Henri Le Grand du Saulle (1830-1886) was a French medical doctor who wrote a monograph on obsessions and compulsions.Henri Le Grand du Saulle (1830-1886) was a French medical doctor who wrote a monograph on obsessions and compulsions.
The phrase folie du doute avec délire de toucher [roughly, madness of the doubt with touching] speaks of my clear desire to name this condition according to its salient clinical features; namely, a mental questioning prompted by doubt and by a fear of contact with certain external objects. Doubt begins the morbid drama. Long afterward, eccentricities about touching bring the drama to a close. In giving a name to the illness, doubt and touching should be juxtaposed. This would probably be the only way of lastingly fixing one's attention on these two fundamental peculiarities of the neurosis in question.
...there will be fear of touching certain objects along with a grossly abnormal preoccupation with cleanliness and repeated washing. There will be eccentricities of every sort... [but] the preservation of one's intellectual faculties remains always intact....
After no end of anxiety, efforts, struggle and suffering, the patients, after having sought stubbornly the origins of their fixed ideas, their strange disturbances and bizarre actions, finally consult a doctor--hoping to be enlightened about their anomalous condition and about their inability to conquer it; also, about the likelihood of improvement, worsening, or recurrence.
...quite unanticipated revelations on the part of the patient, in the form of extremely detailed recitations of his hitherto unsuspected suffering, in the inception of an endless chain of questions, in the repeated imploring of reassuring words, and in the extraordinary ease with which an acquaintance can--for the moment at least--dispel the patient's seemingly deepest fears....
In the grip of unceasing anxieties and of suffering without end,...disillusioned with everyone--especially with doctors and the medical profession--and, with their intelligence well preserved, aware at every moment of the bizarreness of the behavior, the patients...venture out less and less, they give up sitting in the waiting rooms of consultants, seek treatment no longer....they remove themselves from life, becoming asocial in the process. They avoid the world....
[Le Grand du Saulle included clinical vignettes in his book, such as the ones below.]
Vignette #1: Miss Hortence G., twenty-four years old, a musician of high reputation, gave music lessons in a large city. She is intelligent, active, punctual, conscientious, and enjoys the good opinion of all who know her. When she is by herself in the street, she has preoccupations of the following sort: "What if somebody falls from a window up above and lands right at my feet? Would it be a man or a woman? Would the person be injured or actually die? Would there be blood on the sidewalk? If the person were to die from the impact, would I be able to tell this? Should I call for help, flee the scene, or recite right then and there a pater noster or an ave? Might others accuse me of having been responsible for the occurrence? And then would my pupils all quit me? Or perhaps people might realize I was innocent." All these thoughts would crowd her mind and affect her emotions. She would begin to tremble.
Vignette #2: A young woman who around age twelve had already been tormented with religious scruples, happened to see a person with a cancerous facial ulceration come to her father's home.... Eventually it became clear to everybody that she was obsessed with the thought that all the clothes and objects around the house were more or less tainted and covered with cancerous matter. Weighed down by this apprehension, she was no longer able to sleep, no longer knew what attitude to take, and spent all her time brushing, rubbing and washing. She understood perfectly well that her fears were without foundation, but she was powerless to dispel them. Her life became a continual torture. Slowly and gradually her fears did lessen and then disappear and her life returned to normal.... A few years later this young woman...married and became a mother.... One day it chanced that someone mentioned to her that a "mad dog" [rabid dog] had wandered briefly into her house. She herself had not noticed this, nor had she been in any contact with the dog--yet she was very shaken. She became more and more worried, grew depressed....she could not bring herself to touch the "rabid dust" on her furniture, on the chimney, the floors, her pockets, other people's clothes, kitchen utensils...in a word, anywhere. She wiped, scoured, brushed or washed everything she touched, even when at other people's homes, nor did she dare touch the door-knocker at her own home. She bewailed her current state (she was now thirty-six), understood that her anxieties were groundless, and beseeched the doctors to cure her....