Mademoiselle X: Living While Dead
By: Dale M. Brumfield
Tags: Death, Bizarre, Medical History, Psychiatry

FRENCH NEUROLOGIST DR. JULES COTARD had to be surprised and confused by the female patient (known only as Mademoiselle X) brought to his office at the Pitié-Salpêtrière University Hospital in Paris one afternoon in 1882. The 43-year-old described a peculiar set of symptoms: she claimed she had “no brain, no nerves, no chest, no stomach, no bowels — that there was nothing left of her but the skin and bones.”

Dr. Jules Cotard

Also, she claimed she had no soul, that there was no God and no devil, and that overall she was nothing but “a disorganized body.” With no internal organs, she claimed to not need to eat anymore. Further, she expressed her belief in her immortality, noting that she could not die a natural death, but “will live forever unless she is burnt, fire being her only possible end.”

A century earlier …

Intrigued by the woman and her ominous indications, Cotard did some research and discovered that a Swiss scientist, Charles Bonnet, had in 1788 reported a curious case of an elderly woman whose descriptions were eerily similar to those of the woman brought to his office.

Bonnet had recorded that the woman was preparing a meal when she felt “a draft” then fell paralyzed on one side of her body. As the paralysis eased, she told her daughters to dress her in a shroud and place her in a coffin, because she was dead, and demanded everyone treat her that way.

Humoring her, the family dressed her in a shroud and laid her in a coffin so they could mourn her. When she finally fell asleep, her family undressed her and placed her in bed. Later she was treated with a powder made of precious stones and opium and her symptoms eased, still returning sporadically every few months.

After studying the Bonnet case, as well as other similar examples presented by the French psychiatrists Jean-Étienne Dominique Esquirol and Francoise Leuret, Cotard concluded that he was witnessing a new kind of depression he dubbed “Hypochondriacal Delirium” characterized by “anxious melancholia, condemnation of ideas, insensitivity to pain, negation delusion of the organs, and immortality delusion.” Sometime later, he created the term “negation delusion” to specify the syndrome.

Both of these women suffered from an extremely rare psychiatric condition now called Cotard’s Syndrome, or Cotard’s Delusion, a term used to describe patients who believe they have died or stopped existing, or no longer have any internal organs. Today the syndrome is known to be secondary to such conditions as psychotic depression, dementia, schizophrenia, bipolar disorder, and the use of psychoactive and psychotropic substances, especially heroin, LSD, and cocaine.

Rare

While only about 200 cases have been reported worldwide since Dr. Cotard isolated and described the condition, several have been reported over the past 20 years.

In 2003 a Greek psychiatrist saw a patient who believed he had no brain and was literally empty-headed. He admitted he had attempted suicide a few years earlier because life wasn’t worth living since he had no brain. He abruptly left without receiving treatment but was re-admitted the next year, when he completed treatment and showed substantial improvement.

Those same Doctors also treated a 72-year-old female who claimed, “all of her organs had melted; only skin had remained and that she was practically dead.” There is no public record of her treatment or prognosis.

In 2008 New York psychiatrists reported that a 53-year-old woman named Mrs. Lee complained she was dead and stunk of rotting flesh. She had wanted her family to take her to the morgue “with the other dead people” but they instead called 911.

She was admitted to the psychiatric unit, where she accused the paramedics of trying to burn down her house. It was reported that after a month of treatment she was discharged greatly improved.

In 2009 Belgian psychiatrists reported that an 88-year-old man complaining of depression admitted that he was in fact dead, and was concerned that no one had buried him. He improved with treatment, which may have included electroshock therapy, imipramine, and risperidone.

The same psychiatrists also reported a 46-year-old woman who insisted she had not eaten or used the bathroom in months and had not slept in years. She also explained that all her organs had rotted and that doctors who examined her were lying about her having blood and a heartbeat. She also gradually improved with medication.

In 2015, doctors in Brazil reported that a 31-year-old male was admitted, claiming insomnia, refusing to eat, and attempting suicide. He later reported that his organs were destroyed, that he was hollow inside, and that his entire body was rotten, reeking flesh.

He asserted also that his body was deformed, and that his face was full of holes. Wishing to die, he declared that he was paying for wrongs committed in his youth and that he was not worthy of any happiness. After a rigorous medication sequence, he was declared asymptomatic 60 days later and was released.

Modern-day sufferers of his bizarre malady fare much better than Dr. Cotard’s Mademoiselle X, who eventually died not of fire but starvation. Charles Bonnet may have missed the first case of what would become known as Cotard’s, but he is the namesake of a condition called Charles Bonnet Syndrome, which is characterized by normally rational people who experience vivid hallucinations.

Not impressed

The Medico-Psychological Association of Great Britain scoffed at Dr. Cotard’s research and conclusions.

In the 1883–84 edition of The Journal of Mental Science, Authors D. Hack Tuke and George H. Savage, M.D. wrote of the symptoms Cotard described that “Somewhat similar cases are referred to as illustrating the one under consideration, but they are not of special interest. Neither indeed is the one recorded by Dr. Cotard, and we cannot understand why he should suggest a special name for such, and give six special characteristics by which they may be recognized [sic].

The fact is that among the educated classes there is no end to the elaboration of delusions, especially in women of a religious and hysterical temperament.”

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Dale Brumfield is proud to announce the release of his latest book “Railroaded: the true stories of the first 100 people executed in Virginia’s electric chair,” now available worldwide on all online sellers. Read more “historytelling” at his website, www.dalebrumfield.net.