Criticism of pithiatism: eulogy of Babinski

Babinski, 'Chef de Clinique' of Charcot from 1885 to 1887, fully supported the ideas of his teacher on hysteria and thought that a dynamic brain cortical lesion is the cause of the disease. After Charcot's death in 1893, Babinski gradually revised his position. In a first step, he described many neurological signs in order to clearly distinguish hysterical manifestations from the organic disorders of the central nervous system. The most famous one bears his name, the Babinski sign, an inversion of the plantar cutaneous reflex, testifying to a lesion of the pyramidal tract. In a second step, he defined what remained of hysteria and proposed in 1901 to abandon the term 'hysteria' in favor of the neologism 'pithiatism', defined as a pathologic state resulting in disorders which can be very accurately reproduced by suggestion, and can disappear by persuasion. Babinski therefore retained the exclusive etiological role of suggestion and refuted, unlike Dejerine, the role of emotion. He also sought to separate pithiatism from simulation, but ambiguously he made pithiatics 'semi-malingerers'. During the Great War, with Froment, he described physiopathic disorders and separated them from pithiatic disorders and simulation. After being accepted by many French neurologists, pithiatism, the word as well as the concept, gently died out. There remained little more than a few philosophical uses (especially by Jean-Paul Sartre and Maurice Merleau-Ponty) or metaphorical ones. What remains of the work of Babinski in the field of hysteria is not so much the creation of pithiatism as the masterly description of neurological signs to formally exclude an organic lesion of the nervous system or simulation before looking like hysteria disorders.