all sorts of problems, and they are curiously powerless in the face of their daily lives. It is these men who find, in the possibility of fugue which after all, means flight an escape over which they have no control, and for which, after the event, they have no memory except when they make use of another device that allows them to remember, namely, hypnotism. I do not find in these cases any significant vestige of fraud or shamming. Instead, their powerlessness, which produces temporary mental breakdown, finds release in a mental illness which relieves them of responsibility, is cultured by medicine, and is medicalized in the culture of the day, a culture that includes both tourism and vagrancy.

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3 Niches When is traveling mad? When do the mad express their insanity by travel? When is the madness of travelers taken to be a kind of madness in its own right? From time to time mad people have traveled, but usually their traveling has not been presented as a specific kind of madness. For example, about 1825 the young German poet Eduard Mörike (18041875) fell in love with one Clara Meyer, whom he immortalized in a song cycle as Peregrina. 1 Other men than he described her as intensely beautiful. She had been a member of a group of itinerant Christian revivalists. After they were proscribed, she began to have fits of compulsive wandering. She would fall into a swoon, wake up, and have no idea where she was. She was held to be insane but helpless, fascinating, lovely. Had she been French and young in the 1880s, she would have been a canonical fugueur. But she never entered the annals of medicine. We know of her only through verse. Aimless wandering driven by irresistible impulses seems, when you come to think of it, such a natural way to be insane. Perhaps we ought to be asking why, in the course of human history, has not compulsive traveling without purpose more often, and in more places, been thought to be a kind of madness? We should look not merely for trips that we regard as crazy but for travel that in its time and place is or was diagnosed as representing a type of insanity, and not merely insane behavior.

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As is the case for so many aspects of the human condition, Greek stories serve us well. Western literature opens with the two epics, one of collective endeavors, the Iliad, and the other of one man's tribulations and achievement, the Odyssey. The two pieces between them set the official poles of Western thought, the community and the individual. The second epic is, among other things, the greatest travel story ever told. Grumpy readers may grumble that Odysseus was as mad as could be, but that is not what the story says. He was, for all his breakdowns, a man who overcame his confusions and triumphed. Albert Dadas was a parody of Odysseus. He traveled more miles and had many an adventure, but for him traveling in itself was an obsession, while Odysseus traveled because of his obsession, which had become his quest. Oedipus was no more insane than Jack Kerouac, on the road. Many of the memorable events of Greek mythology happened while the characters were en route. Arrogant Oedipus was traveling on foot through the narrow defile between Delphi and Daulis when he encountered his father coming the other way in a carriage. Tragic, doomed, but not mad. Yet I suggest that you have to have exceptional, admired travel, a heightened form of travel, even tragic travel, in order for mad travel to be its mirror and recognized as madness. Oedipus and Odysseus were part of a space that truly insane Greek travel could occupy. So who were the mad Greeks? It would be fierce anachronism to foist our concept of mental illness onto ancient Greece, but notice this. To call something an illness, and not just madness, is to imply that there are experts to be called in, professionals who can attempt or achieve cures. There are just such experts in the myths. They treat mad travelers with medicines made of herbs or powdered rock. They use dance therapy, water therapy, and a good deal else. There is an almost endless stream of mad Greek travelers. 2 Take just one example, the three daughters of King Proetus of Tyrins: Iphinoe (the eldest), Lysippe, and Iphianassa. The women went mad, "according to Hesiod, because they would not accept the rites of Dionysius, but according to Acusilaus, because they disparaged the wooden image of Hera. . . . When these damsels were grown up, they went mad. . . . In their madness they roamed over the whole Argive land, and afterwards, passing through Arcadia and the Peloponnese, they ran through the desert in the most disorderly fashion."3 A physician, Melampus, knew how to cure the

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madness. He used strong young men to chase the women "from the mountains of Sicyon with shouts and a sort of frenzied dance. In the pursuit . . . the eldest of the daughters expired, but the others were lucky enough to be purified and so regain their wits." In other versions of the myth, Melampus used herbs to cure the sisters. Or secret purification rituals at the sanctuary of Artemis. Or by having the women washed in the river Clitor. 4 Everything is writ large in Greek myth; cynics will suggest that Lacan would have loved Melampus's fee structure. One-third of the kingdom for a cure! Proetus refused. The women got worse, and other women became mad in the same way. In the end Melampus demanded another third for his brother, Bias. Proetus caved in. One sister died, and two survived. Proetus squared things up by marrying his two surviving daughters to doctor Melampus and brother Bias, thus keeping the kingdom in the family. When it comes to scholars writing about those very travelers, we are in luck: the reality question rears its tiresome head, and we are led off in another direction, to another place and time. Early in the twentieth century Sir James Frazer, the translator of one version of the myth, fitted the story of the three daughters of Proetus right into our theme of the reality of mental illness: "It is possible that the tradition describes, with mythical accessories, a real form of madness by which the Argive women, or some portion of them, were temporarily affected. We may compare a somewhat similar form of temporary insanity to which the women of the wild Jakun tribe in the Malay peninsula are said to be liable."5 "A real form of madness" Frazer goes on to quote from a colonial traveler, anthropologist, and archaeologist. Ivor Evans, publishing in 1920, said that the Jakun women "were frequently seized by a kind of madness presumably some form of hysteria and that they ran off singing into the jungle, each woman by herself, and stopped there for several days and nights, finally returning almost naked, or with their clothes torn to shreds. [The informant said] that the first outbreak of this kind occurred a few years ago, and that they were still frequent, one usually taking place every two or three months. They were started by one of the women, whereupon all the others followed suit."6 The ''wild Jakun tribe," to use the language of the British, was an aboriginal people, that is, a people who inhabited the Malay Archipelago before the arrival of the Malays. Whatever was going on, we appear to have a transient mental illness. I do not mean that the women were affected for at most a few weeks at a time. I mean

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that the illness itself had appeared only recently: the first "outbreak" of this aberrant pattern of behavior began "a few years ago." Frazer led us from ancient Greece to twentieth-century Malaya. We may seem to be drifting hopelessly into irrelevance. Yet the circles are surprisingly tight. We are not so far from the Salpêtrière as we might think. The Malayan behavior or state called latah has fascinated European travelers and administrators for two centuries. British, but also Dutch reporters from what is now named Indonesia, reported that Malays would suddenly and inexplicably (to Europeans) have a fit of strange and jerky movements and give vent to uncontrollable obscene shouting ("coprolalia") and imitation of what other people were doing or saying ("echolalia"). Charcot's student Georges Gilles de La Tourette picked this up when, by coincidence, Albert was on his last fugue before checking into the SaintAndré Hospital in Bordeaux. Gilles asserted that some people in Siberia and also some French Canadians in Maine do something very similar. In Maine it was called ''jumpers" a label that must come from the New Englanders, not the Canadiens. Gilles asserted that we in the Salpêtrière observe exactly the same behavior in some of our patients! 7 This was a common move. For example, in Supplement 2 I describe how the Wandering Jew turns up in the Salpêtrière suffering from fugue. Anything anomalous from the ends of the earth was to be pathologized in the Paris mental hospital. Gilles proposed a new pathology and thereby gave rise to the diagnosis now called Tourette's syndrome, made famous in our time by Oliver Sacks. Charcot, ever the able diagnostician, corrected his pupil, distinguishing between latah and Tourette's syndrome; yet it remains the fact that Tourette's syndrome got into the books via Malaya.8 What is latah? Recent opinion ranges all the way from biology to sociology. Ronald Simons argues that the behavior is basically biological, the so-called startle reflex, a human universal, which is given a social role in the Malay Archipelago and some other parts of the world. The anthropologist Michael Kenny has long contended that the phenomenon is purely social in character, a cultural adjunct of some parts of Malay life; it has no significant biological or cognitive basis. If other people elsewhere behave in similar ways, they do so for reasons peculiar to their culture, and not because they share in some biological quirk common to all human beings.9 When hysteria was in full bloom, doctors and anthropologists alike read

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latah as hysteria. In the heyday of psychoanalysis, Freudians emphasized the outbreaks of uncontrollable obscenity and attributed them to intense sexual repression. In the 1990s we favor the biological and cognitive as the underpinning of strange behavior and are offered the startle response. Yet at least one Malayan psychiatrist explicitly connected latah and fugue and suggested that a tendency to wander is the core phenomenon, on which mimicry and obscenity are epiphenomena. 10 If fugue, rather than hysteria, had been a dominant diagnosis in the English-speaking world in the 1890s, would the British have seen latah as a variant on fugue, with the obscenity and mimicry mere epiphenomena? To recapitulate. Frazer took it to be an objective question as to whether there was a definite mental illness, manifested in aimless travel in the wilderness, from which women suffered in ancient Greece. The implication was that if some 1920s expert had been on the spot in ancient Greece, then the question could have been answered, just as the traveler in a Malayan jungle could assume that temporary outbreaks of running off were "hysteria." My own view is different. Wandering over deserts and mountains, often also taking on the behavior of cattle, was a way to be mad, or to be thought of as mad, in the era represented by the myths. I venture the same for latah, though it would be foolhardy to enter the latah controversy.11 I suggest that scholars should not turn to psychiatrists, asking, what disease ailed these women, be they Argive or Jakun? Instead we should ask, what in Greek or Jakun culture made this a possible way to be mad? The biological metaphor of an ecological niche comes into its own. We have innumerable species of living things on the face of the planet, past and present, many of which, when you reflect, appear to be obvious kinds of ways to be alive. Yet it requires a quite exceptional combination of circumstances for any particular species to emerge in a habitat. There is also the doctrine of convergent evolution. Functionally similar species will evolve in similar niches the marsupial rat, for example. The marsupial rat, which carries its little offspring in a vest pocket, is of a species unrelated to the Norway rat. Yet it has the same lifestyle, even the same habit of adapting readily to the city life of humans. But our comparison should invert the relation. The marsupial rat and the Norway rat are distinct species inhabiting similar ecological niches, while mad Greek travelers and French fugueurs are similar species of madness inhabiting distinct ecological niches. I would venture the same

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remark for French Canadians in Maine in the nineteenth century, compared to Malayan villagers. Latah still exists in Malaysia, but jumpers does not exist in Canada or adjacent parts of the United States. In one case the niche persists, while in the other, it has long gone. If we want to grasp the nature of a niche, we need on the one hand examples of species that inhabit it and on the other hand slightly different habitats that lack anything like the species in question. Thus far in these lectures I have concentrated on the presence of fugue. Now, enlarging our view to the niche in which fugue thrives as a kind of madness, we need new environments where fugue is found and similar environments where fugue is not found. That is the primary topic of this lecture, but the very character of this topic means we must look in diverse quarters. I have my eye out, then, for fuguelike behavior taken to be madness. There are the Greek myths. Frazer's Malays are described as "being seized by a kind of madness." I am told of crazed walkers who have been striding along the coastal highway of Peru for as long as anyone can remember, as if there were a ritualized way of expressing madness on that mostly wild and desolate coast. 12 Anthropologists and psychiatrists have more instances to give. There is a temptation to say each of these phenomena must be a manifestation of the same underlying biological madness. That is a possibility. Another question to ask is, what makes it possible, in such and such a civilization, for this to be a way to be mad? It is with that question that I return to fugue around 1890. In looking for an answer we need to examine not only positive cases, where fugue became an acceptable medical diagnosis, but also negative cases, where it did not. For a short time fugue found a niche in France and then in most of the continent of Europe. It did not take in the British Isles or the United States. Why fugue on one side of the Atlantic and not on the other? What circumstances in one environment made it possible for the best doctors of the day to argue the niceties of diagnosis, while in another environment the matter did not arise? In order to raise the question, I must convince you that fugue was never taken seriously as a medical entity in America. Then I return to Europe and speak seriously of the dark side of fugue, of degeneracy, vagrancy, the police, and the military. If my ecological approach is correct, we should expect a disorder to mutate or disappear if its habitat is destroyed. So this lecture ends

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with a man whom I call the last fugueur, strangely reminiscent of Albert and presented at the last major public event in France when fugue was in view. That was in 1909. The fugue epidemic lasted only twenty-two years. But first let us go through each of these themes in order, beginning with the United States. Fugue and its diagnosis never did settle into America, but not for want of trying. For the record, there was a predecessor diagnosis that could possibly have interfered with the reception of ambulatory automatism. In 1850 the Louisiana State Medical Society appointed a commission to study the characteristics of the Negro race. One peculiarity was that some and only some slaves had a tendency to run away. This was clearly a type of madness, so the commission invented a diagnosis of "drapetomania." The word is derived from a Greek root meaning, to run away. Slaves who tried to escape their masters were said to be insane and to suffer from drapetomania. 13 Drapetomania, an invention of white medical men, was a short-lived diagnosis, but one may suspect that it lingered long in southern minds. It was part of a larger project. For example, it was briefly maintained that the U.S. census of 1850 proved that there were far more mad blacks in the North, especially in the state of Massachusetts, than in the South. Ambulatory automatism was something else. American doctors were kept up-to-date on the new illness. Each of Charcot's two Tuesday lectures on Mén were accurately summarized in the Medical News within a few weeks of their delivery. And where an English report in the Lancet began with a note of skepticism about Mén" a singular case which borders on the incredible, and yet, if accepted, is full of interest from a medicolegal point of view" the American assessments were properly respectful.14 Between 1890 and 1905 quite a few troubled people in many parts of this continent were described with symptoms and behavior that in France during the same years would have indicated hysterical fugue. But in the United States different sets of symptoms were emphasized. A number of men deemed to be mentally ill did travel, in some cases prodigious distances. When out on a fugue they lost any sense of their old identity. They had no recollection of where they had been. Memories in some cases could be restored by hypnotism. But these people were not presented as fugueurs. Ambulatory automatism was not mentioned. The diagnosis was double consciousness or multiple personality. And I have been saying men: America of

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1890-1905 is the only place and time, since double consciousness was first explicitly diagnosed two centuries ago, in which a majority of recorded multiples were male. Simplistic minds may opt for one of two explanations: Fugueurs were wrongly diagnosed as multiples; they were men all right but should not be tallied among the multiples. Or, only at that time did American doctors attend to the fugueurs, who are mostly men, and file them with the multiples, thus giving a correct gender ratio. I am not here concerned with the "right" diagnosis. Many doctors who today treat the dissociative disorders would say that the turn-of-the-century American doctors put the right foot forward, namely, dissociation, while the French ones put the wrong foot forward, namely, fugue. My point is that whereas in some American cases hysterical fugue fits like a glove, this diagnosis was never even mentioned. Only in 1906-7 did the French literature cross the Atlantic in a serious way, and by then, despite the care with which it was discussed, it was oddly irrelevant. Only one mad American fugueur, if that is what he was, became famous. The Reverend Ansel Bourne was a born-again preacher in Coventry, Massachusetts. He disappeared and woke up two months later tending a little shop in Norristown, Pennsylvania, under the name of John Brown. He had no memory of how he got there. He took off on a day that had been nationally dedicated to the rebirth of the American nation and family values. Ansel Bourne, thrice reborn. He was interviewed by William James in person and was discussed in The Principles of Psychology. The great Boston student of spiritism, Richard Hodgeson, wrote the man up, in over thirty pages, for the 1891 issue of the Proceedings of the Society for Psychic Research. 15 Why that journal, of all things? Because the Bostonians you will recall Henry James were fascinated by all things psychic and wondered if multiple personalities, in their second state, might not be spirits. The spiritist tinge to multiple personality, although by no means unknown in France, was pretty much an English-speaking adventure. Spiritism was one element in the ecological niche found for multiple personality in New England. Hodgeson wrote Bourne up as "A Case of Double Consciousness," and that is how William James described him too. Bourne was not obviously a fugueur because he moved but once and established a new life, amnesic for the old one.16

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I mention Ansel Bourne for his fame. Less well known cases are more plausible examples of hysterical dissociative fugue. A respected fifty-year-old Virginian doing business in "a Northern city" suddenly disappeared, only to reappear six months later in "a distant Southern city." He had no memory of what happened. When he came to, he was emaciated and still had the same suit of clothes. In no sense did this man do what Bourne did, assume a new and settled life. He was on one almighty fugue, but he was duly reported as suffering from ''duplex personality." 17 Even when there was a fugue along classic French lines, with compulsive disappearance, aimless wandering, loss of memory, and recovery by hypnotism, the doctor saw "A Case of Multiple Personality."18 Conversely, even when the case was avowedly standard epilepsy, events could be interpreted as multiple personality, worth publishing not only for psychiatry but for spiritist research.19 Single disappearances, removal, recovery of self, and amnesia for travel and activity in between seem to be an American mode of behavior, located somewhere between hysterical fugue and double consciousness but always described under the rubric of doubling or multiplicity. Fiction is full of multiple personality, to the extent that I am sometimes unsure which is at the cutting edge, fiction with strange behavior and subsequent medical observation following in train, or vice versa.20 Mark Micale has speculated on the extent to which the great and the lesser novels of the nineteenth century are not patterned on medical hysteria but lead it.21 Multiple personality has acquired its share of novella and what I have called multobiographies that hover between fact and fiction. Amnesia is a staple of thrillers, but fugue as a specific syndrome has not evolved its own literature unless you take a large part of Simenon's oeuvre to be a series of studies in fugue.22 Ansel Bourne and the Virginia businessman do seem to be recollected in a fragment from Arthur Schnitzler's 1926 Traumnovelle, where the protagonist self-consciously contemplates becoming like an American fugueur-double: "He recalled certain strange pathological cases which he had read in books on psychiatry, so called double-lives. A man living in normal circumstances suddenly disappeared, was not heard from, returned months or years later and didn't remember where he had been during this time."23 This is no simple case of a man considering whether to feign fugue as a way of absconding, because the hero is (ambiguously) already in a trance state.

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Fugue did surface as an academic question late in the day. In 1906 Morton Prince, the great American student of multiple personality, published his patient, that classic American multiple Sally Beauchamp, in a seven-hundred-page book. She had plenty of fugue episodes, but ambulatory automatism was not diagnosed. In the same year Prince founded the Journal of Abnormal Psychology, for which he solicited articles, especially ones that had to do with multiplicity. One of these, "The Clinical Differentiation of the Various Forms of Ambulatory Automatism," was something of a two-finger exercise. The topic was mainly Jules Voisin's discussion of differential diagnosis of epileptic and hysterical fugue, which was seventeen years out of date. The author was sympathetic to Charcot. His contempt for hysteria was plain enough: "Since Charcot's time the attitude of certain clinicians towards the phenomenon [of fugue] appears to have undergone a radical change, and at present it seems to be their main endeavor to entangle it within the meshes of the capacious semiological dragnet of hysteria." 24 ''Since Charcot's time" is a little odd, considering that Charcot published in 1888 and 1889, and that Jules Voisin, the author's prime example of someone who tried to entangle fugue in the capacious semiological dragnet, also published in 1889. This skeptical essay prompted the first, and last, serious American study of fugue, Hugh Patrick's 1907 President's Address to the American Neurological Association. "In this country the subject has received little systematic attention."25 He used Pitres's definition of ambulatory automatism of 1891. He surveyed French work and presented six new cases from his practice in Chicago. I have some hesitation in calling these men "mad travelers," for although their fugues were indeed compulsive, at best semiconscious, and accompanied by amnesia, they had awfully good reasons to get away. Patrick noticed this too, suggesting that medical fugue was half intentional and half irresistible impulse. He began with a henpecked husband, in turn-of-the-century mold; his wife "boxes him on the ears" when she is irritated. Or a businessman in debt and with substantial "irregularities" being charged to him. Then there is our first black fugueur on record, whose story would be better told by W.E.B. Du Bois than Dr. Patrick. Let's see. He is a skilled steelworker aged forty-three. Starting in 1902, his home and all his possessions

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are washed away in a flood. The next month his leg is injured at a rolling mill. As soon as he is able to start work again, the mill closes. He has four healthy children, a sturdy wife, and is out of work and in debt. In 1905 there is a railway accident, loss of teeth, and concussion. In 1906 he is mugged and beaten unconscious. The only sign of mental imbalance in his history is "that once he came home with ten dollars, gave them all to one of his children, and `carried on' like a child." The occasion of his last fugue, in 1906, was his inability to buy Christmas presents for his family. He went on many fugues along classic lines. He recovered memories of his trips when hypnotized. What impresses me in a story that when fully told makes one weep, is the man's courage, his dedication to his family, and the way that his wife manages everything under conditions of appalling adversity. I would have cracked up long before he did. Patrick presented him as a hysterical fugueur. There were three more cases. Throughout them Patrick favored hysteria and doubted even Charcot's paradigm, Mén. "It seems strange that Charcot and his pupils did not hit upon hysteria as an explanation for some fugues, for they were near it at many times." The discussion throughout is exemplary, better, perhaps, than anything in France. But I am reminded of the phenomenon that the sailing ship was perfected only after it had become obsolete I refer to the great China clippers. Or, since I have spoken of early bicycles, it reminds me of the penny-farthing, invented only after it had been made obsolete by the patented Safety bicycl, but still, briefly, the speediest thing on two wheels in a velodrome. In both cases the obsolescent invention could, for a moment, go faster than its rivals, but after that it became a mere curiosity. Likewise Patrick's learned study was about to be irrelevant because hysteria, as a diagnosis, was about to disappear. There are obvious reasons why America should not be preoccupied by fugue. Go west, young man: the fugueur never came back. This motto also applied to some extent to Englishmen. They could disappear to America, the dominions, or the colonies far more readily than Frenchmen could or chose to. Emigration was not a French way of life in the way that it was for Britons. An English remittance man, reported in the first volume of Morton Prince's journal, settled in Rochester, New York, but did most of his real or imagined wandering in Canada, including the forests of the North and the prairies of

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the West. 26 There was no equivalent role for a Frenchman to adopt overseas: yes, a few Frenchmen went to Africa, South America, Southeast Asia, where inhospitable climates discouraged wandering off to the frontier.27 There were other major reasons for the lack of anglophone interest in fugue. Neither Britain nor America had conscript armies. There was nothing corresponding to a basic category of young French and German men who would take off: draftees. I do not mean wartime deserters, filled with fear of battle, most of whom would now be assigned to the post-traumatic stress disorder clinic. Because of current dogma about trauma, it is taken for granted by psychiatrists who work with dissociated patients that the place to look for fugue is in men who have been in battle and are scarred by the psychic trauma. The truth is quite the opposite. Fugue was a medical entity of peace, boredom, and dull regimentation. The first deserters to be called fugueurs had not reached puberty by 1870, and in France the medical entity withered before 1914. Men had shell shock in the Great War. They ran away when they could. But compulsive aimless wandering as a medical entity was a thing of the past, part of the end of the nineteenth century and la belle époque. Military service had two consequences. First, young men on the road were far more rigorously scrutinized on the European continent than in the English-speaking countries. They were also more controlled. Throughout the nineteenth century there was a Napoleonic law on the books that required a French citizen to have a passeport in order to leave his region (canton) of France and travel to another one. Even if this came to be honored more in the breach than the observance, the law was there. It was a way of controlling individual movement and, in particular, checking on deserters. And in addition to the passport, a young man who had done his military service was supposed to be carrying his livret, recording his time in the army and stating the circumstances in which he could be called up again. We have seen that over and over again Albert lost his papers, so when he was stopped, found sleeping rough, or walking in a dazed state, he was suspect. During a fugue he used his livret as ID to pawn his watch and later lost it. He had no memory of what happened to either object, but during hypnosis he recalled the pawnshop which still had the watch and the public garden where he had left his livret. A fugueur in Britain or North America was

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invisible so long as he kept his nose clean. One in France was always liable to be checked, and if his papers did not answer, he could be stopped, jailed, or hospitalized. Conscription had a second consequence. A body of medico-forensic expertise was needed to distinguish the willful deserters from those who could be excused on account of a medical condition. The French, and later the German and Russian, army or naval authorities who published on the topic took the side of conscript deserters remarkably often. They could thereby establish themselves as independent authorities vis-à-vis the rest of the military. There is no evidence that British or American army or naval doctors favored deserters, who were of course volunteers. The present situation of fugue in France may be of interest. I know of only three long series of cases of fugue in recent times ten, sixty-two, and twenty-nine fugueurs respectively, although only five of the sixty-two cases are given in detail. All three were published in France, the first in 1956, the second in 1967, and the third in 1993. France still had a conscript army. You are supposed to carry identification papers. Police can still "control" anyone they like, that is, ask for papers without stating any reason. And, to remind us that medical traditions do not always die, the base for the doctors who wrote the 1967 and 1993 reports is Bordeaux. One thing I would emphasize is that the thirtynine men of the first and third reports are peacetime conscript fugueurs. The 1956 report deals with conscripts before France's colonial wars erupted in earnest, and the 1993 report describes young men who were drafted after the wars had finally been put to rest. The five men of the second report included volunteers and conscripts, all stationed in barracks near provincial towns; none of their units was even threatened with being sent overseas. 28

I have said that fugue became a medical entity in Germany only after 1898. Now it is important that hysteria, especially male hysteria, was never such a major topic in Germany as it had been in France in the days of Charcot. Moreover, hysteria was disappearing, even in France, in the face of German diagnoses such as dementia praecox. German doctors who wanted to get deserters off the hook could not usefully plead a hysterical disorder of males before a court-martial. Hence while in France hysterical fugue was a useful plea until the early years of the twentieth century, after a brief struggle

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latent epilepsy became the thing in Germany. Practical facts like these, discussed further in Supplement 3, are often the central determinants of the contours of a medical entity. But why should not a military court conclude that a deserter was just that: a deserter who became bored with the army? In 1902 Pitres the head doctor of the ward in which our Albert first appeared wrote a book with one of his students, Régis, the man who coined the word dromomanie as a blanket name for an underlying disposition, the impulsion toward fugue. The book is called Obsessions and Compulsions. Fugue was one of its topics. Fugue was common among conscripts. Because they did not like being conscripted? No, it "is to be explained by the large number of degenerates of every degree found among them, in the absence of a system of psychological selection as rigorous as the physical one, and thanks to the natural tendency toward escape that pathological impulsion tends to take among individuals who are rigorously controlled by discipline." 29 This is an early plea for psychological testing of conscripts. It also implied that desertion should be medicalized. This strategy is not to be thought of in terms of the usual recent cant about oppressive medicine, Michel Foucault's power/knowledge, and all that. It was a matter of power, certainly, power to be grasped by the doctors, who thereby declared themselves to be experts in these cases. But the point was to prevent deserters being jailed and then assigned to long terms of hard labor. If they could be proved to be dromomaniacs, then they were released or given mild punishment. Régis gave some florid examples. Summing up the case of one M.: "Hysterical degeneracy. Impulses toward fugue and theft. A very attenuated sense of responsibility." Theft? Not exactly. This man had rented bicycles over and over again, then took a job with a bicycle mechanic, and one day flew out the door with the speediest cycle in town. "Not only has he never stolen in the proper sense of the word, even though that would have been very easy for him, but he never attempted to profit in any way from the objects that he did take." On the occasion of one disappearance, the local newspaper described him as a mad shopper "il a manie des achats" and told merchants not to sell anything to him. When in the army, the man deserted. Régis attempted hypnotic treatment, which helped for a while, but in the end the patient disappeared. Summing up the case, Régis concluded that "(1) M. is a hysterical degenerate, intellectually and morally feeble, incapable

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of resisting impulsive solicitations. (2) His punishment [when he is found], without being nonexistent, should be unusually light." 30 Degenerate! "M. is in fact a degenerate. . . . Several physical stigmata of degeneracy. . . . He is not only a feeble degenerate but also, like his mother and grandmother, a hysteric." What is this degeneracy? It is an all-purpose notion whose primary connotation is the decline of France compared to Britain and Germany. Throughout the century it was connected with low birth rates, and hence with suicide, prostitution, homosexuality, insanity, and, among much else, vagrancy. In Lecture 2 I mentioned a persistent program of research into degeneracy. Let us now address that. Degeneracy had been deemed a problem in France throughout the nineteenth century, and this concern was exacerbated by the loss of the war with Germany, proof of a debilitated population.31 Heredity and degeneracy. Charcot was convinced that epilepsy, hysteria, and neurasthenia were inherited, although not in any simple way. There was the hysterical family a family of conditions which differ within members of a genealogical tree, but which could all be traced to weak organic stock. Take for example the distinct failings alcoholism (chronic drinking) and dipsomania (binge drinking). Both could be inherited, and both could lead to the family line becoming degenerate, so that drunkards would breed hysterics who would breed epileptics. Hysterics and epileptics were degenerates. Hence fugueurs of either type were degenerates too. Here we have another reason why fugue did not take in America: there was no degeneracy program. The nearest one got was an inferiority program: systematic proof of the inferiority of African Americans and arguments against miscegenation to prevent degeneracy. There was a space for drapetomania, the madness of runaway slaves, but none for dromomania. Nothing is ever quite that simple. There was the upsurge of eugenics, connected with the doctrine that immigrants from Eastern and Southern Europe were inferior, in every respect, to those of British and North European stock. Hence they should be stopped from immigrating, for fear of diluting good stock. That is how the European degeneracy program was picked up in the United States. I shall cite just one amazing instance of the intersection of eugenics and fugue. The author is distinguished enough. Charles Davenport was director of the Department of Experimental Evolution at Cold Spring Harbor and the leading scientist campaigning to keep America pure: Norwegians

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yes, Sicilians no. In 1915 the Carnegie Institution in Washington, D.C., published a set of his studies, 158 pages in length and with this title on the cover: THE FEEBLY INHIBITED. Nomadism, or the Wandering Impulse, With Special Reference to Heredity. Inheritance of Temperament. The "Inheritance of Temperament" section is itself subtitled "With Special Reference to Twins and Suicides." The cost of the entire body of field work for these studies was paid by "Mrs. E.H. Harriman, founder and principal patron of the Eugenics Record Office, and Mr. John D. Rockefeller." It is "Nomadism" that concerns us here. The title The Feebly Inhibited was a deliberate allusion to the then current usage of "The Feeble Minded." Davenport's idea was that there is an innate tendency to nomadism in the human race, which is inhibited by civilization and culture. Mad travelers are afflicted, quite literally, by feeble inhibitions, which are inherited and correspond to some extent to the French notion of degeneracy. On the opening page we have a discussion of terminology. The German Wandertrieb is admired. "Vagabondage" connotes pauperism and won't quite do. "Fugue is usually applied to the extreme cases, of most markedly pathological nature, where normal consciousness is impaired. Dromomania has been used as a synonym for ambulatory automatism. Nomadism has often been applied to a racial or tribal tendency to wander. On the whole, I am inclined to use the word `nomadism' just because it has a racial connotation. From a modern point of view all hereditary characters are racial." 32 One hundred family pedigrees formed the data. A total of 168 cases of male nomadics were found but only 15 female nomadics; "this fact leads one to formulate the hypothesis that nomadism is a sex-linked trait." This hypothesis is shown to fit the data. Full scientific method is followed. Rival hypotheses are considered for example, that it is easier, in human society, for men to be nomads. That will not do, as is shown by Gypsies and data furnished by the Gypsy Lore Society. "All the evidence supports the hypothesis that the nomadic impulse depends upon the absence of a simple sex-linked gene that `determines' domesticity."33 All this is carefully explained in terms of the genetics

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of the day ("Nomadism is probably a sex-linked recessive monohybrid state"). Has madness then disappeared? Not quite. The American focus has shifted from psychiatry to eugenics, but we do have this conclusion: The nomadic impulse frequently occurs in families showing various kinds of periodic behavior, such as depression, migraine, epilepsy, and hysteria. It is concluded that these periodic states are not the true cause of nomadism, but rather that, for the better inhibited part of the community, the nomadic tendency is released in the periodic state which paralyzes the inhibitions. The feebleminded and demented may wander without going into a periodic state. The periodic psychoses are frequent concomitants, but not the fundamental cause, of nomadic impulses. They merely permit the nomadic impulses to appear. 34

The abstracts of one hundred family histories are themselves fascinating. They are rich in italics that reveal the excitement of the author as he recounts his titillating tales. (In Case 1: "The mother's father was a Western desperado; drank hard at times and was involved in murder, etc.") In many of the entries, especially but not exclusively for the women, we find the discreet symbol Sx, which, we are told on page 13, "is frequently used as a symbol indicating uncontrolled eroticism, leading to various unsocial acts in the sexrealm." And of course drink plays a major role in these stories, often in a rather splendid way (Case 94: "has always been an alcoholic, drinking whenever he got the chance. Now at 73 he has developed insane ideas, of which one is to travel all over the country on a bicycle. . . . When not riding his bicycle, he will walk for hours at a time.") When degeneracy moved to the United States and the eugenics movement, it transferred to a quite different environment. Nomadism is not madness, even if madness can inhibit the domestic instincts. Nomadism is an atavistic throwback to a time before the domesticity gene had emerged. Nomadism is hereditary, and as Davenport states, "all hereditary characters are racial." To return to France and 1890, it was equally to be expected that the alcoholic and the dipsomaniac, standard figures on the stage of degeneracy, would join the actors for the part of fugue. And so they did, not as the classic

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hysterical fugueurs but as a new breed. Where would you find the drunkards? At the Infirmerie Spéciale du Dépôt, next to the Prefecture of Police, where "all the mad or presumed such, who are creating a public nuisance, are taken." In 1889, when Charcot was still a force, this was said to be the ideal place to examine patients "in the state of nature," in contrast to Charcot's displays. 35 Two cases were presented. The second was a hysterical automatism, but the first was alcoholic automatism. But not drunken wanderings. The man's fugues were made after he had sobered up. They were very similar to epileptic fugues, but after careful examination a diagnosis of alcoholism had to be made as the veritable cause of the ambulatory automatism. The police were not only on the lookout for drunkards and deserters. The degeneracy program worked at the intersection of theories of heredity and what were deemed social problems. Its foci were not so different from today. You have heard of the search for suicide genes, alcoholism genes, for the "homosexual gene," for genes that predispose toward violent crime. A French scientist of the nineteenth century, reincarnated in 1997, would not raise an eyebrow; that was what he was after a century and more ago. The degeneracy portfolio of the nineteenth century, like that of the late twentieth century, took stock in different ways at different times. At the beginning of the century, suicide, madness, crime, and prostitution were favored choices. After 1870 vagrancy vagabondage became important, and by 1885 tramps were deemed to be a critical social problem. A fierce set of antivagrancy laws was passed in that year. It made a sharp distinction between habitual and redeemable offenders. The redeemable ones were to be released on their own recognizance, although subject to a sort of parole. They were also given assistance to find their way to the place they might best call home. The vagrancy laws went hand in hand with recidivism laws passed in the same year, according to which recidivists were liable to transportation to a penal colony. The habitual vagrant was liable to imprisonment in exile. It is important not to identify vagrancy in 1897 with homelessness in 1997. The meaning of the homeless to us is different from the meaning of vagrancy to the French a century ago. To us, the homeless signify no home, i.e., the great fear of the 1980s, the end of the nuclear family. To French people in the 1880s, the vagrant signified racial degeneracy, no reproduction, or reproduction of those very features that the French race ought to get rid of.

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Jacques Donzelot, with grand exaggeration, has said that vagrancy became the "universal of mental pathology, the prism through which all the categories of madness and abnormality could be distributed." 36 Vagrancy was straightaway medicalized. Vagrants were degenerates, sure enough. And many must suffer from ambulatory automatism. There is one book-length study of French fugues, a polemical but insightful essay by Jean-Claude Beaune, The Vagabond and the Machine, an Essay on Ambulatory Automatism: Medicine, Technology, and Society in France, 1880-1910. Note the dates, which in Beaune's judgment mark the beginning and the end of the vagrancy scare. Beaune went so far as to describe the medicalization and medical incarceration of tramps and hoboes as a species of "genocide" the elimination of a class of people, occasionally, perhaps, by actually killing them but usually by putting them in institutions. He also speaks, but only metaphorically, of the "murder of the vagabond."37 The population of vagrants was extinguished, he argues, in asylums and jails. That, says Beaune, was what the medical topics of fugue and ambulatory automatism were all about, really. Did physicians think of their role in this way? To some extent. René Beck wrote a thesis for the medical faculty at Lyon on the relationships between vagrancy and madness. Vagrants, he wrote, "must be eliminated systematically from society, because they are noxious, but they must be cared for, because they are above all ill."38 That is a fine example of the liberal solution to society's problems, eliminate by putting in care. The long arm of the law was indeed astonishing. There is a fascinating tale of one André R., in pretty much the most rustic and isolated region of France.39 André was a stranger who in 1892 set up as a fortune-teller and healer. In no time the law was on to him for false practice of medicine and for being a vagrant. The very fact that his portable library included works on mesmerism and the tarot made him an object of suspicion. "I don't practice medicine; I give information based on divination; if I give simples [herbs] I do so because I am asked for them." He did not charge for his services but accepted gifts: "I have to eat, you know." Fined, he stayed on. But, wrote the doctor and expert medical witness who interviewed him: "Some day, without doubt, pushed by necessity or by some new fantasy of his troubled mind, he will once again take up the stick of the traveler and ask for help at one of the temporary shelters that the authorities provide for men like him. I have simply wanted to describe an episode in the life of one of those thousands of

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outlaws who are beginning to disturb the mechanisms of modern life.'' 40 An "outlaw." The American word was used in this French text, a strange blending of the Wild West and an old French village. This way of thinking about an itinerant homeopathic fortune-teller does confirm the way in which Donzelot and Beaune discuss vagabondage. Nevertheless they seem to give an unduly romantic reading to it. They ignore one of the causes of the vagrancy scare, or scares.41 These were not only politically troubled times for the French body politic, with a competition for power, and for a conception of the nation, between republicans and authoritarians (if we may so call the mix of monarchists, Bonapartistes, and religious figures). These were also economically hard times, a belle époque that danced to the tune of massive unemployment. The Boulangist near-coup of 1889, mentioned in Lecture 1, was fueled by a depression that drove men out on the road in search of a better place, or in despair. The Boulangists, for a moment, were close to whipping this dreary scene into a sort of national socialism that would march on Germany and wreak its revenge. Despite some appealing individuals such as André R., it is mere radical chic to present the vagrants as free spirits. What is true in the versions of Beaune and Donzelot is that policemen and jails have lurked behind the scenes of my stories. Charcot's Mén was caught in the railway infirmary after he leaped into the Seine. In a subsequent fugue the man was jailed in Brest where he had asked for help from the police. Albert was arrested over and over again. Tissié speculated that half the time the poor lad was on his travels he was in jail. So what did the police think about it all? Doubtless the medical literature is not the place to look, but there is one remarkable series of essays written jointly by Benon, a police doctor at the Paris Prefecture, and Froissart, a physician at a mental hospital who was widely used as an expert witness in prosecutions. In one respect these two men wrote with exemplary clarity. Fugue is definable only within the context of the social order. The point is straightforward. As I said at the end of Lecture 2, an incident is counted as a fugue only if the individual has a regular style of life, a regular location. If Charcot's unfortunate patient Mén had fled the first time for keeps, as he did the last time, that would not be a fugue incident. That would be a missing person. Benon and Froissart likewise put the word domicile into their definition.

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They wanted to define vagabondage, not fugue. They did not care for the tedious medical arguments about hysteria versus epilepsy. They did not want accused persons getting off on a plea of generic fugue, or dromomania. "Fugue," they insisted, "is an antisocial act": "Every individual has obligations in which he lives. From the moment that he breaks the social contract, be it instinctively or voluntarily, he puts himself outside legality. That is the case of the fugueur who abandons his domicile, and that is why fugue is an antisocial act." 42 Fugue is distinguished from "procursive epilepsy, automatic somnambulism, alcoholic and all other displacements which are not accompanied by the disappearance of the subject.''43 In short, the police don't care about the medical niceties. If the person stays at home or at work, fine, no matter what ails him. If he flees for whatever reason or cause, that is antisocial, subject to detention and punishment. Thus do the police confront the medical men. Régis gave us dromomania, a nonspecific mental disorder covering all types of pathological flight and serving as a ground for excuses. It exculpated acts performed by traveling or in transit. The police countered by saying that the mental diagnosis has nothing to do with it. If the person is sick and stays home, that is none of our business, but if he leaves home, he has already shown himself to be antisocial, and we the police take charge. There were many expressions of this hard line, which was part of the medicalized assault on vagrancy.44 That attack had run its course around 1910. The team of Benon and Froissart, whose publications peaked in 1908-9, were at the end of the line. Now I want briefly to tell you how fugue itself declined. Undoubtedly the end of the vagrancy scares was salient. A vital ingredient in the ecological niche for fugue was eliminated. But other things disappeared too. A key player was Joseph Babinski, once Charcot's star student, who had fallen for the worst excesses of hypnotism. Back in 1887 he was transferring the hysterical symptoms of one patient to another at the touch of a magnet. But he grew out of that. In September 1899 he presented, in the manner of the great Charcot, a woman of fifty-five. She had taken short fugues for the past decade. Epileptic or hysterical? The question was still on the books, but the details were ambiguous. Babinski, like his old teacher, came down for epilepsy and administered 2 grams of bromide daily.45 In conclusion he took an hysteric patient, hypnotized her before his audience, and sent her on a

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trip around the block, as it were. On awakening, she had no memories of her little expedition, but they were restored when she was hypnotized again. "If a parallel state developed spontaneously and lasted twenty-four hours, wouldn't that be a veritable attack of ambulatory automatism?" This did not bode well for ambulatory automatism as defined by Babinsky's master, Charcot. Some years later Babinski demolished the medical substructure for fugue with his assault on hysteria. He became a rumbling volcano that erupted in 1908 at meetings of the Societé de Neurologie in Paris, 9 April and 14 May 1908. The classic stigmata of hysteria were, he asserted, the consequence of suggestion, sometimes directly from a doctor and more often culturally absorbed. Talk about Oedipal reactions: Charcot the father was slain, and with him his creature, hysteria. The famous Babinski reflex was a device for distinguishing neurological damage from hysterical suggestion. Joseph Babinski turned his back on hysteria and, from a position of considerable power in the military medical establishment as early as 1916, insisted that hysteric symptoms were not primarily neurological in origin, as Charcot had taught. They were the consequence at most of the suggestion of ideas and should be renamed. The chosen name was "pithiatism." After minor treatment for their fears, men could be returned to the front come what may, as the best cure for whatever troubled them. His work was published in English almost as soon as it came out in France. 46 Even a man as influential as Babinski even one as filled with Oedipal rage against Charcot as Babinski was did not do the deed single-handedly.47 Skepticism about hysteria was in place. Mark Micale argues that one ground for doubt was the influx of new types of diagnoses, including such German imports as dementia praecox, soon to be replaced by schizophrenia. Hysteria, writes Micale, "vanished into a hundred places in the medical textbooks."48 He means that the miscellany of symptoms was redistributed among a new set of illnesses. This is a rare unequivocal example of a scientific revolution, in the sense of Thomas Kuhn's last work.49 One taxonomy replaces another, to the point that we simply do not know what hysteria was any more. It was Kuhn's idea that when taxonomies are dumped in the course of revolution, a concept (or linguistic entity, a lexical item) from an old taxonomy could not be translated into a concept in the new taxonomy. Hence old ideas and practices become literally unintelligible to new-wave

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thinkers. Or, as Kuhn puts it, the old and the new taxonomic structures and languages express incommensurable ideas. Kuhn, I think, provides an analytic framework within which to understand the extinction of hysteria as a diagnosis. Here, however, I do not want to delve into grand schemes of intellectual history but to examine the transformation of ideas in terms of only one local curiosity, fugue. As new diagnoses came into play, fugue joined hands with them. Dementia praecox came into vogue in France at the turn of the century and by 1906 was firmly in place. One French pioneer of that diagnosis, Maurice Ducosté, was a Bordeaux graduate. He first found a fugue in dementia praecox, and within a year he generalized his analysis to a study of fugues in every kind of psychosis, as that term was understood at the time. 50 He thought that the word fugue was hopelessly vague. It had become increasingly important for social reasons, in assisting the law courts, and fortunately the obscurity of the word did not matter in questions of assigning responsibility. He was loyal to his roots: he stated that there was nothing much new in his ideas if only we had read Tissié carefully enough, we would have known that fugue was only an episode associated with many psychoses. Tissié, said Ducosté, devoted half his thesis to Albert, but he began with a basic list of five types of fugueurs the delirious, the hallucinating, the demented, the impulsive, and the captivated (the last being Albert). In addition Tissié had mentioned other psychoses as causes of fugue: erotomania, claustrophobia, anthropophagie (crazed cannibalism), and lycanthropy (assuming animal form, especially that of a wolf, and behaving accordingly). Ducosté in effect invited us to begin all over again, treating Albert as one among many types of fugueurs but adding the new dementia praecox to the list of possible causes of fugue. In short, the study of fugue had come full circle, back to zero. It had come back to that initial point where fugue was not yet an autonomous diagnosis. A present-day clinician who is skeptical about the fugue diagnosis may wonder if a large proportion of these old fugueurs would not now be diagnosed as manic-depressive (bipolar disorder).51 The fugue would be undertaken at the start of a "manic" state. This possibility virtually never comes up in the old literature. In France folie circulaire was diagnosed from the 1850s, and the descriptions are not so far from what we call manic depression. I have found one discussion, in 1903, that I reproduce in its entirety:

Page 74 M. Thivet. One can add to the different types of fugue that have been described, patients who are afflicted with folie circulaire, and who, at the moment of an attack, present themselves precisely in the form of migrateurs. M. Ballet. That is absolutely right; I can cite numerous examples in support of that; I recall in particular a fine fellow, a bit of an original, whom I diagnosed with folie circulaire only retrospectively, for I was young when I knew him. Normally he was a homebody, but he set out on an adventurous journey at the moment that he became excited. 52

The end of French fugues was signaled when the alienists and neurologists met in Nantes, 2-8 August 1909. Their congress was dedicated to two topics, mental illness in the military and fugue. Papers about fugue routinely discussed fugues by men with dementia praecox, or what we would now call schizophrenics.53 The survey presentation of fugues by Victor Parant began by distinguishing distinctive fugue types, namely melancholic fugues, oneiric fugues, epileptic fugues, the impulsive fugues of dementia praecox, dromomaniac fugues, second state (alternate personality) fugues, and systematic fugues. Those are the specific fugues; then there are the banal fugues, everything not included in the above. The old sortings were collapsing.54 Note the melancholic fugues in the above list. Melancholia! Now that is a very old category indeed. Parant introduced it in the light of a contribution from one of the Bordeaux contingent at the Nantes congress. Gaston Lalanne ran a private asylum on the outskirts of Bordeaux. His paper, Des fugues chez les mélancoliques et les persécutés mélancoliques, refers back to the very first paper with the title of Les Aliénés voyageurs of 1875 and notes that the author had said that it would be a complete mistake to think of mad traveling as a special kind of insanity, monomanie des voyages. Patients merely suffered from complex kinds of depression. Lalanne presented six new cases of melancholic fugue in which there was no amnesia.55 As for hysteria, our police-doctor contingent, Benon and Froissart, addressed that sarcastically: "Diagnosis of so-called epileptic and so-called hysterical fugue does not appear possible at present, to judge by the observations

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that have been published up to now." 56 Had we been at the Nantes conference, we would have felt ourselves entering a new era in psychiatry. Hysteria was out. Charcot had virtually disappeared. German-language psychiatry was increasingly to the fore. Fugue went out with a whimper. It is true that by the time of Parant's summary for the Nantes congress, there was a rapidly expanding array of fugue episodes, but hysterical fugue episodes were not among them. And as for hysterical fugue itself the diagnosis with which we began, and which seemed to fit the first fugueur perfectly it had virtually disappeared. I do not mean that French alienists or their heirs, the psychiatrists, never again mentioned fugue as opposed to fugue episodes. Men with an established interest in the field continued to contribute occasional cases. Roger Dupouy was the coauthor of a solid text from the year of the Nantes congress, 1909. It drew on cases presented by the authors the previous year, at the previous congress, in Dijon. They gave yet another tripartite classification, the obsessive, the persecuted, and the hysterical.57 Dupouy continued to classify fugues long after fugue ceased to be an autonomous disorder. In a coauthored paper published much later, in 1925, he made a final appeal to what he called grande fugue, strongly contrasted with epileptic fugue, although the prototype was furnished by the case reported in Dijon in 1908. "The ambulatory automatism of the great fugueurs, to which we have alluded, is not epilepsy. It is vigilambulisme, in every particular analogous to classic somnambulism, formerly linked with hysteria, and certainly very close to that neurosis, even if it is not to be confounded with it."58 The authors asserted that after years of attention to one ward for epileptics, there were no cases like Charcot's wellorganized Mén. The battles faded on. In 1933 Louis Marchand wrote a survey article on epileptic ambulatory automatism, insisting that one never saw fugue in epileptic wards (Dupouy was right), but that it was found in 6.4 percent of a series of 1,052 outpatients (Dupouy had drawn the wrong inference).59 Epileptic fugue was a phenomenon of the streets, not the wards. Three women and two men among the epileptic wandering patients had no other sign of epilepsy except fugue. Latent epilepsy lives, or so taught Marchand. The fact that fugue is wasting away as a distinct something is confirmed by the fact that Marchand's survey cited seventy-seven papers published before 1910 and only fifteen after 1918, most of them written or coauthored

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by Marchand himself, our friend Roger Dupouy, or Henri Claude. Claude had written extensively on childhood fugue and had shared in the description of fugues that occur in the manic phase following intense depression. 60 For a sense of how not only fugue but also the entire topic of dissociation had become the preserve of an old boys club, consider an event of 1937. Henri Claude (1869-1946) had just given a talk on the relations between hysteria and schizophrenia. Pierre Janet (1859-1947) was in the audience and said: "I thank M. Claude for the interesting way in which he has called to mind our old studies of psychological dissociation in hysteria. While I was listening to him I wondered whether this was still 1937, or if M. Claude had succeeded, by a trick of magic, in taking us back to 1892."61 It is ironic that Pierre Janet has been adopted as the godfather of the field of multiple personality and, more generally, of dissociation. He himself came to the conclusion that multiple personality was folie circulaire.62 And here, in 1937, we find him suggesting that dissociation was a fine conjectural idea for 1892 but not for the modern world. The same thing is true of fugue. Between 1887 and 1909 fugue was a significant, if transient, mental illness in France. And then it was no more.63 So I allow myself a moment of nostalgia. Why did Albert so grip the imagination of Philippe Tissié, future pedagogue of the velocipede? Because of the adventure. Those romantics among us who, although we pity Albert's very genuine suffering, nevertheless take a certain pleasure in his picaresque adventures, would not have been completely disappointed at the Nantes conference. One professor of medicine in attendance was Joseph Grasset (1849-1918). Grasset was another provincial, whose entire career was spent in the ancient medical faculty at Montpellier on the Mediterranean coast. He attained national recognition for his work on hysteria, writing the encyclopedia entry of 1889-112 pages long.64 That was a Charcotian account of the subject. But his views evolved in the course of successive editions of his textbook on nervous disorders. By 1905 he was stating a topography of the mind/brain that anticipates Freud's. In a popular article for the Revue des Deux Mondes he wrote of the two psychisms, one conscious, one unconscious, each correlated to a part of the brain; hysteria resulted when the two failed to interact with each other in an appropriate way.65 However, his lectures, when they turned to fugue, were more conventional and followed the Bordelais tradition.66

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Grasset presented to the Nantes congress the story of a patient who might restore us to the state of mind of the first students of fugue twenty years earlier. The subtitle, "Histoire d'un déserteur voyageur," has the right ring to it. The hero never arrives at quite such terrifying predicaments as did Albert, but the tale has something of the same charm. Henri C. was not, literally, the last fugueur. But he does mark the end of two decades in which impulsive uncontrolled traveling, with confused memories, was deemed to be a specific mental disorder in France. His is the story of a "demifou à fugues, who deserted over and over again, made the most improbable journeys, and would have ended by being severely punished by the court-martial if the military had not requested medico-legal expertise about his degree of responsibility." 67 Henri had not turned twenty at the time of his first desertion, in 1901. But that was not his first compulsive trip. At seventeen, when he had a good job as a garçon de café in Paris, he disappeared for Belgium. Next year, he left another café and traveled throughout the Midi, doing occasional work in the grape harvest or the coastal saltworks. He enlisted in 1900 and asked to be stationed in Montpellier on the ground that he had friends in a village nearby. His officers liked him. He adapted well to military discipline and had a cheerful disposition. But he would be struck by a fit of depression and leave his barracks. His own word for what I call depression was cafard, something that "took him," a black state that he "had." The army recorded eight fugues. He had little or no memory of the beginning of each of his journeys. He would recall later episodes and places and dates with greater clarity. He survived by occasional labor and by considerable native skill at sponging to the point of confidence trickery. He would claim to be a refugee from a French congregation that had been expelled from France; he feigned various nationalities and scrounged money from consuls of respective countries; in cafés he picked up the names of French residents to ask for help. His most spectacular fugue began on 9 September 1903. He traveled through Italy, Germany, Austria, Hungary, Romania, Serbia, Bulgaria, Turkey, Russia, Switzerland. Near the end, the French embassy in Vienna gave him 33 francs and letters for the railway and border authorities in Austria and Switzerland. One is forced to wonder: had he been told about Albert? Was he a true copycat? He got to Strasbourg, reported to a German officer as a French deserter, and said he wanted to join the German army. He received more small

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change and was on his way, going to Munich, reporting to a French official, promising to return to France and surrender as a deserter if given money. He did not, then, return, yet his fugues would always terminate in France, where he reported to French police, often at a point as far as possible from his unit, to which he then asked to be returned. He was sentenced to prison or hard labor on several occasions, but his incarceration usually ended in an asylum, and then his penalty was diminished. On one of his journeys he claimed to be Italian and enrolled in the French Foreign Legion, serving briefly in Oran before another compulsion to travel. The trips were real enough. Henri left a good enough paper trail, from the various authorities from whom he had scrounged, a trail patiently followed up by letters sent out by the military doctors. The experts wrote that Henri was above all, an "amoral. . . . The notions of good and evil do not exist in him: he has no idea of authority, of his superiors, of patriotism, of duty, of remorse." He fooled people about who he was in order to get their help, but he never stole, he never hurt anyone physically. The authorities noted, with some disdain, that Henri was absolutely indifferent to religious, political, or social questions; he scarcely knew the name of the president of the Republic. He drank absinthe, but this was held to be a consequence of his setting out on a fugue, rather than a cause. The doctors could not judge him to be insane, even at the moments of his desertion, at least not in the sense of the relevant section of military law. But they did conclude that Henri was in a state of diminished responsibility: (1) to a very great extent at the beginning of his fugues; (2) to some extent during the later period of his fugues; but (3) only to a slight extent for acts committed outside of his "attacks of ambulatory automatism." I have spoken of fugue as a mirror of tourism. I take Henri C. to be something of my own mirror image. His eighth and last reported fugue of 26 August 1907 took him over routes of which I am deeply fond. He had been in a military hospital at Montpellier, where he was struck by another fit of cafard. He managed to undo an iron bar on the window of the cell where he was detained (his only recorded damage to property, for which he was later to be fined 50 francs). He traveled on to Perpignan. From there he walked over the smugglers' trails between France and Spain, a network of glorious rocky walks in the Albères, the foothills of the Pyrenees, smothered, at the time of the year he traveled, with tiny flowers.

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The beekeepers of the region produce the best honey in the world, each peculiar to the flowers growing on a certain patch of chalky soil, where "the tiny pharmacists" 68 produce honey within which are ancient cures, while the old women of the region comb the stones for herbs, some as common as thyme or St. John's Wort, some so rare that they are named only in Catalan. Henri kept on traveling throughout Catalonia, as far as Barcelona. He even wrote to his unit from Gerona, the first major city on the Spanish side. In due course he reported, as usual, to the French police at the border town of Le Boulou. That is great fugue country. There on a flowery slope or on a windblown outcrop you may still encounter a nervous man who was hoping not to be seen. Today he is more likely to be a confused Moroccan making his way gingerly through to France than a dazed French infantryman heading for the safety of Spain. Today he is just a mixed-up illegal immigrant. Ninety years ago he suffered from a distinct mental malady, ambulatory automatism.

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4 Five Questions, Five Answers 1. What made fugue possible, as a medical diagnosis? An ecological niche, with four principal vectors to be named medical taxonomy, cultural polarity, observability, and release. 2. What did those old fugueurs suffer from? By 1990s criteria, some suffered from head injuries, some from temporal lobe epilepsy, and some from dissociative fugue. 3. Were doctors of the day warranted in holding hysterical fugue to be a real mental illness? Yes. 4. Was hysterical fugue a real mental illness? No. 5. Are analogous conclusions to be drawn about transient mental illnesses today? Yes. I have stated these answers abruptly, because I do not want to leave you asking, "and what does he really think?" I shall of course make some qualifications, but some parts of my considered answers will continue to be dogmatic. That is deliberate. The answers to the first four questions do not matter very much, but the

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framework within which the answers are given is of fundamental importance. No one now cares about hysterical fugue, but questions exactly like mine arise, right now, for many mental illnesses. I ask the questions about an obsolete diagnosis to prevent inflamed passions from obscuring our view about how to answer such questions. The ways in which I answer are intended as models for present debates. When I turn briefly to these I shall be forthright. I conclude with some strong words about the futures of both schizophrenia and the dissociative disorders. First Question What made the diagnosis possible? An ecological niche with four principal vectors to be named medical taxonomy, cultural polarity, observability, and release. I mean nothing technical by the word vector, whose origins are in mechanics, and which is also used in epidemiology. Here I use it as a metaphor. In mechanics, a force vector is a force acting in a direction. When there are several forces acting in different directions, the resultant force is the product of the different forces and their directions. The metaphor fails for niches, because we have no vector algebra to resolve forces. Yet the metaphor has the virtue of suggesting different kinds of phenomena, acting in different ways, but whose resultant may be a possible niche in which a mental illness may thrive. Medical taxonomy. Fugue fitted into a taxonomy, either as hysteria, or as epilepsy, or both. It did not dislodge existing systems of classification. But it invited a controversy: into which part of the established taxonomy should fugue be fitted? That made fugue theoretically interesting to physicians and alienists of the day. This was the medical taxonomy vector of the niche for fugue. Cultural polarity. Fugue perfectly fitted between two social phenomena that loomed very large in contemporary consciousness: romantic tourism and criminal vagrancy, one virtuous, one vicious. Both were deeply important to the middle classes, because one stood for leisure, pleasure, and fantasy escape, while the other stood for fear of the underworld. So fugue, as a phenomenon, was not interesting to ordinary people who did not go on meaningless and compulsive trips, people who could control their fantasies

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or indulge in them. It was an option that for the less fortunate lay between affluence and crime. This was a vector of cultural polarity. Observability. A substantial system of surveillance and detection was in place. French fugueurs had to have papers, if they went far. They were systematically subject to scrutiny as deserters or draft dodgers. You could not simply wander about the continent of Europe without being noticed by the authorities. In order for a form of behavior to be deemed a mental disorder, it must be strange, disturbing, and noticed. This is the observability vector of the niche for fugue. Release. Fugue was an inviting escape for a particular class, men who had steady work and a certain amount of independence. Their circumstances of income and family kept them this side of leisured travel. Their deep-set conformity to established mores kept them this side of crime. Fugue was a space in which dysfunctional men, on the edge of freedom yet trapped, could escape. This is the release vector of the niche for fugue. The metaphor of an ecological niche invites us to think of life in all its rich biocomplexity. I used to speak of the recent wave of multiple personality as parasitic upon child abuse. I said that in early twentieth-century America it was parasitic on spiritism and so on. The metaphor of the parasite is biological, but far too narrow. It is rather condescending, insulting even. It suggests that there is just one cultural element that enabled multiple personality to thrive. The concept of an ecological niche has the opposite effect. It reminds us that there must be many relevant vectors in play. To postulate a niche for an illness is to make two kinds of claim, one positive, one negative. In the presence of the relevant vectors, the illness flourishes; in their absence, it does not. We have controls in the past to check this. America and Britain, lacking both the cultural polarity and the observability vectors, had no fugue epidemic. Cultural polarity: Vagrancy was not a central social problem, and tourism within America had not yet become an industry. Observability: Travelers were not systematically inspected for papers; indeed one need have no identifying document on one's person. We also have controls in the present. Dissociative fugue is there on the books, in the 1994 Diagnostic and Statistical Manual of the American Psychiatric Association. So this behavior fits a present medical taxonomy. But fugue as such (as opposed to fugue episodes) seems almost never to be diagnosed. When the committee for dissociative disorders, under the chair of

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David Spiegel, looked for published recent medical cases, it could find virtually none. Why is the disorder there in the American Manual but not on the highways and byways? There is an unkind answer. The dissociative disorders section of the Manual was introduced only in 1980 after a lot of jockeying by advocates of multiple personality. It is still highly contested. It is striking how recollections of the recent history of multiple personality disorder, written by members of the multiple movement, emphasize the importance of DSM-III; in 1980 multiple personality became an officially approved illness for Americans. Once multiple personality was on the books, it was diagnosed much more frequently. Advocates of this diagnosis write as if multiple personality just happened to get into that 1980 Manual. In fact it got there thanks to the insistent lobbying of the very authors who recall the history of their movement. One thing that helps keep dissociation in place is the existence of a small taxonomy under a single heading. Thus we have dissociative identity disorder, dissociative amnesia, dissociative fugue, and depersonalization disorder. The last is, on my reading, not a dissociative disorder at all, but dissociation clinicians want to maintain it there in order to keep a taxonomic structure of interest. Fugue is there for the same reason. Spiegel, who chaired the dissociative disorders committee for the 1994 DSM-IV, is one of the most successful scientific investigators in contemporary American psychiatry and also a powerful figure in its corridors. He has many fields of expertise. His most famous contribution thus far has been the breast cancer study showing that women with a positive attitude to their illness and participating in various types of psychological selfimprovement have better life prospects, to the tune of eighteen months, than their sisters who are depressed by their illness. So far as concerns the dissociative disorders, he is above all a traumatologist, at the forefront of research in post-traumatic stress disorder. One of the incidental hazards of being involved in a mass disaster in America is that you will now be descended upon by traumatologists who will track you down for the rest of your life, to determine the long-term effects of the trauma upon your psyche. Spiegel helped give a strong trauma spin to dissociation. The dissociative disorders should be thought of as caused by trauma. In the case of fugue, he and his colleagues encouraged a search for trauma victims. In particular the

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case histories of soldiers were examined for trauma and fugue. They did not find much. The definitive ''Comprehensive Review" of psychogenic amnesia and fugue preceding DSM-IV was written by Richard J. Loewenstein, president of the International Society for the Study of Dissociation and Multiple Personality, 1991-92. Noting that the twentiethcentury literature is inconclusive and driven by many different theoretical perspectives (and not knowing about the nineteenth-century fugue epidemic), Loewenstein described his intention to "review conceptual and clinical issues in the study of amnesia and fugue with a particular focus on the relationship of these conditions to severe psychic trauma. The latter factor has only recently been systematically recognized as a significant determinant in the development of dissociative disorders." 1 In the literature reviewed, "amnesia and fugue" are very often jointly referred to, with the psychic trauma being associated with the amnesia. Differential diagnosis of amnesia and fugue is a bit of a mess, because one finds clear fugue episodes among individuals diagnosed with amnesia, and vice versa. To speak of "amnesia and fugue" is misleading, for the emphasis in nearly all the older wartime studies is amnesia.2 The review committee, theoretically dedicated to trauma as the cause of dissociation, did not realize that historical fugue in the military has been associated primarily with boredom, not fear. In the previous lecture I mentioned the only sustained studies of military fugue in recent times with which I am acquainted. All three report on French soldiers, mostly conscripts stationed in France, for a total of forty-four detailed cases, plus another fifty-seven who are listed. This is a very much larger sample of fugueurs than the American multiple personality movement has been able to uncover, and in none of the forty-four cases was there a reported history of significant trauma.3 Hence one has a good deal of caution with the assertion in a paper on amnesia, not fugue that fugues are most commonly reported in wartime.4 Better, perhaps, to state that "at this time there are no reliable statistical data that confirm any of the theoretical hypotheses advanced in connection with the disorder."5 I am not here taking a position on whether fugueurs may not all or most have experienced some kind of trauma, physical or psychic. Who has lived the trauma-free life, given present generous understandings of trauma?

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There is in fact one American example of a "young man who joined the army and served for a year during a fugue state." This underage soldier was very unhappy, teased by his schoolmates because of his large size, and generally miserable, but the data do not justify a claim of post-traumatic fugue, unless "trauma" means "unhappiness.'' 6 I am not arguing that trauma was irrelevant to dissociation. Elsewhere I have indeed urged a close and skeptical look at the ways in which psychic trauma, especially child abuse, became connected with multiple personality.7 Here I am making an uncontroversial statement of historical fact. The class of men in the military diagnosed with fugue is a class of peacetime draftees and occasional volunteers. It is not a class of battle-scarred veterans. But there is still a question as to why fugue is not diagnosed in America today. The trivial answer is that it is attached to a large number of different disorders, as an incident, not as a central disorder, but that is not very explanatory. Notice that even in the case of what would once have been called fugue, the very idea of fugue does not arise. Just before I gave these lectures, the San Francisco Chronicle had a story headlined "Police Need Help to Find Missing Epileptic Girl" (7 February 1997). A sixteen-year-old had "run away from her home." Her family was worried because she had not taken her epilepsy medication with her. A century earlier she might well have been sought as an epileptic fugueur. No sort of fugue has any niche today, except as a fugue episode in one or another disorder. The metaphor of the niche is my own, but there are many other metaphors in circulation. Readers of Michel Foucault have deluged us with descriptions of mental illness using the linguistic metaphor of discourse, or of a discursive formation. This is undoubtedly the most popular metaphor of the moment. I find this sad. Foucault carved numerous turns of phrase into ice sculptures, which had, for a moment, sharp contours. Then he walked away from them, insouciant, and let them melt, for he no longer needed them. His less gifted readers put the half-melted shapes in the freezer and, without thinking, reproduce these figures as if they still glistened in the midnight sun and meant something. Do not misunderstand me. My own debts to Michel Foucault are great. In a series of books published in 1975 and thereafter sometime before the

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anglophone Foucault industry took off I have been regularly acknowledging the profound influence of that wonderful thinker on my work. I used his thoughts but did not copy his vocabulary. But my lack of regard for the metaphor of "discourse" in connection with fugue is not just a matter of wanting to leave Foucault unscathed. It is because discourse does not do the work. Of course language has a great deal to do with the formation of an ecological niche, but so does what people do, how they live, the larger world of the material existence that they inhabit. That world must be described in all its peculiar and idiosyncratic detail. I hope that my example, drawing on diverse vectors of different types, may suggest the importance of not focusing on just one thing, not just discourse, not just power, not just suffering, not just biology, when one speaks of a niche. One point of the metaphor of an ecological niche is the complexity and sheer size of the manifold of elements that makes a new type of diagnosis possible. The only new generalization that I am suggesting is the existence of a good/evil pair. This polarity is mobilized by the new kind of illness in creating what we might, with some irony, call role models. The fact that I suggest that we look for both good and evil elements in society at large implies no commitment to any mystique of bipolarity. There could be several quite distinct "good" (or "bad") elements. The thought is more that madness may hover between virtue and criminality. 8 I do not venture onto the terrain of hysteria; that has been so intensely cultivated of late by historians of medicine and of nineteenth-century French society. We see, nevertheless, that the notion of an ecological niche fits that protean disease surprisingly well. The medical taxonomy vector was there to hand one had only to move hysteria out of gynecology and into neurology for Charcot's diagnosis to flourish. Hysteria, especially under the ministrations of that master, was quite extraordinarily visible, observable. And hysteria was a release, in words quoted in Lecture 3, a bodily expression of female powerlessness. What about the cultural polarity vector? This is the most original of my suggestions. Between which extremes of romantic virtue and frightening vice did hysteria hover? Micale has suggested that presentations of hysteria in novels, and among artists themselves, actually preceded the medical fascination and common diagnosis.9 That squares nicely with the picture of a

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romantic, higher, even virtuous type of behavior, above the constraints of society; mere madness could emulate that. On the other hand, there was the great scare of vice, of women falling prey to uncontrollable voluptuousness, of men and women giving way to crimes that they were not even aware of committing. Hysteria fits almost too nicely into my model of cultural polarity and indeed the entire formation of an ecological niche. The fit is so unnervingly good that it is necessary to repeat my caution. The ecological niche metaphor serves as a scheme in which to think about transient mental illnesses. It is not the whole story. Like any scheme or formalism, it omits the content of the illness. It is the warp and woof of the tapestry, not its vibrant life. Second Question What did those late nineteenth-century fugueurs suffer from? By 1990s criteria, some suffered from head injuries, some from temporal lobe epilepsy, and some from dissociative fugue. Historians of medicine have realized for a long time that retroactive diagnosis is a foolish game. It may be possible to play it in an amusing and instructive way, with this or that famous figure: a monster or a poet, a Hitler or a Byron. A certain type of biographer likes to find a rather uncommon present-day diagnostic category that nicely fits some of the odder features of the biographical subject. But when we turn from individuals to an extinct class of people, hysterics or fugueurs, there is no point in discussing what they "really" had, in part because there is no one present-day illness from which even the majority of them suffered. We can understand this as a striking instance of Kuhn's thesis, already mentioned in Lecture 2, that when an old classification collapses, we cannot translate the names for the old "kinds" (e.g., names for kinds of illness, such as "hysteria") into names for "kinds" in the new system of classification. The impossibility of retroactive diagnosis is the academically correct, official history-ofmedicine or philosophy-of-science teaching. But like many teachings that place great weight on propriety, this one contains more than a touch of self-righteous cant. We can say some things about old cases in the light of present experience. For example, when I described fugue in a seminar,

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two guests said, hey, those are our guys. Stanley Klein and Daniel Kaplan worked at a small clinic supported by public welfare funds rather than public medical funds. Community Head Injury Rehabilitation Services helps people for whom the health system has done what it can for severe head injuries but who have residual problems of living in the world. The clients are mostly men, because men, and especially young men, are the most likely to be head-injured: in motorcycle accidents, construction work, logging, barroom brawls. 10 In the past the most serious of head injuries were lethal. But medical technologies, many developed during the Vietnam War, now ensure that people who get to a trauma center within ninety minutes of their accident are quite likely to live. They are also quite likely to recover with various types of deficit, many of which heal slowly, if at all. The biggest problems for the most serious cases are amnesic lapses, sudden outbreaks of unmotivated rage and fury and fugue. The clients at CHIRS have, in effect, full-time backup support in the form of one or more social workers who know their full story. They carry a tag with a phone number. If they wake up with a feeling of amnesia or on the West Coast not knowing how they got there from Toronto, they phone in. Here is what is especially relevant to us: the social helper often has the task of filling in bits of memory, in ways that are eerily reminiscent of nineteenth-century memory recoveries done under the aegis of hypnotism. Mind you, the people helped by organizations like CHIRS are relatively lucky. I have met men elsewhere with a sorry tale to tell, for example, a man injured in a factory when a pile of pallets at a higher level fell on his head. Now he cannot hold down a job because from time to time, at work, he will break into a furious screaming fit of rage against his co-workers, of which he recalls nothing afterward. After the initial treatment for physical injury, the Workmen's Compensation Board denies any responsibility for his fits. It is tempting to play the retroactive diagnosis game with nineteenth-century fugue. You certainly can make a good case that childhood head injury, the result of a fall from a tree, was what really ailed Albert. I discuss that in Supplement 1. We find head injury in a number of other cases of fugue. We cannot avoid the conclusion that some of the fugueurs who made the French medical reports in 1887-1909 suffered from some sort of long-term

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brain damage. So there is a neurological, biological, element in the fugue epidemic, one that could not be well isolated at the time for lack of instrumentation and technology. That addresses only one aspect of the fugue epidemic. Perhaps we should attempt a different type of analysis, along the lines of Elaine Showalter's recent discussion of hysterical epidemics. Her examples include satanic ritual child abuse, alien abduction, multiple personalities, and delusional claims about government surveillance, as well as chronic fatigue syndrome and Gulf War syndrome. In my opinion Showalter, one of the most distinguished feminist historians of hysteria, is profoundly right in saying that hysteria is not dead. The word has so often had two connotations one of feminine overemotional reaction and the other of collective irrational hyperexcitement. Recent nonsense about aliens and Satan horrifically illustrate both the idea of psychological epidemic and the connotation of hysteria as contagious group excitability. Showalter demonstrates how our recent hysterias have one thing in common, a tormented fear of some evil other, from outer space, or from the depths of the soul, or from federal agents, or from the vicious patriarch, or from poisonous gas cocktails in the desert. After describing a few notorious examples, she says that "these sensational cases exemplify individual hysterias connecting with modern social movements to produce psychological epidemics." 11 I am inclined to treat the occurrence of Satan and similar devils in most of these epidemics as noncoincidental. I suspect that we are here concerned with an essentially Christian phenomenon, the devil, who has for two millennia stood in as a scapegoat to allow Christians to make sense of their own cruelty to Jews, heretics, women, witches.12 Mad bombers blow up federal buildings in the United States because these offices are in the devil's service. It must be a coincidence, but we should not forget that there was a Great Satan in the Gulf War. I do not claim that "hysterical" contagion of excess or madness is peculiarly Christian; I observe only the conjunction, in most of Showalter's examples, of hysteria with Satan or his surrogates. End-of-the-nineteenth-century fugue seems to me to be different. It was treated by a lot of positivist, republican (antimonarchist) scientific doctors who did not let the devil get a purchase. If we are to make a comparison between the dynamics of the fugue epidemic and the very recent and much

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more grand hysterias, we would point to the vagrancy scare of the 1880s. But there is a critical difference. Each individual afflicted with a current hysteria believes that he or she is being demonized. There is an enemy out there to be blamed, hunted, punished, destroyed. There is hardly a vestige of scapegoating in the stories of the hysterical fugueurs. There is a social history to tell about contagious psychological symptoms, but in the case of fugue, demons did not provide the catalyst not for the doctors, anyway. The nearest we get is another type of scapegoat, the great vagrancy fear studied by Beaune and emphasized by Donzelot. What does a more conventionally medical approach teach? In some cases we seem entitled to retroactive diagnosis. The category of dissociative fugue is there on the books, in DSM-IV and ICD-10 both definitions were quoted in full in note 9 to Lecture 1. It is to be expected that they should fit hysterical fugue, because the 1990s criteria are, as I put it, grandfathered from the earlier era. If we apply our current 1990s criteria mechanically, we can say that a good number of cases, right up to Hugh Patrick's sad 1907 story of the black steelworker, fit the template of dissociative fugue. From these we must exclude, by the official criteria, men with temporal lobe epilepsy or brain damage which might produce their behavioral problems. We have to insert a caution here. A number of cases discussed in Lecture 3, especially those under the care or scrutiny of Jules Voisin, were said to have double consciousness. DSM-IV explicitly excludes those patients from a diagnosis of dissociative fugue. When double consciousness was diagnosed, we ought, by definition, to file the case under dissociative identity disorder. Using the current format, then, some of the old fugueurs did not suffer from dissociative fugue but from dissociative identity disorder. This conclusion is more a matter of fiat than fact. Had the taxonomies been drawn differently as William James seemed to imply they should be, in his 1896 Lowell Lectures all fugueurs might have gone into the fugue box, while multiples who did not travel would have gone into the remainder box, the multiple box. At this point the question of what the old fugueurs "really" suffered from becomes arbitrary, much as today it may seem a mere matter of decision whether we say a person suffers from dissociative fugue (with extensive periods of amnesia) or dissociative amnesia (with fugue episodes). To conclude. My second question was: what did those late nineteenth-century

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fugueurs suffer from? For those who are content with the diagnostic manuals, the answer is: aside from those who had dissociative identity disorder, temporal lobe epilepsy, or brain damage, they suffered from dissociative fugue. Third Question Were doctors of the day warranted in holding hysterical fugue to be a real mental illness? Yes. There were disagreements, just as today there are disagreements about parallel questions. Charcot was skeptical about hysterical fugue, while Pitres, his student, thought that it was a real disorder. Both took for granted that if it were a real disorder, it would have a bodily, neurological, predisposing cause, activated by some occasioning circumstance. The belief in underlying neurology was more a research program than an established fact, in much the same way that a present-day commitment to the genetic basis of schizophrenia is programmatic rather than proved. I do not want to argue that the Charcotian program was as well warranted as the present searches for genetic determinants of schizophrenia, but it was in the same ballpark, and indeed the schizophrenia research program is a linear descendant of Charcot's. In both cases the evidence thought to be least controversial is derived from the incidence of illness in family trees. 13 Charcot did not have the bureaucratic resources of Danish records of diagnoses, family trees, and adoptions that have fueled more recent studies. I asked whether nineteenth-century beliefs were warranted. Unlike true, the praise word warranted is relational. A belief is warranted relative to available evidence and an underlying agreed conceptual structure. In 1997 a belief in the hereditary and neurological character of hysteria would be completely unwarranted. It was warranted in France in 1887. But what about hysterical fugue? That was controversial. Charcot was skeptical. Maybe you feel you would have been as skeptical as Charcot. Yet in 1907 Hugh Patrick, president of the American Neurological Association, argued that Charcot and his students were wrong in their skepticism. All the evidence, he said, pointed to fugue as hysterical in nature even in the case of Charcot's paradigmatic Mén. Many physicians, Tissié through Patrick, were confident that hysterical fugue is a real mental illness. Perhaps their confidence was not war-

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ranted they ought (we judge) to have been more cautious. But their conjecture, that it is a real mental illness, was altogether warranted. In brief, the answer to my third question is an emphatic Yes! Fourth Question Was hysterical fugue a real mental illness? No. Tense is confusing here. I am asking, in the present, a question about a past diagnosis. Since real is tenseless, we want to be asking whether hysterical fugue is a real mental illness, and yet we want to be referring to the past, past patients, past diagnoses. If you take the current diagnostic manuals the 1994 DSM-IV or the 1992 ICD-10 as authoritative, or at any rate the best available criteria for diagnosis, then it is easy to answer the question. Hysterical fugue was the old name for dissociative fugue. According to the manuals that is a mental illness. Hence, using the established criteria of 1997, what was once called hysterical fugue is a real mental illness. One way to answer the fourth question is, then: According to criteria approved by the American Psychiatric Association and the World Health Organization, hysterical (viz., dissociative) fugue is a real mental disorder. Unfortunately, people who ask my fourth question do not want to know what current manuals authorize. They want to know whether the disorder, by whatever name, is a real mental illness! The questioners want a more reliable authority than the current manuals. It would be hubris for a philosopher to profess to know better than the experts. That leaves us in a quandary. People who ask whether fugue was real do not want the DSM answer, and yet I have no right to go beyond that answer. What to do? Here is one possibility, at least for a philosopher. Invoke pragmatism. This is precisely the juncture at which the classical American philosophy, pragmatism, may seem to be useful. I do not mean latter-day pragmatism in its various guises, but the original product, propounded by C.S. Peirce, and which even by 1897 Peirce had renamed pragmaticism (not genuine without this signature). He renamed it because he disliked the way in which his creation was being abused even by his supporters, yes, even by William James. In a famous essay of 1878, "How to Make Our Ideas Clear," Peirce briefly stated his understanding of the true and the real: "The opinion which is

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fated to be ultimately agreed to by all who investigate, is what we mean by the truth, and the object represented in this opinion is the real." 14 Peirce explained that "fate means merely that which is sure to come true." Elsewhere Peirce observed that something akin to St. Paul's trio of faith, hope, and charity must be invoked in order to accept that something is fated to be agreed upon by all who investigate. In the case of psychiatry, even that may seem an understatement. One of the few domains in which I am a consistent pragmatist is pragmatism itself: use it when it is useful, but don't when it isn't. In a moment you will see why Peirce is so convenient to me here he allows me to evade a lot of endless debates and to do so without any shilly-shallying. I do not in general support Peirce's account of reality. I have long argued that the grammatical observations about the adjective real made by the Oxford linguistic philosopher J.L. Austin are more to the point than most philosophizing about reality.15 Obviously I cannot state what, at the end of inquiry, we shall think about dissociative fugue. Psychiatry has hardly begun its inquiry. But we are in a position to make a wellgrounded guess about future inquiries. The last time fugue was taken seriously as a major illness, worthy of collective discussion, was in 1909, at the Congress of Nantes. Fugue did continue a little longer, as a legitimate enterprise, in Germany. And it has been grandfathered into the diagnostic manuals of today. But it is not there because psychiatrists are diagnosing fugue in the wards and clinics. It is there to furnish an extra leg (or taxonomic branch) to prop up the category of dissociative disorders. Fugue is still discussed in the French tradition, literally in its home, Bordeaux. Is it the case that old diagnoses never die, they only fade away? No, just like old generals, they die. Dissociative fugue is on its deathbed. To tell the truth, an announcement of its death at the Congress of Nantes, in 1909, would not have been overly premature. Does not my very notion of an ecological niche contradict my negative judgment? Might not circumstances arise once more, in which dissociative fugue could thrive as a way to be mad? Yes, anything might happen in psychiatry. A Peircean answer requires Peircean virtues, faith, hope, and charity. The hopes of a curmudgeonly analytic philosopher will be very different from those of, let us say, a New Age prophet. The New Ager may hope that past-life regression comes to the point that we do all sorts of travel, in space

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and in the past, occupying new-old lives as we go. The New Ager may have faith that these cultural practices will come to pass and charitably hope that the curmudgeons will change their minds. More modestly, of course dissociative fugue could once again flourish as a type of mental illness. My hope is that the vector of medical taxonomy never succeeds in making space for it again. I have sufficient faith not based on good evidence or sound induction in the way in which psychiatry will work out to believe that fugue will never again appear as a distinct and autonomous and routinely diagnosed illness in its own right. Fugue episodes will continue aplenty, but they will be filed in many different interstices of the psychiatric taxonomies of the future. I could well be wrong. After all, traveling is such an obvious way to be mad that the human race may have an endless cycle of episodes in which fugue and its kind count as types of madness. Pragmaticism seems like a cheat. We did not want to know whether fugue would be accepted as a kind of madness "ultimately agreed on by all who investigated it." We wanted to know whether it was a real disorder! Some who protest so loudly are asking whether it will prove to be an identifiable organic, neurological, biochemical, maybe inherited (genetic) disorder. Well, if it were to prove to be genetic, and genetic disorders were to prove in the end to be the ones on which human beings agree, then it would count as real, on Peirce's criterion. Not everyone takes a biological attitude to every mental illness. Yet many may agree, each along their own line of thought, that fugue is not a real mental illness (Freud, for example, paid it no heed and pretty much dismissed multiple personality too). My answer to question 4, that fugue was not a real disorder, is one which a good many different attitudes to madness may be able to share. Peirce provides a neutral pragmaticist ground on which to do the sharing. So why do we feel dissatisfied with a Peircean answer? Because there is something more that we want to know. We have objective difficulties, at present, in grappling with the idea of real mental illnesses. This is not because we are in general prone to confusion about reality, but because psychiatry is in a transitional stage in the development of treatments for, and diagnoses of, mental illnesses. We think the problem is about reality when in fact the difficulty lies in the rapid progress of psychiatry itself. The philosopher Hilary Putnam recently wrote about a "common philosophical error of supposing

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that ''reality' must refer to a single super thing, instead of looking at the ways in which we endlessly renegotiate and are forced to renegotiate our notion of reality as our language and our life develops." 16 We have the feeling that there is some fixed, super thing about mental illness, a reality that divides the real illnesses from the fakes. I believe that our conceptions of real illnesses are of necessity being, as Putnam puts it, renegotiated at present. This is because of rapid changes in biological and chemical psychiatry. For two hundred years most psychiatrists have had the background vision that mental illness must be organically based. But classic figures such as Eugen Bleuler and Sigmund Freud, fully committed to that vision, had no trouble reconciling it with a psychological treatment. In their day the belief that mental illnesses were biological had few therapeutically significant consequences. We have seen Charcot with his bromides for epilepsy and today bromide means a palliative of no significant effect. Things have changed. There are now plenty of consequences of the biological approach thanks to the appearance of a wide range of quite successful drug therapies. At the same time psychological, so-called dynamic, therapy, still seems relevant to many clinicians, in all but the most grave cases. We simply have not sorted out our confusions about this. In America psychoanalysis is in disarray. In Europe and South America it still goes strong. I write these words in Zürich, rich in analysts of every known persuasion. Many of them have a very complex view of the value of analysis. Since they are so entrenched here, many have no problems about sending a patient for drug therapy if the patient prefers that. In their own work they speak not of cure but of a certain type of understanding. Events in medicine, not in philosophy, in time will lead to sorting out what we come to mean by a real mental illness. For the time being, it makes good sense to be pragmatists. Even the most charitable pragmatist may hope that fugue, as a diagnosis, will evaporate. Fifth Question Are analogous conclusions to be drawn about transient mental illnesses today? Yes. When we move to the present, it is the first and fourth questions that press on us. What makes an illness possible? Is it a real illness? My responses

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must be schematic. I shall run through the example I know best, namely, multiple personality, now named dissociative identity disorder. I invite readers to apply similar reasoning for other mental illnesses that appear to be transient. First question. What made possible the recent efflorescence of dissociative identity disorder? Was there, for example, anything like the cultural polarity, the tourism/vagrancy (romance/fear, virtue/vice) formation for multiplicity when multiple personality reemerged in America after 1970? Yes. One negative element in our world, on which multiplicity fastened, was child abuse. Child abuse was being presented as the gravest evil of all. One positive element on which multiplicity fastened was the rather romantic challenge to ideas of identity and selfhood that were going the rounds at the same time. These were taken to be very liberating. They overthrew the hegemony of the modern by the splintering glory of the purely "post-." (Post-modernism, which by definition implies a multiplicity of readings, especially selfreadings, can well be interpreted as a banalizing repetition of German romanticism, without the poetry.) People have criticized me for not discussing the self in connection with multiplicity. They were right, although not for the expected reasons. Worries about identity and the plethora of new identity options even sex changes that have appeared in our culture since 1970 are, in my opinion, rather like tourism for nineteenth-century fugue, a romantic opening up of possibilities, cast against the dark side of what is supposed to be identity destroyed and trust lost through child abuse. I do still maintain, as I argued in a long chapter of Rewriting the Soul, that multiple personality, as a disorder, shows nothing about those traditional philosophical conundrums labeled the mind, the self, the soul, the person, or identity. On the contrary, multiple personality, in my opinion, used some cultural events in the sphere of identity to embellish its niche. Multiple personality teaches nothing about "the self" except that it is an idea that can be exploited for many ends. So what makes a transient mental illness, like multiple personality, possible at a time and a place? I repeat my implausible answer. There is a pair of romantic-virtuous and frightening-vicious models manifest in the culture at large, between which the illness poses itself. On the virtue side is the liberation from hegemonic ideas about identity. On the vice side was child

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abuse. This pair forms a cultural polarity vector. But that is only one vector. An ecological niche must be constituted by many interacting elements. The observability vector always matters. In a quite literal sense multiple personality was highly observable not by policemen at the crossroads, as with the old fugueur, but by everyone watching afternoon talk shows. In the case of multiple personality we must never overlook the influence of feminism, trauma studies, the survival movements, the national fears about the dissolution of the family, and much more. There is also the internal history of dissociation in the psychiatric community and even the rediscovery of Pierre Janet by readers of Henri Ellenberger's The Discovery of the Unconscious, published in the critical year, for multiple personality, of 1970. Second question. What did recent multiple personality patients suffer from? In the case of fugue, I gave the rule book answer, namely, whatever the diagnostic manuals said they suffered from. Since multiple personality and now dissociative identity disorder are on the books, that is what many of the patients suffered from. Third question. Have recent clinicians been warranted in their diagnosis of multiplicity? Here we want not just the trivial answer, that the rule book OK's the diagnosis. We want to know whether the multiple personality movement was warranted in pushing its once iconoclastic diagnosis. I have often enough been asked my own opinion about this. Often the question "Is it real?" gets mixed up with "Were they warranted?" I am here giving my own opinion about whether they were warranted. My opinion is: yes, though I wish they had been more self-critical. It is pretty clear that I dislike the movement and many (but not all) of its practitioners. There were excesses beyond any expectation. The movement fed on a good many of the baser instincts of the human race. But (since I have been asked) I think that movement doctors were in the first instance warranted in their approach, even if they might have acquired some skepticism before lawsuits forced them to button their lips. Frederic Crews and others have engaged in therapeutically-induced-memory bashing, and in turn multiple bashing, as by-products of their industrial-strength Freud bashing. Doubtless in the dialectic of ideas bashing was called for, but I am not impressed by hyperbole on either side. Mikkel Borch-Jakobsen, who on the surface takes a much gentler (but perhaps in the

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end more seditious) line on Freud, has published an interview with the distinguished senior psychiatrist and expert on hypnotism Herbert Spiegel. Spiegel, as fate had it, was a consultant on the first modern multiple, fictionalized as Sybil. The headline in the New York Review of Books read: "Sybil Was Not a Multiple." 17 It is no accident that Frederic Crews's own wonderful anti-Freudian polemics first appeared in the New York Review. Several other patterns are evident. Mikkel Borch-Jakobsen (from whom I have learned a good deal) wrote increasingly skeptical analyses of Lacan. Then he did a delightful exposé of Anna O., the inaugurating patient for psychoanalysis.18 Anna O., you could say, has the role for the psychoanalytic movement that Sybil has for the modern multiple movement. Now even if we put the worst possible construction on the inaugurating patients, it does not follow that the movements to which their cases gave rise are corrupt, false, or evil. To think otherwise would be to commit a kind of genetic fallacy. Thus even granting every word of Herbert Spiegel's as literal truth, I am not persuaded that Cornelia Wilbur, Sybil's very eccentric clinician, was wrong in creating a veritable prototype of multiple personality out of Sybil, the disturbed young woman. Agreed, Sybil did not behave as a multiple for Spiegel. But that is characteristic of prototypical multiples, that they do not perform as multiples in all contexts and overtly deny their syndrome when convenient. I am not saying, contrary to the headline, that Sybil definitely was a multiple. I say only that Spiegel's repeated interviews with skeptical parties are not compelling. I shall leave it at that. I have been asked what I thought. I believe the multiple movement clinicians were warranted in their early diagnoses and treatment but then went wild. I judge that some of its leaders, like those of other flamboyant movements, are credible, and some are charlatans. Fourth question. Is dissociative identity disorder a real mental illness? Using Peirce's criterion of reality, I think not. But this is a matter of faith, hope, and charity. Some mental disorders are, in my opinion, real. In the case of schizophrenia, for example, despite the conflicting claims, I hope that within twenty years we shall have a grip on one or two or perhaps three fundamental types of schizophrenia. Possibly these will be completely distinct entities with distinct etiologies. One might be genetic in nature, one

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environmental. Or more complex stories may emerge. What I hope is that schizophrenia will emerge as one (or several) bodily dysfunctions, neurological, biochemical, or whatever, which we shall be able to help or cure in a theoretically well-understood and a practically well-articulated way. This hope must be shared by the majority of research scientists in the field, although there is a minority whose expectations run counter to this general trend. If this hope is fulfilled, then schizophrenia is a real disorder, or perhaps several distinct real disorders are at present called schizophrenia. My own expectations about the dissociative disorders are different in kind from those for schizophrenia. In the case of dissociation, I hope that history repeats itself, but once only. I hope it goes away, for keeps. Let me explain. It is a mere figure of speech, a conceit, to speak in terms of exact centuries, but it is a convenience. The situation, in the spring of 1997, was analogous to that in the spring of 1897. A few years ago a brief and working consensual synthesis about multiple personality was reached. In 1992 and 1994 the two manuals for psychiatric diagnosis were published. Each found a place for multiple personality; in the case of the American diagnostic manual, the disorder was named dissociative identity disorder. There were rules for differential diagnosis. Psychiatry was less bureaucratic a century ago, but in 1895, for example, Fulgence Raymond made his authoritative statement on hysterical, epileptic, and psychasthenic fugue, providing differential diagnosis to sort between the three. That event begins my centennial analogy. What about the future? The future of 1897 was 1909. It is true that in 1907 Hugh Patrick came out strongly in favor of hysterical fugue. But that position was, as I put it in Lecture 3, obsolescent. The Society of Neurologists and Alienists had its Congress of Nantes in 1909. One of the two topics was fugue. That was the last congress ever to address fugue as an autonomous illness. Hysterical fugue made its last glorious stand in France with Henri C., with whom I ended Lecture 3. And that was that. I would like something similar to happen in twelve years' time, in 2009. I would like to observe the very last congress at which the dissociative disorders, including dissociative identity disorder, were treated as autonomous illnesses. I would like to see the entire conceptual organization, of multiple personality (dissociative identity disorder), dissociative fugue, and dissociative

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amnesia, disintegrate, with the symptoms dispersing into a new conceptual organization. Moreover, and this will be offensive to many, I hope that post-traumatic stress disorder, far from absorbing these other disorders, will also disperse and no longer be a usable classification. Finally I hope this will happen as a result of sustained inquiry. The sustained inquiry matters. Janet abandoned the idea of dissociation about 1892. I quoted his own wry remarks on that topic on page 76. Dissociation survived, partly because of the work of an able man in a good place at a good time, Morton Prince in Boston. Boston was the home of the latter-day spiritists, who loved multiple personality as an option because the alter personality might be a dead soul speaking from another place. And then, as spritism waned, multiple personality, homeless, died. It was born again for a complex of reasons that I have indicated in Rewriting the Soul. Would that Pierre Janet were immortal and could remind us that the idea of dissociation ought to have died in, to use his date, 1892. Alas, even if dissociation is as dead in 2009 as it was in 1939, it could return. Dissociation could return in a cycle that recurs throughout the history of the human race. Personally, I hope not, but others have other hopes. But, people will go on asking, are these things real? Peirce's view on truth and reality is useful because it commits us to less metaphysics than other theories about reality and yet suffices to make the point. Suppose, for example, that we followed current scientistic medical metaphysics and held that every real illness has a bodily, biological, cause. If I stated that the dissociative disorders are not real in this sense, someone might cavil on the ground that some mental illnesses are purely psychogenic, with no meaningful physiological, or chemical, or neurological correlates. I can express my skeptical hope about the dissociative disorders without getting into that debate. Of course anyone who thinks that every mental illness is of its nature neuro-chemo-biological will think that inquiry can properly end only when we know the neuro-chemo-biology. I do hope we know enough about that by my deadline of 2009 (a date chosen, to repeat, only by historicist artifice, a play on the 1909 Nantes conference). But inquiry could end for other reasons too. We may consistently find that dissociation talk and practice, for reasons we do not understand, leave human beings weaker in the long run. Harm outweighs help.

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There is one fashionable phrase that I have not mentioned. Social construction. Why not say that transient mental illnesses are social constructions? Do I think that multiple personality recently, hysterical fugue a century ago, and post-traumatic stress disorder in the past decade were all social constructions? No. I would rather say that I hope they turn out to have been mistakes. That is the way to express skepticism. I hope that the dispersal of the dissociative disorders will be the result of greater knowledge, greater ability to help people, and greater understanding of the human condition, both moral and physiological. I have deliberately avoided the lazy terminology of social construction. In a forthcoming set of lectures, The Social Construction of What? I state what, in my opinion, is useful and what is deplorable in the idea of social construction. 19 The closest I have got, in the present lectures, to social construction is the idea of an ecological niche for mental illness, a niche that involves social vectors, certainly, but something that requires more vivid and more detailed description and analysis than talk of construction. If we use the construction metaphor literally, as having to do with building or assembling from parts, then hysterical fugue was definitely not constructed. Nobody built it or assembled it. What if we use construction talk more metaphorically? Then we are merely mouthing a popular phrase, a vogue word, which tells us almost nothing. Someone might wish to say that the dissociative disorders were constructed, almost step-by-step, by dissociation lobbyists in the late 1970s. Such literal talk is seldom what social constructionists intend. Even if one did make that argument, the dedicated building up of the diagnosis and the patients was incomplete. There had to be an ecological niche in which the construction could thrive. It did, until dissociation theorists ate their own nest, multiplying personalities beyond necessity, teaching fantasies to the innocent and escapes to the guilty. It is the fault of the dissociation theorists that they have been attacked by a mob of pretenders as insensitive as themselves. Their assailants are as ignorant of humility, as indifferent to morality, and as ruthless with facts as they themselves once were. Serves them right. In general, the transient mental illnesses are precisely those that exist only in niches. The ones that we unreservedly want to call real do not need much of a niche. Niches can be characterized by a number of vectors, of

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which I have offered four. When those vectors are blunted or deflected, the niche is destroyed. Then the transient mental illness disappears. The saber-toothed tiger was once said to have evolved five times in the history of the planet. Five times a biological form found a place in which to live. That could happen to dissociation too, but enough is enough.

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Supplement 1 What Ailed Albert? L'histoire de Bordeaux est l'histoire de mon corps et de mon âme. Toujours, quand on écrit d'une ville de province telle que Bordeaux, if faut venir à cette idée d'évasion.

The history of Bordeaux is the history of my body and of my soul." "Always, when one writes about a provincial town such as Bordeaux, one must come to this idea of escape." 1 That is not the voice of Albert Dadas, the mad gas fitter. François Mauriac speaks, the Nobel laureate of Bordeaux. Mauriac was born twenty-five years after Albert, indeed just at the time when Albert entered the hospital of Saint-André. He was regarded as the leading Roman Catholic novelist of his era and the greatest chronicler of the provincial bourgeoisie whom he knew so well. It seems absurd to use him as a witness for the life and times of Albert Dadas. Yet Mauriac too fled Bordeaux for Paris, and he too, when younger, fled to the pines, the country, the roads, the sounds. Of course he knew a world that Albert never entered, le snobisme bordelais. "If he had never lived anywhere else but Bordeaux, Proust could have written a book that differed little from Du côté des Guermantes. Bordeaux snobbery doubtless did not merit such a subtle analysis, being at the same time less complex than the Parisian one and more definitively comical."2 But for the rest, the streets where Mauriac roamed, they were Dadas's streets too. The streets to which their inhabitants fled from their stifling rooms in June and walked, single file, down the boulevards,

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only to collapse on the iron chairs in the hope of a breeze. Streets whose overheated walls, as in Poe's tale, seemed to close in from either side. The hills to the north that blocked every cooling breeze; the countryside to the south that blew a deadly suffocating wind laced with pollen over the town. Those chestnut trees in the public gardens that attracted Mauriac in a vain hope of cooling belied by the motionless leaves, discolored by the lamps those were the trees beneath which Albert fell asleep on a bench, some years earlier, also sweating, we expect, and slept through his date with his fiancée. You have perhaps seen the streets of Bordeaux, for this is the best-preserved nineteenthcentury town in France. It is used in films for authentic backdrop. Not the Grand-Théâtre by Louis, the noblest theater standing in France, so say the proud Bordelais, or Gabriel's Bourse (Mauriac's own list of famous sites about which he will say nothing). 3 But the closed narrow streets. Walking down them, even in single file, is hazardous because of cars (today) or horses and carts (then). Narrow streets that now smell at night of acrid exhaust fumes and once smelled (Mauriac tells us) of the acidic reek of horse piss. Closed in. No, says the proud Bordelais, we have the largest public square in Europe, the Esplanade des Quinconces. Yes, but this square, the result of Napoleon's demolishing the old castle, an event intended to simulate the destruction of the Bastille, is filled, almost all of the year now and, to judge by Mauriac, a century ago, with an endless clutter of fairs, expositions, race tracks, and, in those days, with dubious stalls that had a girl's professional first name discreetly written above them.4 People say that Bordeaux turned its back on two things, Mauriac (until he won his Nobel Prize) and the river. The Garonne is grand and wide, more than a third of a mile, and spanned by noble bridges. Yet the town is not there, now. When Albert was young there were 9 kilometers of docks along the Garonne. In 1864 fifty-seven ships were launched by the ten shipyards, but new technologies made the yards out of date by the time Albert comes to our notice. This was the third port of France, not far behind Le Havre and Marseille. Yet even when Bordeaux was a great port, not even the squalid brothels were alongside the water, unlike other seafaring towns. They were a few yards off one of the three main avenues, in the center of the town. A closed-in town. Independent to its roots. Bordeaux was English until 1451. Once Bordeaux had been able to play its master, the king of England, off against the rival, the king of France up north in Paris. A rich town. The

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wealth of the vineyards continued the English connection, for when it came to unfortified wine, the English ever preferred claret, their name for the red wine of Bordeaux. There is a darker side to the city's wealth. Bordeaux was the center of trade with the West Indies, so there were twenty sugar refineries. But this had been a triangular trade, with ships taking slaves from Africa and bringing sugar to Bordeaux. This trade was the foundation for much of the inherited wealth of the great families. In later times the town continued to serve the sub-Saharan colonies. Why, that was where Tissié broke free of poverty, on the good ship Niger on the Senegal run. A truly bourgeois town. The public gardens (where Albert roamed when at home) were laid out, it is said, to imitate the royal gardens, the Tuileries or Versailles. But there was no palace at the end of them. The gardens were designed as a place for merchants to walk after dinner, before making more deals. When that custom passed, the gardens became unkempt, until Albert's boyhood, when they were turned into English gardens of a sort, with fountains and a little lake. 5 This is a city that foresaw the industrial revolution and deliberately and self-consciously decided to keep industry out. Wine, yes. The shipping trade, yes, with the consequent sugar refineries and shipyards. But almost no endogenous industry. That is why Bordeaux is so well preserved a nineteenth-century town, fit for cinematic backdrop. It also meant that there was not much of an industrial underclass. Elsewhere young Albert might have sunk into the mire of the sous-prolétariat and disappeared, as his daughter did in Paris. Before we take leave of Mauriac, one last remark. There are no individual people in his memoir of Bordeaux. Oh, there are ''boys," but he mocks his own way of writing when he says how his family referred, when anything happened, to some impersonal mob, "the boys." Mauriac, ever aware of place, says not a word about individuals. "The houses, the streets of Bordeaux, these are the events of my life."6 Mauriac could have been a solipsist or an alien. There is a suggestion of his that Bordeaux made him that way, devoid of curiosity about people as long as he lived there. That, by and large, is our man Albert. Albert was formed not only by the houses, the streets, of Bordeaux. The Saint-André Hospital became a home away from home. That is a building truly worthy of note, yet it escapes the most fastidious of architectural guides,

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which describe, in fatuous terms, the Palais de Justice that faces it. The Law Courts were erected in 1839-46 and have a faceless facade over 150 yards long, decorated with blank doors and Doric columns. 7 I hope not to be summoned before the law in Bordeaux. But I fancy spending my last days in Hôpital Saint-André. It dates from 1590 but was rebuilt in 1825-29; indeed the Law Courts take their shape from the hospital, which for a moment seems as frightening until you enter the main door and are almost at once in a large cloister, which encloses a pleasant garden some 60 yards long and 45 broad. It has walks, lawns, a fountain. In addition there are nine small court-yards leading off the main building. Albert walked compulsively in the hospital, sometimes under the eye of a guardian to make sure he did not leave. Our psychiatrists today speak of patients having to find a "safe place," which is often a euphemistic metaphor for something many of us would find repugnant. Saint-André was more than a safe place for Albert. It was a lovely place.8 You did not have to be crazy to find in yourself an obsessive need to leave Bordeaux. But what, from a psychiatric point of view, was wrong with Albert? At first he was thought to be epileptic, although Tissié and Pitres soon took him for a hysteric. Some clinicians continued to regard him as epileptic, much to the irritation of Tissié.9 He comes down to us as a hysterical fugueur. Are we to rest content with the diagnosis of dissociative fugue? There is a very plausible alternative diagnosis. Albert Dadas seriously injured his head at the age of eight when he fell "straight down" from a tree in which he had been playing. Not only did he have a concussion but also the ensuing vomiting, headache to the point of migraine, and then ringing in the ears which lasted a very long time. These symptoms only gradually faded away in the course of a year. As he grew up, he had severe toothache that was not relieved by pulling the teeth. With that history he would today be sent off for brain scans, MRI, PET, and the like.10 We suspect brain damage caused by the childhood fall. But is that the history? Retroactive diagnosis from a given set of facts is bad enough, but suppose the facts change? Tissié resumed his reports of Dadas in his book on dreams published in 1890. There we are casually told that Dadas's accident happened when he was twelve, shortly before his first fugue. In the 1887 report the age was plainly stated as eight.11 Is this the same accident, whose date has been corrected after two or three more years of clinical

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work? There is a real problem with that: in the 1887 account Dadas's general state of health after the accident was so poor as to make a spell as an adolescent apprentice umbrella salesman improbable if the accident happened at age twelve. Does the 1890 summary speak of a second accident? Or is there some sort of slip on Tissié's part, with the first and very detailed case history to be preferred to the casual remark that precedes detailed observations of events in 1887-89? Whichever dates are right, the 1887 clinical report does go along with standard sequelae of head injury: amnesic patches, headache, emotional ups and downs, moods of despondency, inappropriate bouts of weeping. Nevertheless I draw back, and not only because those signs are associated with any number of troubles, neurological, psychogenic. First, it is worth noting that in a good number of modern cases of head-injured men, fugue appears to be associated with random outbreaks of violent rage. There is antisocial anger, not clearly motivated, for which there is subsequent amnesia. We find at most one such incident in Dadas's dossier. Document 3 shows that on 9 June 1888 the man had a fierce argument with his coworkers, with no clear motivation, and asked to quit work for the rest of the day. Later he completely forgot the incident and made up a different story of the morning's events. Soon afterward he had terrible fits of nightmares. But that is the only instance of irrational rage on record. A second reason for caution in the head injury diagnosis is that doctors in Dadas's era were immensely attentive to possible brain damage. Eugène Azam, the doctor of Félida, star of double consciousness, wrote a classic paper on traumatic amnesia, from which we take our present terminology of retrograde and anterogade amnesia. 12 We can point to a history of head injury in a number of historical cases of fugue precisely because physicians of the day paid particular attention to any history of accidents to the head. These doctors were still in a transition stage between concepts of physical and psychic trauma and thought a great deal about both. Hence I respect the fact that none of the doctors who saw Albert Dadas seem to have attributed his problems to head injury. If we do favor the head injury analysis and look for confirming diagnoses from the physicians of the day, the best we can do is to conjecture that their initial suspicion, that Albert was epileptic, was motivated by the history of a childhood fall. A third ground for doubt is that there is at present no evidence that head-injured

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patients who go on fugues can retrieve lost memories by hypnosis, whereas Tissié and Albert were a wizard team when it came to hypnotic recollection. This too is not conclusive. Perhaps what does the trick is slow sympathetic working through of the initial scraps of memory that remain from a fugue. Tissié did not hypnotize Albert until December 1886 but got a good deal of the story out of him before that. Maybe hypnotism, in the old days, was merely the mode in which such work was done. Perhaps hypnotism is more of a social than a medical aid to recollection. Perhaps we should not expect hypnotism to work for modern clinicians helping head-injured patients, in a climate that is hostile to hypnotism. Move the same patient to a ward for hysterics, or, today, for dissociation, and hypnotism might work wonders. Not because one finds out something that "really works" on the patient, but because hypnotism works only on a stage, in an environment, where both doctor and patient know what to do. Dadas's story can in any event be read as one of neurological damage occasioned by one (or two?) falls in childhood. If so, the injury underlies the compulsion to travel, the severe headaches that Dadas experienced before a fugue, and the subsequent dazed behavior and amnesia. In contrast, the hysterical symptoms, including the ensuing partial anesthesias and regions of hypersensitivity, could be seen as part of a current symptom pool of which there was wide general knowledge. Not just general knowledge! Dadas had been in Pitres's ward, off and on, in the two months before Tissié began his observations. At that time Pitres was giving lectures on hysteria and hypnotism. Male hysterics were being assigned to the very ward number 16 in which Dadas was placed. Pitres provided the first statistical summary of hysterics classified by age at onset, sex, and occasioning causes, based on a series of one hundred admissions. Thirty-one out of this series of a hundred hysterical patients were male. 13 We can only suppose that the series is based on actual admissions to Pitres's clinic, perhaps even to ward 16. Once Dadas had got to Saint-André, he had plenty of opportunity to learn about male hysteria. That leads on to another chain of thought. Could Dadas, although genuinely troubled by a neurological problem, have been feigning the symptoms of hysteria? Let us be more subtle. Mikkel Borch-Jacobsen has recently discussed the most famous psychiatric patient of the same decade, Anna O., the woman who, with her physician, Josef Breuer, inaugurated the "talking

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cure" that in turn mutated into psychoanalysis. Borch-Jacobsen is skeptical, in a complex way, about the reality of Anna's symptoms and speaks of "simulation." But not pretending: rather Anna, in the course of finding ways to express her distress, acquires those symptoms. A type of behavior congeals around her, without her having consciously to plan things that way. The woman whom we know to be, in later life, the distinguished social activist and feminist Bertha Pappenheim became, for a while, the woman whom we know as Anna O. 14 Did Albert's behavior simply congeal around him? Was there an odd mix of fugues caused by head injury with traveling caused by a desire to get away from closed-in Bordeaux? Did his head injury conspire with his childhood fascination with foreign parts? Were his symptoms after years with Tissié a complex product of what was expected of him, combined with a genuine uncontrollable breaking away associated with subsequent amnesia? I first encountered a parallel suggestion in a 1903 survey paper for German readers. The topic was not Albert but fugue in general. The author suggested that although an initial fugue or two may be caused by some profound upset, neurological or psychological, the continued practice of taking fugues may become a habit triggered by insignificant disturbances.15 Most of what I said about Albert Dadas in Lecture 1 was based on his preliminary encounters with Tissié. We do not know how much of the reconstruction of the early journeys, reproduced in Document 1 below, occurred after hypnotic treatment had begun in December 1886. To judge by later recollections by Tissié, the story was put together only by hypnotism, but the initial case report leaves a different impression. In the lecture I did not develop Dadas's later symptomatology. I have left that for Documents 3-5, parts of which were written in the course of Tissié's investigations of dreams. The accounts of Dadas's original trips may be fairly untainted by subsequent therapy. But few can doubt that some of his later "somnambulistic" behavior resulted from his interaction with Tissié and other doctors. I am suspicious even of the four photographs of Albert Dadas, in the normal, somnambulistic, hypnotized, and fugue condition (see fig. 1). These appear in Pitres's book of 1891. In Tissié's thesis we have an agreeable drawing of Dadas, but not in these "states." Had Dadas learned how he was supposed to look when in different states? In Document 3 Dadas is lying on his bed moving his legs vigorously as

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if he is pedaling a bicycle. He is dreaming that he is on a bicycle fugue and talking to his companions. 16 Bicycles play no role in Dadas's life. We have seen how great a part they played in the life of Philippe Tissié. Here is Albert dreaming that he is on a fugue and actually pedaling pedaling for Tissié. Moreover, he is pedaling with companions. (A casual remark to these imaginary cyclists plays a major role in Tissié's interpretation of behavior subsequent to the waking-dream.) In real life Dadas was a solo fugueur. Even if he did ride a bicycle, which I doubt, he certainly did not go in for the fashionable group tours of the day. Some readers may describe the material in my documents using Freud's invaluable terminology: dream work, displacement, etc. Others may say that this active dream evinces a desire, at some level of Dadas's being, to please Tissié. The two alternatives do not exclude each other. Documents 4 and 5 move us on to increasingly bizarre territory. They discuss "ideogenic zones." Tissié suggests to a hypnotized Dadas that pressure on his right knee means Virtue and pressure on his left knee means Vice. Then experiments are performed with results that are so odd, and on occasion so gross, that I would not venture to paraphrase them. Read them. We also have photographed dreams, that is, photographs of Dadas physically acting out the events in his dream, stealing when he is in Vice mode, returning a wallet in Virtue mode. Dadas knew perfectly well that he was serving as the subject of experiments. Photography in 1892, although described as "instantaneous," was no matter of snapshots. The changes that took place in Dadas's demeanor had to occur at a certain measured rate to conform to shutter speeds, the insertion of new plates, and so forth. I am told that you might need at least three seconds a frame. It is hard not to suppose that in a significant sense the subject was collaborating with the experimenter, even if he was asleep, somnambulistic, unconscious, whatever words are used then or now. I am not even confident about an elaborate waking-dream in which Dadas, believing himself cuckolded, proposes dashing off to Paris to murder his wife. Tissié hypnotized Dadas out of this impulse by getting him to destroy all recollection of the dream. My interpretation is twofold. First, the dream content does express real worry about his wife, who married him at short notice and has been putting up, as he well knows, with both grinding poverty and really bad behavior on Dadas's part. But second, at some level of

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his consciousness Dadas knew the point of Tissié's experiments on influencing future behavior by having hypnotic intervention in dream content. He acted out a dream in a certain way precisely so that Tissié could hypnotize him out of the very thoughts conveyed by the dream-action. Clinician and patient, experimenter and subject, are so much parts of each other that the question of what "really" ailed Albert Dadas late in his interaction with Philippe Tissié becomes idle, a free wheel that ceases to mesh with the course of events. I must repeat that I do not accuse Dadas or Tissié of falsifying or faking anything. Perhaps the best word for two people in a hypnotic relationship, the hypnotizer and the hypnotized, is that the two are extremely accommodating to each other's needs and expectations. This phenomenon was well described one hundred years ago by a sensitive philosopher, Joseph Delboeuf. Compare the way that small children understand things that are going on around them, in a family setting, especially when parents try to cover up. The children cannot express what they sense, but they know. In the hypnotic relationship both parties know, without verbal formulation, the needs of the other and accommodate themselves accordingly. 17 Azam thought that Albert was more intelligent in his fugue state than in his normal state. Perhaps theory played a role here. In Azam's clinical experience and in his study of earlier case reports, he found that a multiple in the second state was more gifted and less inhibited than in the normal state. Intelligence aside, Albert seems to have been quite an outgoing chap on some of his later fugues. In Document 4 he meets a drum major from his former regiment and buys so much food and drink that the man ends up under the table while Albert contents himself with a small glass of gin. There is a tone of revenge or mockery in the tale. There are other accounts of this strange acted-out hospitality, which Albert never displayed in his normal state. Albert increasingly knew how to work the system. He stole money from his wife's savings. Savings from what, we wonder? Did her family give her money? He began to set out on his fugues with planning and premeditation. In time he knew he could check into certain hospitals in northern Europe, Liège or Berlin, and declare himself to be Tissié's mad traveler. He would be assisted home or, long after he himself had set up in Paris, assisted to Tissié's home in the Southwest. (Tissié relocated in Pau.) What for? A warm and caring

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reception, I fancy, perhaps a bit of countertransference. Albert, after all, was one of Tissié's two claims to fame. Interestingly, in 1930, when Tissié was aged seventy-eight, Albert seems to loom larger than a lifelong and highly influential career in physical education. The disillusion with physical education may in part have been caused by the Great War. Tissié was much involved in improving the health of young men, both in and out of the army, and worked from time to time for the military. His healthy young men ended up dead in the trenches. In 1930 it was better to have memories of Albert, perhaps. When Albert's wife died of tuberculosis, his daughter Marguerite-Gabrielle was adopted by a family of market gardeners. He continued to see her, fondly we imagine, but between episodes of fugue. We gradually lose sight of him. Our last miserable glimpse is when Marguerite-Gabrielle is, apparently, abducted for the white slave trade. Albert died at exactly the same time (Document 6). There are no descendants. The family line died out. 18

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Supplement 2 The Wandering Jew We expect allusions to the Wandering Jew to bundle together all the strands of antiSemitism. In a 1960 movie by Jean-Luc Godard, Une femme est une femme (it is a comedy), Jean-Paul Belmondo is trading obscene insults across the street with a dirty old man. The worst that he can reach to, after a string that would be unfit for family consumption were it in English, is "Juif errant!" Yet the legend of the Wandering Jew has had two roles, in one of which the Jew stands for all of suffering humanity, for us. That Jew is a person who, like the rest of us, has made an honest mistake. His story is sad, but he is not a sign of evil. This extraordinary ambivalence of the legend is disconcerting. The story of a man condemned to live forever, going on and on, never resting, has certainly had an amazing life in Europe. Byron, Shelley, and Goethe found the image compelling. 1 It crosses paths with fugue. In his first report of Albert Dadas, published in 1887, Philippe Tissié wrote that "we begin to make clinical observations of this new Wandering Jew." Early the next year the military doctor Emile Duponchel asked, isn't Dadas "truly a subject worthy of our reflections? And does not one automatically think of the ancient legend of the Wandering Jew, constrained by divine power to wander over the face of the earth, always walking, without respite or mercy?"

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And in 1890 Georges Sous (whose thesis told us about the final disappearance of Mén, Charcot's paradigm case of ambulatory automatism) wrote that "the ancient legend of the Wandering Jew, with the voices that cry `Go on! Go on!' seems to have as origin one of these curious cases of ambulatory determinism that M. Tissié, of Bordeaux, studied so well in his thesis about mad travelers." 2 For Tissié and Duponchel the Wandering Jew was a metaphor. Albert was not Jewish.3 Tissié's thesis was not widely read, but Duponchel was writing in the influential Annales d'Hygiène Publique et de Médecine Légale. Charcot, never one to miss the chance to dramatize someone else's idea, hammed it up in February 1889, presenting a young Hungarian Jew named Klein, who for the last three years had been traveling all over Germany, England, Belgium, and now France. When he ran out of money in Belgium, the man walked from Antwerp to Liège, during terrible summer storms. In the end he made it to Paris; he arrived at the hospital with bruised feet. He got somewhat better, but then he wanted to get up and go again, perhaps to Brazil. He had scary dreams of being driven by dogs from right to left. From right to left across the map that would be from Hungary to Germany to England, with anti-Semitism following all the way. "I present him to you as a true descendant of Ahasverus or Cartophilus."4 Ahasverus was the traditional name affixed to the Wandering Jew in 1602. The name Cartophilus derives from the thirteenthcentury text of Matthew of Paris; Cartophilus is an imagined attendant of Pilate, condemned to live forever. Unlike Tissié, Charcot was not speaking metaphorically. At most we have hyperbole, for Klein was a wandering Jew. He did not suffer from fugue, neither as that disorder was at first understood nor as dissociative fugue is nowadays defined. Likewise Klein did not suffer from (epileptic) ambulatory automatism. Charcot presented Klein as neurasthenic. He directed the trope of the Wandering Jew toward real Jews, and away from fugue. Sous, on the other hand, followed on the heels of Tissié and Duponchel. He even offered an explanation of the Wandering Jew story. There had once, he speculated, been a Jew who had the same trouble as Albert, and about whom legend had accreted. A supplement on fugue and the Wandering Jew ought to be unnecessary, because almost all the relevant information (and much more) is contained in the classic essay by Jan Goldstein, "The Wandering Jew and the Problem of Psychiatric Anti-Semitism in Fin-deSiècle France."5 Fugue

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enters only incidentally into her analysis. She regarded Tissié's story of Albert as a rather droll aside. 6 I repeat her material not simply because of my difference in emphasis, but because her essay is reaching the status of a work that may be more cited than read. The golden decade for fugue, the 1890s, was that of the Dreyfus case, but Jews were also deemed to be a pressing problem at a much lower stratum of society than the army. The intense anti-Jewish legislation of Czar Alexander III, when he assumed the imperial throne in 1881, combined with innumerable acts beyond the law in the villages, drove Jews all over Europe. The anti-Semitic agitation in Germany made that country a foul stopping point. Even though times were bad economically, the Republican authorities in France were fairly hospitable to eastern refugees. That, combined with the swinging vagrancy laws of 1885 (see Lecture 3), provided wonderful polemical material for nationalists, chauvinists, and monarchists. Old-stock Frenchmen had been driven by desperate straits (so went the argument) into becoming tramps and hoboes. Their vagabondage was caused by the stupid economic policies of a Republican government. And now these harmless Frenchmen were to be exiled to penal colonies, while those greedy invaders, the Jews from the East, were being welcomed! I paraphrase from a specially nasty treatise of 1886, by the leading anti-Semite journalist, Edouard Drumont.7 When in 1887-90 Tissié, Duponchel, and Sous compared Albert Dadas to the Wandering Jew, they must have been perfectly well aware of the connotations of that phrase to men like Drumont. Let it be said that French anti-Semitism, unlike that in Germany, did not form itself into an autonomous political movement until after the collapse of Boulangism in 1889 (see Lecture 1, note 22), for Boulangism had briefly taken under its wing all antiRepublican forces, including both anti-Semitism and revanchism against Germany. Philippe Tissié put the Wandering Jew metaphor into the arena of fugue. What did it mean to this self-made physician, provincial republican, and scion of Huguenot stock? We do not know enough to answer, but here is some background. First we have to recall Ahasverus. ''Verily I say unto you, there be some standing here, which shall not taste of death, till they see the Son of man coming in his kingdom" (Matt. 16:28). The canonical first item about Ahasverus (there are four centuries of possible predecessors) is a pamphlet named Short Description and Account of a Jew named Ahasverus, published in nine different printings in Danzig, Leyden, and near Dresden in 1602.8

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But that rare document was not what French readers knew. Something else had the role of a standard text. For two generations or more after 1847, almost every French reader did know that "according to the legend, the Wandering Jew was a poor shoemaker from Jerusalem. Christ, carrying his cross, passed in front of the house of the cobbler on a stone bench situated near the door. Go on! . . . Go on! . . . said the Jew harshly, pushing him away It is you who will go on until the end of time! . . . Christ replied, in a tone both severe and sad. (See, for the details, the eloquent and learned note by M. Charles Magnin, placed at the head of the magnificent epic Ahasvérus by M. Edouard Quinet.)" 9 This is a footnote to Eugène Sue's The Wandering Jew, which ran as a serialized novel in 1844-45 and, when published in book form, occupied ten volumes (in the 1980 reprint of the 1883 illustrated edition, 1,501 pages of text). The novel was the best-seller for many years and saved the fortunes of Le Constitutionnel, the fairly radical political newspaper in which it first appeared.10 The Quinet epic cited by Sue appeared in 1833. It covered everything from Creation to the Last Judgment and beyond. An angel takes pity on the Wandering Jew, and together they represent the onward and upward struggle of the human race toward knowledge of beauty and of evil. There were countless variations on the Wandering Jew tale in nineteenth-century France, but Quinet's version captures the tone of the vast proportion of them that were intended for up-market readership. The Wandering Jew stands for the human race; his ultimate redemption is our redemption. In the 1602 original the hero was a totally pious man who in ignorance had taken Christ to be a heretic. When he heard the Lord's name taken in vain, he denounced the speaker: "If thou hadst seen and heard how sorely the Lord Christ was wounded and tortured for thee and me, as I saw it, thou wouldst rather torture thyself than name thus His name."11 There were ever so many versions of the story, humorous, scabrous, sentimental, pious, but Sue's was the most widely read in France, by a large margin. The one thing he omitted from the summary footnote I have quoted was the fact that the Wandering Jew always had a few and only a few cents in his pocket (leading to malicious jokes about how he got rich, little by little, by taking the few sous out of his pocket over and over again). In its written forms the legend of Ahasverus was a Protestant production all the way. It has been conjectured that the 1602 pamphlet was to be a confirmation

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of the facts of the Crucifixion by a witness, who directly trumped the Roman Catholic claim to legitimacy through the apostolic succession. Sue's novel, 240 years on into the evolution of Ahasverus, is a multicontinent spectacular in the same anti-Catholic vein. The heroes descend from an exiled Huguenot. The closest recent relatives to Sue's The Wandering Jew are the early James Bond novels of Ian Fleming and the endless successors in that genre that grace airport bookstalls. But where the intrepid villains of labyrinthine and brutal plots for James Bond are masterminded by the KGB in Moscow, the villains for Sue are Jesuits, whose evil empire has a worldwide network that would have been the envy of Moscow in its imaginary prime. The good guys are the seven living heirs of an extremely wealthy Huguenot family, exiled in 1582. All descend ultimately from the sister of the Wandering Jew. Through marriage they are spread across the planet. One is an Indian prince, two more are twin girls in Siberia, one is a Jesuit missionary in America, ignorant of what his order is plotting against his own family. The book does not say so, but by matrilineal descent from the sister of the Wandering Jew, they would all have been Jewish, had they retained their religion. The Sweetie-pie Seven are virtuous to the point of nausea. But in case we wonder who they stand for, the Wandering Jew reflects: "The history of this single family . . . it is the history of the whole of humanity! Passing through so many generations, in the veins of the poor and the rich, of the sovereign and the bandit, of the wise man and the lunatic, of the saint and the atheist, of the coward and the hero, the blood of my sister is perpetuated until this very hour." 12 The Jesuits, by wile, cunning, and bloody murder if necessary, in Java, Leipzig, and the rest of the world must prevent the family from gathering at an appointed spot in Paris on 13 February 1832. They will wrest the now gigantic Huguenot fortune from its rightful heirs and put it to their own wicked ends. This is an absolutely dreadful book, that did not deserve the many plays based on it (Sue himself wrote a melodrama of his own plot). It richly deserved the many parodies, which began appearing in 1844, before Sue had even finished writing the novel. Nevertheless, about every fifty pages there is an incident that is more gripping than most of the stuff in those novels at the airport bookstalls. Sue had, in his day, a reputation for terrifying his readers once in each installment. And where does the Wandering Jew fit in? Sue gives us a Jew and a Jewess,

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who never cross paths but pine for each other (in the prologue they barely make each other out across the icy mists of the Bering Straits). 13 They are the conscience of humankind, and as bad at arranging affairs as is the human conscience. Both do their best to help the Seven but are impelled to go on traveling. A voice within cries out to them, "Go on! Go on!" and they cannot help themselves.14 There is one extraordinary contrast with James Bond versus the KGB. The bad guys win. Six of the Seven end up dead, and the survivor is in a pitiful state. It is true that the Jesuits do not get their lucre, thanks to a trick by the Wandering Jewess, but virtue distinctly does not triumph. The book is socialist by inclination. It denounces terrible working conditions and supports a Fourierist model factory for workers. It reviles British and Dutch, but not French, imperialism, yet that is pro forma, for it paints lurid colonial fantasies of red Indians crucifying and beginning to scalp one of the Seven in the Rocky Mountains. There are even more terrifying pictures of the Assassins, or Thugees, that originated in the North-West provinces of India and ply their deadly trade, instant death with a stone on the end of a sling, throughout Southeast Asia. (But one of them gets to Paris and poisons the Jesuitical archvillain of the book.) Readers did not think of this book in the context of anti-Semitism. Yet Sue could not resist. As part of the novel's machinery, he created a ghastly correlate for the Jew, whose peregrinations through Asia and Siberia track the ravages of cholera. When he gets to Paris in 1832, so does pestilence. Jews real Jews have no part in Sue's book. I have gone on about Sue because his book shows what the Wandering Jew signified to the French reading public and to Huguenot Philippe Tissié, I am sure he read the book as a lad. I imagine his father giving it to him in the same year that he had the local wheelwright make up a wooden bicycle. There were plenty of anti-Semitic folk tales and sayings in circulation. Here I speak only for the overt aspects of Sue's book as read by the lowbrow middle classes, many of whom were of course anti-Semitic, but whose Republican government had taken a fairly relaxed attitude to Jews displaced from Eastern Europe.15 All that was about to change, just at the time when Tissié encountered Albert. The vagrancy scare intersected with the Jews fleeing the East, the poorer of whom traveled cheaply, even on foot. Then there was a third intersection: the belief, confidently held by many Jews themselves, that Jews were

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especially likely to suffer from mental illness. This last is an immense topic in itself, on which Sander Gilman is the best single current authority. 16 Charcot rode high on all three horses, vagrancy, eastern refugees, and Jewish mental illness. Gilman refers to him as "the anti-semite Charcot." Concluding a discussion in which Charcot and his school are the dominant figures, Goldstein emphasizes the complexity of the situation: "If psychiatry was not quite innocent of anti-semitism, it was not quite guilty either."17 Charcot came to use Jews regularly as examples in his lectures and to emphasize that they were Jews. This material was splendid fodder for the antiSemitic press, and Charcot did nothing to combat that use of his research. I shall not add to the finger-pointing or nuancing, for I am more concerned with the obscure Tissié than the famous Charcot. Remember, however, that Charcot's analyses were embedded in contexts other than antiSemitism. First is the claim that mental illness (including hysteria and neurasthenia) is neurological, viz., biological in nature. Second is the claim that neurological defects, and hence mental illnesses, are hereditary. To all that let us add the conviction a virtual commonplace of the time among Jews, Gentiles, and psychiatrists of all persuasions that Jews were curiously prone to mental illness. All these factors made Jews central to Charcot's psychiatry, especially in his later years. For here was a relatively closed gene pool (as we would now say) in which to study the heredity of mental illness. Charcot's fascination with Jews, doubtless informed by his contempt for them, had a natural place in his neurology. To change the perspective, notice how Charcot shared most of the pre-suppositions of the genetic approach to mental illness that are current today. He could not fall back on a genome project to support his scientific speculations, but he did have a closed gene pool to study, not just in that Jews were endogenous but because many Jews in his clinic were descended from relatives, even cousins, who married each other. Scientific reasoning could motivate his constant attention to Jewish family lines and to the distribution of mental illness within those lines. His work is at one with the 1990s genetic determinism approach to mental illness that constitutes the present most popular paradigm for fundamental research. Thus a reputable scientific quest merged with a great willingness to see Jews as aberrant, troublesome, ill.18 Charcot never connected ambulatory automatism, the classification that

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he invented, with the Wandering Jew. On the contrary, his wandering Jews were diagnosed as suffering from the "American illness," neurasthenia. Beard's diagnosis of neurasthenia, imported to France around 1880, was taken as a symptom of the hectic pace of life in America, a pace shared by the urban Jews of commerce. No matter that neurasthenia was typically associated with exhaustion and enervation, to the extent that it has been identified with chronic fatigue syndrome today while Charcot's wandering Jews were supposed to be able to walk at great speed all over Europe. They were diagnosed as neurasthenic because they complained of innumerable illnesses, for which they sought treatment and because Jews were neurasthenic. Even Charcot had to confess that "it is remarkable" that in the case of his man Klein, "one does not meet with very accentuated neurasthenic symptoms." Accompanying Klein's (invisible) neurasthenia is traumatic hysteria, the trauma consisting (it appears) in the physical pain suffered on the walk from Antwerp to Liège. Charcot and hence his assistants were fascinated by what they called the iconography of the mad. They were delighted to compare representations of the insane in medieval art with photographs prepared in their clinic, and they produced amazing illustrated books displaying the results. It is no accident that the first multiple personality, Louis Vivet, and the first fugueur, Albert Dadas, were presented in photographs of their different states. Charcot's students, working in a public hospital, saw many poor Jewish refugees. The wandering Jews in Charcot's ward were duly photographed. A thesis by Henry Meige, a student at Charcot's clinic, is rich in copies of mostly seventeenth-century woodcuts of the Wandering Jew, alongside drawings taken from three photographs of patients in the wards. 19 "The Wandering Jew of the old prints is indeed a true Wandering Jew, none other than the Wandering Jew of the Salpêtrière."20 The Wandering Jew of the Salpêtrière is becoming the most frequently cited French medical dissertation of its decade, if not of its century. But this is for an odd, adventitious reason. Meige's dissertation has been incorporated into the recent spate of writing about Daniel Paul Schreber, the paranoid schizophrenic Saxon Supreme Court judge, topic of Freud's famous essay. In the course of his own interminable account of his insanity, published in 1901, Schreber briefly fantasized himself as an effeminized Wandering Jew. Scholars such as Jay Geller and Eric Santner who use Schreber's mad

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text as a mirror of his culture invoke Meige on the side and tend to take for granted that the Wandering Jew has identical meanings, at the same times, in France and Germany. 21 I suggest not. Different does not mean free of anti-Semitism. It means different. For example, the very name of the Jew is different in the two languages. In French he is the Wandering Jew, le Juif errant, but in Germany he is the eternal Jew, Der ewige Jude.22 I suspect this is one reason that the Jew seems never to be picked up in the German fugue literature discussed in Supplement 3. The men suffering from Wandertrieb in the German-speaking world were, whatever their problems, not eternal. Despite the fact that Meige's thesis has attracted so much attention, I shall venture a summary. After its obsequious preface thanking Charcot, it began with an introduction stating that the legendary Jew "is only a sort of prototype of neurotic Israelites journeying throughout the world."23 Why are these travelers pathological? They search out fortune or a cure for their ills. Nothing is wrong with that, but they always want "something else," and want it "elsewhere." They are unable to resist this need to move on: that is what is crazy about them. Meige then summarized the history of the legend and wrote a section on the iconography of the old woodcuts, which he compared to drawings made from photographs of men in the hospital. Then he presented five cases. (1) Charcot's Klein, using the words of Charcot's Tuesday lecture. (2) Moser, a thirty-eight-year-old Polish Jew nicknamed Moses, who has been in hospitals all over Europe and had the run of cures. But electricity is new to him; he stays in Paris and comes to the hospital every day for electric treatment (probably feet immersed in water while mild and not so mild shocks are applied to various parts of his body). For a while he gets better. Then he develops new symptoms, including having wet dreams twenty to thirty times a night.24 He accosts Charcot and others every day in the ward. When they refuse to listen, he moves on, who knows where. (3) Meyer, forty-two years old, from Vilna (Lithuania, in the Russian Empire), gets a bed in the Salpêtrière because he has no money. When he is told of all the possible treatments he can have, he replies that he has had them all; they do not help. He agrees to be photographed and then leaves, for good. (4) Sigmund, aged forty, born of a German father and an Italian mother. More cultured than the rest, he is a violinist, but he trembles too much and has lost the memory of most of his music, so he can only give

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lessons. He has been to New York, Chicago, "etc." In 1882 he was struck by lightning near Brussels (hence the traumatic hysteria). In 1889 someone called "fire"; when he saw the flames, he fainted and was paralyzed. He had an almost complete roster of hysterical symptoms. Outside of the Salpêtrière he would have been almost a classic hysterical fugueur, especially since he walked immense distances, climbed perilous mountains, and ran prodigious distances. But in that hospital there was no such thing as hysterical fugue, and since Jews were neurasthenic, Sigmund was a "hystero-neurasthenic." (5) The wandering Jewess, Rosa, aged forty-seven, born in Russia. 25 She lives in Kiev. She splits blood, had dreadful headaches, and takes numerous cures in Germany. But the renown of Charcot in Kiev is great. Finally she gets to Paris, where she has complete confidence in a cure. She is given zinc oxide pills. After a month she is better and goes home with a valise full of tablets; she agrees that Charcot's fame is justified. Meige regarded the cure as the result of suggestion, not medicine. "How long will this happy suggestion persist?" he wondered, and was afraid that a contrary idea would come into her head, and she would then leave for new clinics and perhaps in a few years come back to the Salpêtrière itself, only to disappear again, "following the cycle of her traveling impulse." In his analysis of these cases Meige began by saying how struck one is by the origin of these patients. Why, they all come from the East. Germany, Poland, Austria. East Prussia reached into much of what is now Poland, as did the Austrian Empire. Russia was amazingly not mentioned, although two of Meige's five cases came from the Russian Empire. Elsewhere Meige was struck by how many of Charcot's Jews come from Odessa, in the Ukraine. What, Meige demanded, is the explanation for the eastern origins? Well, the Wandering Jew is an essentially German legend. "The wandering people, they are not the Jewish people; it is the Germans, whom one calls Vandals, Normans, Visigoths. If there are wandering Jews, they are German Jews (Heimathlos: without a country)."26 Considering that another war between France and Germany had been seriously contemplated as recently as 1889, you can see that Meige did not miss a trick. No wonder his thesis defense was reported in the major daily, Figaro. This horrible wandering is really a German problem! Which of course it was, with the anti-Semitic agitation of the 1880s, combined with the fierce anti-Semitic legislation and enforcement in

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the new Russia of 1881. There was not a word of the realities in Meige, only fantasies about Visigoths. Meige went on, in Charcot's footsteps, to become a respected neurologist, editor, by 1905, of the Revue Neurologique, the journal of the organization of which he was secretarygeneral, the Société de Neurologie de Paris. Most of his mature published work was about tics, including the phenomenon that Oliver Sacks has made famous, Tourette's syndrome. We can think of this syndrome, like classic hysteria, as being cultivated in the Salpêtrière, where first Georges Gilles de La Tourette and then Henry Meige began their careers. 27 I shall leave Meige there, for indeed there is little more to say, except for a word about Albert Dadas. "There," wrote Meige, "is a case that comes very close to that of our wandering Israelites."28 Good pupil of Charcot that he was, he urged that cases like Tissié's should be thought of as neurasthenia, "on top of which hysteria may be added." It was even suggested that some of the anticipations of the legends, such as the Cartophilus of Matthew of Paris in the mid-thirteenth century, imply hysterical incidents. And in the German tradition there is another theme, of Wandering Jew as the persecuted persecutor, himself murdering from time to time, or at least being an intimation of approaching death when seen. ''However, this gloomy aspect of the Wandering Jew is very rare, and in the legend, he is above all a good man, although very unhappy." All that was changing. Jan Goldstein writes that "by the end of the century, the French image of the Wandering Jew had recovered its literalness." Literal could even mean the Antichrist, for had not the Jew scorned Christ carrying the cross? Because of this transition, it has become all too easy to read gross and manifest anti-Semitism into the psychiatric wards of the 1880s and early 1890s. Goldstein has charted public reaction to an unusually prominent medical dissertation. Edouard Drumont, the doyen of antiSemitic journalists, reveled in it. Jews were intrinsically, genetically, degenerate madmen. Figaro, at that time moderate Republican, was cautious. So too was the Jewish press. On the one hand, it tried to guard against the idea that eastern Jews (and by implication most Jews) were born to be at least neurotic. On the other hand, it welcomed the exoneration implied in medical diagnosis. Eastern Jews, by nature hardworking and persevering, were seen

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as shiftless and dirty in the West; they were merely neurasthenic and could be cured. The place of the Wandering Jew in French psychiatry seems to derive from Tissié's metaphor about the first fugueur, Albert Dadas. If so, it began very differently from the way it ended, with Meige handing the potent mix of legend and refugees over to the antiSemitic press. Tissié, proud if poor heir to a Huguenot tradition, had his idea of the Wandering Jew formed by Sue's epic of Huguenot descendants fighting the Jesuits. The Wandering Jew in fiction was on his Huguenot side, all the way. He retained the metaphor at least until 1901, when he wrote almost the last medical word on the topic until the recent fascination with Meige's thesis. Let us give him those last words. He was not speaking of the Jewish patients of the Salpêtrière. A legend is sometimes based on the truth. Is that the case with the Wandering Jew, obliged to march forever with a few coins in his pocket? Does this tale of extended tourism originate with the observation of a man impelled to walk on and on? Or is this the way that popular imagination has summed up the character of a people dispersed to the four corners of the earth, after the fall of Jerusalem? Be that as it may, the legend of the Wandering Jew has become a reality, proved by numerous observations of patients or unbalanced persons who suffer from an imperious need to walk, on and on. 29

As for Charcot's ambulatory automatism: to say that mad travelers, filled with an imperious need to travel, suffer from ambulatory automatism is "seriously to distort psychology."30

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Supplement 3 Wandertrieb in Germany Les Aliénés voyageurs was published in 1887. Charcot presented Mén in 1888. Italian doctors began publishing fugue-type diagnoses in 1889. Italy was in the French sphere of influence. The German-speaking countries, whose psychiatric taxonomies were soon to swamp French ones, had quite different traditions. It took a full decade for fugue to infiltrate them. Here I very briefly and superficially describe what happened. The medical cultures of the German language were politically and geographically dispersed even within the German Empire. German psychiatric culture extended beyond Austro-Hungary to Scandinavia and Russia. Perhaps the most influential center, in the period under discussion 1898-1914 was the Burghölzli Hospital in Zürich. Yet I could find no trace of the fugue diagnosis there, although quite a few German-speaking fugueurs do head off for Switzerland. 1 It all began (in Germany) in 1898 when Ernst Schultze, in Bonn, published a "Contribution to the Theory of Pathological Disturbances of Consciousness."2 I am not bringing much new, wrote Schultze, for Charcot laid out his "Symptom complex" of automatisme ambulatoire very clearly. But if you look at the literature, he continued, you would conclude that this disorder is rare in Germany, or at least seldom diagnosed. Look at the French survey of 1894. Forty works are cited there, but only one in German!3

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Only a great leap of the imagination would lead anyone to file even that case under ambulatory automatism. Written up in 1880, it involved a very sick unmarried shepherd who came under observation in 1857, when he was committed to an asylum. 4 The man died at the age of forty in 1860. He had severe seizures. Before or after an attack he would compulsively pace up and down, or in circles, always clockwise. He had an obsessive conviction that he should put the whole world, and the heavens and angels, in his head, or in his heart.5 An autopsy exposed severe sclerosis and even atrophy of the brain, especially of the right hemisphere. Even before knowing the neurological root of the man's illness, it was plain that he did not have Charcot's latent epilepsy. The epilepsy was all too manifest, at any rate to the attending physician. The pacing resembled, or simply was, the "procursive" aimless walking up and down and round about that was known to follow some epileptic seizures. The shepherd was placed in an asylum not because of his pacing but because of his delusions about the world being in his head. Upshot: when Schultze began, there were no published German cases at all. That is not quite right. Of course there were earlier cases that fit the diagnosis, even though the diagnosis did not yet exist. They show up in the ranks of deserters, such as musketeer J.M., who went absent without leave numerous times, each time setting out on foot and walking compulsively.6 His first military tribunal was not impressed: the man usually went home, claiming that he was overcome by an attack of homesickness. But on appeal it was observed that the musketeer from puberty had suffered from a striking mental disturbance accompanied by a need to travel (eine Neigung zum Wandern, Fahren, Reisen). There was neither a family history of epilepsy nor any indication of epilepsy in the accused. It was concluded that the man suffered from brief morbid disturbances to his mental activity, and that his absences without leave took place during such disturbances. The musketeer was found not responsible for his actions under section 51 of the German military code. A person cannot be held responsible for an act unless the act is intentional and the person has freedom of the will at the time. The incidents for which the man was accused took place between 1880 and 1882; the report was published in 1883. The diagnoses of fugue or ambulatory automatism did not exist. At best one could speak of temporary morbid disturbances of mental activity.7 Here, we might say, was a case waiting for the diagnosis of fugue to be invented hysterical fugue, even, given the

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absence of epilepsy. But hysteria was problematic in Germany, where the diagnosis of male hysteria had not experienced the impetus of Charcot's campaign. It was all very well for Freud to import it into his bourgeois consulting room in Vienna, mostly treating manifestly "neurotic" patients. Freud's initial rejection by the Viennese medical establishment had as much to do with his confidence in the phenomenon of male hysteria as with his enthusiasm for sexual etiology. How much the worse for young soldiers: in 1883 hysteria was not the type of diagnosis that quickly transferred to the Eighty-seventh Infantry Regiment. 8 Ambulatory automatism did not get to Germany until 1898, when Schultze set out to fill the gap. He offered three new cases, to which he added a fourth in 1900.9 He kept on insisting that German doctors needed to build up a repertoire of cases: we must not fall behind the French! His stories are very robust. Each could well serve as an outline for a novel or film, but I must omit the anecdotes here. X is a young volunteer in the army, a good soldier and planning to reenlist. But off he goes, to London, where he takes ship for New York, and gets to Cincinnati. Only then does he fully come to and realize that he has deserted, although he is partially aware of who he is before then and even writes his parents for money. Y, a thirty-seven-year-old man of Austrian origins, shows up in Schultze's clinic in Bonn. There has been a history of minor fugues, starting during military service. On one occasion he travels from Prague to Trieste and back with his old servant and a parrot; when he arrives back home in Prague, he has no memory of what he has done.10 Some years later, after quarreling with his wife, he ends up in Marseille with ten to twelve days missing from his memory. In Paris he passes by a recruiting office of the Foreign Legion. He enlists and is sent to Oran and then to a fort in Morocco. He disappears, gets back to Paris, where he enters a hospital and is treated with electricity and cold baths. Suddenly he is in Holland and tries to enlist in the colonial army; he is rejected. He becomes a dipsomaniac, viz., a binge drinker, drinking for a week or so followed by three or four months' intermission. He suffers from dizziness, has fainting fits, and has an attack of agoraphobia that leads to his being taken home by the police. Z, a chemist aged twenty-three, never quite gets down to anything. He does well at his polytechnic in chemistry and physics but turns to languages with a vengeance French, Russian, English, Polish, Sanskrit. He too trav-

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els, with memory loss, but he is as ineffectual at completing a journey as he is at completing his studies. He does get to Plymouth to take sail for America or Canada but cannot quite make up his mind as to the where and how. He also seriously contemplates making a career in the army, but indecision prevails. Schultze's fourth case, taken from a colleague, is a carpenter aged thirty-seven who has attacks in which he feels himself hunted from place to place by a diabolical power. 11 He has been arrested for stealing two watches. He has no memory of the event and, finding himself with two watches not his, presumes he has broken the law and willingly accepts punishment. It turns out that he deserted from the army numerous times, with a series of punishments building up from two days, to three months, to a year in prison. Before one recent attack he had a terrible headache for one or two hours, and he had the feeling that a knife was being drawn through his brain; he saw little stars before his eyes; then his wandering began. After some time he came to; it felt like waking up. He would then ask himself, "And what have you done now?" By the end of the story he has a new job coachman. These tales, in Schultze's recounting, are frightening European fin-desiècle psychodramas. Two of the first three men feel urges to commit suicide and go about with revolvers that they put to their heads from time to time. I have omitted great swathes of detail; Schultze, like so many students of fugue, was a pretty good raconteur. At the end of the 1898 paper: "For my part, I am inclined to take all three patients to be epileptic." X had something like an epileptic attack, once. Y had attacks of vertigo and fainting. Moreover Kraepelin had argued in his 1896 textbook that dipsomania was the result of a kind of epilepsy. Z had severe depression at the start of his trips, his memories faded out, he even had a loss of speech. Even the suicidal tendencies were taken to support the diagnosis of epilepsy. In each case we have what Schulze, even in the title of his paper, called a disturbance of consciousness, Bewüsstseinstörung. He concluded his analysis with the question of therapy. Charcot had advocated the bromide cure. This was tried but without any notable success. Maybe, Schulze wrote, we shall be reduced to the methods of the father of a fifteen-year-old student who kept on wandering. The lad was installed on a yacht, from which there was no escape.

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Thus was fugue introduced to the German medical world. 12 Everything was set up for a recapitulation of the French debates, although until 1903 the question was more, "epilepsy or what?" than "epilepsy or hysteria?" The first challenge to Schultze came in 1899, not from hysteria but from an extended conception of epilepsy. Julius Donath had three more cases.13 One was a master carpenter, aged thirty-eight, who had taken a horse to the nearest train station and traveled thence to Budapest, Vienna, Leipzig, Hamburg, and New York, without any memory of what he was doing. Then a forty-nine-year-old shop assistant whose fugues are quite brief; he walks hard, sleeps rough, and is never hungry. Next a tailor's assistant, aged nineteen, who would rather be a coachman, the trade of his best friend. Moody, sleepless nights followed by erratic fugues in which he may run after girls or a marching band. In all three cases there were headaches, partial amnesia, and a feeling of an irresistible but purposeless need to travel. Donath diagnosed epilepsy and made up a new word for epileptic compulsion to travel: poriomanie (Greek poreia, marching). But (in the author's original emphasis), "For me, epileptic poriomania is a psychic equivalent [of epilepsy] of a special kind which is distinguished from the more common kinds [of psychic equivalents] in that a disturbance of consciousness is either completely lacking or is of secondary importance due to its undeveloped nature."14 The word at issue is Bewüsstseinstörung. Schulze retorted that he took amnesia to be evidence of disturbed consciousness.15 He also agreed with Donath that epileptic ambulatory automatism could take many guises, but this was because epilepsy itself is so notoriously protean. Far more striking than his sniping at Schultze was Donath's differential diagnosis for hysterical fugue. Where epilepsy had been expanded, hysterical fugue was contracted to cases in which the patient was obsessed by a single fixed idea or in which there was doubled personality. Fugue took place in the "condition second (second life)."16 Donath had himself witnessed conclusive proof of the reality of such a condition, which he had described in 1892. This was a woman undergoing painful treatment for gonorrhea. She had never been hypnotized. She was attractive and fiercely intelligent. In the middle of a conversation, without warning, she would start playing about, talking in a childish voice, singing, and she felt no more pain. She could get up and run about, whereas normally she could hardly get out of her bed. Her

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mother said this was her "crisis." Donath had not actually seen a hysterical fugueur, but he took for granted that they would be like the one double he had encountered. It is quite exceptional to find a classic case of double consciousness in a Budapest hospital bed until you notice that the patient's mother was French. Where Donath quoted her as saying "Krise," the German word, she must have meant, or even said, the French crise. The German word is not regularly used in this connection, whereas the French one was standard in French multiple personality talk. This case of double consciousness had been exported from France, rather in the way that, in recent years, multiple personality behavior has been exported from North America to Australia and Holland. Epilepsy continued unchallenged as the basis for fugue. The common name Wandertrieb became entrenched as the medical name for the illness, poriomanie notwithstanding. It is striking how suicidal thoughts and actual attempts abound. 17 We should note that some of the patients came from Saxony, Silesia, and Hungary, which had, and have, dramatically higher suicide rates than Western Europe. For a Silesian or Hungarian, suicide was always an option, in the way it was not for a Parisian, let alone a Gascon. Hysteria was waiting in the wings. Its entry into discussions of Wandertrieb roughly tracks its increasing acceptance into German medical practice. The first German article surveying the literature on fugue appeared in 1903. Heilbronner presented twelve new cases of his own, which he embedded in a table of fifty-seven cases of what he called "Fugue and Fugue-like States."18 Thirty of these were French, with a typical mix of hysterical and epileptic diagnoses. Heilbronner selected severely from even the sources available to him and added cases of epilepsy that had not previously been filed as fugue (under any name). He ignored the classic French synthesis, the 1895 lecture by Fulgence Raymond written up by Pierre Janet. He concluded that at most one-fifth of the cases were definitely epileptic, and that the number of cases with hysterical symptoms was considerably greater. He also urged that fugue was generally produced by some sort of "dysphoric" state, which could be an epileptic attack, an accident producing traumatic hysteria (physical trauma, but not necessarily head injury), or some family or work-related circumstance. Dysphorische Zustände became a standard phrase in the fugue literature, perhaps because it seemed to indi-

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cate a cause, an etioliogy, although in fact it could signify any unpleasant condition or feeling of unease whatsoever. Heilbronner also made one of the most useful suggestions to appear anywhere in the history of fugue. Fugue may begin spontaneously, as some sort of attack, be it epileptic, hysterical, or whatever. But the tendency to escape, he wrote, can become habitual, so that quite insignificant incidents can come to trigger fugues. In my opinion, that fits many a fugueur, including Albert. Heilbronner did not imply that the fugues are faked. They are real enough, with genuine amnesia and the rest. But they represent something of a mental habit. Such habits may be used to argue nonresponsibility in law. Indeed the only proper forensic application of a fugue diagnosis must be when there is evidence that fuguing has become habitual. After that, the field was wide open. In the same year, 1903, Schulze published a major lecture with nine new cases, many of them characteristically colorful. He asserted that he and Heilbronner agreed on fundamental points but differed on others. Yes, some physicians had diagnosed epilepsy overconfidently. But it was quite wrong to suggest that only one-fifth of the known cases of Wandertrieb were epileptic. One had to put Schultze's own new cases upon the scales, and they did not involve hysterical symptoms. Those cases alone changed the proportions a good deal! The next year, 1904, produced the first German paper analogous to the French ones of 1889, with titles such as "Fugue in the Case of a Hysteric." 19 Raymond's 1895 synthesis was brought to the attention of German-language physicians. The same author later was able to observe another hysteric while in the altered state.20 We may note here one of the problems for the hysteria diagnosis in the German sphere of influence. Charcot had rid male hysteria of the stigma of effeminate characteristics, but German-language writers accepted the stigma and hinted at latent homosexuality. We also see the firming up of different schools of thought about fugue. Great names help do this. The doctrine that all fugue is epileptic in origin was now called Kraepelinian. Another author challenged Donath with detailed clinical observation of the pathology and found a disturbed consciousness in three new cases examined with "microscopic" precision.21 Always the armed services played a significant role; many of the men not in uniform had deserted while doing their military service. In 1906 some eighteen new cases were described, each an

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instance of desertion from the navy. 22 It came increasingly to be acknowledged that fugue was not a single disorder. In a 1907 study (accompanied by the obligatory three new cases) Julius Donath vacillated between restricting poriomanie to cases that are definitively epileptic and making it a catchall name, rather as Régis had done in 1895 with dromomanie. Men, men, men, and, as we shall see in a moment, a lot of children. Did Germanlanguage doctors never diagnose grown women with Wandertrieb? Donath's second contribution included a female case, with little detail. Stefan Rosental related a sad tale of a sixty-three-year-old woman. The paper was titled, "Depression with Wandertrieb and Paranoia."23 Frau Sch. married at the age of forty-two, after supporting herself for many years. Her husband invested her life savings in a sawmill that burned down. Then he died intestate, enabling his relatives to appropriate all his belongings. She received a pittance to support herself from an older brother in Vienna. She lived in Berlin. She took a train to visit relatives in Pommern, got off at a small station, and wandered aimlessly; the police put her in a mental institution. She said she wanted to die, and she hated her attendants. She was released. She made five unannounced trips to see her brother in Vienna, who in each case had her sent away; only once was she allowed to remain a fortnight. On her last visit after her brother had remarried to a young woman she was not allowed even to say hello. She got off the train on her way back to Berlin and secretly returned to Vienna, where she was hospitalized. She was well aware that she had a tendency to suffer from optimistic delusions. This is paranoia? This is the story of a pathology? And children. When you look carefully at Heilbronner's table you notice that a lot of the fugueurs began their traveling very young. Fourteen of them began between the ages of eight and fifteen. Indeed, while adult fugue was discovered by French doctors, wrote Wilhelm Schlieps in 1912, it is a signal triumph of German psychiatry to have discovered childhood fugue!24 The xenophobic need to surpass the French had persisted long after Schultze. Schlieps's claim to national supremacy is not very well founded. Raymond in 1895 had presented in detail the boy whom I called a Tom Sawyer. Schlieps's claim is not so much to the first cases but to recognizing a specific type of fugue, namely childhood fugue. In 1909-10 Benon and Froissard, the influential police team discussed in Lecture 3, published at least three papers on childhood fugue.25 The urge to create child fugue as an

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autonomous diagnosis is analogous to present-day attempts to get childhood multiple personality into the next edition of the Manual of the American Psychiatric Association. 26

Schlieps's three cases included two girls of eleven and twelve. These were indeed the first girls to enter the case histories. It is quite wrong, our author wrote, to think that only boys go off traveling while girls fall into sex, either by being corrupted or by being voluptuous. The difference is only that boys go off to the woods and fields while the girls say they ''have been taking a stroll in town." The wandering children are viewed from the degeneracy perspective. They are taken to be intellectually feeble. They commonly profess amnesia for part of their trips. Both of Schlieps's girls began their fugues by playing truant from school when quite young. One had to be assigned a guardian to accompany her to and from school. Both have had gonorrhea for some time; there is an implication that at least the first was raped. What to do? Schlieps is not much help, although he does propound the minimal basic wisdom still in circulation. Get the parents to open their eyes! See what disturbs their children! Get counseling! Escort your children to school and back, or if you cannot do that, hire a guardian to accompany them! In summary, Wandertrieb in Germany, 1898-1914, pursued a course similar to the French one, 1887-1909. The military was even more inescapable than in France. Yet there is a different feel to these cases. It is not just that there are minor lacunae: the figure of the Wandering Jew seems simply not to arise. I suggested that the explanation may be trivial. The "Wandering Jew" of French and English is the "eternal Jew" in German. Fugueurs are not eternal. A more important difference is the fact that vagrancy is not an issue for the German writers. Yes, vagrancy was a social problem during the same time period, learned tomes on the vagrancy question appearing from the 1880s.27 But in Germany the only major social problem that intersected with fugue was desertion from the army and an attempt to get young deserters off the hook. There are less tangible differences than the relative emphases on the army or vagrancy. We have not merely begun the story ten years later, but we have moved to Central Europe. The men may go west, to England, Holland, France, or America, but what seeps out of these pages is not just the sadness

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of the patient but the melancholy of the world around him. After reading a couple of dozen cases, you begin to wonder if every man did not travel with a revolver and put it to his head from time to time. But that could be true of many a sane traveler, and not just of the men suffering from Wandertrieb. The truth is that there was no epidemic of Wandertrieb in Germany. There were cases. There was a patriotic desire not to fall behind the French. There was a need to find diagnoses to save young deserters from cruel punishment. But there was no ecological niche in which fugue could thrive. Let us run through my four vectors. Wandertrieb did not even fit into an established German taxonomy. It taught nothing about any illness then of interest. Likewise there was no vector of cultural polarity, of virtue and vice, within which mad traveling could be suspended. Yes, deserters were observable, but as deserters, not as fugueurs. And there was no social purpose that Wandertrieb, as such, and not as something else, could serve as a way of release. None of my four vectors is exerting a significant amount of force. Hence in the German world there were fugue episodes which a few doctors tried to promote as a diagnosis in itself. But Wandertrieb never did become a full-fledged but transient mental illness in Germany.

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Document 1 (Tissié, AV 59-76) Albert's Tale (1872-May 1886) At the age of twelve, when I was an apprentice to M.L., manufacturer of gas equipment in Bordeaux, I left town abruptly. It seems that the neighbors had been watching me pace up and down for a long time in front of the door. They told my father that I had gone in the direction of Arcachon. My brother left immediately to seek me out and found me at La Teste, in the employ of a traveling umbrella salesman with whom I must have been traveling on his route. "What on earth are you doing?" asked my brother, as he tapped me on the shoulder. I came to with a shock. I was astonished to learn that I had been apprenticed to a traveling salesman. My brother took me home. A few days later they talked about an inheritance that my father had come into at Valence-d'Agen. One month later I found myself in that town, without knowing how I got there. A friend of the family kindly sent me home to Bordeaux. One day M.L. sent me with a co-worker to fetch coke for the gas company. He entrusted me with 100 francs. The next day I was astonished to find myself on the train and to hear the announcement, "Tours." I was asked for my ticket; I looked at it and saw that it was for Paris. Had I any money? I don't

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know. Whatever transpired, I was found one night lying on a bench at the Orléans station in Paris. Not being able to say how I got there, I was sent to the police station, then to Mazas, where I was held for a fortnight. They obtained information about me from Bordeaux and agreed that I should return to my family. Since my family had to reimburse my employer for the 100 francs I had taken, they did not want to pay my fare home. I got a travel warrant to return on foot, stopover by stopover; it entitled me to 1 franc 50 in public assistance every 50 kilometers. That is how I got to the vicinity of Angoulême. The grape harvest was in full swing, so I engaged myself as a servant at the home of M. Michel B., at Lagroue, in the village of Marsac. I stayed there two months earning 1 franc 50 a day. The police who saw me working did not trouble me. I returned to Bordeaux having saved 50 francs. I then joined the gas company where my father and brother worked. All went well for several months, when one fine day I found myself in Barbezieux. I was arrested there and imprisoned, for I had no papers. On obtaining information from Bordeaux, the authorities released me, giving me new papers for Paris, where I wanted to go, because I no longer dared to return to my family. Arriving at Châtelleraut, I was arrested anew, for I had lost my papers again. I was given new papers and went through Poitiers, Tours, and Orléans, where the police commissioner led me to understand that it was wrong of me to live as a vagabond, and that I would do well to return home. I agreed and accepted a free pass on the train to Bordeaux. My father and my employers, thinking that it was Paris that attracted me, resolved to send me there. So it came to pass that I went to work for M.L., rue Martel; I lodged in the Hotel de Lyon, passage des Petites-Ecuries; I was very happy. I worked with enthusiasm for a fortnight. I took my pay and left abruptly. I found myself at Joinville-le-Pont. I did not dare return to my boss, so I continued on my way, going through Champigny, Meaux, Longjumeau, Provins, and Vitry-le-Français, where I asked for a billet and was immediately given one in prison. I had lost my papers. Inquiries were made, and I was set free a fortnight later. After that I traveled through Châlons-sur-Marne, Chaumont, Vesoul, Dijon, Mâcon, and Villefranche. I visited Lyon, which I found to be very

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beautiful, especially the Place de la Perrache. I saw the funicular railroad. I went through Grenoble where I admired the fine promenades along the banks of the Isère, but at Annecy I was taken once again, put in prison, being always without papers. Then I was released with a certificate and travel assistance that permitted me to get back to Bordeaux, passing through Lyon, Saint-Etienne, Le Puy, Mauriac, Tulle, Brives, Périgueux, Coutras, and Libourne. I joined the gas factory again, where I worked wholeheartedly for three months, when one fine day I found myself in a square completely unknown to me. I was in the Place de la Préfecture, at Pau. "Just my luck," I exclaimed. "Yet another fugue! Ah well, never mind. Since I am here, I will look for a place." I had 5 francs on me; I slept for 5 sous a night at the home of a rag merchant. I wrote to my father who sent me 10 francs and a letter of recommendation from the gas company. I got work at the Tarbes arsenal. But one evening, having collected my pay, I left and found myself in Bagnères-de-Bigorre; I went to Lourdes where I took the train to Tarbes and Toulouse, where I arrived at one in the morning. I heard the announcement, "Travelers for Cette and Marseille, all aboard!" and I got into one of the carriages. Next day I arrived at Marseille at six in the evening. Once there, I heard a good deal of talk about Africa, and I resolved to go there. I exchanged the new clothes that my father had sent me in Tarbes for old ones, and the next day I took a passage on the deck of the Maréchal-Canrobert for 15 francs. I was without a cent and worked as a kitchen boy in exchange for food. I hunted for work in Algiers in vain, so I went as far as St.-Eugène, Mustapha Supèrieure, and Blidah, from whence I returned without having found anything. I stopped at Trappe de Staouël where they make rose water; I was fed and lodged, and when I left they gave me 40 sous. On returning to Algiers I wandered on Government Square and in front of the Isolés barracks, when a Zouave, seeing me so unhappy, gave me a mess tin and two biscuits and advised me to return to France. So I applied to the captain of the Moses who sent me to the headwaiter. I returned to France polishing the copper pots in the kitchen and even made 5 francs from this work, plus 40 sous that a gentleman gave me for some services that I rendered. I went to Aix. It was harvesttime. One morning when I was pitching hay,

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the police asked for my papers; as usual I had none; they arrested me and put me in prison, from which I left a month later with a compulsory itinerary and aid for the trip. I got back to Bordeaux, passing through Arles, Nîmes, Montpellier, Pézenas, Cette, Bèziers, Narbonne, Carcassone, Castelnaudry, Toulouse, Montauban, Castel-Sarrazin, Moissac, Agen, and La Réole, where my brother came to fetch me. My mother died several days after my return; I was reinstalled at the gas factory. I was calm for a long time when one fine day I awoke on the train. I was at Puyoo. "Well," I said to myself, "yet another escapade. What a calamity!" Luckily I had some money. I took the train for Orthez and Orloron, where I looked in vain for work. So I returned on foot by Navarens, Orthez, Dax, Mont-de-Marsan, and Roquefort. Having learned that there was work at Labouheyre, I went there, by walking cross-country for two days. I worked there for two months when my father had me brought back to Bordeaux. One of my brothers had been drafted, and since my love of travel was only too well known, they proposed that I should enlist, in order to exempt him from military service. I agreed, but I was declared unfit for service by the review board. This decision upset me very much. I returned to work with difficulty, and some days later I found myself at Mont-de-Marsan. This time I had my papers, and that gave me the idea of presenting myself to the recruiting officer on my own. I enlisted voluntarily on 19 April 1878 and three days later, 22 April, was enrolled in the 127th Infantry Regiment at Valenciennes. I began to wet my sheets in the first days of May. They took away my mattress. Then I began to do it in my pants. They sent me to the hospital, where I stayed in treatment almost three and a half months. After that I got convalescent leave which I spent at home, in Bordeaux, in the country. Opposite my house there lived a childhood friend, Baptiste. I told him my impressions of travel, and especially of the agreeable life a soldier could have in Valenciennes. Baptiste, amazed, agreed to follow me. So the two of us arrived in that town. I was obliged to leave my friend. He had been posted to the 16th Dragoons. I was sent with a detachment of the 127th Regiment to Condé, where he could not follow me. I missed him a good deal. I had severe headaches, so they sent me to the hospital. Scarcely had I been released from the hospital, than one day, as I was walking in the barracks yard, they told me that a civilian was asking after me. It was Baptiste. He was just as fed up as I was.

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He had deserted and came to propose that I should do the same thing. I do not hesitate for a moment, and I cross the Belgian frontier, with my effects and my weapons, which I trade at Percewaltz for laborer's clothes and 2 francs. We then travel through Tournai, Bruges, Ostende, Ghent, and Brussels, where, not finding any work, we live by begging. We go to Charleroi, where for three days we unloaded cars of ore. We leave this town, each of us with 3 francs in his pocket. When we arrived at Liège, the Société Française gave us a kilogram of bread and 20 sous, which allowed us to reach Verviers. There we learn that in Holland one can secretly embark for the East Indies. We therefore head for Amsterdam. We were in the middle of the winter of 1879, which was very severe, and we lacked bread, shoes, and clothing. Baptiste was exhausted. As for me, feeling the need to walk, I left my friend dragging himself along the road, while I walked 4 or 5 kilometers in front of him before retracing my steps to rejoin him. We finally arrived at Maastricht. My friend, not being able to go further, was admitted to the hospital. Alas, when I went to see him the next day, I learned that the poor lad had died of exhaustion. This death saddened me a lot. Moreover, because I did not have a cent and could not find work, the Dutch police sent me to the Belgian frontier. Thus I returned to Brussels where I got a job in a ceruse factory. [Ceruse was a type of lead paint used in cosmetics.] Laborers could work there for only a very short time because of the lead poisoning. The doctor attached to the establishment inspected everyone who remained at work every day. I had always entertained a plan of going to Austria. I wrote to my brother-in-law saying I was departing for Vienna and asking if he would kindly send me some money. I left immediately for Aix-la-Chapelle; Dusseldorf, where the French consul gave me 5 marks; Cologne; Bonn, where the police gave me an itinerary with assistance; Audernach; Coblenz, where I was very ill, throwing up everything I had eaten, and I slept for 20 pfennigs at a traveler's hostel, a sort of asylum run by the state. Then I got to Mayence where a man from Brussels gave me 3 marks, a shirt, and some shoes. From there I went to Kassel, Darmstadt, Frankfurt, where I got some help from the consul. Hanau, Aschaffenburg, and Wurzburg, where my brother-in-law had sent me a letter by general delivery, as we had agreed before my departure from Brussels, with a money order for 32 marks. I got to Nuremburg, where I took a fourth-class ticket to Ratisbonne. From there I went on foot to Passau on the Austrian border.

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I soon got to Linz, and then to Amstette. There I was asked for my papers. I had lost them. So they sent me to prison, where I suffered a good deal. At the end of eight days a doctor saw that I was ill and had me sent to the hospital at Watof-an-der-Hisp, where I was treated, for a month and a half, with icepacks on the head and quinine sulfate. When I was cured they sent me to prison again in order to wait for a convoy of prisoners that was to be sent to the frontier, to Salzburg. However, I had a fixed idea: to go to Vienna, so I went to Linz by a devious route. I met a Belgian commercial traveler there, who gave me a florin and advised me to go down the Danube on a log raft. Thus it happened that rowing for my bread I entered the Austrian capital. I slept at the hostel the evening I arrived and presented myself to M.D., manager of the Gaswerk-Tabor gas factory. This gentleman was the former manager of the gas factory at Bordeaux. He knew my father and brother, so he took me in and gave me work in his establishment. Tissié interjects at this point: We possess the letter that M.D. wrote to Albert's brother-in-law. Here is an extract from it: Vienna, 4 April 1880. ... I have so often been taken advantage of by people who say they are French, that I hesitated to believe [Albert], especially because the unhappy lad is so miserable that I did not recognize him. He showed me a letter that you had written him at Wurzburg, dated in Bordeaux, 26 December 1879. . . .

Albert's brother-in-law responded with a good report of Albert's willingness to work. Some weeks later, M.D. replied with the following letter, testifying to our patient's goodwill when it came to work. Vienna, 30 April 1880. Sir, I have received your respected letter of the sixth of April, for which I greatly thank you. I have learned with pleasure that young Dadas

Page 141 is an honest and good lad, and in fact, since he has been here, I can only praise him for everything that he does. I hope that he continues this way.

Unhappily, things did not transpire in the way that M.D. wanted. For one fine day Albert found himself on a steamship. At the moment of his disembarkation the captain asked him what he was doing there, and what drew him to Budapest. Great astonishment on the part of our traveler, who did not know that he had embarked. He went directly to the French consul who gave him a fourth-class ticket to Vienna, where he worked valiantly until he got a letter from his brother-in-law inviting him to benefit from the amnesty just granted to deserters and to return to France. Immediately Albert went to the ambassador, who gave him a train ticket, and he returned to his regiment at Valenciennes on 21 September 1880. The story continues in Albert's own words: I was thus returned to the 127th Infantry Regiment, but since I had deserted with my equipment, my gear was far from complete. So they put me in the kitchen to earn some money. This annoyed me, for I wore greasy clothes. At this time I was subject to the only punishment that I ever received from the regiment, apart from being condemned to hard labor. My military record has the entry "for having spent the night absent without leave," but I intended to desert. However at the border a customs officer had me sent back to Valenciennes. I continued to be tormented by a need to travel. Thus one Sunday, after preparing the grub, I asked one of my comrades to replace me. I set out, very well turned out, and got to Condé and after two hours crossed the border for the second time. I went through Bons-Secours and Percewaltz, without selling my clothing, which I deposited with a police superintendent at Mons. My brother-in-law sent 30 francs to me in Brussels and promised me work. On reaching Liège, I am admitted for two months to the English Hospital. After that I go through Verviers, Aix-la-Chapelle, and Cologne and reach the Rhine again. I admire the tomb of General Hoche at Andernach, then going to Mayence I am on the road cut into the mountain, reminding me that the previous year I very nearly was crushed by an avalanche. I cross the fine sus-

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pension bridge thrown across the Rhine at this point, and the memory of my crossing the river on foot came back to me; I was almost swallowed up when the ice cracked under my footsteps. Then I come to Kassel, where I was sick for two months Kassel, where the magnificently sculpted town hall resembles a church, and where there is the castle in which Napoleon III was held prisoner. I return to Frankfurt with its magnificent public gardens on the edge of the Main. Hanau where I stayed a month in the hospital. Friederichsdorf, a village founded by Protestant refugees after the revocation of the Edict of Nantes. I got help in this charming village, where all unhappy French are received as friends. I was fed in a pension for young girls and given 10 marks. Finally, always walking, I went through Ratisbonne, Passau, Linz, and arrived in Vienna, where I once again went to work in the gas factory. I was peaceful for some time. I was present on the first of May at the public festivities for the marriage of Princess Stephanie and Archduke Rudolph. 1 Yet I found myself suddenly at Budweis in the middle of June. Would that I could return to Vienna! Certainly I could not dare present myself to M.D., so I decided to get to the nearest French consulate. In Prague the French students made a collection for me; I got 8 florins and a shirt. In Leipzig the conMap 1. Albert's longest journeys. Drawn by Dr. Niko Scharer.

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sul gave me 5 florins. My trip from Leipzig to Berlin cost 3. On arrival I went to the embassy and to the Société Française. They gave me something to repatriate myself, but instead of heading to France I found myself in Posen. What should I do now, I asked myself? The consuls will have nothing to do with you. Go, therefore, and walk at random! Posen is a poor town. People feed themselves on potatoes that have been boiled or fried in fat. You can have a meal for 10 pfennigs. I found that the men were dirty. Their dress consisted of breeches, high boots, a velvet vest with old coins instead of buttons, and hats of black felt. A few had no shoes. A large greatcoat covered their misery. I left Posen and wandered aimlessly for a long time. One day, when I was lost in the country, peasants said to me: ''Since you are French, go to the castle over there; they will give you money and bread." I went there, and the steward asked me to come in. I had just obtained entry to the park when an enormous dog jumped on me, rolled me on the ground, and savaged my arm and right hand with its fangs and claws. People ran to help me, but I was injured. The lord of the manor sent me, at his cost, to the hospital in Warsaw where I was taken care of for a fortnight. When I was cured, some Jews advised me to go to Moscow, where they said there were many French people, and that for sure I would get work in that town. So I made the trip from Warsaw to Moscow in cattle cars where I took care of the animals. I got to Moscow a short time after the assassination of the czar. 2 The town was very excited. As for me, not having eaten and being without work, I did not know what would become of me. The Russian government undertook to lodge and feed me for some time. Here is how it happened. I was admiring the statue of Peter the Great in the middle of a large square, when some police officers with pointed helmets felt the need to enter into conversation with me. Greatly embarrassed, for I knew no Russian, I made them to understand my great annoyance at being unable to reply to them, using gestures that nonetheless I found to be very expressive. Perhaps they misunderstood me, perhaps they were scandalized at my behavior, anyway they grabbed me in spite of my protests and took me before a gentleman who, not knowing any French, summoned an interpreter. I was in front of a superintendent of police.

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"Your papers! Where are your papers?" he demanded. "I have none." "What are your means of support?" "Numerous, M. Superintendent. I travel a lot. When I have money, I make use of it. When I have none I ask for it. When no one gives me any, I am famished. "Why are you in Moscow?" "I am embarrassed to tell you. Here is how it goes. I have terrible headaches, I become upset, I feel a great need to walk, and I leave. I always go straight ahead, and when I come to myself I am far away. The proof of this is that a few months ago I was in Valenciennes, and I am now here." "No doubt about it!" the gentleman exclaimed. "We've got one," and his face beaming with delight. "OK, don't try to fake it," said the interpreter to me, "We know you." "You know me! What luck! Then will you get me some work?" "But, of course!" continued the policeman, "The more I look at him, the more the resemblance is striking. Finally we have got him. Let us take him away." And I am seized, pushed, and dragged. I protest. "What do you want to do with me?" "To prison with the nihilist!" shouts the gentleman. And yes! I was a nihilist without knowing it. My description corresponded to that of a man they were looking for. And that is how the Russian government for three months furnished me with shelter and a blanket in company with a great many students and women. Those folks certainly knew I was not a nihilist! A lady prisoner who had studied in France and who spoke our language well was able to cheer me up somewhat. I can tell you that the prospect of a knot around my throat or the snows of Siberia did not make me smile one bit. In the course of the fourth month the prison yard filled with soldiers. Prisoners were called one by one. Four left the ranks, heads shaved, to be hanged. I was not comfortable. My God, I said to myself, let's hope I am not going to be hanged! Some fifty were called to be sent to Siberia. Let's go, I said to myself, laughing when I saw that I no longer need fear the rope. Having learned of my taste for voyages, the Russian government is going to send me on a trip out there, far, far away! I was at that state in my thoughts when

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the interpreter approached me and read me a decree according to which, since France was not going to do anything for me but recognized me as a French citizen, I should be led to the Turkish border! Decidedly my wish had been granted, and I would see the country. I was put into a convoy of prisoners, dropping some off or picking up others on the way. I had to bear atrocious suffering on this trip. We would march in groups of four, our hands tied behind our backs; we were freed only at mealtimes. We often had to walk 50 kilometers, and we had to walk quickly, for otherwise the Cossacks would come up on their horses at a gallop and give us great blows on the back of our legs with the flat side of their swords. When we got to a town, it was only half as bad. We were put up in a prison where we were almost fed; unfortunately, we usually slept in the isba of the guards. These guards were charged with guaranteeing the postal service and were occupied at the same time with maintaining the roads and forests. The isba was divided into two rooms, in one of which the guards and the Cossacks were put up, and the other where we were locked up. We slept there pell-mell, men and women, together with the Gypsies who were being expelled with us. The unhappy Gypsies covered themselves in a greatcoat in which they carried their children. They were beautiful but revoltingly dirty. In the morning they made their toilet in front of us, and then they would give themselves to us, to anyone who wanted, for a piece of bread, a cigarette, or a little schnapps. Sometimes even at the midday halt, and in spite of the fatigue of traveling, men and women prisoners would copulate in the open. No one found fault with that, not even the Cossacks who looked on. One night my traveling companions saw that from the beginning of the journey I had been deprived of the pleasure which was so readily available and urged me to partake. Adversity makes it better. "He needs a woman too," they said. "I'll see to it," said a beautiful Gypsy. And she lay down beside me. She had a lovely body, and for a long time she cuddled me, excited me, rolled on me, with no effect. She gave up. Then, alone, I had my pleasure that she had been incapable of giving me, and which, anyway, I gave myself several times a day. One of the unfortunate women had to give birth to a baby. She was left in a town. Another died among us, in prison, in horrible convulsions, rolling on the ground and foaming at the mouth, her limbs contorted. She must

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have been killed by the alcohol that they gave us. It was so strong and evil-tasting that I refused to drink it. Finally, after several weeks we arrived at a post which bore the Turkish insignia. There the Cossack chief had us form a circle, and he read an imperial decree, stating that if we were to return to Russia we would be sent to Siberia. He then sent us off with a gesture of his hand. I slept the following night at the home of a poor fisherman from whom I asked shelter in sign language. Then I walked for long weeks begging for bread and sleeping where I could. Finally I arrived at a great city built on the edge of the sea. I was in Constantinople. I saw a storefront with the words, "French spoken here." I went in and learned that there was an international hostel in the city. I went there. They took my name and gave me a kilogram of bread and a stamped card with the number of a bed. I was covered with vermin, and they made me take myself and my clothes to a room with burning sulfur. They put me in a bath and then gave me a long flannel shirt. The doors of the hostel were closed at eight at night. A priest came to say a prayer for which we took off our shoes, raised our hands, and kissed the earth. The next day I was shaved. I polished my shoes, I ate some flour soup, and they returned my clothes to me. During the day I went to the French consul. He promised to return me to Vienna, gave me a train ticket, 3 Austrian florins, and a note to the railway staff to take care of me, for I knew no Turkish. The trip took forty-eight hours. I reentered Vienna by the Pradstrass station. I went to M.D., who was quite astonished to see me and did not want to believe my adventures. He wanted to take me on as an employee, and I returned seriously to work. One Sunday I was present in the Prado at the parade of the Tir International [the annual international shooting competition]; when the French passed, I heard people shouting, "Vive la France!" One person who shouted was near me; we chatted; he was a deserter, an artilleryman from Besançon. He had crossed into Switzerland, through which he had traveled and of which he spoke often. From that time on the idea of Switzerland and its mountains did not leave me. Sometime later I was at Klostenburg. The French Dominicans gave me soup. I did not dare return to Vienna. I left for Rufstein and Munich, where the French consul gave me a train ticket for Gunzburg and Stuttgart. There I got 12 marks from the consul and left for Carlsruhe, Kehl, and Strasbourg. At Schelestadt a captain of the Bavarian infantry, married to a Parisian,

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advised me to return to France and gave me 5 marks. Stopping one night on a bench at Colmar, I was arrested but released the next day when they found that I had some money. At Mulhouse a foreman, whose son had left for France to avoid serving in the German army, agreed to employ me. I had a letter from the police authorizing me to stay in town for two weeks. I pushed a wheelbarrow, carried tiles, and earned a little money. Then I crossed into Switzerland. I visited, in turn, Interlaken, Geneva, the canton of Vaux, Schaffhausen, and Basel. There, feeling unhappy and being so close to France, I went to the consul on 5 September 1882 and declared that I wanted to turn myself in. I received assistance and papers. On 25 September I put myself in the hands of the police at Delle, from where I was sent to the military prison, after having been sent first to Valenciennes. Tissié takes up the story at this point: Having arrived at Lille, Albert was subject to a military interrogation. He alleged that he had no idea why he deserted. They pressed him with questions, and finally he stated: "I left because my fellow soldiers made me miserable." On 24 November 1882 he was sentenced to three years of hard labor for desertion with his uniform and weapons. According to Albert, his lawyer argued that Albert was not mentally responsible for his actions, basing this plea on Albert's good family and especially on his client's headaches. On the other hand, when we questioned this lawyer directly ourselves, he said that he could not remember this affair, that there was no record of it in his notes, which shows that Albert was judged summarily, without a serious investigation, because his two desertions had led to his being judged in advance as incorrigible, and not irresponsible. It is however probable that the lawyer pleaded irresponsibility for form only, and without being himself convinced of the innocence of his client. Albert was thus sent to Africa to the camp at Portes-de-Fer. They shaved his head, which made him suffer terribly on the hypersensitive zone of which we have spoken. The pain that he experienced was connected with the perforation of the tympanum of his left ear. He suffered violent headaches, which necessitated his being sent in an ambulance to Bord-Bou-Aneridj, where he stayed for two months, after having passed eight days at the camp. He was then sent to the military post at Bougie, where he entered the hospital twice, the first time for five months, the second for three.

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On 14 July he was pardoned in consideration of his good conduct. Then he was assigned to the 11th Infantry Regiment and sent to the hospital at Sétif, where they urged that he should be declared unfit for service. This finally happened in Bône, on the ground that he had a perforated left tympanum. Returning to Bordeaux, Albert worked again at the gas company. His employers were content with him. He had certificates to prove this, which are now in our possession. His family was just delighted to have back the prodigal son, who promised to behave properly. And he made the acquaintance of a young woman, whom he liked very much. They fixed a marriage date. Albert was looking forward to the joys of family life and to being free of his fugues with which he was fed up, when on 18 June 1885 he disappeared. He woke up in a hospital in Verdun (Meuse) in the first days of September, having no idea how he got there and not knowing what he had been doing since June. He was deeply affected by this escapade, especially when he thought of his fiancée whom he had left so abruptly, and whom he might perhaps now find married to someone else on his return as was in fact the case. A ministerial decision dated 9 December 1885 granted Albert a travel warrant with assistance on the road; he arrived in Bordeaux on 17 January 1886 and was admitted to the Saint-André Hospital, room 12, bed 39, in the ward of Professor Lande. We noticed him during the first days of February. Dr. Lande agreed to have him transferred to room 16, in which we work. [Pitres's ward.] When we arrived next day to question the patient, we learned that he had left once again. He had taken advantage of having his own clothing returned to him and had escaped from the hospital. He turned up in Labouheyre, where the mayor gave him a ticket for lodging and advised him to return to Bordeaux. But he left the next day for Pau and stayed there in the hospital from 10 to 25 March. He left for Tarbes, then worked at Ilos from 26 March to 28 April, and finally ended up at the Saint-André Hospital, 3 May 1886, in the ward of Professor Pitres, where we began the clinical observation of this new Wandering Jew.

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Document 2 (Tissié, AV 83-103) Albert Observed (June 1886 February 1887) We ask Albert, the day he comes into the ward, how old he is. "Perhaps twenty-nine!" he replies. "Why perhaps?" "Because I am not at all sure. My passport says twenty-nine." We know that he was born in 1860 and hence is twenty-six years old. "You are twenty-six," we say. "Ah! Thank you. I'm very glad to know my age." The next day we put the same question to him. "I know very well that you told me yesterday," he replies, "but I don't recall what you said to me." We inform him again, and now, when we speak again, he replies, "I am twenty-six years old; I know, because you told me so." Between two fugues Albert, having made the acquaintance of a young worker, asked her hand in marriage and was accepted. On being received at the house where she worked, rue St.-Antoine, in Bordeaux, he promised her one day to come for her at four o'clock in the afternoon, in order that the two of them should go for a walk. While awaiting for that time to come, Albert, who was not working that day, tells his fiancée that he would go and take a rest in the public gardens. And so he walks down the rue Ste.-Catherine which leads down to the Chapeau-Rouge Square. He arrived on the quays and a moment later finds himself at La Bastide in front of the Alcazar, where he hears music being played.

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There was a rehearsal going on. He enters . . ., and at six o'clock knocks at the door of his fiancée. He had forgotten the time when he was to meet her! Three or four days later he left and awoke in prison in Verdun. We will presently see what a detour he made before arriving at this town. When he returned, the young woman begged him never to darken her door again. During this trip he lost his watch and his military papers. We ourselves found them at the end of this observation. Sometimes it sufficed to give a simple hint, a single word to Albert in order for him to recall a whole series of events. "Were you in Africa before you were a soldier?" "No, sir." "And are you completely sure about that?" "Absolutely sure." "Think about it tonight. You can answer me tomorrow." And next day: "Well, Albert, what reply?" "I recall nothing." "However, you were a kitchen boy . . ." "Kitchen boy? . . . Kitchen boy? . . . wait. It's coming to me . . . I know now . . . It was just like that . . . I went to Africa before being a soldier . . . It was on board the Maréchal-Canrobert. Dammit, yes, . . . I had not a sou to pay for the voyage that I earned by working as a kitchen boy." Tissié here records the incident of the scar from the dog bite quoted in Lecture 1. Next he compares it to an experiment in which Albert is confused about the names of colors such as pink but gradually gets it right. Wishing to know if his stories of his journeys were false or at any rate more or less exaggerated, one day I asked Albert to come home with me. I had made an appointment with a woman who was a friend of my family. She used to live in Friederichsdorf, where she had a position as French teacher in a boarding school for young ladies. By a happy coincidence she happened to be in this little village at the time that Albert passed through it on his peregrinations through northern Europe. I should say in passing that he constantly felt himself pushed to go north, and that he did not like the south of France.

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Then he tells us that he entered Friederichsdorf by a shortcut, coming from Hamburg. This road ends in the middle of the village. A cross is erected there. Friederichsdorf is a long village that extends along both sides of the highway. There is a café which faces the main street. "I went to knock," he said, "at the door of a boarding school where I was admitted and where I was given food. It was a brunette, aged about thirty, who opened the door and had me fed. She wore a hairpin in the shape of a sword." This observation was exact. All the women in the house wore sword-shaped hairpins. That was the fashion at the boarding school in those days (1879-80); we know that because Albert had been welcomed at the very school where our friend was working at the time. Albert's memory resembles a photographic plate of which certain parts are blurred, while other parts had come out well. One must hear him tell of his travels. And yet this is a lad who has received no education. He is very humorous on occasion. That's how he describes to us the rotund wife of the mayor of a village near Friederichsdorf. He speaks to us of kingdoms, duchies, and provinces that he had visited; he tells us the names of the rivers that he crossed, the towns where he had admired the monuments; he gives us details of the clothes worn by the inhabitants, adding this or that historical fact that made them famous. Albert can forget his age, that he had his first communion, that he had been bitten, that he had been imprisoned as a nihilist in Moscow, etc., etc., but he always remembers the fine landscapes that he has seen and the monuments that he has admired. When he was a small boy he liked travel stories, asking what was remarkable about this or that country, this or that city. Albert experiences, he tells us, an irresistible impulse to walk two or three days before the attack that forces him to leave. His character changes; he becomes morose and taciturn, he experiences a violent headache accompanied by profuse sweating; he has a ringing in the ear, dizzy spells, and a nervous trembling that forces him to walk. He becomes absentminded; for example, he holds out a knife instead of a glass when he is served drink. Finally, without being able to reason through the deed, he leaves on the spur of the moment, but not without gulping down great quantities of water and then two or three glasses of barley water or any soft drink whatever that is served to him at the first bar that he comes across. Albert, who dislikes strong

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drink when he is healthy, detests it when he is ill. His existence is complete. He feels well in every part of his body, but it seems to him that he cannot get soon enough all the things that he needs for his departure, hat, shoes, etc. "I would put on a woman's coat," he said, "if I found it immediately to hand, in order to leave more quickly." Once departed, he no longer knows what he is doing; he is unconscious; if it rains, he gets wet without noticing the rain falling on him; he eats and drinks, in all probability, but he is not sure about that; the only reason that he said so was that of course he must have eaten and drunk during the days when he had his attack and his days of walking when he wanted to be alone. He does not feel alive, or, if he does, he does not remember it. He takes great care of his person, he is always very clean, even during his attack. When walking by chance, rain or shine, in the dust or in the mud, on roads or across fields, he inevitably gets dirty. He scrapes off the mud with his fingers. He washes at all the streams that he encounters. Albert wears trousers that he had made in Bordeaux several days before his departure for Verdun. He is irreproachably clean, despite the fact that Albert has made a large part of the trip on foot, sleeping, presumably, where he could. His taste is modified. In a crisis state everything that he eats is bland; his sense of smell remains normal, but he has delusions. In broad daylight trees take fantastic shapes which make him shiver with fear. When he comes to, everything seems "funny." 1 Trees appear to have lost their leaves, the road on which he is walking is a field, and the prison in which he had been locked up seems to be an ordinary room. Only after about an hour later does he have an exact perception of his whereabouts. The end of the attack is accompanied by yawning and tears, after which he feels completely dejected. The will becomes weaker as the attack increases in intensity. Although he gets up three hours before he has to go to work, he likes to lie in bed as long as possible and to postpone the decision to dress until the last possible moment. His will is incapable of counteracting the limpness that overcomes him or the timidity that haunts him. He tells us, on this topic, that several days before his last fugue he had been sent by his employer to a clothing store for women. Arriving at the threshold of the workshop where he was to install a gas lamp, he did not dare enter, intimidated by the sight of the young women inside. He left, giving as an excuse that the job could not be done with so many people around. He came back at dinnertime, when he was sure to be alone. Albert does

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not try to understand anything which he cannot grasp immediately. If he is reading a newspaper, he occupies himself with what it says about foreign countries that he has visited. He reads the local news, accounts of accidents and crimes, but he never reads about politics or the articles that are labeled ''in depth." [Some more remarks about Albert's weakness of will.] 29 June. Albert, not having had an attack, wants to leave the hospital in order to resume his job. He learns from his boss that there is no work for the moment, and that he can only start work in September. Albert goes to find his brother, who does not want to see him, regarding him as lazy and a disgrace. Next day, he returns to the hospital; he is sad, he cries, he does not know what will happen to him. Professor Pitres reassures him, telling him that he can stay in the ward if he wants until September. This favor made our patient very happy. There was nothing special to notice on the fifth of August. 6 August. Albert walked, as is his custom, in the corridors of the hospital, not showing any anxiety. No one has spoken to him of travel to another town. He went to bed about eight o'clock, appearing perfectly well. But at half past eight he calls one of his neighbors, C. (from Liège), and asks him if he wants to leave with him for that town. C. does not reply, because he is astonished at Albert's unnatural voice. Albert speaks to other neighbors who ask him, sarcastically, if he wants to leave right away. To which he replies that he will not leave until the following morning. "You understand," he adds, speaking to C., "I cannot stay here without doing something. There, there is work, they do a lot of work with gas there, and moreover, I ought to meet someone there who owes me 200 francs." That said, Albert becomes silent and stays peaceful until midnight. Then C., hearing him mumbling to himself, comes and sits beside his bed. Albert's eyes were wide open, and he did not notice his visitor listening to him. "He would go," he said, "to the consulate passing by such and such a street, in front of such and such a church, he would cross the Meuse by the bridge in order to go to the gas factory." He told how he had once enjoyed so much being in Liège, and he named people whom he had known. This state lasted an hour, and then Albert was silent. 7 August. Albert gets up at eight o'clock and in his normal voice makes

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a few idle remarks to his neighbors. Then he begins to sew a pair of trousers. There is no need to do so; he attaches a patch to an area where there is no hole. He complains of severe headaches. "Do you want to come with me to Liège," he suddenly says to C. "It is too far to go there by foot." "Oh! Not so far," replies Albert, "we'll be there in three weeks." "You don't have clothes or shoes for such a long trip." "You will loan me what I need." He takes C.'s boots and put them under his own bed. That done, he washes his face and takes a few turns in the corridors as is his wont, and then lies down before nine o'clock. At visiting time we find him in the following state: His face looks tired and red. His pulse is regular, eighty-four times a minute. Pupils and tongue are normal. Albert is very thirsty and is not hungry. "Where do these boots come from?" we ask, and show him where he put them under the bed. "I know nothing about them." "Someone loaned them to you?" "I don't know." "You took them, then?" "I don't know." And he tells us how in the night he went to Liège, that he met a man who gave him a letter to go get shelter at a church, and that he came back. Albert had already told this story about his trip to M. Bitot, a nonresident student attached to the ward, asserting firmly that he had been to Liège. "But it is impossible to go to Liège and return in the space of one night, even by the train." "Indeed it is impossible, but I did not dream it; I didn't shut my eyes the whole night." "Do you want to leave now?" "No, I only need to walk, but a few moments ago I had a terrific desire to go. I almost left you for Liège." The surface of his legs and torso is normally sensitive, but pressure and friction are

painful to the crown of his head. No ideogenic zones. To sum up: at nine o'clock the hallucination left an impression that was too lively to be rectified by argument. . . . At 10:25, reason convinced Albert

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that he could not have been in Liège and come back in so little time. He described the town, but he could in no way recall having spoken of it during the night. He breakfasts, the redness of his face disappears, and his head clears. At 11:30, on leaving the hospital, we notice Albert walking very quickly from one end to the other of the long corridor. He walks in a hurry, head low, without looking at the people he encounters on the way. He evades obstacles. We stop him. He recognizes us. He says that walking like this calms him down. We return to the hospital at four o'clock in the afternoon. Albert is still walking in as lively a way as before. We are told that he went back to the room on two or three occasions. Once he sat beside the bed and read a newspaper for a moment. Twice he asked C. what he should do in order to get some clothes. C. replied that it was impossible for him to get any before tomorrow morning. Albert did not pause and made no requests of the nursing sister or the hospital director. "Why do you walk so much?" we ask him. "I have a terrible headache," he replies. "I would be more at ease on the open road where I can walk freely." "Are you tired?" "Not in the least. I never get tired. I do 70 kilometers a day. Walking clears my head and does not tire my body." He no longer speaks of Liège. On the seventh of August at the morning visit, Albert returned to his normal state. He slept during the night; he had many nightmares, he quarreled with his parents and strangers. He did not travel, but he saw wolves, lions, and so on. He also saw a woman, and he masturbated. After that he fell asleep. He urinated three or four times during the night, which happens to him only very rarely. We know that he drank a good deal during the previous day. In the morning Albert no longer felt pain in his head, which had cleared; he no longer felt the need to leave immediately. But how happy he would be to be able to walk on the open road! "I would like to go far, very far, with someone to watch over me and bring me back if need be. If it pleased you," he says to Professor Pitres, "I would go to Libourne and return; in all it is only 64 kilometers." "If we allowed that," we say to him, "you could push on to Liège."

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"I no longer want to go there," Albert replies. On being assured that on the Sunday he could walk to Libourne, Albert becomes cheerful. How he would walk! During the night he does not sleep, out of joy. 8 August, Sunday. Albert gets up at 4 A.M., cleans his clothes, and leaves at five after eating a piece of bread and drinking a glass of wine. M. Bitot, having some business to attend to on that day in Libourne, wanted to wait for Albert and to have lunch with him. Albert told us that up until the seventh kilometer his gaiety had no equal. In this neighborhood the local fair was under way, the hawkers were displaying their wares, the acrobats had climbed onto their stalls, the fair was being announced by salvos of artillery. These unexpected incidents surprised Albert and increased his gaiety. He did not stop, he continued on his way. But a kilometer later a sudden shiver ran through him from head to foot; the shiver was very violent and followed by abundant sweat. Then he sat down on the side of the road. "I saw," he said, "the leaves of the trees fading, all nature invaded by a fog; the road was desolate. I had no strength, I was in pain, and I began to cry. I thought of my poor mother, telling myself that if she had lived I would have gone to the fair. I told myself that the trip I had undertaken was the cause of my misery. At this moment I thought neither of M. Pitres, nor of the aim of my journey, nor of you, nor of who was in the hospital. A good woman seeing my tears and my distress invited me into her house in order to comfort me. I refused. She brought me a glass of sweetened water. I don't know if I thanked her. After drinking, I wiped my face and left, without knowing where I was going or what was the point of my trip. I was very unhappy. When, a kilometer later, my sadness suddenly disappeared, and I was once again contented, I began to sing, recalling perfectly the promise I had made to go to Libourne. On the road Albert admires the views of the country, the vineyards, and the castles, etc., etc., and arrives at Libourne at ten o'clock, where M. Bitot finds him at the agreed meeting place, with no headache and ready to start walking again. After a good meal Albert leaves at half past two, with the advice not to press on too quickly, because of the heat. He stops for an hour at the local fair we mentioned earlier and arrives at the hospital at nine in the evening, when he goes to bed without asking to eat. He slept perfectly. 9 August. Albert is delighted with having taken a little stroll of 64 kilo-

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meters; he feels only that it was a bit short. His cheerfulness has returned; no more headache. 18 August. A patient in a bed next to Albert's, reading the newspaper in front of him, says that the leisure train for Arcachon had carried many people to that town the previous Sunday. Albert feels very disturbed; he walks a great deal in the galleries [viz., of the cloister around the hospital courtyard]. During the night of the nineteenth to the twentieth, he dreams that he is on the road to Arcachon; he believes that he is really walking in the pine forest. 2 20 August. Forced march in the corridors, sadness, boredom, no hallucinations at night; he sleeps well enough. 21 August. Forced march, no more sadness, because we have promised to let him go to Arcachon on Sunday, the following day. The night is good. Albert does not sleep out of joy. No hallucinations. He is eager for the day to come so he can leave as soon as possible. 22 August. Leaves the Saint-André Hospital at six in the morning. No illusions on the road, unlike the last trip. At eleven Albert gets to Facture (47 kilometers). He takes lunch and presents himself to the mayor of Teste at half past three in order to have stamped on his visa that he has been in that place. This formality having been completed, Albert goes to have dinner with his relatives, who live in this town, and then he walks to Arcachon (6 kilometers) where he passes the evening, returns to Teste, sleeps there, and leaves on 23 August at three o'clock in the morning. He stops for three hours at Pierroton and arrives in Bordeaux at three in the afternoon. Albert enters the hospital at half past four, refreshed and glad to have been on the road. Some days afterward he had an attack of typhoid fever. This is cured, and on 20 September he joins the gas company, where he is at present. 14 November. Albert tells me that he had a bout of melancholy during the days of the eleventh and twelfth. "But," he added, "I am pleased with myself; I was able to combat this attack by a determined effort. It is the first time," he says with a feeling of joy, that he was able to drive away his black ideas. He tells me he is losing his hair. No syphilis. In spite of all his efforts, Albert has kept to his solitary habits. He feels and dreads his isolation, not wanting to hang out with his workmates, whom he finds too coarse. 17 November. Passion overcame his will. Albert told me that he had given himself over twice the previous night to self-abuse. Today his memory

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is confused, as it always is after masturbating. Thus he forgot the key to the door of his room, his things in the workshop, and during the day the jobs that his boss had given him to do. He just came from presenting himself to someone other than the one he was supposed to work for. However, this evening, payday at the workshop, he wanted to settle immediately with his landlord; he was in haste to go home. He stated that this was the first time this had happened; he liked to keep money in his pocket as long as possible, not worrying about paying his debts. 30 November. Albert has a headache. He feels a need to set out again; he goes to the hospital to tell Professor Pitres about his condition. A dose of bromide is prescribed. 2 December. Albert's landlady tells me he is peaceful and shows no signs of wanting to leave. At that moment he arrives for dinner; he is gay, he sings, he is pleasantly surprised to find me there. When we are alone in his room, he tells me he had a crazy desire to leave on the days of 30 November and 1 December. "I went to the Midi railway station with a companion from my ward when I saw some young men getting on the train to join their regiment, at Niort. I could not stand it. I had a headache; I envied the lot of the conscripts who were going to see the country. My distress increased when I saw them leave. The next day, the first of December, my headache was severe, and my melancholy even worse; I felt the need to walk, to go a long way. Every moment I felt the pressure which drives me toward the road. I no longer knew what I was doing, taking the pliers for the hammer and that sort of thing. I fought all day long, and little by little the obsession diminished. On leaving work, however, I felt the need to walk. Then I strode through town and got home in a more settled state. Today is better, but my head is always sore." Then, lowering his voice, he stated that he had given in to his vice twice on the evening before the last incident and three times on the night of 29 to 30 November, equally on 30 November to 1 December, and four times last night. His imagination has become ardent again, and the woman whom he saw only in his dreams when he was in the hospital and given the bromide treatment takes form today. Albert did not take the dose of bromide prescribed for him by Professor Pitres a few days earlier. 9 December. Albert's landlady tells me he suffers greatly in the head, that he goes to bed early. She gives me excellent information about our patient,

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who is a friend of her son. She knew Albert's family well and held it in respect. She says he is distrustful and hides the least of his possessions. 14 December. Albert goes to see M. Pitres during his morning hours, for he feels pressed to leave. He does not agree to return to the hospital. 25 December. Albert is a little more cheerful. He wants to get married! But he is afraid of leaving at the very moment when he least wants to. He is not sure of himself. At this time he has cast his eyes at a young working woman, but he does not dare to go far, fearing to behave toward her as to the other one. I tell him there is perhaps a way to make him more stable and to get him to stay in Bordeaux: [hypnotic] suggestion. I explain to him in a few words what suggestion is, and how it might help him. He asks for nothing better and prepares for this new therapy, for he wants to be cured more than anything. It is 5:20 in the afternoon. A gasoline lamp having been lit, I put myself in its full light, facing Albert whom I have placed in the shadow. At the end of a minute, his eyes blink. I press lightly on his eyelids and glide my thumbs over his eyeballs. At 5:25 Albert is asleep: somnambulism. "Where are you," I ask. "I don't know," he replies softly. Then I impose the three following commands: 1. You will no longer masturbate. 2. You will not leave Bordeaux. 3. You will come to see me next Sunday at ten in the morning. "Have you understood me?" "Yes." I repeat my words again, in a tone of authority. Albert sleeps tranquilly; he snores, his head resting on the back of the armchair. I breathe on his right eye. Albert wakes up little by little. "Where am I?" he asks. "My word, I did not expect to be here. It is odd all the same." "What's up with you?" "I do not know. But why did I come to your office?" "We were chatting," I say to him. "You have probably just had a moment of `absence.' Nothing has changed, as you can see." And on the threshold as he is leaving, I add in an

indifferent tone, "Are you on call next Sunday?'' "No, I am on call today," and he leaves. Our interview lasted scarcely fifteen minutes.

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1887 3 January. Since Albert did not come to me yesterday, Sunday, I go to his lodgings at a time when I know I can find him. Scarcely had he seen me when he extends his hand, wishing me a Happy New Year. Then he adds: "Did I promise to see you yesterday at your home?" "No, why?" "Because all yesterday I was pursued by the idea that you expected me, and that I was obliged to stay with you. If I had not been on call, I would certainly have come to see you." "And what is more astonishing," he continued, "is that I did not think of you all week. On New Year's Day I was free; it was my duty to come and see you and wish you a prosperous new year, which I did not do. Then on Sunday, when I woke up, the thought that you expected me came to me and did not leave me all day." "Have you been sensible since our last meeting?" "It is a victory. I had no desire. I have not given in to my wicked tendency and have no desire to start again. "Do you want to leave Bordeaux?" "Not for a while! If I can stay I will marry." Then returning to his first idea, he adds, "It is strange, however; I believed I had promised to come and see you yesterday." "Ah well, come next Sunday," I say. Needless to say, I had not seen Albert since 25 December. Sunday 9 January. Albert arrives at my home a little in advance of the set time. The best news continues: he does not give in to his solitary pastime. He is cheerful, full of hope for the future. "If this continues," he tells me, "I can marry. But I must stay for one year without having any desire to leave." He agrees to be put to sleep. A few seconds suffice to put him into a state of somnambulism. [Tissié here provides some standard information about tests of Albert's hypnotized state. For Albert awake and hypnotized, see fig. 2.] Wishing to know if he recalls in his state of somnambulism what he did when awake and wishing, in addition, to verify his stories, I ask him if he knows Moscow.

"Perfectly." "Were you ever there? What did you do"

Page 161 Fig. 2. Two photographs of Albert, awake and hypnotized, by Panajou. From Tissié (1901).

"Nothing. When I was on the square of Peter the Great, I was arrested and imprisoned for nihilism." In this way I checked all of Albert's stories. I suggested to Albert anew: 1. Never to masturbate. 2. Never to leave Bordeaux. 3. On waking, to go and pour a glass of wine mixed with water in my kitchen and to drink it. 4. To go on Monday, at 10:30 in the morning, to the clinic of Professor Pitres, where he will lift the doctor's cap from off his head and put it on his own. 5. That he will not be astonished on awaking, that he will have no headache, that he will find himself in my sitting room with nothing changed. I awake Albert by a command. He opens his eyelids little by little, he looks at me, his astonishment is barely noticeable, he speaks of the time passed as if he has been continuing a conversation; all that without a brusque

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transition. All at once I see him concerned; he raises himself a little from his chair, he settles again, looks at me, turns his head toward the door, then continues to speak. Again he raises his head in embarrassment. "Mademoiselle your sister, is she there?" "Yes, why?" "It is just that I am thirsty." "Well then! Go and drink." However, he does not dare advance. Then, pushed by suggestion, he opens the door of the sitting room and goes toward the kitchen. "Are you there, Miss," he asks of my sister, who was in the adjoining room. "I would like a drink." And then he goes toward the cabinet, uncorks a bottle of wine, pours a full glassful diluted with water, and swallows it in a gulp. "It is good to drink when one is thirsty," he says. "Although this is not a time to drink cold." Monday 10 January. Albert does not come to M. Pitres's ward. I go to see him, accompanied by a friend, a medical student. We find him at lunch, very pressed, for he has a lot of work and only an hour for his meal. He informs us, without our asking, that he could not come to the clinic this morning, and when I show surprise that he tells me this, he adds, "It has been a long time since I saw M. Pitres; I would have liked to go this morning but I could not." Sunday 23 January. I try in vain to put Albert to sleep. He masturbated twice last night. He suffers in the head. He again feels the need to walk. Perhaps it could be the presence of some people whom I invited to witness the experiment that impressed our subject and put him off. Wednesday 26 January. Albert is put to sleep at his home, and even though he is pressed, having scarcely had time to eat, sleep comes in a few seconds. I suggest to him: (1) the idea of coming this evening to M. Pitres, at nine o'clock, and then to take a cigar from my mouth and put it in his pocket; (2) not to masturbate any more. Nine o'clock in the evening. He goes to the meeting place and performs the suggested act. I put him to sleep in front of Professor Pitres. State of somnambulism. Absolute anesthesia of the skin. New suggestion of not masturbating. Sunday 30 January. Albert has not masturbated again. I put him to sleep

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on his own. When I left him for only an instant with people who were helping me, having had some business in the next room, I hear him call me with a tone of fear mixed with joy; I run in. Then he briskly seizes both my hands: "I remember! I remember! I know where my watch is! I see it. You don't see it? Strange phenomenon! . . . My head is clearing. I can see all my life at this moment! . . . What things! . . . What things! . . . When I left Bordeaux and found myself at Verdun, I had 60 francs in my pocket, my military record book, and my silver watch. I took the railway to Paris. Beside the Gare de l'Est there is a pawnshop in a dead end. I left my watch there. You go up three steps to enter this building; the corridor is 60 centimeters wide and 3 meters long. At the end there is a door leading to an apartment where one borrows on security. To the right, on entering, there is an office with a wood balustrade. The first clerk receives the object and checks it. The second, further on, takes my name and passes my livret to the former, who gives me 10 francs. "This is a young man between twenty-five and thirty, with a brown mustache, with a parting on the side of his head, medium height, quite large, black cardigan, soft voice, Parisian accent; he has copper scales to the side of the counter; the base of the balance is made of black wood. "The second clerk is a big man of forty, blond, small, in a gray suit with black dots. He has a watch chain, short, flat, of .005 meter thickness or thereabouts. "They return my military livret. Then I leave Paris and go to Brussels. Cost of a secondclass ticket, 20 francs. Not having a penny left, I return on foot from Brussels to Paris, where I sleep for three nights at the Vaugirard hostel. I leave and go through Meaux, Longjumeau, Vitry-le-Français, where I was arrested by the police for not having any papers. I lost my livret in a farm where I slept. They give me a certificate, and I arrive at Châlons-sur-Marne, Bar-le-Duc, and Verdun where I arrive at the Place Chevert. They send me to the hospital, where I was looked after by doctors from Paris and Verdun." We know the rest. But what we absolutely do not know is the detour that Albert took in his waking state.

Page 164 Map 2. Towns in the Bordeaux region mentioned in Albert's stories. Drawn by Dr. Niko Scharer.

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Document 3 (Tissié 1890, 121-46) Dreams (May 1887 September 1889) Philippe Tissié's book Dreams, published in 1890, was intended as a general description of and theory about dreaming but includes Albert as an exceptional example. "Here is the continuation of the observations presented in my thesis," wrote Tissié, "for I had the privilege of being able to study this patient for four years." One theoretical question stalks behind Tissié's observations. What are the relations between ordinary sleep, the altered state of "spontaneous somnambulism," and "provoked somnambulism" or hypnotic sleep? This question had raged for centuries. The best recent history and discussion is in Gauld (1992). Gauld takes this question to be a live one, that still makes sense, and to be one that is still open, unanswered. Although Tissié did not take his observations to be conclusive, he did think he had made an important discovery. Albert can remember somnambulic events when hypnotized, and there are traces of events that occur when he is hypnotized to be found in the somnambulic state. In later work, excerpted in Supplements 4 and 5, Tissié hypnotized patients and then suggested that they would have certain beneficial dreams during ordinary sleep. Because of the healing dream, their state of mind about a person or situation would improve, and their neuroses would ameliorate. 1887 29 May 1887. Albert dreams that he is going to leave for Saint-Gaudens, Spain, and Germany. He thinks he is at Aschaffenburg, where he recognizes several people whom he knows.

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1 June. I put him to sleep. Immediately he becomes very serious and says to me: "I feel that I am going to leave you soon. I want to travel in Spain and Germany. How awful it would be, if I were to leave once again!" Suggestion that he forget the dream and is forbidden to leave. 13 June. He recalls, while awake, having dreamed of Spain and Germany, but he has no desire to depart. In the state of induced sleep, he tells me he will not leave, "because you have forbidden it." He does not recall this prohibition in his waking state. Albert marries. I lose sight of him. 21 November. I receive a letter from Paris written by a worker who found Albert very upset on a boulevard. He did not want to eat; he was not hungry. I send a letter and a medical certificate to Joinville-le-Point, where he was supposed to be a few days later. On 26 November, Albert is at Liège, at the English Hospital. M. Arnaut, the house physician on duty, obtained travel assistance for him from the French consul. 7 December. Return of Albert. He looks dazed, stupefied. Very sharp pain on the cephalic region. He tells me that on the evening of his departure (17 November), he saw me passing in front of his door about six in the evening (which is correct). His head hurt. He went to bed at ten o'clock, with an even more dreadful headache. He then saw M. Pitres passing in front of his house (which is false, M. Pitres not being in Bordeaux that day). M. Pitres advised him to go to Liège with his wife, assuring him that he would find work there and earn plenty of money. M. Pitres added that he himself was leaving the next day for that very town, and that they could travel together. The next morning Albert got up at five. He dressed hastily, for he was afraid of missing the rendezvous at the Orléans station. Not finding his hat, he took his cap and left, taking about 200 francs belonging to his wife, a marriage certificate, and an old passport. He arrives at the station, where he sees M. Pitres waiting for him at the ticket office. "Hurry up, Albert," says Dr. Pitres when he catches sight of Albert, "we're going to miss the train." Albert gets his ticket and finds a place in the third-class carriage, while M. Pitres takes first class. The train stops at Libourne. He sees M. Pitres get out and go toward the exit. He calls after him several times, but M. Pitres does not come back. Albert wants to run after the doctor, but a passenger stops him. The train leaves the station. Albert, finding himself alone, weeps, for he is very unhappy.

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I asked him how he had managed to have a certificate from me in his pocket. He confesses that he cannot explain that. He thinks I gave it to him several months ago. He does recall, however, having been in Paris and Liège, but he has completely forgotten his trip to Joinville-le-Pont, where however he had received my letter and the medical certificate. I proposed to put him to sleep, but he refused. I once more lost sight of Albert until 10 February 1888. I found him again with an intense headache: he was lying in his bed. He had that stupefied look. 1888 11 February 1888. The headache continued. He had to quit his job. At seven in the evening, while he was swallowing the last mouthful of his meal, he feels a terrible pulsing in the temporal arteries [on the sides of his head]. His head becomes congested, the headache ceases suddenly, and immediately he spits out a large tumbler-full of vermilion blood. He is cold, goes to bed. He looks stupefied. At two in the morning, he coughed up a great deal more blood. 1 12 February. No more headache. A feeling of well-being, of having had an iron helmet lifted from his head. His wife, frightened, even though he feels better than ever, calls in the doctor from Albert's employee benefit society. The doctor orders that a vesicant should be applied at the top of the right lung and another underneath the shoulder blade on the same side but on the back. He formulates a hemostatic mixture, from cod-liver oil, etc., in a word, the classic treatment for tuberculosis.2 16 February. A new intense headache, which forces him to sleep rather than walk. A new feeling of an iron helmet. He cannot eat. He takes a footbath in mustard water, lies down, and falls asleep. At two in the morning he once again coughs up blood in abundance. New visit of the doctor, new application of a vesicant, and a discussion of using ignipuncture.3 18 February. Albert has never felt better, although his temperature is below normal. He goes for a walk in the country. 23 February. New headache, toward eight in the evening; new coughing up of blood at three in the morning, equivalent to half a tumbler full. More headache. 24 February. A walk of 20 kilometers in the outskirts of Bordeaux, and that in the snow with a temperature of -2° C. Good appetite, good sleep, no more headache.

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27 February. He allows me to examine him with a stethoscope, something he has not permitted until today. [Here follows a technical summary of problems in the right lung. The left lung is all right. Tissié is sure that Albert does not have tuberculosis, and that the spitting of blood is hysterical.] He does not want me to put him to sleep. Once again I lose sight of Albert. 1 May. His wife receives a letter from Marseille. Her husband got there without knowing how. "I think," said the author of the letter (Albert does not know how to write) that "he is off his rocker." Return of Albert. He tells me that having been present at the departure of the president of the Republic from the Midi station in Bordeaux, he himself had taken the train for Cette a few minutes later. 27 May. While he was on call [for emergency gas repairs] at the warehouse, he heard his companions speak of traveling. No headache, no problems. 28 May. He finds himself in possession of the sum of 5 francs that his boss had given him to do an errand. Pain in the cephalic region. He pawns his wedding ring at the pawnshop near his house, gets 6 francs for it, and takes the 3 P.M. train for Libourne. He spends the night walking and reaches Angoulême without having eaten, since he had not been hungry. He returns to Bordeaux. Stupefied look. He does not have his watch and does not know what he did with it. 31 May. Same amnesia. I recall that there is watch shop not far from the Orléans station. I ask him if he did not sell his watch. After thinking for a long time he remembers that in fact he had given it up for 3 francs. His wife went to get it back. "I have to take the train for Libourne," he had said to the jeweler. "I don't have enough money on me; buy my watch." Tissié tested Albert's sensitivity to being pricked with a pin. His face and legs are normal, but there is greatly decreased sensibility on many parts of the body, and the back of the arms are anesthetic around the triceps. Albert does not want to take his shoes off. His hands and feet sweat profusely. 9 June 1888: The Pedaling Dream Albert makes several trips about town for his employer. On returning to the warehouse, he has a big argument with one of the workers and immedi-

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ately requests his foreman to pay up his wages, for he did not want to stay in this place any longer. On meeting with a refusal, he leaves the workshop and returns home to lunch at half past eleven. He does not eat. He looks stupefied. At noon he says to his wife that he is going to the branch of the warehouse located at rue Vital-Carles, in order to be admitted there. 12:15. He goes by himself to the Saint-André Hospital, where he is recognized by the admissions clerk. He asks to be admitted, saying that he feels that he is about to depart on a trip, begs that he should be kept as a patient in order to prevent a fugue. He is sent to M. Pitres's ward, room 16. 2:10. His wife having told me what was up, I go immediately to the hospital. I found Albert half-undressed on his bed; his face is flushed, the lower lip droops down at an angle from right to left. Semicomatose state. He is curled up, his legs tucked into his abdomen. I call out to him. He does not hear me. I press lightly on the hypersensitive zone that is located on the top of his head. He wakes and jumps up, uttering a cry of pain, but he immediately falls back into the same slumber. His arms are anesthetic to pricks. He moves his legs in the bed as if he is pedaling or walking. All at once he bursts into tears, his face becomes even more flushed, his legs move more rapidly. He utters several unintelligible words, the tears increase, then he shouts, ''Ah! My God! My God! My head! My head! There is no one! My poor wife!" I call to him, but he does not reply. I ask him where he is. Same silence. All at once he sees the nurse, looks at him angrily for a moment, and then, taking him by the arm, implores him in an unhappy and weepy tone to do him the favor of writing to his wife. He believes he has arrived in Orléans. He takes me for a policeman. He says that he took the 7 P.M. train from Bordeaux, passing through Libourne, Angoulême, etc. He recalls that he is married and works for the gas company. He adds that he has run away, that he took money, and asks the nurse if people are nasty in Orléans. He sees the prefecture, the grand-rue, the statue of Joan of Arc. He takes the nurse for an employee dressed in black and wearing a helmet (the nurse was in his shirtsleeves). He begs this employee to accompany him back to Bordeaux, where he will be cared for. I ask him who I am. He looks at me fixedly and touches my frock coat. "You are very dirty," he says to me, "you have a waistcoat with gray polka dots." (I am wearing a black-and-white checked waistcoat.) "You do not look mean, you. I don't occupy myself with other people's business. I have to hit the road

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tonight to find a place to sleep." Then his head falls on the pillow, he falls asleep, and suddenly his legs resume their pedaling. His face, which had a pained expression while he was speaking to me, becomes calm, then it lights up and becomes joyous. "Ah, it is very hot on the road," he cries, "you others don't feel the heat?" I prick his legs. They are insensible. 2:20. I press his hypersensitive zone, and all at once, like a coiled spring that has been released, Albert sits up with a jerk. He awakes, furious, looking fixedly at the nurse, his eyes nailed on him. "Oh, don't touch me!" he exclaims. Insensitive legs. Albert recognizes me. He sees that he is in the hospital, but he has no idea how he got there. He suffers in the head, his feet are cold. He wants to urinate. Even though this takes place normally, he has no awareness of the act until he hears the liquid falling into the container. His testicles are insensitive when pressed. 2:25. General exhaustion. He rubs his occiput frequently, he appears restful. Face, legs, arms, and hands are anesthetic. Insensitive feet, but the soles are hypersensitive. 2:35. He wants to vomit. He yawns and spits. His torso is insensitive, both in front and behind. Each prick produces a little pimple at the center of the prick which is as large as a grain of millet. His eyes scarcely respond to light or looking at an object; his pupils are very distended. 2:40 Albert experiences a violent need to walk. He is not fully aware of his situation. Thus he is astonished at the roughness of the shirt that he is wearing, for he thinks he is wearing his own shirt, while instead it is a hospital shirt. Beside the bed there is a basin. He grabs it by the handle and, taking it for his hat, puts it on his head, after having, nonetheless, looked at it for a moment. Then, since the other patients laugh, he ends by seeing what it is. The nurse had given him a cup of herbal tea; he drinks it enthusiastically. I try in vain to suggest to him that the tisane he is drinking is champagne. Then all at once he puts his hands to his head and cries out in pain. 3:00 He does not know how he came to the hospital. But he knows that it is three o'clock. He thinks he has sold his watch. It had been placed under his pillow, by a patient, when he arrived. "It is traveling, it too," he says with a resigned air. He is astonished to find in his trouser pocket a rag which he put there the previous evening. He looks for his shoes, which are beside his feet but which he does not see. He begs a man in a neighboring bed to loan him his sandals, for he must leave, he must walk, even though the weather

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is bad and it is raining. For him, the weather is fine. He sees his watch, which I have put on his bed. He does not express the least surprise at having found it again. But he puts his hands on his head, which hurts terribly. He does not know he went home before going to the hospital. He had not heard any talk about traveling. His wife, who arrived a moment ago, hides behind the bed curtains. I ask him if he is married. He makes a slight affirmative sign with his head; he looks dazed. He does not want to go home. To several questions that I put to him, he says that he did not drink in the forenoon, that on leaving the workshop he went directly to the hospital, so that he could be detained, for fear that he would head off to Paris. At ten in the morning he had asked his senior supervisor to pay his wages; but the man treated him as if he were crazy. He wanted to go to Paris for keeps; he felt the need to walk a great distance. He tries in vain to put on his flannel undershirt, which he has pulled over his hospital shirt; one of the sleeves was reversed; he did not notice that. He could find only one sleeve, right or left, depending on whether he turned the undershirt to one side or another. "So there is only one sleeve," he exclaims impatiently. 3:20. He recognizes his shoes, which have always been in the same place. The idea of seeing his wife again torments him terribly. He hurts in the head. He puts his shoes on. Suddenly his wife appears and embraces him. He does not want to look at her. He has a vague look about him; his face is flushed, and he looks stupefied. He desperately wants to walk. He urinates. I send him to walk up and down in the arcade [of the cloisters of the hospital courtyard]. Since he wants to leave, I have another patient watch him. 4:00. Albert walks without stopping. I try several times to put myself in front of him to stop him. Every time he evades me. But he says to me, speaking of his guard, the patient I have assigned, "This man persecutes me; he follows me everywhere. Won't that stop soon?" I leave him. 6:00. He walked up and down for a long time after I left. Then, being tired, he went to lie down. Insensitive on his legs, arms, and hands. Hypersensitive on the soles of his feet. Sharp pain on the cephalic zone and on the forehead. He settles down but nevertheless makes little moaning sounds from time to time. His lower lip falls. He has a stomachache and a need to vomit. When I hypnotized him a month later (1 July), I made him tell about the

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various fugues he had taken. He immediately told me that he had ended up at the hospital on leaving the workshop because he felt that he was going to leave on a fugue. He wanted someone to restrain him because he had no money with which to travel. "I know all about that," I told him, "because I saw you." "But no," he replied, "you did not know me there." Then all at once, taking me by the hands, he cried, "Wait . . . wait . . . I went to Orléans . . ." And after a moment's reflection, "No, it wasn't this time . . . Didn't you see a police officer?" "How come? After all, I was in the hospital? . . ." Then suddenly opening his jacket, he says to me, "How hot it is in this room! You do not feel it!" The temperature of my office, which faces north, was not excessive. This observation is very interesting. I was able to be present during the development of a dream of Albert's in which he had been semiactive, since he had pedaled in his bed. But the psychological point is in the recall of memory which he had a month afterwards, when Albert was put into a hypnotic trance. He believed that he had been in Orléans. Then he recognized his error. He had cried out a month earlier, during a somnambulic sleep that had not been induced, when addressing imaginary companions on the road! "Ah, how hot it is on the road! You're not hot, the rest of you?" 4 And, by a flash of memory, he feels the same warmth in my office, and he asks me if I am not hot! Thus, in the state of hypnotic sleep, one can experience the same sensory impression that is felt during somnambulic sleep, and that by a flash of memories, a long time after the imprint of the original memory. Hypnotic sleep is the same type of phenomenon as somnambulic sleep, since a memory stored in the first state can be aroused in the second. <space>15 June. The doctor from his benevolent society having ordered showers [viz., a long time in a cold shower], Albert went to take them in the hospital. When my colleague Dr. Delmas asked him for news about me, Albert not only did not know my name but did not know who he was talking about. Headache. 16 June. His wife, having noticed his stupefied look, hid her money in the wardrobe. But Albert looked for it and found 100 francs. He got to Paris. At the moment that he was to leave for Germany, he went back to Bordeaux, summoned by his wife who told him she was very ill. This deception worked.

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21 June. He had the look on his face that he had on bad days. He asked me to stop the treatment with bromide that he had been following since 31 May, since it did not stop him traveling and it gave him a headache. I agreed to this wish. 22, 23, 24 June. A forced march cleared his head. 25 June. New fugue. Departs at six o'clock in the morning for Agen, having taken 12 francs from his wife's wallet. 30 June. Return. Stupefied expression. Although he had walked endlessly for the past few days and had sore feet, he still wants to leave again. 1 July 1888: The Drum Major 1 July. Albert asked me to put him to sleep. I had not done so for more than a year. I put him to sleep. Curious to know if, while in the state of induced sleep, he could fill in the gaps in the various accounts of his fugues that he had given me during the waking state, I ask him whether it was not true that he had left Bordeaux a long time ago. Negative reply. He sought in his memory, but in vain. He could not answer me, no matter how hard he tried. "Were you not in Liège?" I said to him. He tried. (After reflecting:) "Yes, I know Liège. I was there sometime. (Recollecting all at once:) Wait . . . I was there five or six months ago. I took 200 francs from the wardrobe; I had seen my wife count them out three days earlier." But he could give me no information that I wanted to know about his fugues, which he could remember only with great difficulty. He forgot having been in Marseille; it was only when I told him to think of M. Carnot's tour [Albert had seen the French president before setting out for Marseille] that Albert recalled having taken the train as far as Toulouse. A railway employee noticed that he seemed agitated and asked him where he was going. "To Marseille, damn it!" For he had heard someone speak of that city. He recalled that the man did not want to let him continue because he thought he was drunk. Albert cannot recall his journeys to Angoulême, to Paris, to Agen. When I turn to his admission to the hospital at the moment of his attack, he believes that he had been in Orléans and, opening his jacket, suddenly cries out: "How hot it is in this room! You do not feel it?"

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5 July. I put Albert to sleep in the presence of Professor Espinas. I ask him again if he had been to Liège, for, in his waking state, he still does not know that he passed through Joinville-le-Pont. He cannot remember. I ask him to think hard. After several minutes the events finally come to him, as if he had sought for them in the most profound depths of his memory. He finally gives us the most precise details about how he had spent his money. He found it astonishing that he had spent 10 francs at Lille on food, since he had only passed through this town. So he told us with great verve how he had met the drum major of his former regiment of Valenciennes in the street. He took the drum major for a drink, but the man never drank without having eaten. Albert, seeing he had a gourmand on his hands, had brought, in turn, four pints of beer, pork paté, a two-pound loaf of bread, coffee, and rum, saying to himself, "Since you want to eat, eat and you will roll under the table." As for himself, he took only a small glass of gin. The drum major, well fed, did in fact roll under the table. Then the woman who ran the establishment demanded to be paid. "Keep on serving him," instructed Albert, while paying his bill. "That is useless," the woman replied. "Your features are as disorderly as your friend's. You are more drunk than he is. When you came in I at once said, `There is a gentleman who has been drinking.'" He then tells us that during his trips he spent generously, inviting this or that person to eat and drink, even though he neither ate nor drank himself. A traveling musician passes in the street playing the accordion. Albert suddenly interrupts his tale; he listens. Passionate attitude. The musician becomes silent. Albert resumes the story where he had broken off. I wake him up. He knew nothing of anything he had been saying a moment before. I put him to sleep by pressure on the right thumb (a hypnogenic zone). 5 He resumed the story at the point where he had abandoned it. I repeat this experiment several times. 27 July. Albert's wife tells me that he has taken a new fugue after he was upset at the yard where he worked. He took the ornaments on his fireplace mantelpiece to the pawnshop and got 30 francs for them. The same day I received a letter from a traveling salesman who met Albert on the road from Nérac to Agen: "When I met this young man," he wrote, "he seemed to me not in full

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possession of his mental faculties. . . . I think he is without resources. . . . When I left him, a few kilometers from Agen, his trouble seemed to me to have completely disappeared." 2 August. Albert returns and tells me about his fugue. He lay down fully dressed on his bed with a bad headache. He thinks he slept for a moment, then heard a whistling in his ears. He had no clear understanding of what state he was in. Then he left at 9 A.M. He took the train that goes to Libourne but found himself at Le Buisson without a train ticket. He was stopped, but when the passengers left the train he was let go. "Where are you going," the stationmaster asked him. "To Agen." "Oh well, get your ticket and this time do not lose it again. If not, it is Prison Station for you!" Prison! . . . Why! . . . The word pursued him. He found six 5-franc coins in his pocket. He had no idea where they came from. He went to the hotel. Next morning, the maid came to wake him at five o'clock. "Why on earth?" he asked her. He learned that on the previous evening he had left instructions to be awakened earlier in order to get the train to Lectoure. "Go to Lectoure!" He dressed hastily like someone who has business in hand and who is going to miss the train. He arrives in Lectoure. He sees a road going straight ahead and reads "Auch" on the signpost. So he leaves on foot for Auch. Next day, suffering terribly in the head, he goes toward Nérac. The more quickly he walked, the more quickly his head became "refreshed." He covered 24 kilometers in two hours [7- miles an hour]. At Nérac he wants to eat, but he does not feel hungry. He returns to Agen and meets a traveling salesman. He tells him about his troubles and his fugue. The other man doubts him and asks, "Do you have your papers?'' Albert shows him his marriage certificate, and a leaf of paper falls to the ground. "Look, it is a ticket from a pawnshop," said the salesman. 6 "A pawnbroker's ticket!" exclaims Albert, greatly astonished. Then he recalls little by little how it had come into his hands. The amnesia had lasted two days. I hypnotically suggested to him that he should not depart again.

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7 August, 9 a.m. Albert told me that he had dreamed of marching; he felt that he was going to leave. Contrary suggestion. He did walk but did not leave Bordeaux. 5:20 p.m. Albert had walked all day. He came to find me under the influence of the suggestion given earlier that day. At 11:30 he returned home, after having spent all day running about Bordeaux and its environs. His wife searched through his pockets. She found his medical certificate and the wedding certificate that she had scrupulously hidden, but with which Albert had equipped himself, as he did for all his fugues. The therapeutic effect of hypnotic suggestion is evident in this case. 12 August. Albert left, having got hold of a sum of 180 francs. 31 October. Return. During this period of time, Albert was arrested for vagrancy on 27 August. He was jailed for twelve days. 2 November. He vaguely recalls what he had done during his fugue. He does not know, for example, how he got hold of 180 francs. I put him to sleep. He recalls everything. Someone made him sign a receipt for the sale of his furniture, for which he got 180 francs. He had headache. He went to Paris, where a pimp stole his money by the confidence trick called à l'américaine, leaving him with a satchel that he was supposed to watch (14 August). Not having a sou, he went to Clayes, hoping to push on to Germany. He becomes distraught at Meaux. He goes to the police station and begs the sergeant to arrest him. In a sudden flash of memory, he tells how he left his wife, how his attacks come on, how unhappy he is, and he kisses the hands of the policeman, weeping. Albert is very emotional in the state of hypnotic sleep. Here I copy word for word from my notes. Albert is speaking: "He is mad," said the police officer. Then I fell asleep. I heard perfectly well when he called me, but I did not want to answer. Me. Why? Albert. Because a doctor in Bordeaux forbade it. Me. What doctor? Albert. M. Tissié. You do not know him. Me. Then it is a doctor from Bordeaux who told you not tell your name? Albert. Yes, certainly It is you you know perfectly well. (Pointless to say that this is false. Albert simply reported to me the idea that he had, of not replying.) I was put in a courtyard, where I walked in my sleep. They locked

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me up. I did not wake up. I arrived, asleep, in front of the state prosecutor. "He is an idiot," said the police sergeant. "He is a drunk," replied the magistrate, and had me put in jail for a fortnight. Albert left and went to Paris, where he was examined by Charcot and Gilles de La Tourette. 7 November. I had noticed that Albert's fugues are always preceded by congestion in the head. I want to try to use suggestion to change the location of this condition. I put him to sleep and suggest to him that on awaking he will have a nosebleed. He wakes up: Albert is all hot in the face. He coughs, he blows his nose several times, but he does not get a nosebleed. However, his face becomes more and more congested, and he falls asleep all by himself. I suggest to him that he has blood in his feet and that his feet feel very hot. On awaking, Albert's feet do feel hot. No more congestion in the head, no more coughing, no more of the earlier somnolence. 20 November. Since 7 November, Albert has had a clear head and hot feet. Having obtained good results by using a perfume to reinforce suggestion in the case of a morphine addict, 7 I suggested to him that his head would clear each time he smelt corylopsis perfume. 1889 22 January. I lost sight of Albert until this day. He came to tell me that the perfume had been very helpful for some time, but that he had just had a new fugue. He had gone to Langon on foot, and he came back the same date, some 75 kilometers. I suggested to him (1) that on feeling a need to depart, his first idea should be to come and see me, and to wait for me; (2) and that his feet should feel hot. 23 January. Albert has a clear head and hot feet. We leave together and walk in the Parc Bordelais [on the outskirts of town, newly opened in 1888]. I wanted to know how he would behave when hypnotized outdoors in a state analogous to his hypnotic sleep. While walking I pressed his thumb (hypnogenic zone). He fell asleep and walked more quickly. He thinks he is in the Bois de Boulogne, Paris. He is far from home; he has to return to Bordeaux.

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He takes up the pace he uses on the road. I have to run to keep up with him. His eyes are half-closed, and one would think he had drunk too much. He has that stupefied look, his lower lip hanging down. He avoids obstacles very well. I wake him up. We return to my house, where I give him the same suggestion as the previous evening. Then, wishing to know if a suggestion given in hypnotic sleep would be reproduced in normal sleep, I told him that the following night he would see me appear in his dreams; when he had seen me, he would get up, then lie down at the wrong end of the bed; get up again, and then lie down normally. 24 January. Albert told me in the waking state that he had dreamed of me last night, but the surprising thing is, he adds, "I heard your voice very clearly, but it was not your face. You said to me, `All right, Albert! . . .' Then I got up, lay down with my head at the foot of the bed, etc., etc." I put Albert to sleep. He told me the same thing. However, I was afraid that he would not recall, in the waking state, a suggestion given in hypnotic sleep. I also knew that he would not lead me into error without his knowing it, and especially without wanting it, for I had known this subject for four years. So I asked his wife if he had truly risen at night and then gone back to bed with his head facing the foot of the bed. She confirmed the fact. Albert, therefore, had accepted the suggestion. 11 March. I met Albert several times, who told me he was well. Having accepted work at a building site some distance from Bordeaux, he could not come to be put to sleep. Today, as I was passing in front of his house, his wife asked me to come in. It was six o'clock in the evening. Albert is lying down, moving his legs as in the hospital; he is in a state of somnambulic sleep. He dreams. I enter into conversation with him. He tells me that he dreamed the previous night that a gentleman had advised him to quit the building site and to go and look for work in Bazas [a town of 4,000 inhabitants 62 kilometers southeast of Bordeaux]. During the night he had been plenty agitated, according to what his wife told me. He woke in the morning with a violent headache. He left and went to the shipyard at Lormont, near Bordeaux [now a suburb], with the intention of working, although he had taken his basket and food for the day. It was only when he began to work that the idea of settling his account and leaving occurred to him. The weather was dreadful, it was pouring and blowing hard. He went off in the direction of Bazas, on foot. Arriving in this town, he did not find the gentleman in question, and he

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returned the same way, not having spent the 6 francs that they gave him at the building site. He told me he had hidden his wallet at the foot of his bed, in order that his wife should not take the money, and that he did that on arriving, namely, in a sleeping state. I suggested to him: (1) not to have a headache when he awoke, and to be cheerful; (2) to give his wallet to his wife; (3) that every time, when he is asleep, and a person tells him to leave, I should appear immediately and tell him to stay. He wakes up: Albert is no longer suffering, and he returns his wallet to his wife. 12 March. His wife accompanies him to the shipyard in order to explain his case to the foremen. They told her that they had only hired her husband by the hour, and that he had very politely announced his departure for Bazas, where, he said, he would earn more money because he was going to work according to his own trade. He had been paid off; no one thought they were dealing with a sick person, for he spoke very naturally. Nothing in his manner could suggest that he was in a somnambulistic state. 4 April. I learn from his wife that Albert has left again, and that he wrote from Pau, where he had a fever. 8 I had not seen him since 12 March. During the night of 31 March or 1 April (Sunday or Monday) she heard him dream: "Look," he said to her, "I have been given the task of tracking down an unfaithful woman who stole 3 million francs. I will be given 3,000 francs if I can find her. Then we will have enough to live on." At that moment she thought that her husband was awake, but the absurdity of it all made her realize he must be sleeping with his eyes wide open. In fact, Albert wakes up, fully alert, and is amazed at what he had just said. Then he added, as if he were resuming his dream: "But I am very embarrassed. I have no idea in which direction she went. All the same, 3 million . . . !" My colleague M. Monod was willing to write to his brother, a doctor at Pau, recommending Albert to him. Thanks to the brother Albert obtained travel assistance from the prefecture, which enabled him to return to Bordeaux on 7 April. 8 April. In the presence of Dr. Monod, I asked Albert to tell us about his fugue. He is in the waking state. Saturday 30 March he was at work in the naval shipyard at Lormont. He heard some of the workers talking about him as if he were a police informer. (Albert did not have hallucinations in his waking

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state.) He became very upset; his troubled state lasted into the evening and through the daytime of the following Sunday. He went to a theatrical matinée to distract himself. He saw [he said, a play called] An III-Kept Wife (in fact Labiche's A Well-Protected Girl, in which a mother puts her child in the care of two maids in order to go out all alone one evening). 9 He did not suffer in the head; however, he could not stay until the end of the performance and went to bed early. During the night he had nightmares: he saw lions dashing toward him; he was shot; he woke with a start when the bullet hit him. He suffered from pain for a long time on the side where the bullet had hit him. "Every time I am killed or struck in my dreams," he said, "I feel pain all day in the part of my body that has been affected." Albert went back to sleep and dreamed that M.D., who had helped Albert in many ways, both in Vienna10 and Bordeaux, had charged him with finding M.D.'s wife, who had left him to run away with his chief accountant, taking a million francs with them. He would have a reward of 3,000 francs if he could find them. He awoke at half past three in the morning, took the satchel which had been left him by the thief à l'américaine, and slipped on some overalls in order not to dirty what he was wearing, for the ship on which he was working had a fresh coat of red lead paint. He left, singing, wide awake, with no headache, and with nary a thought of the dream he had just had. When he got to the Quai de Queyrie, that is to say about 5 kilometers from his home, he noticed it was too early to enter the shipyard. He retraced his steps, and when he got to the Bastide-Bordeaux bridge, he leaned on his elbows on the parapet and looked at the water flowing beneath him; the gas jets were reflected in it. It was 4:30 in the morning.11 From this moment on he could recall nothing. He was woken up by the baaing of sheep. He was wet; he was cold; he was nestled among sheep in a field, kept warm by contact with them. He was in the midst of the Landes forest.12 Astonished, he waited until dawn. He saw, from a nearby kilometer stone, that he was 4 kilometers from Puyoo. A workman passed by and gave him directions to several places. He chose Pau, where he arrived on foot on Tuesday 2 April, at seven o'clock in the evening. He had a fever. He searched in his pockets and found 1 franc 50. He bought some quinine. We know the rest. I put Albert to sleep. He began to cry. He is very unhappy. He has just

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left home. He tells us what I have just reported, saying once again [that the play was called] An Ill-Kept Wife instead of A Well-Protected Girl. "My wife," M.D. told him, "is hidden in the Landes forest with my accountant, like Aguer; 13 hunt for them there; you alone can do me this service in return for those that I have done for you. You will get 3,000 francs for yourself." He got up from his bed with the intention of following the unfaithful woman and leading her back, but he did not want to speak of this to his wife. However, the fresh air of the morning woke him up, and he forgot his dream, a kilometer farther on, at the Bastide-Bordeaux bridge. His memory of the dream came back to him, but in the course of crossing the bridge, that is to say, 500 meters, he forgot it anew. He arrives at the shipyard, near Lormont. It is closed. He retraces his steps. He leans with his elbows resting on the parapet. He is hypnotized by the reflections of the gas jets in the water. "Suddenly," he said, "since I was sad, I saw M.D. coming toward me. He was dirty and covered with mud, like someone who has been running across fields. "____ I have just come from looking for my wife at the home of her parents in Lormont," M.D. said to Albert. "Her parents did not even want to listen to me. She left in the direction of the Landes forest. You must follow her no matter at what cost. Go, my friend." And M.D., desperate, dashed along the bridge going toward Bordeaux. (M.D., who was a man of high standing in Bordeaux, was in fact married to a young woman living in Lormont.) "I did not know what to do," Albert continued. "I noticed that I did not have enough money to take the train. I dashed forward to catch up with M. D., in order to ask him for some; but, arriving on the other side of the water, at the Quai de Salinières, I no longer saw him. I retraced my steps. I then recalled that I was owed 14 francs at the shipyard. I waited until it opened. I was paid off, at 7 A.M. I was cold, I was trembling, I had cold sweats. Since I had money, I went in the direction of the Gare du Midi. However, reflecting that Mme D. could well be in the neighborhood of Lormont, where her family lived, I scoured the countryside, I went as far as Quatre-Pavillons, looking all over the place, before undertaking a trip that would be very expensive. Realizing I was fighting a losing battle, I crossed the Garonne at La Passerelle and arrived at the Gare du Midi at eleven in the morning. I asked

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for a ticket to the Landes forest. The train would not leave for an hour. I sat down on a bench and waited. I took a ticket for Dax, where I arrived at 5 P.M. 14 I left immediately, on foot, and searched the forest. All at once, in the distance, on the road, I saw the silhouette of a woman passing by. It was the figure of Mme D.; I hurry toward her. She flees. I run more quickly. I am about to catch up to her, when all at once she vanishes; I can no longer see her! . . . I was exhausted. It was raining. I noticed a sheep pasture. I climb the barrier and lie down among the sheep. I wake up in the morning and only then understand that I have been the toy of a dream." We know the rest. 12 September. Albert definitively left Bordeaux with his wife. He went to settle in Paris. He is the father of a daughter. He has spent all the household savings. Unscrupulous people have exploited him and bought his furniture for terrible prices. All too well known in Bordeaux, where no one wanted to employ him any longer, he was changing his surroundings. The commissioner of police in my quarter sent me the following dispatch that had been sent from the prefect of Indre to the prefect of Gironde: "The individual named D . . ., Albert, requests means of transport in order to return to Bordeaux, 6, rue Barada, where he lives. He presents certificates from Doctors Tissié and Monod stating that he suffers from hysterical somnambulism. He can give no account, he says, of his departure from Bordeaux and his arrival at Châteauroux, etc." Albert left a night hostel in Paris and was in a state of somnambulism when he got to Châteauroux; he dreamed that he was coming from Bordeaux and gave my address, thinking that it was his own. It follows from this long observation of Albert that Albert is a hysteric. At this point Tissié reviews the evidence. The restricted visual field, as published in Les Aliénés voyageurs. The alterations to sensitivity of the skin. The hysterical spitting up of blood, which occurs at the same time as headaches, and the headaches end when he spits up blood. Like some hysterics, including one Albertine made famous in Pitres's clinics, he is often taken for drunk when he is in a hysterical state. He does not eat during his fugues. Tissié then resumes some of the ways in which Albert's fugues are preceded by talk of travel, and how his memory returns under various circumstances. He concludes with an insightful dream analysis.

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Albert's last fugue is especially interesting to analyze. He dreams that M. D., who is a real person, promises him 3,000 francs if he finds Mme D., who has left with the chief clerk. In the morning he gets up and has forgotten all that. He goes to the shipyard, near Lormont, 6 kilometers from his home. He gets there early. He retraces his steps. He leans against the parapet on the Stone Bridge. 15 He looks at the flowing river, he sees the gas jets reflected in the water. He is hypnotized by these brilliant points, he falls asleep, and immediately the dream begins again. He sees M.D., and he hears M.D. He wants only to do what M.D. wants, for M.D. has helped him many times. But he recalls he has not enough money for a long journey. He follows M. D. to the quai of the salt merchants. He passes the bridge, then retraces his steps again, doing the 3 kilometers to where he can be paid for the two or three days' labor that are owing to him. Then he travels to the neighborhood of Lormont and looks for the unfaithful wife. He once again crosses the Garonne, waits two or three hours at the station, gets in the train, gets out at Dax, goes into the forest, where a new hallucination makes him see, at a distance, the silhouette of Mme D. He runs toward her, but she vanishes. Albert wakes the next day in the middle of a flock of sheep! . . . All that sounds like a novel . . . And now, why does Albert dream about M.D. rather than someone else? Is it by chance? Perhaps. But without wishing to seek out a hypothesis to answer the question, I cannot help from drawing attention to certain facts. What we already know about dream formation can help us here. 1. Albert heard that he was thought to be a spy at the Lormont yard. This disturbed him and was a predisposing cause of a pathological dream. 2. Next Sunday, suffering from a headache, he went to the theater and saw a play called A Well-Protected Girl, but Albert named it An Ill-Kept Wife. We know that in this play a fashionable woman, wanting to go out one evening, leaves her child in the care of the maids and leaves. In the course of the play an actor takes a doll that is in the little girl's bed, throws it to the ground, and breaks its nose. 3. M.D. was married at Lormont and subsequently lived in Bordeaux. 4. Mme D. lost a baby daughter. 5. Albert likes children a lot. 6. The newspapers were full of stories about a murder who hid in the Landes forest. Albert has tacked to his wall a portrait of the criminal.

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We observe here a very curious chain of ideas and very probably can make out the association of ideas that they represent. The trouble at the workyard in Lormont arouses the memory of M.D. who was married at Lormont. The scene of the doll with the broken nose recalls the child that Mme D. had lost. The act of the mother who left her child in care of the domestics in order to go out in the evening is related to Mme D. by association with the ideas of maternity. Albert's lively affection for M.D. makes him put himself at the service of M.D.; he projects on to M.D. what he himself feels. As to the pursuit in the Landes forest, we find there the reason for the state of mind of the dreamer. Whatever is the explanation of the dream, when we return to clinical matters, Albert could never be thought of as a latent epileptic, stricken with ambulatory automatism, such as M. Charcot observed with his patient M. in the Tuesday lectures at the Salpêtrière. He is an alternating hysterical somnambule belonging to the class of Captives. Further on this subject, somnambulic sleep and hypnotic sleep appear to be of the same nature, because one can recall in the one state what happened in the other, and vice versa.

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Document 4 (Tissié 1896, 4-5) A Pathogenic Dream (1892) Albert X . . ., having left Bordeaux to set himself up in Paris with his wife, came to see me during a fugue. I put him to sleep the morning of the very day on which he was going to return to Paris using a certificate for travel assistance that I had obtained for him. Immediately asleep, Albert struck the armchair with two blows of his fist. ''I am going to Paris; I want to kill her! I have seen my wife this night." Me: In a dream? Albert: No. I could not dream; I could not sleep; I was awake as I am now. Me: What time was it? Albert: It was half past midnight. At midnight I went down to the office to see if I didn't have a letter from her. I expected that I would find nothing, because at ten, at the last delivery, there had been nothing, but, well! . . . I lay down. I saw my wife. Her hair was done up. She had on a black blouse, a leather belt to nip in her waist, with the rings in front. She is prettier now. She was at V Street, in the concierge's lodge. Mme P., the landlady, was there, M.B., Mme C., a prostitute, and an old man whose mistress was a young girl from the Louvre. The old man flirted with my wife. They spoke of me. Someone said, "Leave him be where he is." The old man offered to pay for a room. "But if he should come?" "If he comes, we shall tell him that you are not in the building, and we will have him put in the Salpêtrière."

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I rose, I took my umbrella, I packed my bag, in which I had a sweater and a flannel undervest. I remembered that this morning you had given me a letter to carry; I left on foot without it. In four days I was in Paris. Albert gave details about how he had traveled. "I had a headache; I strode up and down; I had the need to walk; in order not to disturb anyone, I went up to the consulting rooms and walked out. Then I heard from out of nowhere a bearded man who said: `It is the right of a married man to kill the wife who has deceived him.' I replied, `I have a journey to make for M. Tissié it is sacred.' I did not leave this morning because I had a letter to carry for you. I will leave at noon. Yesterday, I met up with a young man at the fair; he is going to look for work in Poitiers. He had put up at the Albert Brandenburg Hostel. I had arranged to meet with him at noon. We will leave together." I then suggested to Albert that he should dream affectionately of his wife. Nervous, spasmodic movements; he does not accept the suggestion without protesting with a very expressive gesture. Me: What's up? Albert: You have forbidden me to kill her, and I will obey you. I give him a new and stronger suggestion. I wake him up. Albert is calm; he speaks of his wife in very favorable terms. To sum up, Albert, preoccupied in the waking state by his waiting for the letter from his wife, which he did not receive, fell asleep and awoke in his second state; he went down to the office at midnight; he walked all night; he saw his wife and a man; he heard the man advise him to kill her, and immediately, under the influence of the visual and auditory hallucination produced by the dream and reinforcing it, he wanted to leave for Paris, but he retained the memory of a duty to me. Would Albert have committed the murder? I have no idea. Whatever is the case, the possibility of being able to commit a murder was created by a dream.

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Document 5 (Tissié 1896, 1-23) Experiments (1888, 1893) I wanted to experiment on ideogenic dreams [dreams suggested by planting an idea in the mind of the dreamer]. My subject, Albert X, served me so much the better because I knew all his psychic reactions, having studied him for a long time in my thesis, for my book Dreams, and in several experiments. I wanted to know how Albert X behaved in connection with two abstract suggestions such as Vice and Virtue. The first experiments go back to 1888; I resumed them in 1893 by means of instantaneous photography. I thus obtained thirty-three plates, thanks to the intelligent and devoted collaboration of M. Panajou, the well-known Bordeaux photographer. Obs. V. 1. Hypnotic suggestions: Having put Albert to sleep, I simply said these words to him: "Your left knee represents Virtue; your right knee represents Vice." That done, I took note of what happened. I press the right knee (Vice). Albert takes an empty glass that was on the table and drinks until he falls to the ground. Noticing a photograph, he takes the image for reality; his face flushes and then he begins an erotic scene that I immediately bring to an end by pressing the left knee (Virtue); Albert immediately becomes very chaste, and his words are entirely proper. I press the right knee (Vice). He sees a wallet in the pocket of a witness of this experiment and steals it from him, putting it in his own pocket.

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I press the left knee (Virtue). He returns the wallet to its owner, putting it right back in the pocket from which it came. I press the left knee and the right knee at the same time. Albert is very indecisive; he struggles violently and ends by leaving the wallet with its owner, but before doing so he extracts a letter that sticks out from it. I press the left knee; he returns the letter. All this is accompanied by a play with his facial features that is impossible to describe, and which shows me the struggle between the two suggestions. 2. Posthypnotic suggestions: I put Albert to sleep and at the same time create twelve ideogenic zones among others, that of the left middle finger which gave him a desire to sneeze, that of the left little finger which represents chastity, that of the right little finger which represents lechery, etc., etc. I awake my subject. Pressure on the ideogenic zone corresponds to the suggestion that has been given; pressing the left middle finger provokes sneezing: the more I press, the more Albert sneezes. But the most curious of all the suggestions concerns the little fingers. According as I press the little finger of the left or right hand, he switches between lechery and chastity. The play on his facial features is characteristic of each. Albert asks anxiously if he is not going mad; he does not understand at all what is going on inside him. If I press both fingers at the same time, he remains indecisive, and the emotional feelings correspond to the intensity of the pressure on the finger. The first time that I made this experiment I forgot to suppress these two suggestions, and here is what happened: The next day Albert enters my consulting room, scarcely able to drag himself in, he was so exhausted, his features drawn. He told me that the previous evening, half an hour after leaving me, he had met a friend in the street. He shook hands with his right hand and almost immediately got an erection. Immediately he remembered the suggestion that I had given him, and he passed the day alternately pressing his right and left little fingers. He had sex with his wife several times during the night. Finally, in the morning, in coming to see me, he twice pressed his right little finger and had two ejaculations that were so violent that he was obliged to lean backward against the wall of a house in order not to fall to the ground. Albert was not deceiving me; his shirt was dirtied. Note that genital excitation, repeated too often, provoked a desire to defecate, with inability to do

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so. 1 Albert fought against this by pressing his left little finger, which pushed down his lecherous thoughts and left him calm. I put my subject to sleep and suppressed all the ideas that I had suggested. On waking up, he had completely forgotten them.2 Here, now, in this tableau, are thirty-three snapshots of photographed dreams.3 On each leg I strapped the top of a cardboard box, upside down, so that the box could be placed right side up in its cover but also removed. The right leg represents Virtue and the left Vice. I poured a certain quantity of lead shot into each box; a screen placed between the eyes and the knees prevented the subject from seeing what I did. When the difference between the weights that I had poured reached 32- to 42 grams, whether on the right or left leg, Albert switched from Virtue to Vice, or vice versa, as expressed by his gestures and noted in the stenographic report of his dreams taken during the experiment. Moreover, I timed various reactions. Thus Albert took 1 minute 7 seconds to fall asleep by pressure on the fingers where I had created a hypnogenic zone. The various dreams lasted between 1 minute 23 seconds and 1 minute 58 seconds, during which time several photographs were taken. The time taken for the dream photographed in print no. 29 was only 2 seconds. In nos. 22-23, we are looking at a psychical transition in the subject, who switched from being virtuous to being vicious, thanks to a 46-gram weight on the left leg. The time of the reaction was 6 minutes 33 seconds. In print no. 23 Albert expresses anger; he hits his chair, he defies, he attacks, his evil sentiments mount, he resumes the dream of theft which was suppressed a few minutes before by pressure on the right leg. He discusses the act that he is going to commit. He exclaims, "It can't go on, I have had enough of it, you know." In photograph no. 24 he is looking into how he will accomplish what he intends to do; he judges, "You can change the tickets. Let's go; it is necessary to leave, quickly. If only I had a knife!" The time needed for elaborating this judgment was 1 minute 20 seconds. Prints nos. 25-26 indicate that the resolve has been made: "If we are caught, I take full responsibility. Let's go, I will strike! I will strike! Come with me. You have nothing to fear, since you are to see to exchanging the tickets. Will you come?" "If someone cuts off our heads?" I say to him. And Albert is silent. He

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sleeps profoundly, he has no more dreams, as is indicated in print no. 27, which resembles no. 13. Albert falls into a deep sleep after dreaming about some vigorous activity. The intense nervous discharge brings the dream to an end and induces a need for rest, as you can see by the two photographs (nos. 13 and 27). However, the idea remains. The proof is given by the dream provoked by my question "If someone cuts off our heads?" Albert, having returned to deep sleep, projects his dream of theft and assassination onto a woman and her child that are going to be guillotined. 4 He cries, he weeps, he demands pardon for the guilty ones. Thus the idea of punishment that I had conveyed found its way down below, in deep sleep, and reappeared in the form of a dream about capital punishment for I had spoken of decapitation. But the gesturing of nos. 14-20 is even more interesting. The mobility of facial expression has been captured instantaneously. I was thus able to fix concretely, at the actual moment, a series of psychic manifestations and reactions between the formation of an idea and the act done. The photograph confirms the psychological law which establishes four stages in every voluntary act: (1) a sensory impression provokes a recollection of memories, that is to say, of testimony; (2) a judgment by association of the testimony, that is to say, a debate; (3) a verdict or resolution of the debate; (4) an act which executes the judgment. When a suggestion of Vice has been given by pressure on the left leg, after deep sleep, we witness, by means of photographs nos. 14, 15, and 16, the formation of the idea of Vice, that is to say, a recollection of memories which is like hearing testimony. The expressive gesture reveals the state of mind. The gesture of no. 17 allows us to witness the discussion of the idea, the judgment. In no. 18 we see that the resolution is made, the verdict is rendered. The act is accomplished in no. 19, where the gesture shows that we are watching a theft in the very process of being committed. The theft has been accomplished by no. 20. The time required to go through the entire cycle, formation of the idea, discussion, resolution, act, was 37 seconds. The weight used to induce the dream was 34 grams. I give Albert a posthypnotic suggestion on the subject of the nature of the tactile sensations that he felt. On awaking, Albert does not know that I gave him the two suggestions of Vice and Virtue, and he did not know the dreams he had had, except the last, about capital punishment, which I had

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suggested to him to remember, in order to have a control by comparing his verbal posthypnotic account with the dictation and the photographs. The tactile impression that he noticed was one of burning exactly localized at the points on his legs where pressure was exerted in the boxes. This sensation of burning was similar for the two series of suggestions, however opposite. On awaking only the memory of the burning persisted, but there was amnesia for the two alternative series that were suggested.

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Document 6 Epilogue (1907) In 1930, at the age of seventy-eight, Tissié published an autobiographical note in his own journal. 1 It tells about his career in physical education and his long encounter with Albert. The note ends with a short section headed "Epilogue" which tells how "Albert Dad . . ., having married in Bordeaux, went to live in Paris with his wife. She died of tuberculosis, leaving a little girl who was adopted by market gardeners in Montreuil," now a suburb just east of Paris proper. The girl's name is given as Marguerite-Gabrielle Dadas that is the first time Tissié used the Dadas surname in print. Then he relates a sad story about the disappearance of Gabrielle, which he says he read in the Paris daily, Le Matin, for ''7 December 1906 (or 1907)". The story cannot be located in the editions of Le Matin in the Bibliothèque Nationale, whose only sensational story about Montreuil concerns the hacked-apart body parts of a woman found at the bottom of a well in the district. Here, however, is an account of Gabrielle from another daily, Le Petit Parisien, for 8 December 1907:2 Another Mystery at Montreuil What has Happened to Gabriel? A Victim of the White Slave Trade? The talk of Montreuil-sous-Bois is the disturbing disappearance of a fifteen-year-old girl. It is suspected that she has been taken away by traffickers in young women. At the very moment when public opinion at Montreuil-sous-Bois is very

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much overexcited by the macabre discovery in the Préaux wells, another mysterious affair is in the air, the abduction of a young girl aged fifteen and a half. At the Home of her Adoptive Parents The Hérault couple are very honest and well-thought-of workers, who have lived for a long time at 14 rue de Vincennes. That is where, yesterday morning, we found Madame Hérault in tears. Many years ago, she told us, my husband and I took under our care Gabrielle Dadas, daughter of one of my friends, who had just died. Her father, working in the country, could not look after her. Not having any children of our own, we quickly became attached to this little girl, whom we have brought up as if she were our own. Very recently, having received a solid primary education, Gabrielle became an apprentice in a dressmaking establishment. Three weeks ago, she got a job with a dressmaker at 28 rue de Strassbourg, in Vincennes. The Proposal from the Old Woman On the twenty-eighth of November, on leaving the workshop, Gabrielle suddenly said to me: "Mama, I am probably going to quit my present job. This morning, as I was looking at the job ads posted at the Vincennes town hall, an old woman came up to me and asked me if I was looking for a post. When I said yes, she replied, `You please me. My daughter, who is a dressmaker, rue de Paris, needs an assistant. Would you like to work with her? You will be well paid!'" "I accepted," Gabrielle continued. "Tomorrow morning this woman will take me to her daughter, at least if that is all right with you." I had no objection, and not suspecting anything bad, I gave my assent, Madame Hérault continued. The next day, Gabrielle left as usual, bidding me good-bye. The day passed without her coming home. Worried, I went to the police station and made a declaration, which I repeated at the prefecture of police. Her previous employer, when I passed by, told me she had not seen my daughter since the previous evening. Just then I received from the main hospital a letter telling us that M. Dadas, Gabrielle's father, had just died, and telling me to inform his daughter. I then set out again to find Gabrielle. Together with my husband and a

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friend of his we went to all the bars in Vincennes, asking everywhere if anyone had seen my adoptive daughter. A Trace of Gabrielle I was giving a description of the missing girl in a bar in rue Terrier, where the lady at the bar knew nothing. Suddenly a blond young man who was drinking nearby announced, "Me, I know her, and even have on me some post-cards that she sent me." "Then you can tell me where she is. I am her adoptive mother, and I am looking for her, because her father died yesterday at the hospital." "But I do not know where she is," the young man exclaimed, with an air of embarrassment. Then, paying for his drink, he disappeared. Another customer, however, gave me an exact address. "Go there at once," he told us, "that man is certainly going there, and perhaps you can find your daughter. It is a house of ill repute." We left at once. What was our surprise, on arriving at this establishment, to find the blond young man from the rue Terrier. "Do you have Mlle Dadas here?" I asked the woman in charge. "I'm her mother and I am looking for her." "No," she replied, "I do not know this young girl, and, anyway, I would not accept her here, because she is too young." There were several soldiers in the room. One of them spoke to me, "If only you had got here ten minutes earlier, you would have seen the kid you are looking for behind the bar, drying glasses." I hurried to the police station. The magistrate listened carefully and then, accompanied by two policemen, went to the establishment I had just come from. He made them show him their books, interrogated the woman at the bar, and searched everywhere. To no effect, unfortunately; we did not find my child. She had certainly been taken elsewhere. Where is she at this moment? I don't know. Vigorous inquiries have been made, I know that. In spite of everything, I am convinced that no one will find my little Gabrielle, who, perhaps, is already the victim of an infamous gang engaged in the white slave trade, and which includes, for sure, the old woman and the blond young man. Here is the description of the teenager. Brown hair, bouffant. Clear blue eyes. Black skirt.

Gray blouse. A little short open jacket. A black boater hat. 3

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Notes Abbreviations Tissié, Les Aliénés voyageurs AV (1887) American Psychiatric DSM-IV Association (1994) American Psychiatric DSM-III Association (1980) DSM- American Psychiatric III-R Association (1987) World Health Organization ICD-10 (1992) Hacking, Rewriting the Soul RS (1995) 1. The First Fugueur 1. Tissié, AV, 3. 2. The Hospital of Saint-André was founded in 1540. The present edifice was built in 1825-29 and remodeled in 1867. It was a major institution with 680 beds, and once you have got inside, it is, from an architectural point of view, the most agreeable large hospital I have ever entered. 3. The quotation is from Ross (1989), 52. The figures on college students are in ibid., 90. On acute-care admissions, see Ross (1990), 449. 4. Boyle (1990). 5. Brody (1997); Ratey and Johnson (1997). Dr. Ratey is executive director of research at Medfield State Hospital in Massachusetts, and Dr. Johnson is described by the Times as a "writer and trustee of the National Alliance for Autism Research who lives in Los Angeles." 6. "Es bestehen nämlich, in der Psychologie, experimentelle Methoden und Begriffsverwirrung." Philosophical Investigations 2:xiv, in Wittgenstein (1953), 232. 7. Hacking, RS, 16. 8. I owe the word doxogenic to Harold Merskey, perhaps the most outspoken psychiatrist

opposed to the diagnosis of multiple personality. See Merskey (1992) and Merskey (1996), 154, 308, where the word is used explicitly in connection with multiple personality disorder. Although Merskey made up the word, he told me in a letter dated 10 June 1996 that he learned later that the word doxogenic occurs in a Dorland's 1974 medical dictionary. 9. The criteria stated in DSM-IV, 484, are: "A. The predominant disturbance is sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past. "B. Confusion about personal identity or assumption of new identity (partial or complete). "C. The disturbance does not occur exclusively during the course of Dissociative Identity Dis-

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order [the new name for multiple personality disorder] and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy). "D. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." The DSM introduced the disorder as a distinct entity, under the label of "psychogenic fugue," only in the third edition, DSM-III. There, and in the third revised edition, DSMIII-R, clause B read, "Assumption of a new identity (partial or complete)." The argument for weakening this clause in the 1994 edition was best stated by Riether and Stoudemire (1988). The standard European diagnostic manual, ICD-10, 155, does not insist even on confusion about personal identity but lays great emphasis on amnesia. "For a definite diagnosis, there should be: (a) the features of dissociative amnesia; (b) purposeful travel beyond the usual everyday range (the differentiation between travel and wandering must be made by those with local knowledge); and (c) maintenance of self care (eating, washing, etc.) and simple social interaction with strangers (such as buying tickets or petrol, asking directions, ordering meals)." 10. Tissié (1887). Tissié's title was not original. Foville (1875) bears the title "Les Aliénés voyageurs, ou migrateurs." Foville was based in Le Havre, the jumping-off point for North America (Bordeaux was the chief departure port for sub-Saharan Africa and for South America). Hence the reference to "migrateurs." Occasionally the name migrateurs was used later, e.g., Wahl (1903). Foville's patients were men with delusions whose travels were rational, given their delusions. Their travels were not in the least aimless or compulsive. Foville's accounts did not suggest a new medical entity, a new way to be mad. A more immediately relevant discussion took place in the Societé MédicoPsychologique on 26 Oct. 1885. The occasion was a paper by A.-M.-P. Rouillard. He had just completed an unusually long dissertation on amnesia; see RS, 189. His paper described a case of amnesia, seizures, and identity confusion following upon head injury. A midwife had been called out at night. She fell down a tortuous flight of stairs, was unconscious for fifteen minutes, woke up in a very different frame of mind, but went off to deliver the baby. Later she had no memory of what she had done. That had little enough to do with what came to be called fugue. But in the discussion following the paper we learn of various tales of men with head injuries who wander. One eminent discussant, Auguste Motet, argued that he had seen a case of "fugue'' (the word he uses)

not preceded by head injury. Motet placed his own case in the category of vagrancy, saying that his patient had an "accès de vagabondage," as if one had "attacks" of vagrancy. Thus Tissié's 1887 title, Les Aliénés voyageurs, and his use of the word fugue were both patterned on the terminology of eminent men, Foville and Motet. Yet Tissié, listing all previous instances of fugues that he could find, using over half a century of primarily French medical writing, was self-consciously creating a new and generally applicable way of classifying some aberrant human behavior. That is why I date fugue as a medical entity the same entity whose criteria are given by the DSM and ICD-10 as 1887, with Tissié's thesis. 11. He grew up in the foothills of the Pyrenees, eldest child of two primary school teachers of ancient Huguenot lineage. This family background of persecution and respect for the Word must have contributed to Tissié's own success. 12. Owner: Messageries Maritimes, the principal steamship company operating out of Bordeaux, and whose chief trade was with Argentina. 13. Biographical details are from Thibault (1981, 1985). In 1981 Thibault wrote that Tissié was a

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"commis subrécargue," in 1985, "commis de l'intendance." For another biography, with a time line and numerous photographs, see Zoro (1986). 14. Tissié (1893), vii-viii. 15. Thibault (1972), 125. 16. In fact there was a short-lived journal called Le Vélocipède in Voiron in 1868 and another Le Vélocipède in Paris in 1869. I owe this information and much else that follows to a letter from Professor Chris Thompson of the University of Indiana; cf. Thompson (1997). 17. Tissié (1888, 1893). 18. For this and many other details, see Thibault (1981). 19. From an American account of the disagreements between Coubertin and Tissié, which I owe to Brian Pronger: "Tissié was dead set against what he saw as the excesses of competitive sport, the very elements of enthusiasm, liberty, and schoolboy association that Coubertin so vigorously endorsed. Their rivalry grew until by the early '90s they were implacable enemies, and when Coubertin again pleaded for athletic games at a conference of the French Association for the Advancement of Science at Caen in 1894, Tissié strenuously attacked him and carried the day. The conference resolved `to encourage physical exercise, but to make war on sports in school establishments'" (MacAloon 1981, 109). Tissié may have won this battle, but he lost the war. In addition to the references cited, see Gleyse (1995), a study in Foucaultian spirit titled Archéologie de l'éducation physique au XXe siècle en France: Le Corps occulté. The author regards Tissié as a "mutant," running counter to the course of history. 20. Grousset had been active in the Paris Commune of 1870-71, especially in its relations with the outside world. He was an avowed anarchist and got on well with the likes of Jules Verne, with whom he published extensive political exchanges, and Robert Louis Stevenson (he translated Treasure Island, which you can see as another travel fantasy). He was not in favor of importing British sport without qualification, only what was consistent with the French national spirit. I have not understood all of his proposals for the Frenchification of sport. Why did he think that in rowing, single sculls suit France, while eights were to be excluded as alien? 21. It stands at the head of the Esplanade des Quinconces, a great square, or rather rectangle, that runs down to the river Garonne. The Esplanade was created at the time of Napoleon by the destruction of a large castle that had served among other things as a prison. This was the Bordelais equivalent to the destruction of the Bastille. Thus the Monument des Girondins, commemorating the Bordelais moderates of 1789 and standing

face to face with the demolished "Bastille," was even more invested with historical meaning than meets the casual eye today. For more about the Esplanade, see Supplement 1. 22. Georges Boulanger (1837-1891) had made popular reforms in the army and could have ordered it to do anything. The far right and the far left, as well as Bonapartistes and monarchists, saw him as the man who would restore French glory in a coming war with Germany. His picture was everywhere; Boulangiste deputies could bring government to a halt. He himself was regularly run in by-elections, often several at a time (you could occupy only one seat, but you could run for as many as you wanted). His increasing success at the ballot box gave him something of a mandate. In January 1889 he was elected in Paris to the National Assembly by an overwhelming majority. The common story is that the night when he could have taken the Elysée he disappeared to spend time with his mistress. Boulangisme collapsed. By March 1889 the government was arranging a warrant for his arrest, but he fled to Belgium on 1 April. The man was formally exiled. Two months after his mistress died, he committed suicide in Belgium on her grave. How did Bordeaux stand in these affairs? The city itself had long been republican. Six of the

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eleven National Assemblymen elected in the Gironde Department in 1889 were Boulangists. The rural Boulangist vote came from the far right, with candidates who four years earlier had run as royalists or "imperialists" (viz., on the side of ex-Emperor Napoleon III). The urban Boulangists were leftish and included socialists; the city was sufficiently republican that republican solidarity was not enough to bind left-wing voters to one candidate (Desgraves and Depeux 1969, 330-32). The president of the Republic during the Boulangiste crisis was Sadi Carnot, who was assassinated by an anarchist in 1894. These facts may be irrelevant to psychiatry, but it is important to remind ourselves that the apolitical documents about Albert that are printed at the end of these lectures were written in troubled times. And Carnot did briefly cross Albert's path. As an act of nation building, the president of the Republic attended as many precentennial celebrations as he could. Albert not only saw his visit in Marseille in 1888 but also was able to restore a memory about Marseille by being reminded of Carnot. See Document 5. 23. Davezac (1891), 443. 24. Duponchel (1888), 12. 25. The shop of the photographer, Panajou, once on the rue Mazarin, still exists on what is now the major shopping promenade, no. 8 on the Allées de Tourny. The Panajou firm kept an archive, which would have had records of the work done for Pitres and others at the Saint-André Hospital, but, alas, all the old records were destroyed in a fire, apparently about 1945. 26. See my RS, chap. 13. 27. In published papers his name is given as Albert, Albert D, Albert X, or Albert Dad. His birth date is, however, stated in, for example, Tissié (1891), 8 ("Albert D . . ., né à Bordeaux, le 10 mars 1860, entre à l'hôpital, le 3 mai 1886, dans le service de M. le professeur Pitres"). French registers of births and marriages are a matter of public record. Hence the published information enabled us to locate the birth registry of Jean-Albert Dadas. The birth was recorded directly after 10 May, and indeed is the only "Dad" recorded within weeks after the known date of birth. This identification is confirmed by Tissié (1930), 108. In that short and sad piece, written at the end of Tissié's life, we continue to read of Albert Dad, but in the same paragraph Albert's daughter's name is given in full: Marguerite-Gabrielle Dadas. See Document 6. Medical records in France are restricted until 150 years after a patient's birth; in this case, until 2010. However, the archives for the Saint-André Hospital for 1794-1950 are missing and are said to have been destroyed in a flood. There appear to be no significant entries for Tissié's patient elsewhere in the restricted files.

28. Tissié said "devoted," but I call his behavior sentimental, self-indulgent, and maudlin. See AV, 81. 29. A law of 1801, which remained on the books well into the twentieth century, required that every Frenchman should have a passeport when he traveled outside of his own region. This law was seldom enforced, especially after 1850 or so, but lack of such a document could lead, among other things, to a technical arrest for vagrancy. Moreover, a man who had done military service had a livret which confirmed his service and stated the conditions under which he might be called up again in the event of a national mobilization or other crisis. Albert managed to lose his livret on one of his fugues from Saint-André, but when hypnotized recalled where he had left it, and also that he had used it to establish his identity when he pawned his watch another forgotten event recalled under hypnotism and confirmed at the pawnshop. As I report in Lecture 3, the French law on vagrancy was stringently overhauled in 1885, but Albert had made his major trips before then. 30. Tissié (1930), 106. 31. Janet (1907), 78. 32. Azam's grandfather had been one of the founders of the Bordeaux Society of Medicine and

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Surgery in 1798, his father had been admitted in 1815, and he himself in 1850. Locally he was a man of great influence, not only in medicine but also in working for the establishment of a university in Bordeaux, to say nothing of his contributions to viticulture, geography, and archaeology. He was also a connoisseur with a notable private collection of paintings, delftware, old clocks, and archaeological treasures (Laserre 1978). The Azam house is on a distinguished street, 14, rue Vitat-Carlos, close to what is now the exceptionally efficient and well-stocked Mollat Bookstore, a shop which, like almost everything in Bordeaux, seems be an eternal institution, even if it moved to larger premises. Mollat nourished Mauriac as a boy; see p. 20 of Mauriac (1925/1990). Tissié, on the other hand, lived on a respectable but less distinguished part of town, 6, rue Barada. 33. Azam (1893), 145-46. 34. Foveau de Courmelles (1890, 1891). 35. Readers of Breuer and Freud, Studies on Hysteria, will know that Breuer described Anna O., using the French words, as having a "condition second." That language of Breuer and Freud is taken from Azam. Even Azam did not originate it, and here is another twist that I mention in RS. The language of first and second states was invented to describe the most famous miracle-girl of the late 1870s, Louise Lateau, a Belgian peasant who went into a trance every Friday and developed the stigmata of Christ. In an official Belgian medical report about Louise Lateau, which Azam read just as he was trying to describe Félida, the neutral terminology of first and second states normal state and trance state is introduced. Thus Azam took his talk of first and second states from Louise Lateau, a canonical case of what he called "bizarreries de la mémoire." Terminology devised by positive science to describe a young woman widely believed to be a saint provided Tissié with a language in which to organize his observations of the unsanctimonious Albert, just as it provided Breuer and Freud with a language in which to organize their descriptions of Anna O. 36. Tissié (1896). Suppose a patient had a deep fear of something. During hypnosis a dream content with pleasant associations was suggested. To check whether the suggestion was working, a control suggestion was also made, e.g., take a drink of wine from that glass over there (it was empty; but on awakening, the patient drinks the emptiness and says, What good wine). In what Freud would have called the subsequent dream work during natural sleep, the suggested dream content works with other thoughts to get at the root of the fear and overcome it. But for a terrifying dream, showing that all was not well in the Dadas family, see Document 4. 37. For many such details, see Brendon (1991). Cook's tourists had begun to appear in

Europe as early as 1855. In 1868 the company provided hotel coupons, which were the first stage of the complete package tour. Business was booming by the time of the 1870 war, during which the company escorted the adventurous down the Rhine or to within half a mile of the Metz battlefield. But a majority had to be diverted to the Mediterranean, thereby massively expanding Cook's field of operations. After the war the tours expanded tenfold, and the company was becoming an arm of empire in India and the Levant. In 1884 it managed the supply system for the army sent to relieve Gordon in the Sudan. 38. The flâneur has recently become an obsession in literary theory, a curious confluence of Baudelaire and Walter Benjamin. See Buck-Morrs (1989). 39. "Regarde bien le port dans le petit matin; ici s'embarqua le jeune Baudelaire à bord du paquebot des mers du Sud. A l'un de ces balcons, auprès d'une bien-aimée, il connut les soirs voilés de vapeurs roses, et le profondeur de l'espace, la puissance du coeur, le parfum du sang" (Mauriac 1925/1990, 33). 40. Mallarmé (1994), 26. 41. Stevenson (1879/1988, 1883/1996).

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42. Although Albert could not write well and had not even learned to read well at school, he had learned to read passably during his stint in the army. As for French-language Baedekers, the complete regional Baedekers for France appeared too late for Albert to use them in his finest fugues: north of France, 1884; Midi, 1885; central France, 1889 (confirming what I said about the expansion of the tourist industry during that decade). But there were Baedekers for Paris, northern French towns, and itineraries to the frontiers by the late 1860s. We recall that Albert always wanted to go north and basically avoided the Midi except for his African tour. There were French Baedekers for Belgium and Holland as early as 1859, of Switzerland from 1852, of the regions of the Rhine much earlier, and for the whole of Germany, Austria, and bordering regions from 1860 on. Only Russia would have been impossible, as a French-language Baedeker did not appear until 1893. For full information on early Baedekers, see Hinrichsen (1979). 43. Montaigne (1983). 44. I owe this insight to an anonymous referee. 45. AV, 108. 46. Tissié's citation was: Du degré de compétence du médecin dans les questions judiciaires relatives aux aliénations mentales (Paris, 1830). 2. Hysteria or Epilepsy? 1. For fugue in Germany, see Supplement 3. In Russia, Godyzatskii (1898) served a function comparable to Schultze (1898) in Germany, drawing French cases to the attention of Russian doctors. Tschije (1900) followed suit. But then the German influence took over with, e.g., Berger (1902), Delov (1907), Beliaev (1907), Lasse (1911). Throughout, the primary concern appears to have been with desertion from the navy, especially after disgrace in the war with Japan in 1905. This was not fugue following a sea battle experience but fugue of demoralized sailors stuck in St. Petersburg. Thanks to Todd Foglesong and Jane Hacking with translation. 2. I say French quite deliberately. In America the diagnosis of neurasthenia, pioneered by Charles Beard in 1869, captured some of the symptom pool that in France was reserved for hysteria (Gosling 1987). That diagnosis was exported to France. Pierre Janet made a great division into hysteria, closely related to hypnosis, and psychasthénie, which, to put it crudely, picked up almost all the remaining mental disorders short of brain injury, epilepsy, and congenital idiocy. For the idea of a symptom pool, see Shorter (1992). 3. The encyclopedic metastudy of histories of hysteria is Micale (1995). 4. On the transformation of the idea of trauma from a physical, bodily wound or lesion

into one that was mental, spiritual, psychic, see my RS, chap. 13. 5. Temkin (1971) discusses the development of Hughlings Jackson's ideas, e.g., 337. See also Penfield (1941), 12. The extension of the concept of epilepsy has been amply confirmed by EEG. Thus from a standard textbook of neurology, Rowland (1989), 843: "People who have only dèja vu, forced thinking, illusions or distorted perceptions, feelings of floating or depersonalization, intense fear or depression . . . may be EEG epileptic." 6. Morel (1860). The physician Erich Hoffman was making parallel suggestions in Germany at the same time. 7. Rowan and Rosenbaum (1991). 8. Charcot (1888), Lecture 9, 31 Jan. 1888, 155-69. For a complete English translation, with commentary and maps, see Goetz (1987), 26-54. Charcot first referred to the patient simple as M , later as Mén. Sous (1890), 28, calls him Mén . . . S., suggesting that the surname begins with S, but

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quotes a letter of Charcot's (p. 35), in which the man is referred to as Mén . . . Léon, suggesting the surname is in fact Mén . . ., with the first name Léon. Charcot says the man is thirty-five in some contexts and thirty-seven in others. Sous, p. 29, gives the age in 1888 as thirty-seven. Charcot briefly discussed two other fugueurs as well; they are summarized in Ellenberger (1970), 124-25. 9. Automatisme had been a French word since the beginning of the nineteenth century, used, for example, to refer to the Cartesian view that animals, unlike people, are machines. The word had gained medical currency in both French and English for involuntary activity. Charcot's argument for epilepsy went as follows: "An individual has a fit and in the aftermath, in the midst of postictal nightmares, becomes violent and breaks everything about him. Afterward he begins to walk about, and this is not a quiet stroll. At the first incident the police will nab him and he will awaken in the police station. These epileptics can kill people and even commit suicide, whereas our patient here probably would not have jumped into the water if he did not already know how to swim. In his case there is no evidence of hyperexcitability or violence. . . . Nevertheless the behavioral changes of these patients . . . are probably the same phenomena under different guises." The misplaced fear of widespread carnage caused by epileptics in a state of automatism is reflected, for example, in an editorial in the British Medical Journal for 1886: "Automatic Homicide." To support his case Charcot related colorful examples of epileptic behavior and latent epilepsy. Some were taken from Hughlings Jackson. There is the story of the music teacher who gave a lesson and then undressed in front of his pupil, "probably a female," without having any other seizure or any memory afterward of what he had done. By this rhetoric the doctrine of epileptic equivalents was firmly planted in the mind of the audience. 10. This is not a case of traumatic (physical trauma) amnesia or male hysteria induced by physical trauma. It can't be real sleepwalking, for real sleepwalkers walk with their eyes shut. It can't be provoked somnambulism (hypnotism). Today, "somnambulism" means sleepwalking, but throughout the nineteenth century it was the general name for a wide range of unconscious acts. There were different types of somnambulism. "Provoked" and "artificial" somnambulism were common names for hypnotic trance. ''Spontaneous somnambulism" included cases that look like what we now call multiple personality. Azam once said that his Félida was a case of "total somnambulism," which meant that in her second state she had all the faculties she had in her normal state, and he thought that Albert, in his fugue state, was also afflicted by total somnambulism. There was a substantial revival of somnambulism talk in the 1880s, coinciding with the resurgence of highbrow interest in hypnotism. Could Mén's problem be spontaneous somnambulism, a hysterical phenomenon? No, because hysterical somnambulists are always very agitated,

while Mén was calm. This last point is more rhetoric than argument. Azam's well-known Félida had ample hysterical symptoms, but in later years she was far from agitated in her second state. She had so well mastered her troubles that when she was working as a seamstress and felt a switch coming on, she would quickly write down the work at hand, so that she would waste no time when she woke up with no memory of what she had just been doing. 11. Temkin (1971), 299. 12. Certainly among doctors who had been trained by Charcot. I have found just this dosage in numerous articles by Raymond, Pitres, Babinski, et al. 13. Sous (1890), 35, reproduces a model certificate from Charcot, dated 4 Feb. 1889. 14. Charcot (1889a), Lecture 14. This is dated 21 Feb., which was a Thursday; there are other indications that the lecture was held on the regular Tuesday, and 21 is perhaps a misprint for 12 Feb. Charcot also briefly took up the case on 5 March. The next Monday, 11 March, Mén was discussed, from a forensic point of view, at the meeting of the Societé de Médecine Légale. Gilles de La

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Tourette (1889) said how disgraceful it was that Mén could have been kept in prison so long in a town with a major hospital and doctors. The ensuing discussion concerned the certificate of ambulatory automatism. Exactly who would have the power to act on it? It is not the job of the police to release a prisoner on such evidence. That must be left to the prosecutor or juge d'instruction. One member of the audience asked, who is to take responsibility for calling him in? The buck ends where? Another asks what sanction does Gilles propose on a police officer or prison warden who does not bring in the magistrate? Gilles was a confirmed Charcotian, convinced that ambulatory automatism was epileptic in character; see, for example, a case in which a deserter is exculpated, Fournier, Kohne, and Gilles de La Tourette (1895). 15. Charcot (1889b), 275-76, on p. 276. This is the first, hasty, version of his lecture, in notes taken down by a student in the audience. 16. Sous (1890). The thesis director was Brouardel, dean of the Faculty of Medicine in Paris. The information on the fugues was largely due to a Dr. Dutil. 17. See his "Second Thoughts on Paradigms," in Kuhn (1977). It is useful to have two words, paradigm for the initiating model of a disorder and prototype for the characteristic and typical example of a patient once the disorder has become an established diagnosis. I used the concept of a prototype, taken from psycholinguistics, in RS, chap. 2. 18. Duponchel (1888), 7. 19. A summary of French cases was published in Filipi (1889), with Duponchel given precedence over Charcot. Then came cases of determinismo ambulatorio, e.g., Verga (1891), Funaioli (1893). Aveta (1892) and Ferrarini (1893) follow Charcot. 20. Charcot (1889b). This is based on notes of the lecture; the notetaker spells Tissié as "Tessier." 21. Kuhn's final versions of this idea will be published posthumously. For a version of work in progress, see his "Afterwords" in Horwich (1993) and my own version of that version, "Working in a New World: The Taxonomic Solution," in Horwich (1993), 275310. 22. Alcindor and Maurat (1889), 253. The two doctors listed their forty-six-year-old male patient's list of hysterical symptoms: restriction of visual field, impairment of taste, cutaneous anesthesia symptoms similar to hemianesthesia. It looks like a bit of overkill. But then the man also had a severe case of the shakes and a history of convulsions, so it had to be shown that the fugue was not epileptic in nature. He came to the clinic after two fugues, one of three days, one of six, of which he had little memory. He presented severe

trembling and great difficulty in speaking. He was in from 25 Oct. 1888 to 10 Jan. 1889, when these symptoms had largely disappeared. The authors concluded that even if the man were epileptic, his immediate problem was hysteria. One has doubts about the diagnosis, for the patient had worked most of his life silvering mirrors. The trembling and speech impairment, the authors noted, are characteristic of mercury poisoning, but they dismissed this because the symptoms worsened after he had ceased handling mercury. 23. Voisin (1889b), 424. Despite the woman's amply hysterical symptoms, Voisin had to establish that she was not epileptic, for example, by noting that although the patient was calmed by amyl nitrate, bromides had no effect. The father of this patient died a month after her first menses, which occurred when she was seventeen. She underwent a period of great anger and did not menstruate again for eight months. After that "she experienced her nervous symptoms for the first time, crises of suffocation, the sensation of a ball rising in her throat and stifling her [the classic hysterical `globus']. Spasmodic nervous cough, in addition, a generally precarious state, great sadness, anorexia, and almost complete insomnia." As she grew older, the suffocation incidents disappeared and were replaced by "feelings of pain in the ovarian region."

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24. Tissié was in the audience and felt a bit upstaged. He is quoted in the discussion following the paper; see Jules Voisin (1889b), also (1889a): "M. Tissié (of Bordeaux). I beg to recall that the description of hysterical fugues is to be found in my thesis Les Aliénés voyageurs. One finds there a very interesting observation of hysteria with fugues in an unconscious state." Tissié (1891) gave two talks to the same congress. One was about Albert Dadas, and it included a rather dull table for differential diagnosis, doing little more than remarking differences between Dadas and Mén. Much later he was to say that the very name "ambulatory automatism" was a confusing mistake (Tissié 1901, 11). 25. Charcot and the Paris school of hypnotism had maintained that hypnotism involved neurological changes in the patients and went through three stages, named lethargic, cataleptic, and somnambulistic. Many of the quite well known photographs of Charcot's hypnotized patients were intended to dramatize these three stages. The rival view was the Nancy school, led by Hippolyte Bernheim, who maintained that there was a mere continuum, that the central feature of hypnotism was the suggestion of ideas, and that one did not get Charcot's phenomena with hypnotism unless one explicitly suggested them to the subject. 26. The crowd on the platform of the Eiffel Tower included Hippolyte Bernheim and Jules Liégois from Nancy, Alfred Binet, once of multiple personality fame but later of IQ fame, René Bertrand, Joseph Delboeuf from Belgium, Augustin Forel from Switzerland, Francis Galton, W.H. Myers, Henry Sidgwick from Britain and best of all, William James. No mean gathering but no Charcot. (He was slated to preside over yet another international congress, of physiological psychology, but Théodule Ribot had to replace him.) I do not know if James listed everyone at the party on the Eiffel Tower; if he did it was a truly select group. Joseph Babinski, Max Dessoir, and Sigmund Freud were also at the conference. The honorary presidents were Azam, Eduoard Brown-Sequard, Brouardel, Charcot, Mesnet, Charles Richet, and Cesare Lombroso, the celebrated Italian advocate of "criminal anthropology." The Premier Congrès Internationale de l'Hypnotisme et Thérapeutique, 8-12 Aug. 1889, was discussed in passing by William James (1889); see James (1983), 243-46, 410. The proceedings are Bérillon (1890). Events are described in some detail in Ellenberger (1970), 759-62. An affair with a very different clientele was the International Magnetic Congress for the Study and Application of Human Magnetism to the Relief and Care of the Sick, held 2126 Oct. For an account of both congresses from the vice-president of the latter, see Foveau de Courmelles (1891), 61-69. Foveau, a physician-hypnotist, thought that the magnetism congress was the important one, but to modern eyes it seems even battier than the hypnotism congress. 27. Saint-Aubin (1890).

28. See my RS, chap. 12. 29. Saint-Aubin ran through a roster of Voisin's cases; they were plainly hysterical. In addition to Voisin's first announced case, the charwoman described in the text, two more were characteristic female hysterics, with laughing and crying fits, partial anesthesias, already patients in hospital, who take off for a few hours and have no memory of the event, not even under hypnosis. The five men also had histories of hysterical symptoms, analgesia on one side of the body, and so forth. These were not male hysterias produced by trauma, that is, they did not conform to Charcot's paradigm. In summary, after Louis Vivet, the five men were aged from thirty-two to fourteen. The hysteria usually began at age twenty or so. The men had partial anesthesia and a restricted field of vision. One came to the hospital diagnosed as epileptic, but the diagnosis was replaced by hysteria. Another had convulsions. None were treated with bromides; all responded well to hypnotism. 30. Four of Saint-Aubin's cases were described as having double personality, because they assumed an alternative personality, usually aggressive, during their fugue episodes. Recall that we are

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also in the middle of the multiple personality epidemic. Boeteau (1892) described more multiple personality fugueurs. 31. Saint-Aubin (1890), 58. 32. Sous defended his thesis on 24 July 1890; Sous (1890). On 27 June, Sous's teacher Chantemesse had presented a new case of automatisme comitial [viz., epileptic] ambulatoire to the Societé Médicale des Hôpitaux. In the discussion Duponchel, the military doctor who had examined Albert, ignored the implications of epilepsy. Instead he remarked that Chantemesse's patient was in the army and made a plea that knowledge of such déterminisme ambulatoire (as he quietly redescribed the case this was the very name he had coined to contrast with epileptic automatisme ambulatoire) should be as widely disseminated as possible to courts-martial and to doctors and lawyers who advised the army in order that deserters should not be penalized for a mental disorder. Sous in his thesis described the case in great detail, but began with a systematic account of latent epilepsy and took a whole series of cases from Legrand du Saulle (1877). 33. The epileptic diagnosis was not privy to the Salpêtrière and its environs. In Reims there was a case supposedly analogous to Charcot's. The man, aged twenty-five, who worked in a brasserie, took many inexplicable and unremembered trips. He passed unnoticed until one day he urinated against a tree and then returned to his relatives without doing up his fly. He was arrested on grounds of indecency, and the stories of his fugues gradually emerged (Colleville 1891). He was fined, but the doctors held him not to be responsible for his indecent act (Colleville 1892). A Lyon thesis by Henry Frenkel (1890) had three new cases. There was another female fugueur, a cook aged twenty-five who had seven fugues in the course of ten years, mostly very short but one of thirty-six hours. She was completely amnesic for all of these. The other two were men who took long flights of up to a fortnight. Frenkel diagnosed all three as epileptic. Other Lyon theses were less enthusiastic about epilepsy, e.g., Denommé (1894). There was also the nagging fear that epileptics gave way to irresistible impulses, which might go as far as serious crime. For a general study of such impulses, see Parant (1895). 34. Preface to A. Proust (1890a), 107. 35. Ibid., 108. 36. Emile had been treated at the Charité Hospital. The hospital physician in attendance was J. Luys, one of the most bizarre medical hypnotizers of the epoch. He transferred illnesses from one person to another by the use of magnets. See my RS, 172-73, and Gauld (1992), 332-36. Luys provided Dr. Proust with Emile's clinical background. Luys

(1890b), 366, was himself to insist that the fugue was merely an incident and not the disorder itself. Instead one should say that such individuals enter "what I call, after Brémond, a state of fascination, characterized by three cardinal symptoms: (1) anesthesia, (2) catalepsy, (3) suggestibility." Luys had written papers on "fascination," one of which ends with amazing photographs of a group of two men and six women ''fascinés en catalepsie." Luys (1890b) ends with a little verbal duel. Ballet was one of the two expert witnesses at Emile's second trial: "Mr. Ballet I see no difference between what Mr. Luys calls state of fascination and what, for the past ten years or so, everyone has been calling catalepsy. He gives us a new word but not, I think, a new idea. "Mr. Luys Suggestibility is not at all a part of the cataleptic state. You cannot give a suggestion to the true cataleptic for the simple reason that he can't hear, and if he can hear he is not a cataleptic. For me that is an absolute truth, beyond discussion, like a dogma. "Mr. Ballet The moment that Mr. Luys draws behind dogma, I have nothing to reply: but for our colleagues I will recall in two words that the cataleptic state reduces to this: Wide open eyes,

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insensibility, and suggestibility. Now, from the symptomatic point of view, I persist in not seeing any difference between that state and what Mr. Luys calls the state of fascination." 37. Ellenberger (1970), 167. 38. Marcel Proust, A la récherche du temps perdu, Pléiade ed., 3 vols. (Paris: Gallimard, 1954), 3:716, trans. by Stephen Hudson as Time Regained, vol. 12 of the Uniform Edition (London: Chatto and Windus), 25. I have, however, rendered Proust's "dédoublements de la personnalité" not as Hudson's "duplications" but as "doublings," both French and English being derived from the original English medical label of double consciousness. "Scamp" is Hudson's somewhat old-fashioned rendering of gredin, a minor malefactor, which fits the historical Emile, who in real life was charged, on his first arrest, with filouterie and, on his second, with escroquerie, both being kinds of fraud or swindling. 39. Here I have to exclude the notorious Louis Vivet, originally diagnosed as a multiple, but whom Voisin conscripted as a fugueur. In at least one of his states, Vivet stole and stole and stole. What he most liked stealing was clothing. 40. Pitres (1891). 41. Géhin (1892), 11. Among related Bordeaux theses, see Laurent (1892). 42. Semelaigne (1894). For an example of such a case, see the 1880 German case discussed at the beginning of Supplement 3. 43. Raymond (1895). The published version is a set of notes of two lectures taken by Pierre Janet. This was standard practice. The great man lectures, and a more junior man transcribes. Since these lectures are mentioned by Henri Ellenberger (1970), modern writers on dissociative or psychogenic fugue, such as Loewenstein (1987), have occasionally referred to this piece. Since Janet is their adoptive father figure, they cite it as "Janet and Raymond 1895." Ellenberger (1970), 124-26, had a decisive influence on recent psychiatric histories of fugue. For example, Proust (1890) is, as indicated above, discussed by Ellenberger, but since Ellenberger did not mention the point of Proust's paper, namely hysterical fugue, Proust does not occur in the recent surveys of fugue. Conversely Ellenberger, a Swiss émigré, was especially knowledgeable about Swiss doctors and their patients. Hence he cites Naef (1895) on pages 125-26 as a case of fugue, so Naef's paper has made it into the bibliographies. Naef did indeed describe a mad traveler, but he wrote the paper in German Switzerland; he was a junior of Forel's at the Burghölzli, in Zürich, the patient's home when he was not lost in Australia. Since fugue had not yet hit the Germanlanguage literature, Naef did not diagnose his patient with fugue. It was Ellenberger, in

1970, who made the diagnosis, and this has been continued in recent surveys. An amusing example of Ellenberger's influence is the way in which the horrible tale of Sörgel has crept into thefugue bibliographies. Sörgel was an epileptic worthy of Georg Büchner. In 1828 he entered a forest in a deranged state and met a woodcutter. He murdered him, cut off his feet, and drank his blood. Later he had no recollection of the events and was found not responsible by the court. This is the case with which Ellenberger starts his section on ambulatory automatism, so Sörgel is to be found in the recent fugue bibliographies. It is true that he killed the woodcutter while walking in a confused state, but he is hardly the canonical case of ambulatory automatism in which the epilepsy is "latent," and the traveling is a "psychic equivalent." During a period of 125 years before Ellenberger filed him under ambulatory automatism, Sörgel was regularly cited as a case of multiple personality. Why on earth? There is, as usual, a definite answer. The case was written up by the eminent jurist Paul Feuerbach (1775-1833) in a volume of famous criminal trials. (Paul Feuerbach, father of Ludwig, the philosopher, is well known as the author of the story of the wolf-boy, Kaspar Hauser.) This book was translated into English by Lady

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Duff Gordon (1846) and had a momentary popular success in London and New York. It was read by the notable London physician-hypnotist John Elliotson. He wrote up the story (without acknowledgment) in the very same year as one of four "Instances of Double States of Consciousness Independent of Mesmerism" (1846-47). Why? Because then, as now, skeptics said that double consciousness (multiple personality) was induced by clinicians and mesmerism (hypnotism). Elliotson grasped for every straw and found Sörgel in the sensational literature of the day. Thus Sörgel entered the bibliographies of multiple personality in consequence of a rhetorical ploy and stayed there for well over a century. Merskey (1992) may have been the first in public to insist that the wretched man was to be diagnosed as epileptic, and that there was no ground for the attribution of multiple personality. 44. Pitres (1891), 2:269. 45. Ibid., 507-11. Here is a twenty-seven-year-old assistant in the family dry goods shop, with a history of eight fugues starting at the age of ten. He is perfectly conscious, has no amnesia, but, in a word, runs away compulsively, on the last occasion for up to six weeks. He takes no care of himself but eats enough to get by; he is never thirsty or footsore despite his long walks. He has no hallucinations, but once he thought he heard his father scolding him when he was on the high road. He recalled everyone he had talked to, he neither stole nor had traffic with women, and he did not masturbate more than usual when on one of his escapades. Treatment: hydrotherapy, plus 2 grams of sodium bromide daily, administered as a tranquilizer rather than neuroleptic. 46. Régis's published work on fugue began with an 1893 study of "hysterical ambulatory automatism," not in a man but a woman, a very interesting older woman who was trying to deal with the imprisonment of her daughter (Régis 1893a, b). I am not sure when the name dromomanie was made up. One of Régis's own students used it in the title of his thesis: De la dromomanie des dégénérés, Dubourdieu (1894), which was the topic of Régis (1895). Pitres and Régis used the term in their talk, "Le Vagabondage pathologique," to the 1895 Congrès de Médecine Mentale, held in Bordeaux. Régis's brief explanation of dromomania was "impulsions à la fugue." Bordeaux was opening its eyes to all kinds of fugue, for example, fugue in general paralysis (Berger 1895). 47. Pitres and Régis (1902). For dromomania, see p. 338. Dromomania was not the only new diagnosis to emerge from Bordeaux. Roth (1991) argues that the core concern of a whole range of disorders was memory and to the usual roster adds hypermnésie, or excess of memory. He cites another of Régis's Bordeaux students, Albert Guillon, whose thesis (1897) was titled Les Maladies de la mémoire: Essai sur les hypermnésies. For earlier discussion of hypermnésie, see Foveau de Courmelles (1890), 108f., citing observations by Charles Richet, Binet and Féré, and Charcot on various hysterical and

hypnotized individuals with unusual memories. In this discussion we find the need to which Roth drew attention, the need to get the memory just right. "To maintain the equilibrium of the organism, it is not advisable to over-excite any particular part of the brain." 48. Including a ten-year-old boy, a sort of Tom Sawyer. His mother even makes him wear girl's clothes to stop him running away to the country, without much success; when in the hospital an older boy tells him of the joys of sleeping under the bridges of Paris, off he goes. 49. Lucas-Championnière (1895) states it as the key difference when reporting Raymond. 50. There were holdouts, of course. A doctor in Lille insisted that all fugues, especially those of Tissié's original Albert, were epileptic equivalents. An anonymous reviewer thought that although there was some plausibility for the idea, "the thesis of this author does not seem to us to be free of objections, especially for the cases under discussion" (Dezwarte 1898, reviewed in Annales Médico-Psychologiques 2 [1898]: 465). 51. Taylor (1982).

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52. I first heard that tag from Elaine Showalter, but she tells me that she does not think she invented it. 53. Patrick (1907), 385. 54. Any such statement deserves a counterexample. We get one from the Bordeaux region itself, although the case was classified as epileptic (Cabadé 1895). This case was summarized by Lucas-Championnière (1895). The summary produced a letter describing another farmer who fugued (Gigard 1895). 3. Niches 1. Mörike (1972). The name Peregrina itself is a wonderful choice for a woman who falls prey to compulsive fugues. Not a German word, but from the Latin peregrinari, to travel. 2. There is Antiope, whose two sons murdered one of Dionysius's followers; she paid the price, wandering all over Greece until she is cured by one Phocus. There is Io, a lovely young woman driven mad by Hera who wanders aimlessly to Egypt under the delusion that she is a cow. She is well known, having been written up by Aeschylus and Ovid. Nearly all the mad travelers are women. Why? Plutarch has a counterexample in On Rivers (21). In the temple of Diana, King Teuthras kills a boar nursed by Diana herself. Diana wishes on him madness and a dreadful skin disease. He too consults a professional, Polydius. Different versions describe different treatments. Robert Graves (1955, 2:189) favored a reading in which Polydius used a powder made from a certain rock. Other stories say that ritual did the trick. Why not have both talk and rock, as in a present-day psychiatric cure? 3. Stuart Edgar directed me to this story. There are many versions. My quotation is from Apollodorus, The Library 2.2.1-2, in the translation of Frazer (1921), 1:147. Cf. The Library 1.9.12, 3.5.2. You will find versions of the story in Herodotus, Histories, 2.49ff.; Pausanius, Description of Greece, 2.18.4, 5.5.5-10, and 8.18.6; also in Hesiod's Catalogues of Women, Virgil's Eclogues, Ovid's Metamorphoses, etc. On the basis of this story alone, one could not claim that wandering was a kind of madness only that some women were driven mad by offending Dionysius or Hera. But the immense proliferation of such stories, barely hinted at in note 2, vindicates the claim that this is no mere instance of insanity but a type of insanity. 4. Throughout the stories there is a strong association with Dionysius and thereby, among other things, with wine. The river Clitor was widely associated with an ability to cure alcoholism. Given the exaggeration, this tale could serve as a trope for hysterical fugue. After Melampus was turned down the first time, the mad traveling becomes an epidemic, many women taking after the three sisters. There were somatoform ailments just as in the

nineteenth century, in this case, an unbearably itchy, dry, scaly skin. In several versions of the story the sisters take themselves to be cows, mad cows even, who eat their own children. Compare the more recent European disease called lycanthropy, a form of madness in which a person believes himself to be an animal, especially but not necessarily a wolf, and acts accordingly. Lycanthropy was named in the seventeenth century. Outbreaks of it persisted until at least the mid-1800s. 5. Frazer (1921), 1:147. 6. After the passage quoted, Frazer cited Evans (1920), 27. Evans provided only one paragraph on this phenomenon, which begins, "A curious complaint was made to the Penghulu of Pianggu, in my presence, by a Jakun man from the Anak Endau. He stated that all the women of his settlement were frequently seized by a kind of madness," etc., as in the text. The location was Pahang, one of the Federated States of Malaya on the eastern seaboard of the peninsula. Its history includes a tale worthy of Homer, in which the late fifteenth-century Malaccan Hang Tuah abducts the daughter of

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the ruler of Pahang for the sultan of Malacca. Before then the land had been ruled by Siam. When in 1511 the Portuguese conquered Malacca, the sultan fled to Pahang and is supposed to have founded the ruling house extant in 1920. The region was racked by civil war for much of the nineteenth century. Pahang finally agreed to join the Britishrun Federation of Malay States in 1895. In short, European colonization had only just begun, and the region was only beginning to be exploited for tin and rubber. The population was small, perhaps 120,000. The Penghulu would be a Malay man responsible for a village of aboriginal Jakun. The Endau is a river running into the China Sea, and the Anak Endau is a tributary. Hardly any Europeans had ever been as far upriver as Evans. One has great caution about a report about Jakun women by a Jakun man to a Malay man who is his superior, in the presence of a British observer. 7. Gilles de La Tourette (1884, 1885). 8. Shapiro and Shapiro (1982). 9. Simons (1996); Kenny (1978, 1990) and a number of papers between those two. Here, incidentally we complete one small circle, for Kenny also wrote the in-depth study of the classic American fugueur Ansel Bourne (Kenny 1986). For full historical and anthropological background on latah, see Winzeler (1995). 10. Neki (1973). I am not arguing that the behavior of the Jakun women was (or was not) their version of latah, or fugue; I am only tracing a natural association of ideas. 11. Deserts become jungles, in this transposition, a new ecology, without metaphor. Is it an accident that the standard example of non-European lycanthropy occurs in the Malay Peninsula? With lycanthropy we have epidemics of men turning into wolves, or sometimes bears, and attacking lost strangers, even to the point of eating them. Malays turn into jaguars. The multiple personality experts take both to be a case of animal alters. 12. I owe the example to Professor George Secada of the University of Virginia. 13. Chorover (1980), 16f. The commission was chaired by the most distinguished Louisiana physician of the day, Samuel Cartwright. I owe this observation to Joseph E. Davis of the University of Virginia. Drapetomania sounds a bit like the "dromomania" of Lecture 2, does it not? At least one thoughtful reader conflated the two, thinking that the name "dromomania" was invented not by Régis but in the American South. 14. One American summary was Charcot (1888b). An English one was "A Correspondent" (1889). In the light of an American review of Charcot's second lecture, Starr (1889) presented a new American epileptic fugueur. It was not a strictly Charcotian case, for there was some history of epilepsy. Even in connection with this case the author wrote, "I have no doubt that others have seen similar cases, though I cannot but believe

that they are very rare." He added that the only other candidate patient he had seen turned out to be malingering. Even true epileptic fugues were not encouraged in the United States. In Britain, Colman (1903) had a case of automatic wandering lasting five days, which was taken to be very similar to Charcot's Mén. Bramwell (1908) described postepileptic automatism. An Irish instance was observed in 1908, though published only later (Lindsay 1915). Stewart (1910), 355, described a nine-year-old boy who fell from a tree, just as Albert had done, and began to go on fugues thereafter. The tentative diagnosis was epilepsy caused by brain damage. 15. James (1890), 1:390-93; Hodgeson (1891). For James's notes on interviewing Bourne, see James (1983), 269. A brilliant modern recounting is found in Kenny (1986). 16. Tissié (1901), 25, when he learned about Ansel Bourne, saw a fugueur. He was glad to take him as a counterexample to Charcot's implication that a fugueur was an automat, unaware of what he was doing. John Brown was well aware of how to conduct his business, but he was in a "second

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state." The most important French scientist concerned both with spiritism and multiple personality was the Nobel Prize winner Charles Richet. See Hacking (1988) and Carroy (1996). 17. Drewry (1896). There was "eccentricity" in the family. An uncle had taken off, suddenly and inexplicably, for California. When he did finally get home, the man had an abscess deep in the ear canal which, when pierced, was followed by rapid improvement in physical and mental health. Both these facts were taken to be causally significant to the case history of Drewry's patient. 18. Gilbert (1902). One fugue took a man through Nashville, Tennessee; Henderson, Kentucky; St. Louis, Jefferson City, and Kansas City, Missouri; Liberty, Kansas; Red Cloud and Oxford, Nebraska. On another trip he went from Glenrock, Wyoming, to Chadron, Nebraska; to Edgemont, South Dakota; to Cheyenne, Wyoming; to Denver, Colorado; to San Francisco, California; and to Portland, Oregon. In Portland he had an accident while working on a log boom. When he came to, he was told he was in Portland. Knowing of the existence of his past habit of unconscious travel, he had to ask, Portland, Maine, or Portland, Oregon? Only by hypnosis was his itinerary unraveled. 19. Trowbridge (1891). 20. A large number of fictional multiples are mentioned in the course of my RS. They run from Heinrich von Kleist's 1807 Pentilisea to 1995, but of course there are more now. I also cited several detailed studies of the double in fiction. On the explicit relation between fact and fiction in multiplicity, see Carroy (1993). 21. Micale (1995), 179-220. 22. Tissié alludes to a novel by Jules Claretie serialized (with glorious illustrations by Macchiati) in seven installments (1905) as Moi et l'autre and published as a book (1908) as Obsession Moi et l'autre. Apparently Tissié thought this story originated with the true story of Albert, but the plot revolves around the classic multiple personality of André Fortis, the fashionable young painter of poetic landscapes. Only his demimondaine bride knows of his two states or even sees the macabre painting by the Autre, a sort of apocalypse now. This is illustrated in Claretie (1905), 249, "She stood in front of it, stupefied," and more vividly described on p. 251. I thought, after writing RS, that I was jaded by multomelodramas, but this is superb stuff and the most visually rich contribution to the entire genre. Finally Fortis is cured in the sixth installment by the great Alsatian alienist Dr. Klipper (of the Nancy school of Hippolyte Bernheim?) who suggests that the vile Autre be killed and interred by the genteel Moi. Claretie, director of the Théâtre Français, wrote very successful psychonovels and became an Academician. He regularly attended Charcot's events, describing one of them in Claretie (1881): at a

patient's ball in the Salpêtrière, a gong is accidentally sounded, whereupon dozens of patients fall into a hysterical trance. Claretie appears in the famous photograph of Charcot demonstrating Blanche Wittman. 23. David Jorawsky drew my attention to this passage in Schnitzler (1926/1990), 139. This is a truly eerie work, which feels to me like James's Turn of the Screw, but in a quite different key. 24. Courtney (1906). The paper is not entirely negligible, for it does conclude with an argument taken from Heilbronner (1903), that we should not look at fugues as incidents demanding diagnosis in themselves but as incidents in "the habitual condition of the patient" (p. 124). 25. Patrick (1907), 355. On page 367 Patrick describes an encounter with Albert Dadas in 1894, in the ward of Dr. Ballet at the Charité Hospital in Paris. Fisher (1907) is a far briefer discussion of criteria for distinguishing between hysterical and epileptic automatism. For later American discussions, see Powers (1917-18). 26. Angell (1906). Henry Rowlands was engaged to be married. He could not take the stress and went on several fugues, with a slightly altered surname. It is a little hard to be sure where he went,

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because his doctor had reason to think he made up some of his travels. He did go to Toronto and probably north to logging in the Temagami wilderness. He claimed to have enrolled as a medical student at McGill University in Montreal (which has no record of him) and to have gone as far west as Winnipeg, Manitoba, where he says he entered a hospital (where no trace of him has been found). It is fitting that his rooming house in Toronto is now the site of the transcontinental bus station. Neither fugue nor ambulatory automatism was mentioned in Angell's article. Another case published in Morton Prince's journal was Fox (1909), described as "dissociated personality, accompanied by the presence of somnambulistic states and ambulatory automatism." Once again, ambulatory automatism was not deemed to be the primary problem. 27. Frenchmen fantasized in boy's stories about canoeing and hunting adventures in Québec but did not actually go there. In fact the closest precursor for the French concept of fugue arose in Le Havre, the great transshipment port for the United States and the Far East. It was not Tissié who invented the elegant title Les Aliénés voyageurs but a doctor from Le Havre who published a paper in 1875, "Les Aliénés voyageurs, ou migrateurs." The mad travelers from Le Havre had problems different from Albert's, but they were, rather literally, men who missed the boat. But in 1875 we were explicitly cautioned against the idea that mad traveling was a specific type of mental illness (Foville 1875). 28. Audry (1956); Roué (1967); Verdoux, Goumilloux, and Bourgeois (1993). The nearest we get to a counterexample is one Jean-Pierre from the 1967 report. He had an eye injury and returned to his barracks to find his unit had left, perhaps overseas, though the report is unclear. He felt he had been betrayed, for he wanted action. His fugues were influenced precisely by the fact that he was stuck at home. He did try for some excitement. He sequestered a hand grenade. In a suburb of Bordeaux he accosted a wine broker from Libourne (one of Albert's nearby fugue sites) who was an amateur pilot. He demanded a flight, on pain of exploding the grenade, so off they went to a flying club and went up in a two-seater Jodel. The flight lasted a few minutes before Jean-Pierre asked to land; they put down in a little field in Médoc. 29. Pitres and Régis (1902), 338. It will be recalled that Alfred Binet (who first came to notice as an authority on multiple personality) was designing intelligence tests at the time Pitres and Régis published their book. His tests were modified by Lewis Terman and were applied, on a hitherto inconceivable scale, to U.S. draftees in 1917. 30. Ibid., 385-91. Another case, of an eighteen-year-old, p. 392: "Military desertion by impulsive fugues condemnation to four years of prison Delirious self-accusation of murder Hysterical degeneracy Mental examination followed by confinement to an insane

asylum." 31. See Nye (1984). On the medicalization of fugue, see esp. 173-79. Sometimes degeneracy could override the debate about whether a patient was hysterical or epileptic. See, for example, a case in which a deserter is exculpated on the grounds that his fugues were impulsive, and that his mother and father were cousins and the maternal grandparents suffered respectively from general paralysis and persecution mania (Fournier, Kohne, and Gilles de La Tourette 1895). 32. Davenport (1915), 7. 33. Ibid., 23. 34. Ibid., 26. 35. The patients are described as "nullements préparés," an anti-Charcotian dig (Colin 1889). Paul Garnier, the distinguished expert on forensic medicine and insanity, held sway at the Prefecture. Henri Colin was one of his interns. Soon afterward another doctor, Souques (1892), presented a dipsomaniac, not the "common alcoholic" but the "hereditary degenerate." He had several fugues when he was sober, but in each case after a catastrophic binge. Sabrazès and de Batz (1897) gave a

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case in which ambulatory automatism was a symptom of a brain tumor and was accompanied by what in horses is called stagger. 36. Donzelot (1979), 130. 37. Beaune (1987), 367, 63. 38. Beck (1902), 76. 39. Cullerre (1895): "un des villages les plus reculés du Bocage vendéen," p. 215. 40. Ibid., 226; "outlaws" in English and in italics. The doctor was especially shocked that André R. could carry on like this in "full middle age." 41. Nye (1984) suggests that there were two distinguishable waves of preoccupation with vagrancy, one leading up to 1885, when the vagrancy laws were amended, and a second at the very end of the century and continuing into the first decade of the next. 42. Benon and Froissart (1908), 305; for a subset of their publications, see their (1909a-e). 43. They did want to make a distinction between habitual and what they called accidental fugue. "We recall that for us the accidental character of the fugue seems to us to be the most important. It permits one to distinguish the fugue from vagabondage properly speaking, which in psychiatry is a habitual morbid character of the subject's activity. Fugueurs and vagabonds, or accidental fugueurs and habitual fugueurs, or occasional vagabonds and habitual vagabonds it matters little which term one adopts must, it seems to us, be kept separate. Without doubt one finds intermediaries between them, but does that justify the confusion?" (Benon and Froissart 1909b, 290f.; the paper was titled "Conditions sociales et individuelles de l'état de fugue") 44. The real hard line was apparent in an essay for a general readership in the Revue des Deux Mondes bearing the title, "Les Vagabonds criminels" (Fourquet 1899). A provincial graduate student could still state the line in 1906 (Pagnier 1906), but when he put it out in a book (Pagnier 1910), his work was panned in the main medical review by Dupouy (1910). 45. For symptom transfer, see Babinski (1887), Gauld (1992), 332-36, and my RS, 172f. For fugue, see Babinski (1899). 46. Babinski (1919, 1918). 47. "Oedipal" is not inapt, but a lot else was going on. As Charcot's influence waned, Babinski could not get an academic post. See Iragui (1986). 48. Micale (1993). One distinguished psychiatrist who thinks that there is a viable

diagnosis of hysteria from ancient times to the present is Harold Merskey (1995). For a different type of defense of the hysteria idea, in connection with psychosis, see Libbrecht (1995). 49. See Lecture 2, note 21. 50. Ducosté (1906, 1907). In his thesis (1899) he had rejected the doctrine that postseizure epileptic acts had to have lack of consciousness and subsequent amnesia. See the 1907 paper for his classification of the three types of fugues that he used in his thesis, a version shared alike by Pitres and Raymond, namely, impulsions épileptiques, hystériques, and neurasthéniques ou dégénérés. Another paper classifying fugues by different causes also included dementia praecox (Courbon 1907). 51. Merskey (1992) favors a bipolar diagnosis for many multiple personalities and would, I expect, say the same of a number of the hysterical fugueurs. 52. Wahl (1903), in the discussion section, p. 436. Wahl used Foville's old label of 1875, migrateurs. 53. Cotard (1909); Nadal (1910). 54. Parant (1909). A systematic fugue lasts a long time and is taken with deliberation, but there

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is always a delirious element. Dromomaniac fugues begin abruptly; the fugueur feels himself a passive witness to his journeys. Régis (who was in the audience) had coined the term dromomanie over fifteen years earlier and came to use it to cover impulsive fugues, be they hysterical, epileptic, or degenerate fugues, but he did not complain that tripartite breakdown of the dromomaniacs had been tacitly dropped. 55. Lalanne (1910). I have expressed Lalanne's word lypémanie by "depression." He directed the Maison de Santé de Castel d'Andor, which admitted about forty to fifty patients a year (1882-1919). His asylum had fewer cases, and less severe ones, than were admitted to the two public asylums in the neighborhood. André LeBlanc finds that the most common diagnoses at Castel d'Andor were general paresis, chronic melancholia, delusions of grandeur or of persecution, and senility. A substantial number of fugues was entered in the registers for individual patients, but fugue was never a diagnosis in itself. Lalanne's private record of the principal new case in his paper, one Victor B., does not tally with the published article fugue leaped into prominence only when Lalanne had to prepare a paper for a congress on fugue! It should be said that Lalanne kept up with current affairs, keeping substantial notes on both Janet and Freud. 56. Parant (1909), 1024. 57. Joffroy and Dupouy (1909). 58. Dupouy and Schiff (1925), 332. 59. Marchand (1933). 60. On depression, Claude, Santenoise, and Targowla (1923a, b). On children, Claude (1925). 61. In the discussion following Claude (1937). This passage is quoted in Libbrecht (1995), 148. Her message is: "The policy directive is clear, the study of hysteria is played out in favor of schizophrenia." My message is: Janet had long ago dumped dissociation as a valuable concept and thought of it as bearing a date stamp of 1892. But see Van der Hart (1996). 62. Janet (1919), 3:125. This passage is discussed in RS, 133f. 63. Every statement has to be qualified. There were inevitable carryovers into military, but not necessarily wartime, fugues. For French fugue in WW I, see Lecture 4, note 2. For peacetime military fugue in France, see note 3. 64. Grasset (1889). 65. Grasset (1905).

66. Grasset (1895-98), 137. 67. Grasset (1908). 68. Les petits pharmaciens, as the beekeeper writes on his honeypots. Henri was not especially gifted; it is still the easiest and most delightful of walks of a Sunday over the mountains to Spain for lunch and back on another track to France for dinner. 4. Five Questions, Five Answers 1. Loewenstein (1991), 189. 2. The most sustained attempt at differential diagnosis is Akhtar and Brenner (1979). Fisher (1945, 1947) described three types of fugue in American service during WW II, namely fugue with awareness of loss of personal identity, fugue with change of personal identity, and fugue without awareness of loss of identity but with retrograde amnesia. For WW II amnesia and fugue in the British North African campaign, see Torrie (1944), with an 8.6 percent incidence of "amnesia and fugue." For similar issues with Royal Air Force personnel, see Parfitt and Caryle-Gall (1944). For the emergence of post-traumatic stress disorder as a solution for the problems of Vietnam veterans and

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its subsequent extension to other trauma, see the detailed field work by the medical anthropologist Allan Young (1996). Fugue as a distinct diagnosis was not significant in the Veterans Administration hospitals that he studied. There are a number of reports of dissociative fugue in WW I, using prewar terms. Logre (1916), reporting to a medical association of the Fifth (French) Army in 1915, used the classification of Joffroy and Dupouy (1909). Chavigny and Laurens (1917) told of a young man who had fugues from the age of sixteen, who enlisted before war broke out, and had a series of fugues both "conscious and unconscious"; it was concluded that he had a mental illness incompatible with battle but not because battle had induced his fugue behavior, which had begun before the war. René Charpentier, who had been publishing on fugue since 1908, described repeated wartime desertion that he called "recidivist" and "paradoxical" (1919). In an Austrian paper wartime fugue was called krankhafter Wandertrieb (Pilcz 1920); in a German one simply Fugue (Popper 1920). A thorough study of these cases would require attention to the very different reactions to the war neuroses among French and German doctors. Very roughly, the French authorities tried to squelch all hysteria diagnoses and with them fugue, while German psychiatry was very open to a new understanding of mental illness in the light of wartime clinical experience. But fugue was not the way to go there, either, and only old-timers involved themselves with it. 3. Audry (1956); Roué (1967); Verdoux, Goumilloux, and Bourgeois (1993). Papers like these do not occur in the American searches because they are not in English. The 1993 paper, in a major journal, with fugue among the keywords, ought to turn up in the mindnumbing computerized literature searches and so be mechanically entered into bibliographies, but it seems to have eluded them so far. 4. Kopelman (1987). This author also mentions marital and financial difficulties or thoughts of suicide. McKinney and Lange (1983) describe a family pattern of fugue. Venn (1984) reports the case of a "family etiology" for psychogenic fugue, but the case seems better to fit a diagnosis of multiple personality. One (unretrievable) Internet communication of about 1993 noted that toward the end of the shakeout Thatcher years in Britain, a large number of minor British businessmen had just "disappeared." Many writers about fugue repeat the association of fugue with war more as a mantra than a hypothesis and take the association to confirm the traumatic etiology of fugue. Hence the sentence quoted from the next reference is salutary. 5. Steinberg (1995), 275. 6. Laughlin (1967), case 170. 7. RS, chap. 4.

8. One questioner thought I was a dichotomizer, addicted to pairs, because in the medical vector we had hysteria/epilepsy. That twoness is just a coincidence, having nothing to do with cultural polarity. Note that unlike fugue in 1890, multiple personality in 1980 was fitted into a single taxonomy, the somewhat artificial category of dissociation. 9. Micale (1995), chap. 9. 10. Essentially half of one series of thirty-seven fugueurs had a history of previous head injury, loss of consciousness, and some postaccident amnesia (Berrington et al. 1956). For an earlier series of thirty-six fugueurs, see Stengel (1939, 1941, 1943). For a wellinformed no-nonsense guide to head injury, intended for patients, families, friends, and caregivers, see Gronwall, Wrightson, and Waddell (1990). See also Ellis and Christensen (1989). The two chief English-language journals in the field are the Journal of Head Trauma Rehabilitation (founded 1985) and Brain Injury (founded 1986). For an early twentieth-century case of head injury with fugue, see Sturgis (1912). 11. Showalter (1997), 3.

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12. For a popular survey of the symbiosis between Christianity, cruelty, and the devil, see Stanford (1996). 13. For classic twin studies, see Gottesman (1972). I.I. Gottesman has for many years been a consistent exponent of the doctrine that schizophrenia is genetic, and that twin studies suffice to establish that (Gottesman 1982). 14. In ''How to Make Our Ideas Clear," 1878, in Peirce (1986), 3:273. 15. Cf. my RS, 11, and my (1983), chap. 3. 16. Putnam (1994), 452. 17. Borch-Jakobsen (1997). The material is not particularly new. Previous interviews with Spiegel are briefly discussed in my RS, 124. 18. Borch-Jacobsen (1995). See also Supplement 1 below. 19. To be published by Harvard University Press in 1999. Supplement 1. What Ailed Albert? 1. Mauriac (1925/1990), 9, 31. 2. Ibid., 17. 3. Victor Louis's theater was opened on 7 April 1780, after vast cost overruns. The Bourse was built under the direction of Jacques-Ange Gabriel in 1748-50, according to the plans of his father, Jean-Jacques. My favorite picture and art history book of the official, proper, Bordeaux is Saunier (1909). It well represents the grand world of Bordeaux on which Albert and Mauriac turned their backs. Avisseau (n.d.) is a collection of some hundred postcards of Bordeaux, made for the tourist market and sent before 1913. Many are lively street scenes. 4. "Les baraques louches nous émouvant où, au-dessus de l'entrée, était inscrit un seul petit nom de femme" the "we" are Mauriac and his schoolmates (Mauriac, p. 14). At the head of the Esplanade is the Girondins monument; see Lecture 1, note 21 and accompanying text. 5. The public gardens are much the same today, occupying a pleasant 20 acres and on one side adorned with greenhouses 100 yards in length. The gardens were established, like much else of excellence in Bordeaux, by the marquis de Tourny, intendant 1743-58. There was also the Parc Bordelais, 64 acres, established on the outskirts of town in 1888, just in time for Tissié to take Albert there for an experimental observation of his state of fugue. See Document 4.

6. Mauriac, 9. He continues: "Bordeaux is my childhood, my adolescence detached from me, petrified." 7. A book gives the length of the Law Courts as 146 meters. We measured the hospital as 143 meters, but it appears longer than the Law Courts. The hospital is 124 meters deep. The outside dimensions of the cloister are 63 meters by 47 meters, so that its covered walkway is itself wide and well proportioned. It is now walled with glass so as to be temperate in winter and summer but to have a clear view of the enclosed lawns and gardens. There is no longer a psychiatric wing in Saint-André, the last one being closed in 1980. 8. In a picture postcard view dating from about 1900 you see a big public ward for women in which a row of large potted palms runs down the center. See no. 88 in Avisseau (n.d.). 9. Tissié (1930). 10. A Bordeaux dentist wrote us with an unusual observation. He noticed Albert's propensity for emitting enormous yawns, especially when he entered a trance state. He connected this with the persistent and, even in those days, abnormal tooth troubles and thought that Albert's problem arose from damage to the jaw which in turn caused pressure on nerve centers.

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11. Here is the entire paragraph in Tissié (1890), 121: "Albert fit une chute sur la tête à l'age de douze ans, et commença ses fugues à cette époque." In Tissié (1887), 57: "A l'âge de huit ans, Albert tomba `tout droit' d'un arbre sur lequel il avait grimpé, il perdit connaissance, on le porta chez lui; en arrivent il vomit et garda le lit pendant six jours avec des compresses froides sur la tête." The paragraph continues by stating that Albert started having violent migraines around this time, with intermittent fevers going on for a year. He would have migraines every three days, then every fortnight, then every month, every second month, and then every third month as he grew older. He suffered horribly, with ringing in the ear that made him deaf. He could not help closing his eyes for the pain. The headache would end after about five hours, with vomiting or sleep. The vomiting finally ended, but toothache continued, despite several extractions. There was no mention, in the 1887 report, of a fall at age twelve. 12. Azam (1880). 13. Pitres (1891), 15, 28. The original lectures on which the book was based took place in the summer semester of the academic year 1884-85. Notes taken by J. Davezac were published in serial form beginning 4 April 1886, in Journal de Médecine de Bordeaux. Male hysteria does not occur in the first sequence of published notes, so we suppose that Pitres's tables were based on later data. 14. Borch-Jacobsen (1996), chap. 8. I take Borch-Jacobsen to be extremely nuanced in his discussion of simulation. Other readers may miss his subtlety. Freud bashers assume that Borch-Jacobsen is telling us that Pappenheim faked it and fooled Breuer, and thereby Freud, setting in motion the disaster known as psychoanalysis. They are delighted with a new ally. Beleaguered defenders of Freud understand Borch-Jacobsen in much the same way and get very angry. I read Borch-Jacobsen as discussing the more delicate phenomenon of accommodation, discussed in the text and in note 17 below. 15. Heilbronner (1903), 206. See Supplement 3 below for more on Heilbronner. 16. Rice and Fisher (1976) describe a fugueur who sometimes sleep-talks through dream fugues and sometimes goes on actual fugues. 17. See Duyckaerts (1992) and the Delboeuf bibliography therein. Delboeuf the philosopher did many experiments on hypnotism. He was a complete skeptic about Charcot from the start and an admirer of Hippolyte Bernheim. When it came to mentally disturbed patients, he did most of his work with the English Hospital in Liège. Since Liège was a favorite destination of Albert, one imagines that the two must have encountered each other. Delboeuf was once well known to philosophers. William James attributed his own

recovery from nervous breakdown in part to Delboeuf's thoughts about the will. Isabelle Stengers drew my attention to Duyckaerts's valuable discussion of Delboeuf. Stengers uses the French word complaisance where I speak of accommodation. She has expressed in discussion what I take to be a deep insight into the evolution of psychoanalysis. The critical turn came when Freud stopped hypnotizing his patients. They had been completely accommodating, complaisant, but as he developed his new technique, he discovered the phenomenon of resistance. In his 1914 essay "On the History of the Psychoanalytic Movement," Freud calls that not only a discovery but, together with repression, the foundation stone of psychoanalysis. Resistance is the exact (all too exact?) opposite of accommodation. What Borch-Jacobsen calls simulation in connection with Anna O. can usefully be discussed in connection with accommodation or complaisance. 18. Albert's brothers died young; it is possible that there are descendants of the sister. All the persons with the surname of Dadas, in the whole of France, who were located by use of the French electronic telephone book (the Minitel) were recent immigrants from Morocco or Turkey (of Kurdish descent). Belgium was also checked, because of Albert's enthusiasm for Liège. One of the Kurds

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whom we contacted expressed great interest in Albert's trip to Turkey. Of course it may have been tempting to change surname, despite the legal obstacles to that act in French law and bureaucratic practice. An etymological dictionary of French surnames gives: "Dadas, Dadesse, Dadi: derived from the onomatopoetic root dad, which is used in the nicknames given to simpletons (personnes niases, nigauds). With the same connotation as Dadais, although only quite late usage of the expression dadair has been established (17th century)" (Morlet 1991). "Dad" is the French spelling that roughly corresponds to the American-English spelling of an utterance indicating stupidity, "duh." Supplement 2. The Wandering Jew 1. Rouart (1988) has the most satisfying analysis of the changing roles of the legend for nineteenth-century literature. Anderson (1965) is an encyclopedic volume briefly summarizing the plot lines of different versions of the legend. Its index of authors and titles runs to more than 1,200 items. 2. Tissié, AV, 76; Duponchel (1888), 15; Sous (1890), 15. 3. At the end of the 1880s, the population of Bordeaux was about 240,000, of whom 3,200 were Jewish. 4. Charcot (1889), 347f., 352f. 5. Goldstein (1985). 6. Goldstein calls my opening quotation from Tissié "a slightly humorous trope." She observes that Tissié "remarked wryly that Albert D.'s voyages were so numerous that he could `give tips to the Wandering Jew'" (1985, 539f.). 7. Goldstein quotes some typical passages from the 200th edition of Edouard Drumont's 1886 La France juive: Essai d'histoire contemporaine 2:284f. 8. Anderson (1965), 38-48. 9. Sue (1844-45/1980), 146. The passage begins, "One knows that . . . ." I take the "One" to refer to "Almost every French reader." 10. Knecht (1977), 245. A long and nasty piece in the November 1844 Gazette de France is quoted: "Le Constitutionnel is the Jew." And although Sue's novel is neither about real Jews nor even importantly anti-Semitic, the innuendos are always just around the corner. The Gazette goes on to say that the rue Montmartre (site of the Constitutionnel's office) "should be debaptized and named the Street of the Jews" (rue de la Juiverie). 11. Translated in Anderson (1965), 46.

12. Sue, 1:146. I have followed the wording and punctuation of the 1883 edition, reprinted in 1980, which differs from the English translations I have seen. 13. The Wandering Jewess occurs from time to time in the legend, sometimes as the Jew's wife. See Anderson's appendix B (1965, 414-16). Sue is sui generis. He makes the Jewess out to be Herodias, after a story found by the eminent scholar Louis F.A. Maury, according to which Herodias "was condemned to wander until the last judgment because she had asked for the head of John the Baptist" (Sue, 1:148). Historically, Herodias was the granddaughter of Herod the Great and wife of Herod Philip, whom she deserted for his brother Herod the Tetrarch of Galilee, whom John the Baptist reproved for divorcing his own wife and setting up with his brother's. Herodias, furious at John, asks her dancing daughter Salome to ask the tetrarch for John's head. Anderson tells how this idea set up Salome as Wandering Jewess for the generation of writers following Sue. Late in the serial production of the story, 1844-45, Sue turned the Wandering Jewess into the sister of the Wandering Jew. 14. The French here, incidentally, is "Marche! Marche!" This command has often been translated as "Onward! Onward!" but I prefer the words that make best sense in expressing the Jew's words

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to Christ, and which occur repeatedly in Sue and elsewhere. The "Marche!" also occurs in fugue stories, deliberately, I suspect, and should not be translated as a military order, "March!" 15. And not so lowbrow. Knecht tells how Saint-Beuve, Balzac, Georges Sand, and Théophile Gautier took the book. Only the last-mentioned liked it: "The general conception is remarkable; the main characters are traced with vigor; the mix of the fantastic and the real is well managed." There was at the time a tremendous bout of anticlericalism on which Sue fed, to the point that he was called the successor to Calvin, Zwingli, and Luther (Knecht 1977, 246-49). 16. Gilman (1993), chap. 3, "Jewish Madness and Gender," together with its predecessors (Gilman 1984, 1992), is a convenient starting point. 17. Goldstein (1985), 532. 18. Freud was once profoundly enamored with Charcot and assiduously translated his work into German. Gelfand (1989), among others, has speculated that at some levels "Freud's doctrinal rift with Charcot" was influenced by Charcot's use of Jewish examples in his clinical work. But the scientific point, however influenced by questions of Jewishness, was Freud's overthrow of Charcot's hereditary model of mental disorders. Freud has now fallen, and we are back with Charcot's biological and genetic model. 19. Meige (1893), 14. Pages 5-8 are translated into English in Hasan-Rokem and Dundes (1986), 190-94, but beware: see note 23 below. Meige reproduced six old woodcuts of Wandering Jews. The usual standardized drawing of a naked male body was used twice, once to indicate the anesthetic parts of the patient Klein and one for the patient Sigmund. There are also the standard diagrams representing the restricted visual field for Sigmund who is said to be hysteric. Then there are two drawings, one of the patient Moser B., looking straight out at us, and one of the head and shoulders of the patient Gottlieb. Both these, and one of the old woodcuts, are reproduced in Gilman (1991), 73-75. 20. Meige, 14. I have said that Charcot's use of Jewish patients was not entirely devoid of scientific merit, in terms of the theory of hereditary transmission of mental illness. Meige's use of the travelers in the clinic has, in contrast, no basis at all. By selection, none of their families are accessible for study, and it is hardly surprising that some of those displaced persons should have taken to traveling from hospital to hospital in search of help. Gilman (1991, 72) suggests we think of them in terms of Munchhausen syndrome, named after the famous and fanciful baron and now used by psychiatrists for patients who make up symptoms for themselves. 21. Geller (1992) and Santner (1996). See also Gilman (1984, published before

Goldstein's paper; 1991; 1992; 1993, chap. 3). 22. Der ewige Jude ties into a body of legend distinct from that of Ahasverus, the one explored by Hans Christian Andersen (and through him, Dvorák in Rushalska) and in The Flying Dutchman, of the human condemned to live forever. Kundry in Parsifal is likewise condemned to live forever until she is redeemed. Santner emphasizes how Wagner used the legend for his own nasty purposes. But as should by now be clear, the Wandering Jew can always be worked both ways, indeed "to parody the antisemitic nationalism of the German composer." Rouart (1988, 179) recalls a pastiche of Wagner, a three-act play with musical leitmotifs published in 1878 by Fritz Mauthner (whose Beiträge zu einer Kritik der Sprache and Philosophische Wörterbuch are due for resurrection by historians of the philosophy of language). Mauthner's "The Unknown Ahasverus, or The Thing in Itself as Will and Idea" is artistically simplistic but polemically lethal (Der unbewusste Ahasverus, oder Das Ding an sich als Wille und Vorstellung [Stuttgart: Union Deutsche Verlagsgesellschaft]). Earlier German poetry, dedicated to the eternal Jew in the romantic era, is mostly sad, mournful, and often rather beautiful. For ample references and selections, see Zirus (1928). Then there is

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the other side of the legend. The Jew as Antichrist, implicit in many folk myths, surfaced in nineteenth-century German literary texts earlier than it did in French ones. In the end it became truly gross. There is the film Der ewige Jude by Fritz Hippler, in which the horrendously ugly eternal Jew signifies not suffering humanity waiting for redemption but World Jewry, Weltjudentum, which settles everywhere and knows no home. 23. Meige, 8. The French words are "sorte de prototype des Israélites névropathes pérégrinant de par le monde." In Hasan-Rokem and Dundes (1986), 194, Lee Benzinger has translated "des Israélites névropathes" as "the psychopathic Israelite." 24. Gilman, Geller, and Santner discuss the effeminization of Jews, partly because of Schreber's conjunction of the Wandering Jew and the effeminization theme. Klein, Meige's case 1, was impotent when he came to the clinic and was cured. This is taken as grist for the effeminization mill (plus the way in which Charcot's clinic replaces the cross as the means of salvation). What of case 2, whose problem seems to be neurotically heightened potency? 25. Gilman writes that Meige gave a "series of case studies of European (male) Jews" (1991, 72) and repeats the "(male)." In fact it is a series of four men and one woman. Meige wrote that "the Wandering Jewess does not have the popularity of the Wandering Jew. Neither legends nor illustrations have popularized her history. A single work bearing the title of La Juive errante, due to the marquise de Vieuxbois, is of little interest for the topic that concerns us here." A footnote refers to a two-volume novel published in Paris in 1845. As remarked above, Sue's novel, 1844-45, put the Jewess into circulation. The marquise de Vieuxbois was the pseudonym of a prolific journalist named Napoléon Lespès, usually called Leo Lespès. I have not seen the work to which Meige refers. It was published in Paris in 1845 by Leclerc. 26. Meige, 46. 27. Gilles got the idea for the syndrome named after him by comparing Salpêtrière patients to colonial reports of latah; see Lecture 3, note 7. 28. Meige, 56. 29. Tissié (1901), 24: "atteint d'un besoin impérieux de marcher." Not travel, exactly, but "marcher," as in the cobbler's retort to Christ, "Marche!" 30. Ibid., 26: "Classer de tels cas sous la rubrique automatisme ambulatoire c'est donner une entorse sérieuse à la psychologie." Supplement 3. Wandertrieb in Germany

1. Naef (1895), an associate of Forel's, describes what could have been diagnosed as fugue or ambulatory automatism, but the idea is not mentioned. Cf. Lecture 2, note 43. 2. Schultze (1898), in Bonn. Schultze's paper was presented at the Verein deutscher Irrenärzte in Bonn, 16-17 Sept. 1898. Although I do not discuss regional medical practices, I mention the workplace of each author in these notes. Also I quote some of the reported self-descriptions of the patients to give this brief account some feel of the phenomenology of the cases. 3. The reference is to Semelaigne (1894). 4. Menschede (1880), in Königsberg. 5. "Das ist hier blos die Luft, aber den Himmel bekomme ich in meinen Körper zu stehen. Ich habe das Alles von selbst in meinen Körper zu stehen. Die Engel [sic] werde ich in mein Herz nehmen, in das goldene Herz" (ibid., 571). 6. Westphal (1883), in Berlin, examining an appeal in military court. 7. "M. leidet an einer in Zwischenräumen auftretenden und schnell vorübergehenden krankhaften Störung der Geistesthätigkeit" (ibid., 213).

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8. I do not mean there was no German interest in hysteria. P. Möbius published an important paper on the concept of hysteria in 1888. Otto Binswanger had a major discussion of hysteria in 1904. But hysteria had a role in the German-speaking world that was very different from that in France. 9. Schultze (1900). This fourth case came from a colleague from Andernach, 30 miles from Bonn. 10. "Wie ich kurz vor Prag zu mir kam, sagte ich mir: `Halt, was machst Du da? Du schleppst ja den alten Mann in's Elend!'" (Schulze 1898, 757). 11. "`Es kam manchmal über ihn, als ob eine innere Macht ihn gewalsame fortriebe'; er habe kein Rast und Ruhe; `als wenn eine teuflische macht ihn von Ort zu Ort jage'" (Schultze 1900, 416). 12. Bregman (1899), from the israelitischen Spital in Warsaw, writing in a major German journal of neurology, presented an interesting case under the title "Ueber den `Automatisme ambulatoire,' `Fugues,' `Dromomania'" (Concerning "ambulatory automatism," "fugues," "dromomania''). This was a fourteen-year-old boy who had taken extensive flights since he was seven. He was no mere runaway but a characteristic fugueur with fixed ideas and amnesia, who felt compelled to walk even when he had no food and wore poor clothing in the bitter cold. Bregman could not convincingly file the lad as either hysterical or epileptic, though he had an epileptic attack in early childhood. He had hallucinations on the road, but Bregman put them down to hypothermia and lack of food. This paper was ignored by the German-language literature inaugurated by Schultze. 13. Donath (1899) in Budapest. He had reported his first patient in a Budapest medical journal of 1898; the citation is S. Pester medic. chir. Presse 24, 22 (1898). He thereby claimed priority over Schultze. 14. Donath (1899), 353. 15. Schultze (1900), 468. 16. Donath (1899), 353. French and English in the original. Donath named the condition doppelter Persönlichkeit. Donath had presented the example to the königlich Gesellschaft der Aertzte in Budapest (17 May 1892); he cited his paper, "Ueber Suggestibilität," Wiener medic. Presse no. 31 (1892). 17. Burgl (1900), in Nuremberg, had a patient, a thoroughly able and much-liked workingman, who in one of his attacks bought a revolver intending to kill himself. Krau (1900), a health inspector in Schweidnitz, Silesia, described a young man who bought

guns to kill himself, did shoot himself ineffectually, bought poison, jumped into a lake, and tried to suffocate himself with carbon monoxide. His fugues lasted up to sixteen days: Breslau to Blankenberg, to Dresden, and as far as Paris, and a lot of local wandering. He accused himself of murder and of assaulting the nine- and twelve-year-old daughters of his landlord; these accusations were found to be ungrounded. 18. Heilbronner (1903), in Halle. 19. Woltär (1904), in Prague: "Wandertrieb bei einer Hysterischen." 20. Woltär (1906). 21. Leupoldt (1905), in Giessen. 22. Raecke (1906), in Kiel. Raecke (1908) presented five civil cases of Wandertrieb, with excellent clinical data. After the Great War, now a professor in Frankfurt, he was discussing desertion and Wandertrieb in time of war (Raecke 1919). 23. Rosental (1911). 24. Schlieps (1912), from the University Children's Clinic at Strassburg. Among citations is: Seige, "Wandertrieb bei psychopathischen Kindern," Zeitschr. f.d. Erforschung und Behandl. d. jugendl. Schwachsinnes 4 (Jena, 1910). 25. After Raymond (1895) there was plenty of study of child vagrancy, e.g., Hélie (1899). For a bibliography of the intersection of child vagrancy and child fugue in France, see Cantégrit (1933);

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unfortunately this has many errors, typographical and factual. This lists "Fugues chez les enfants," in Bulletin de la Société pour la Médecine Légale; "Les Fugues de l'enfance" and "Fugues infantiles" (!), both in Annales d'Hygiène Publique et Médecine Légale. Victor Parant gave a talk titled "Vagabondage des mineurs" at the Congrès Nationale de Toulouse du Patronage des Libérés, 1907. Naturally the interest continued, but only in France were runaways classified as fugueurs, for example, Claude (1925). But also as "vagabonds'' (Néron 1928). Even in 1949 we have "Réflexions sur la fugue et le vagabondage chez l'enfant et l'adolescent" (Reflections on fugue and vagabondage in children and adolescents) (Kohler 1949). 26. See my RS, 19. 27. For example, Braun (1883), Die Vagabunden-Frage. Document 1. Albert's Tale (1872-May 1886) 1. Crown Prince Rudolph, heir to the Hapsburg throne, married Princess Stephanie, daughter of King Leo II of Belgium, on 10 May 1881. (On 30 January 1889 Rudolph and his mistress Baroness Maria Vetsera were found shot dead in a hunting lodge, a revolver in Rudolph's hand.) Albert does seem to get dates and events slightly wrong (see note 2). This may even add credibility to his story. It is to be expected that his memories would be confused; if he got everything exactly right, we would suspect that he, or someone else, was checking out the facts. 2. Alexander II was assassinated in an explosion of 13 March 1881. Albert cannot have reached Moscow before late July. We suspect that it was after 26 August, after the "Statute providing special measures for the maintenance of order" was passed (14 August 1881 on the Russian calendar). This allowed any region to be placed under a "state of reinforced protection," meaning a full police state. Moscow was under reinforced protection after 3 August. See Pipes (1974), 305-9. Document 2. Albert Observed (June 1886-February 1887) 1. Tissié wrote: "drôle" (sic). 2. The pine forest was Les Landes, the largest forest in France. See Document 3, note 13. Document 3. Dreams (May 1887-September 1889) The entry for 9 June 1888 is on pp. 81-84 of Tissié (1890). I have inserted year dates. 1. Tissié: "hemoptisie." 2. A vesicant was a plaster that produced blistering on the skin, which was believed

helpful for tuberculosis. 3. Tissié: "pointes de feu." Hot needles pierce the skin. 4. Tissié uses slightly different wording in repeating Albert's exclamation. 5. At a previous hypnotic session, Tissié had suggested that Albert would fall into hypnotic sleep whenever Tissié touched the right thumb. 6. A mont de piété, and not a pawnshop of the English sort that we know through Dickens. The Italian monti de pietà had a long history, many of the early ones being established by Franciscans as a social net for the poor. France, like most other European countries, adopted variants of the idea. The mont de piété was state regulated and either a state or a municipal monopoly with low rates of interest. Bordeaux, in Albert's day, seems to have had pretty much the highest rates in France. 7. [Tissié's note.] Tissié, "Un cas d'obsession intellectuelle et émotive guérie par la suggestion

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renforcée par le parfum du corylopsis, l'isolement et les douches," Semaine Médicale, 1889, p. 297, col. 1. 8. Pau, the town to which Tissié moved in 1900, is, by train, 233 kilometers south and a little east of Bordeaux. 9. Albert called the play Une femme qu'on garde mal, while the real title is Une fille bien gardée, by Eugène Marin Labiche (1815-1888), who was for many years the most successful writer of French farces; his collected plays run to ten volumes. At the end of the present document, Tissié offers his own analysis of the wordplay and dreams. The word switch is clear. Fille, daughter or girl, becomes femme, wife or woman. But the fille of the real title is presumably both the little daughter of the society woman and the woman herself, fille in the sense of prostitute. 10. See the letters from M.D. in Document 1. 11. The Quai de Queyrie is across the Garonne River from the heart of old Bordeaux; Bastide is the suburb beyond the quai. The Bastide-Bordeaux bridge is named the Pont de Pierre, the name Tissié uses later. The quai on the Bordeaux side of the bridge is the Quai de Salinières. The Gare d'Orléans, where Albert was always getting the train north, abutted the quai near the bridge and is a little distance from the present freight station; the main Gare St.-Jean that now serves Bordeaux is relatively recent. 12. "Les Landes" is an enormous area, once barren, stretching from Bordeaux south almost as far as Biarritz, and stretching inland some 100 kilometers. It was turned into a fertile forest and grazing area during the mid-nineteenth century, especially thanks to a system of drainage. It was still pretty wild in Albert's day, but it has now been domesticated to the point of seeming almost artificial. See the next note. 13. [Tissié's note.] Aguer is a murderer, who, several days before Albert's dream, was arrested in the Landes forest at the end of an unusual chase that lasted eight days, in which a pack of dogs was sent after the man. The regional press was full of this news. 14. Dax is 148 kilometers south of Bordeaux by train and about 25 kilometers north of Puyoo, mentioned above as 4 kilometers from the field of sheep where Albert woke up. 15. The Pont de Pierre = the Bastide-Bordeaux bridge. 16. When we look at the pathogenic dream, Document 4, we see Albert deeply worried about the fidelity of his wife. It is just possible that Tissié was delicately hinting that Albert sees himself as a criminal for the way in which he behaves to his wife and fears that she will not stick with him, given that he is so impossible to live with. Document 5. Experiments (1888, 1893)

1. Ténesme rectal. 2. The selection from the earlier paper ends here. 3. This reads like a lecture. Unfortunately we lack the thirty-three photographs. "Instantaneous photography" was a technique that, with excellent lighting, required only short exposures, but probably Panajou required at least three seconds for each shot, despite the fact that on one occasion Tissié tells us that the transition from one state to another happened in less than two seconds. 4. Tissié's verb, which I have freely translated as "project," is objectiver. Document 6. Epilogue (1907) 1. Tissié (1930), 108.

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2. Le Petit Parisien, 8 December 1907, page 2 (Bibliothèque Nationale: Micr. D 64, bobine 105). 3. On 9 December Le Petit Parisien reported that there was no progress, either in the case of Gabrielle or of the macabre discovery at the bottom of the well. "So far as concerns the disappearance of Mlle Dadas, very active inquiries are in progress, as much in Paris as in the suburbs, but up to now it has been impossible to find the young girl." That is the end of the story.

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Index Note: Page numbers for illustrations are in italics. A Ahaseverus, 114-16 Albert Dadas, 5, 7, 20, 18-30, 37-38, 44, 52, 54, 64, 73, 103, 105-12, , 135-94 161passim; amnesia of, 168, 175; arrested as nihilist, 22, 144; birth certificate, 198 n.27; Charcot on, 37, 177; death of, 25, 112, 193; head injury, 21, 106-7, 215 n.11; helped by D in Vienna, 140-41; as héréditaire, 35; hysterical symptoms, 167-68, 182; as Wandering Jew, 113-15, 123-24 Family of: brothers, 20-21, 135-36, 138, 140, 215 n.18; sister, 21, 215 n.18; brother-in-law, 139-41; daughter Gabrielle (Marguerite-Gabrielle), 25, 182, 192-94, 198 n.27; father of (Romain Dadas), 19, 135-38, 140; mother (Marie Dumeur), 19-20, 138, 198 n.28; wife of, 110-12, 166-69, 171-74, 176, 178-79, 182, 184, 185-86, 192, 221 n.16 Incidents in life of: argument with co-workers, 169;

desertion, 22, 139, 141, 147; dogbite, 24, 143; dreams of killing his wife, 110-11, 185; drum major, 173-74; hypnosis of, frontispiece, 1, 18-19, 26, 62, 108-11, 159-62, 165, 171-72, 175-78, 180, 185-86, 187-91; ideogenic dreams, zones, 110, 187-91; loses his livret, 62, 150, 163, 198 n.29; marriage of, 166; masturbation, 23, 145, 157, 159-62; moves to Paris, 182; pawns possessions, 163, 168, 174, 175, 220 n.6; pedaling dream, 169-70; search for D's wife, 180-84; steals from his own wife, 111, 166, 173; tricked by pimp, 176, 180; Une fille bien gardée, 180-81; yawning, 214 n.10 Places: Algeria, 7, 21, 23, 137, 147; Constantinople, 7, 23, 146; Liège, 111, 139, 141, 153-55, 166-67, 173-74, 215 nn.17, 18; Marseille, 21, 137, 168, 173; Moscow, 7, 22, 143-45, 160 alcoholism, 34, 65, 67-68 Alexander II, czar of Russia, 22, 143, 220 n.2 Alexander III, czar of Russia, 115 ambulatory automatism (automatisme ambulatoire), 8, 36-39, 45, 48, 57, 79, 119, 124,

125-27, 201 n.9; and Albert, 184 American Psychiatric Association, 12, 82, 92 amnesia, 59, 83-84, 88, 90, 129; differential diagnosis with fugue, 213 n.2; in dissociative fugue, 196 n.9; traumatic, retrograde, anterograde, 107 Anna O., 38, 98, 108-9, 199 n.35 anorexia, 1, 8 Antiope, 207 n.2 anti-Semitism, 13, 115-24, 217-18 nn. 18-25 antisocial personality disorder, 8 Arnaut (doctor at English Hospital, Liège), 166 attention deficit hyperactivity disorder, 8 Atwood, Margaret, 3-4 Austin, J.L., 93 Azam, Eugène, frontispiece, 26, 40, 107, 111, 198 n.32, 199 n.35, 201 n.10, 203 n.26 B Babinski, Joseph, 35, 71, 201 n.12 Baedeker's guides, 28, 200 n.42 ballet, 74, 204 n.36 Baptiste (Albert's friend), 138-39 Barker, Pat, 3 Baudelaire, 28, 199 nn.38-39 Beard, Charles, 200 n.2 Beauchamp, Sally, 60 Beaune, Jean-Claude, 69, 90

Beck, René, 69 Belmondo, Jean-Paul, 113 Benjamin, Walter, 199 n.38 Bernhard, Thomas, 4 Bernheim, Hippolyte, 40, 47, 203 nn.25, 26 bicycling in Bordeaux, 14-16 Binet, Alfred, 203 n.26, 210 n.29 bipolar disorder, 73 Bitot (doctor at Saint-André), 156 Bleuler, Eugen, 35, 95 Borch-Jacobsen, Mikkel, 97-98, 108-9, 215 n.13 Bordeaux, character of the city, 15-17, 103-6, 214 nn.3-8 Boulanger, Georges, 17, 70, 115, 197-98 n.22 Bourne, Ansel, 58-59; Tissié on, 208 n.16 Bregman, L.E., 219 n.12 Breuer, Josef, 38, 108, 199 n.35 bromide, 36-37, 41-42, 67, 71, 95, 128, 150

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bulimia, 8 Bunyan, John, 29-39 Byron, 113 C cafard, 77-78 Caillebotte, Gustave, 29-30 Canetti, Elias, 3-4 Carnot, Sadi, 168, 173, 198 n.22 Cartophilus, 114, 123 Charcot, Jean-Martin: on Albert Dadas, 37, 177; ball at the Salpêtrière, 209 n.22; death of, 44-45, 75; and Hughlings Jackson, 34; and hypnotism, 40, 111; and hysteria, 14, 18, 32-33, 46, 61, 80, 91; on inheritance of mental illness, 65, 91, 119; invents name "ambulatory automatism", 36; Jewish patients of, 114-15, 119-24; on latent epilepsy, 34; on male hysteria, 32-33; and Mén, 35-37, 40-41, 46-47, 54, 60-61, 68, 70-71, 75-76, 86, 91, 114, 125-26, 128, 131, 184, 208 n.14. on trauma, 33; Tuesday lectures, 35-37, 39, 57, 68, 201 n.14. Students of: Babinski, 72;

Bleuler, 35; Freud, 35; Gilles de La Tourette, 54; Pitres, 14, 208 n.14. See also Mén (Charcot's patient) child abuse, 86 chronic fatigue syndrome, 1, 120 Claretie, Jules, 209 n.22 Claude, Henri, 76 Comte, Auguste, 16 Congress of 1889, 39-40, 203 n.26 Cook, Thomas, 27, 199 n.37 Coubertin, Pierre de, 16, 197 n.19 Crews, Frederick, 97-98 cultural polarity, 1, 80, 134; for dissociative identity disorder, 96; for fugue, 81-82; for hysteria, 86 D Dadas, Albert. See Albert Dadas "Dadas", etymology of, 215-16 n.18 Davenport, Charles, 65-67 degeneracy, 33, 45, 56, 64-65; in U.S.A., 66-68 Delboeuf, Joseph, 111, 215 n.17 Delmas (doctor at Saint-André), 172 dementia praecox, 63, 72-74

depersonalization disorder, 83 depression, 76-77, 212 n.55 desertion from military, 62-64, 77, 82, 126-28, 131-34; Albert's, 22, 139, 141, 147 determinismo ambulatorio, 8, 37 Diagnostic and Statistical Manual (DSM), 9, 82-83, 90, 92, 133, 195-96 n.9 Dionysius, 52, 207 nn.2, 3 dipsomania, 65, 67-68, 127-28, 210 n.35 dissociation, 58, 80, 83-84, 98, 101-2, 108, 210 n.26, 213 n.8; Ellenberger on, 43, 97; Pierre Janet on, 76, 100, 212 n.61 dissociative fugue, 12, 49, 59, 81-83, 86, 90, 98-99, 114; and Albert, 106; and amnesia, 84, 90-94; definitions of, 12, 195-96 n.9; Ellenberger on, 205 n.43; and soldiers, 84; and trauma, 62, 84-85 dissociative identity disorder, 8, 26, 83, 90-91, 96-99, 196 n.9. See also double consciousness; multiple personality Donzelot, Jacques, 69, 90 double consciousness, 25, 39, 57-59, 90, 107, 129-30, 203 n.30, 206 n.43 drapetomania, 57, 65, 208 n.13 Dreyfus case, 16, 115-16 Dromomanie, 8, 45, 64, 66, 71, 132, 206 nn.46, 47, 211-12 n.54 Drumont, Edouard, 115-23 Du Bois, W.E.B., 60 Ducosté, U.-J.-M., 73

Duponchel, Emile, 19, 23, 35-37, 113-15, 204 n.32 Dupouy, Roger, 75-76 Durkheim, Emile, 15 E ecological niche, 1, 28, 55, 59-60, 67, 75, 80, 86, 134 Ellenberger, Henri, 43, 97, 205 n.43 Elliotson, John, 206 n.43 epilepsy, 32-33, 39-40, 200 n.5, 201 n.9; latent, 33, 36-37, 41, 45, 64, 75, 126-30, 134; temporal lobe, 80, 196 n.9. See also hysteria and epilepsy Espinas, Professor, 174 eugenics, 66-67 Europe, place d', pont d', 29 Evans, Ivor, 63, 207 n.6 F feeble-minded, 66-67 feebly inhibited, 66-67 Félida X., 25, 107, 201 n.10 Feuerbach, Paul, 205 n.43 flâneur, 28, 199 n.38 Flaubert, 28 folie circulaire, 73-76 Foreign Legion, 78, 127 Foucault, Michel, 27, 64, 85-86, 197 n.19 Foveau de Courmelles, 203 n.26 Foville, Achille, 196 n.10, 210 n.27

Frazer, James, 53, 55-56 Freud, Sigmund, 3, 26, 35-36, 55, 76, 92-93, 97-98, 110, 120, 127, 199 nn.35, 36, 215 n.14; and Charcot, 217 n.18 Froissart, P., 70-74, 132 fugue: and amnesia, 212-13 n.2; in Italy, 8, 31, 37, 202 n.19; origin of word, 196 n.10; in Russia, 31, 200 n.1; WW I, 213 n.2; WW II, 212 n.2. See also dissociative fugue and the next four entries

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fugue, hysterical, 35, 39, 41, 45-46, 57-59, 63, 68, 75, 77, 122, 130-31, 202 nn.22-23, 211 n.51; Charcot on, 46, 91; Patrick on, 60, 91, 99; Raymond on, 47, 99; reality of, 80, 91-92; Régis on, 64-65, 206 n.46; Tissié on, 91, 106, 182, 184, 203 n.24; social construction of, 101; Voisin on, 29, 60, 203 n.29 fugueurs, American: black steelworker (Patrick), 60-61; diagnosed as multiple personalities, 57-58; Henry Rowlands, the English remittance man (Angell), 61-62, 209-10 n.26; seventy-three-year-old alcoholic cyclist (Davenport), 67; Virginia businessman (Drewry), 209 n.17. See also Bourne fugueurs, French: André R., the fortune-teller (Cullerre), 69; Babinski's example, 71; charwoman (Voisin) 39, 202 n.39; child, 76, 132, 206 n.48, 219 n.25; dementia praecox (Ducosté), 73; dipsomaniac (Souques), 210 n.35; eighteen-year-old deserter (Régis), 210 n.30;

Emile (Proust), 42-44, 49, 204 n.36; fictional, 209 nn.20, 22; folie circulaire case (Thivet, Ballet), 74; Frenkel's three cases, 204 n.33; Henri C., "the last fugueur" (Grasset), 76-79, 212 n.68; Jean-Pierre (airplane hijacker), 210 n.28; M, the cycling fugueur (Régis), 64; military (recent), 63, 210 n.28; mirror-silverer (Alcindor and Maurat), 202 n.22; outpatients of Pitres, 44; peasants, 207 n.54; railway clerk P (Raymond), 46-47; in Reims (Colleville), 204 n.33; Saint-Aubin's nine cases, 41, 203 n.29; shop assistant, neither epileptic nor hysteric (Pitres), 45, 206 n.45; "stagger" case, 210-11, n.35; survey of, 125, 218 n.3; ten-year-old "Tom Sawyer" (Raymond), 206 n.48; Victor B., melancholic (Lalanne), 74, 212 n.55; in WW I, 213 n.2. See also Albert Dadas; Mén fugueurs, German: fourteen-year-old boy (Bregman) 219 n.12; carpenter haunted by devil, 128; children, 132-33; deserters, 131-32; hysterical, 131; musketeer J.M., 126;

paranoid widow, 132; X, Y, and Z (Schultze), 127-28; shepherd with the angels, 126; suicidal, 128, 219 n.17; survey of, 130-31; in WW I, 213 n.2 G Garnier, Paul, 210 n.35 Gauld, Alan, 165 Geller, Jay, 120-21, 218 n.24 Gilles de La Tourette, 54, 123, 201 n.14; and Albert, 177 Gilman, Sander, 119, 218 nn.24, 25 Girondins, monument to, 17, 197 n.21 Godard, Jean-Luc, 113 Goethe, 29, 113 Goldstein, Jan, 114, 119, 123, 216 n.6 Grasset, Joseph, 76 Graves, Robert, 3 Grousset, Paschal, 17, 197 n.20 Gypsies, 66-67; Albert with, 22, 145 H Harriman, Mrs. E.H., 66 head injury, 3, 80, 86, 213 n.10. See also under Albert Dadas Heilbronner, 130-32

Heraults (adoptive parents of Gabrielle Dadas), 192-94 Herodias, 216 n.13 Huguenot, 22, 116-18, 196 n.11 Hume, David, 16 hyperactivity, 8 hypermnésie, 206 n.47 hypnotism, 13, 18, 26, 34, 43, 46, 50, 57, 71, 86, 98, 108, 199 n.36, 201 n.10, 203 n.29, 206 n.46; and Babinski, 71-72; Charcot versus Bernheim, 41, 203 n.25; Congresses of, 40; Delboeuf on, 111, 215 n.17; Elliotson, 206 n.43; and Janet, 200 n.2; and Pitres, 14, 18; and sleep, 165, 184; in treatment of hysteria or fugue, 39-40, 48, 59, 61, 64, 209 n.18. See also under Albert Dadas; Charcot hysteria, 13, 40, 88, 108; and Albert, 25, 106, 133, 168, 182, 184; Babinski on, 71-72; Charcot on, 32-33, 65, 86, 119-20, 123; and criminality, 34; and degeneracy, 34-35, 64-65, 210 n.30-31; disappearance of, 38, 61, 63, 72-73; ecological niche for, 86-87; and female powerlessness, 49;

in fiction, 59; in Germany, 63, 126-27, 219 n.8; grande and petite, 18; Grasset on, 76; history of, 89, 208 n.3; and hypnotism, 26, 108; and Jakun women, 53-55; Janet on, 25; male, 32-33, 108, 215 n.13; Merskey on, 211 n. 48; and neurasthenia, 200 n.2; and nomadic impulse (Davenport), 67; Pitres on, 14, 18, 44, 106, 108, 215 n.13; and schizophrenia, 76; as semiological dragnet, 60; Showalter on, 89; Studies in Hysteria (Breur and Freud), 199 n.35; trance in, 209, 22. See also fugue, hysterical, and hysteria and epilepsy hysteria and epilepsy, 32, 37-38, 41-42, 44, 60, 81, 90, 129, 201 n.10, 206 n.47, 210 n.31, 212 n.54, 213 n.8, 219 n.8; Babinski on, 71; differential diagnosis, 47, 129, 209 n.25; Heilbronner on, 130; as hysterical family of disorders, 65; hystero-epilepsy, 32, 35, 44; police on, 68, 74. See also automatisme ambulatoire

hystero-neurasthenia, 122

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I intermittent explosive disorder, 1, 8 International Classification of Diseases (ICD), 10, 90, 92, 196 n.9 International Magnetic Conference, 203 n.26 J Jackson, John Hughlings, 33-34, 200 n.5 Jakun tribe, 53, 206-7 n.6 James, Henry, 58 James, William, 40, 48, 58, 90, 92, 97, 203 n.26 Janet, Paul, 42 Janet, Pierre, 25, 47-48, 76, 100, 130, 200 n.200; van der Hart on, 212 n.61 Jaspers, Karl, 5 Juif errant, Le, 116-18 jumpers, 54 K Kaplan, Daniel, 88 Kenny, Michael, 54, 208 n.9 Kerouac, Jack, 52 Klein, Stanley, 88 Kraepelin, 128, 131 Kuhn, Thomas, 37-38, 48, 72-73, 87, 202 nn.17, 21 L Labiche, E.M., 180-81, 221 n.9 Lalanne, Gascon, 74, 212 n.55 latah, 54, 218 n.27

LeBlanc, André, 42, 212 n.55 Léotard, Jules, 14 Lespès, Leo ("marquise de Vieuxbois"), 218 n.25 Ligue Girondin pour l'Education Physique, 17-18 Loewenstein, Richard J., 84 Lothane, Zvi, 4-5 Luys, J., 204 n.36 lycanthropy, 207 n.4, 208 n.11 M Malaya, fuguelike behavior in, 53, 207-8 n.6 male powerlessness, 49-50 Mallarmé, Stephane, 28 Manet, Edouard, 29 manic-depressive, 73 Mann, Thomas, 29 Marchand, Louis, 75 Matthew of Paris, 114, 123 Mauriac, François, 103-5, 199 n.32, 214 nn.3-4 Mauthner, Fritz, 217 n.22 Meige, Henry, 120-24 Melampus, 52, 207 n.3 Mén (Charcot's patient), 35-38, 47, 61, 70, 75, 91, 114, 125, 200 n.8, 201 n.10, 202 n.14 Merskey, Harold, 195 n.8, 206 n.43 Meyer, Clara (Peregrina), 51 Micale, Mark, 72, 86, 200 n.3 Monet, Claude, 29-30 Monot (doctor at Saint-André), 179, 182, 214 n.7

Montaigne, Michel, 28-29 Morel, B.-A., 34 Mörike, Eduard, 51 Motet, Auguste, 196 n.10 multiple personality, 1, 8, 10-11, 16, 25-26, 57-59, 83, 96; and animal alters, 208 n.11. See also dissociative identity disorder; double consciousness N Naef, M., 205 n.43, 218 n.1 Nantes, Congress of (1909), 74-78, 93, 99 Napoleon, 104 neurasthenia, 45, 114, 120, 123-24, 200 n.2 Niederland, William, 4 Niger (ship), 14, 105 nihilism (Albert arrested for), 22, 144 nomadism, 66 O observability, vector of, 80, 82; hysteria, 86; multiple personality, 97 Odyssey, 52 Oedipus, 52 Olympic games, 16 Owen, William, 3 P Panajou, F., 20, , 198 n.25161 paradigm, prototype, 202 n.17

Parant, Victor, 74, 204 n.33 Patrick, Hugh, 49, 60-61, 90-91, 99; and Albert, 209 n.25 Pau, 25, 111, 179 Peirce, Charles Sanders, 92, 98 photographs: of Albert, 19, 20, ;161 of Albert dreaming, 189-91; of Jewish travelers, 120; of Vivet, 19 physical education, 16-18, 192, 197 nn.19-20 pithiatism, 72 Pitres, Albert, 14, 18, 37, 44-46, 50, 60, 64, 91, 109, 182, 198 n.25, 201 n.12, 206 n.46, 210 n.29, 211 n.50, 215 n.13; and Albert Dadas, 7, 14, 19, 23, 44, 106, 108, 148, 153, 155-56, 158-59, 161-62, 169, 198 n.26; Albert's fantasies about, 166 police, 68-71, 74 poriomania, 8, 129 positivism, 16, 18 post-traumatic stress disorder, 62, 83, 100 pragmatism, pragmaticism, 92-94, 99-100 premenstrual syndrome, 8 Prince, Morton, 60-61, 100 Proeteus of Tyrins and his daughters, 52 Proust, Adrien, 42-44, 49 Proust, Marcel, 43, 103, 205 n.38

psychasthenia, 200 n.2 psychic research, 58