Freud and the diagnosis of Gilles de la Tourette's illness.
A number of observers recently have taken Freud to task for failing to have diagnosed both Frau Emmy von N.'s (1888-9) involuntary ticcing and vocalizations and Daniel Paul Schreber's (1911) coprolalia and convulsive tics as Tourette's syndrome.  None of Freud's critics, however, has placed Freud's understanding of motor and vocal tics in historical context.  None seems aware of the contests over the classification of tic symptoms in the 1880's and 1890's, nor do they appreciate the extent to which Charcot and Gilles de la Tourette had conceded that motor and vocal tics, as well as coprolalia, could also appear as symptoms of hysteria. By 1893 (when Freud first wrote out his case of Frau Emmy von N.), both Gilles de la Tourette and Charcot had defended themselves against Guinon's claim that conculsive tics were always a symptom of hysteria by distinguishing those tic symptoms that should be classified as "maladie des tics" from those that accompanied hysteria.  Yet Charcot and Gilles de la Tourette had agreed by 1890 that tic symptoms were possible outcomes of either maladie des tics or of hysteria.  What separated those afflicted with "hysteria", were particular inherited factors and whether or not the patient could be cured of tics and vocalizations.  Thus, within Charcotian terms, Freud was hardly obligated to conclude that his ticcing and cursing patients should have been diagnosed with maladie des tics de Gilles de la Tourette.
Kushner
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HI
Department of History, San Diego State University.
D003933:Diagnosis; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D011570:Psychiatry / Q000266:history*; D005879:Tourette Syndrome / Q000266:history*