Charcot was almost completely uninterested in his patients’ words, even when they were reenacting traumatic, often sexual episodes—Augustine’s visions included “rape, blood, more fires, terrors, and hatred of men”; scenes from novels she had read; and, according to Bourneville, the hallucination that “when the men around her speak, flames emerge from their mouths.” It is difficult to imagine, given the pointed nature of the hallucinations, but Charcot considered anything said during a hysteric attack to be “vocalization, not communication, a clinical feature that helped to differentiate hysteria from diseases it resembled, such as epilepsy.” During one of his lectures, he presented to his viewers a hysteric in the midst of an attack. She called out, “Mama, I’m scared,” after which, Charcot remarked to his audience, “You see how hysterics scream. One could say that is a lot of noise about nothing. Epilepsy is more serious and much more silent.” But Augustine was a talkative girl. During another demonstration, Charcot induced a contraction of her tongue and larynx muscles, leaving her mute for six days.

Sometimes, Augustine relived traumatic incidents from her childhood through her attacks. She’d been sent to a convent school in a small town forty miles east of Paris at age six, where she remained until she was thirteen. She relished long walks in the countryside there, during which she befriended an older woman stuck in a miserable marriage with an abusive husband—when she was ten, the man turned his attention to Augustine, and attempted to sexually assault her. Her most potent memory, which she frequently acted out during attacks, was of a man she called Mr. C. Augustine was sent to Mr. C.’s household to work as a servant when she was thirteen. He brutally assaulted her, and six days later, Augustine had her first attack of hysteria while gazing into the eyes of a cat. Daily attacks followed, which were addressed, unsuccessfully, with bloodletting. Augustine suffered her most intense attack after running into Mr. C. while doing an errand. The scenes following Mr. C.’s assault on her foretold why observations of hysterics would later serve as the basis for psychoanalysis. While her attacks became milder once she was working as a chambermaid for an elderly woman, she also developed an interest in two of her brothers’ friends and became sexually active with each of them. When her parents found out, they were furious, and in the midst of that fury, family confidences were revealed: Augustine learned that her father believed that her brother was not his son and that her mother had been sleeping with Mr. C. Asti Hustvedt notes, “While it is not mentioned in the text, this revelation raises the real possibility that her brother is her rapist’s son. Augustine also finds out that her mother had sold her daughter to Mr. C. as a sexual favor.” The structure of the episode alludes to Freud’s case study of Dora—who was implicitly handed over by her father to his lover’s husband to fulfill the cost of his adultery—and to countless others in Studies in Hysteria.

Augustine would see Mr. C. one more time, when he came to the Salpêtrière for one of Charcot’s lectures, presumably with the hope of catching a glimpse of the young woman he had assaulted. “A man like you, a forty-year-old man,” Augustine recounted to Bourneville, while she was possibly in a hallucinatory state, “what do you know about medicine . . . You will not see me in the class . . . I have decided to tell . . . On two Sundays . . . Why did I hide my face in the class . . . Because of you.”

While Charcot sought to identify an organic biological illness causing the hysterics’ symptoms, Bourneville was more inclined toward considering the psychological context of the patients. He paid attention to the consistency of trauma in the histories of the women of the Salpêtrière years before Freud developed methods to force them to relive it, repeatedly, in the hope that something useful might emerge. Bourneville justified including a great deal of information about each patient’s life, “so that our readers can clearly appreciate the different phases of the delirium phase of the attack.” It was with Bourneville that Augustine felt she could speak and be heard. It was Bourneville’s idea to photograph the hysteria patients in Charcot’s ward, to allow them to speak through, or be lost in, the language of images.