COMMENTARY

Morgellons: Real Disease or Imaginary Malady?

Andrew Scull, PhD

Disclosures

June 18, 2015

In This Article

"The Napoleon of the Neuroses"

For a medical historian, the whole debate is an example of déjà vu all over again. Over the past three centuries, in particular, there have been many examples of similar squabbles. And although it has become fashionable to denounce an imperialistic medical profession, the reality is that very often it is bands of sufferers who combine to insist on the reality of their troubles, and to search out compliant physicians who will attempt to validate their claims and hopefully take them seriously.

The language of "nerves" had begun to enter medical discourse in the late 17th century. Gentlemen, and especially ladies, of quality in the years that followed swiftly adopted the new language, which claimed many converts. As George III, the last king of North America, began to lose his wits, he famously informed anyone who would listen that "I'm nervous. I'm not ill, but I'm nervous; if you would know what is the matter with me, I am nervous." But he wasn't. He was mad.

Other wealthy sufferers had less serious troubles that did not condemn them to the tender mercies of the "mad-doctors." Decades before the king became insane, the nervous ladies and gentlemen of fashionable London had found a champion in the transplanted Scottish physician, George Cheyne, who pronounced their ailments to be as real as smallpox or fever.

Molière might dismiss such complaints as Le Malade Imaginaire—a view shared by many of Cheyne's professional competitors, and common among the public at large. But the Scot's flattery of his patients—nervous complaints, he insisted, were to be found almost exclusively among the most refined and successful, whose nervous systems were equally delicate and refined—was combined with an equally confident claim that they deserved the dignity of the sick role, not the opprobrium meted out to counterfeits and frauds. Cheyne's reward was a doubling and tripling of his practice, as dukes, bishops, lords and countesses flocked to his consulting rooms.

A century and a half later, tout Paris was drawn to the weekly lectures, the leçons du mardi, offered by the man who reveled in the title of "the Napoleon of the Neuroses": Jean-Martin Charcot. Charcot had built his reputation as a neurologist on his skill at delineating a whole string of debilitating neurologic disorders: disseminated multiple sclerosis, aphasia, amyotrophic lateral sclerosis (better known to most Americans as "Lou Gehrig disease"), Tourette syndrome, chorea, locomotor ataxia (a complication of tertiary syphilis, as would become apparent in the early 20th century), and so on. But what drew his audience to his lectures was not these unfortunates, but another sort of patient—those suffering from what became the iconic disease of the late nineteenth century, hysteria.

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