To think of the hysterics’ madness as cries from the heart, an expression of some soulful artistry of women kept emotionally captive by their time and context, feels too easy, too literal. There is such strategy in the articulation of suffering of some women in pain that it can be difficult not to approach their words and images as art objects, but isn’t an articulate strategy always demanded of a woman whose symptoms are not medically legible? What is she supposed to do but try to communicate the nature of her illness? Whether her culture understands her vocabulary has very little to do with it.

A dangerous dichotomy remains, then: What of Charcot, unable to help himself from documenting Augustine’s beautifully expressed symptoms, her luxurious pain? Do I excuse myself from this atrocious paradox—am I not considering her actions as some sort of performance, accusing her of fabrication? The closest thing to a consensus on the images, from art historian Georges Didi-Huberman: “A reciprocity of charm was instituted between physicians, with their insatiable desire for images of Hysteria, and hysterics, who willingly participated and actually raised the stakes through their increasingly theatricalized bodies. In this way, hysteria in the clinic became the spectacle, the invention of hysteria. Indeed, hysteria was covertly identified with something like art, close to theater or painting.” Huberman adds that he is “nearly compelled” to consider the Salpêtrière’s hysteria spectacle as “a chapter in the history of art.”

Hegel’s chiasmus, the turning point, the catharsis, was incorporated by Pinel into the psychology of madness. The chiasmus says that madness is not a true loss of all reason, according to Hegel, but “a simple contradiction within reason,” which, with human treatment, can be redirected, “just as physical disease is not an abstract, i.e., mere and total, loss of health (if it were that, it would be death), but a contradiction in it.” But what is the chiasmus of Pinel’s freed woman? She has been treated “philanthropically”—Hegel long lauded Pinel for the humanity with which he approached the madwomen—but her mannerisms suggest that, despite this, she is no closer to being freed of her condition. Hysteria treatment under Charcot maintained this fluidity between the carnival and the clinical, but unlike Hegel and Pinel, Charcot always believed that he would find a lesion, a biological marker for hysteria, an authenticator of sorts. “Gentlemen, we have yet to determine the relationship that ought now to exist between pathology and physiology . . . the new physiology absolutely refuses to see life as a mysterious and supernatural influence, which acts as fancy takes it, free from all laws. Physiology goes so far as to believe that vital properties will one day be reduced to properties of a physical order.”

Authenticity was at the core of all Charcot believed about hysteria, and during his medical seminars, spectacles in which he would hypnotize the hysteric and manipulate her attacks, he believed that the phenomenon of hypnosis was not the hallucination of a madwoman, insisting, rather, on the reality of the patient’s perceptions. Blanche was questioned as to whether the hypnotized hysterics were faking it, to make fools of the doctors or the audience. “Simulation!” she exclaimed. “Do you think that it would have been easy to fool Monsieur Charcot? Oh yes, there were certainly some jokers who tried! He would look them straight in the eye and say ‘Be still.’”