On hysterical Anorexia

Dialogues in Philosophy, Mental and Neuro Sciences 9 (1):24-31 (2016)
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Abstract

Ernest Charles Lasègue was a neurologist and alienist whose contributions to psychiatry vary from alcoholism to the famous folie à deux. One typical theme discussed in that historical period in France was hysteria, and the present work on anorexia is part of a larger reflection on that issue. This article is the English translation published by Lasègue of a contribution originally written in French. Anorectic symptoms are seen as part of a more general symptomatic complex. This paper is a good example of the progressive shift occurred in the nineteenth century from the mere empirical description of single symptoms and phenomenal varieties to a more comprehensive approach considering symptoms in relation to the patient’s personality: in Lasègue’s terms, the ‘true condition’ or ‘mental disposition’ of the patient. Another relevant issue is the role theories play in the description of mental disorders. This paper shows that Lasègue’s anorexia is not an early detection of anorexia nervosa as we conceive it today. Rather, it is a syndrome seen through the lenses represented by the concept of hysteria. Accordingly, some symptoms are more ‘hysterical’ or ‘phobic’ than those we usually find in present days anorectics. Finally, Lasègue describes a disease progression from disgust and ‘uneasiness after food’ through the ‘conviction that food will prove injurious’ to complete opposition and refusal. At the end symptoms appear rigidly structured and stereotyped. This progression from early different and still flexible ways to experience psychological distress to final rigid and stereotyped syndromes has been proposed for the classical endogenous psychoses and it may be an interesting topic also in the case of eating disorders.

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