Faith Healing, Jean-Martin Charcot, and Neurology

In September 1891, Émile Zola visited the Sanctuary of Our Lady of Lourdes and returned again in August of the following year to conduct research for a novel. His interviews with the pilgrims and the sick who had gone there to take the holy waters received attention in the press, and the editor of the New Review approached Jean-Martin Charcot to see if he would write an article for the periodical on "the faith cure."

Charcot’s essay was published in January 1893 and proved to be his final publication before his death in August. He began his essay by stating that the aim of medicine was to heal the sick irrespective of the method used, and, as a consequence, the topic of faith healing should be of interest to all physicians. He defined faith healing as the instantaneous cure of a disorder that had proved refractory to all established medical treatments:

Impassioned polemics serve no purpose except to confuse the issue and imperil even the strongest case. One cannot possibly hope to settle this question of the faith-cure—which, I say again, is entirely of a scientific order, one in which facts long and faithfully noted and grouped in logical order are the only admissible arguments—by unproved assertion or groundless negation.

A Natural Phenomenon

Charcot believed that faith healing was a natural phenomenon and, therefore, could only be effective in dynamic nervous disorders in which the mind exerts power over the body. In the course of his extensive studies on hysteria, he had observed a number of examples of the sudden disappearance of chronic nervous complaints that had proved resistant to treatment. In one of his lectures, he had described how "Pin’s" right-arm paralysis had been cured by finding a hysterogenic point, and how "Le.log," a paraplegic who believed falsely that a carriage had run over his legs, recovered after he had experienced a spontaneous convulsion in which his feet had struck the bed rail with considerable force. On coming round, "Le.log" had risen from the bed and begun to walk unsteadily at first, but with full strength after a few hours.

Charcot also wrote how "moral shock" sometimes triggered an immediate cure. For example, a woman with a longstanding hysterical contracture of her right leg got better after being accused of theft, while another hysterical patient whom he had been forced to admonish for misbehaviour recovered immediately afterward. Jane Avril, a teenage girl who would later in life become a star at the Moulin Rouge dance hall, recovered abruptly from a psychogenic movement disorder after she had attended a hospital dance, where she impressed all those present with her graceful choreography. Charcot was aware that sometimes even his mere presence at the bedside or in the lecture theatre could induce complete remission or severe relapse in his patients.

In the New Review piece, he also reviewed the history of thaumaturgy and pointed out that, as far as he could determine, there was not a single convincing example of the restoration of an amputated leg. The disappearance of tumours, ulcers, and oedema, he believed, could be explained by natural laws.

Many of the world’s greatest shrines have similar settings. Often they are situated in beautiful countryside on hillsides or the side of mountains close to natural springs, and they frequently include caves or grottos with religious relics. In an aperçu, he also mentioned that the patrons of some of the most renowned sanctuaries are devoted to saints who themselves had experienced mental health problems (e.g., Theresa of Avila, Francis of Assisi). Although he believed no distinction should be drawn between medical, lay, and religious faith cures, he concedes that there have been occasions when patients he had failed to help had gone to holy shrines and returned free of symptoms. La Salpêtrière could not compete with the successes of Lourdes for miracles.

Ideal Candidate for Faith Healing

Charcot believed that the ideal candidate for faith healing was a patient with a functional nervous disorder who was brimming with expectation of a cure, full of blind faith, and highly autosuggestible, characteristics that his adversary Bernheim had considered ideal for medical hypnotism. The use of suggestibility as a treatment approach in hysteria was hazardous and one he likened to the employment of a medication with an extremely narrow window of efficacy. In one of his lectures, he cautioned physicians against the routine use of commandment in hysteria:

A miracle worker can say to his patient, ‘Get up and walk.’ Why should we not play the thaumaturge, since it is for the good of our patients? Well gentlemen I do not say that categorically you should never do anything of the kind. In certain cases, if you are quite sure of your diagnosis, perhaps you will do well to take the risk. You had better walk cautiously in such matters. Do not forget that, in practice, you have to deal with questions of taste, opportunity, and let me add, medical dignity, for the importance of this last must never be overlooked. Do not forget that nothing can make you seem more absurd than to predict with great pomp and circumstance a result which will perhaps never be achieved.

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Because only a small proportion of his patients with hysteria were highly suggestible, he preferred to use an intensive mental training programme to try to induce remission. This involved gentle persuasion, graded exercise with visualisation in paralysis, isolation from the family in children and young women, and the application of static electricity, hypnosis, cold showers, and sulphur baths:

In the first place we acted, and continue to act every day on their minds as much as possible, affirming in a positive manner, a fact of which we are ourselves perfectly convinced—that their paralysis, in spite of its long duration, is not incurable, and that, on the contrary, it will certainly be cured by means of appropriate treatment, at the end possibly of some weeks, if they would only be good enough to aid us.

The practice of prayer and the laying on of hands is no longer discussed in medicine because it is believed to lack biological plausibility, and, in the United States, spiritual healing is not reimbursable. Faith healing is considered a pseudoscience or even a form of magical thinking even though millions of people believe that divine intervention can heal incurable diseases.

On the other hand, there is considerable interest and discussion of the potential for open-label placebos (sugar pills) in the treatment of psychosomatic conditions. Doctors who are compassionate and kind are inadvertently enhancing the placebo response, possibly working through activation of the patient’s dopaminergic reward systems. Is it conceivable that the window of opportunity offered by the first medical interview in the investigation of functional neurological disorder could owe its success to faith and belief in the practitioner?

Charcot concluded his essay with cautionary words that have lost none of their relevance in more than a century of further enquiry and encourage all doctors to keep their minds, ears, and eyes wide open:

Can we then affirm that we can explain everything which claims to be of supernatural origin in the faith-cure, and that the frontiers of the miraculous are visibly shrinking day by day before the march of scientific attainments? Certainly not. In all investigation we have to learn the lesson of patience. I am among the first to recognise that Shakespeare's words hold good to-day—'There are more things in heaven and earth, Horatio, Than are dreamt of in thy philosophy.’