Postpartum women

In 1858, Marcé wrote Traité de la folie des femmes enceintes, a treatise about emotional disorders during pregnancy and after delivery. Equally important was his role in understanding anorexia nervosa in the nineteenth century. In a paper delivered to the Medical Psychological Society in Paris on October 31, 1859, Marcé described "young girls, who at the period of puberty and a precocious physical development, become subject to 'inappetency' carried to the utmost limits. Whatever the duration of their abstinence they experience a distaste for food" (i860: 833). Publishing in French and in English more than a decade before William Gull (who cites him), Marcé is regarded as "anorexia nervosa's forgotten man" because his commentary and evaluation of the disorder was generally ignored (Silverman 1989: 833). Yet, Marcé's descriptions of anorexia nervosa and the "inflexible, rigid, and stubborn characteristics of the personalities of anorexia nervosa patients" (Halmi 1999: 1673) are the first of their kind in modern medicine. The researchers and physicians of the twentieth century went on to follow Marcé's diagnostic criteria.

Marcé believed that the first physicians who addressed this "obstinate refusal of food" misunderstood its true significance (Marce i860: 264). He advocated the change of habitat in order to remedy the "sufferings of the stomach" because he believed that the family surroundings perpetuated the disorder (Silverman 1989: 833). Marce ascribed the symptoms to a "hypochondrial delirium." He also argued that what such sufferers eat helps define the syndrome: "the majority of hysterical and nervous sufferers make themselves remarkable for the slenderness of their diet, for their liking for indigestible food, and their antipathy for bread, meat, and strengthening dishes" (Marce i860: 264). Here, the ghost of Marce's contemporary Brillat-Savarin and the question of taste and cure reveals the symptoms of anorexia to be very much in line with the notion of "healthy" and "unhealthy" foods of mid-nineteenth-century Paris. The cure is not, however, in the kitchen; rather, it is "a sustained effort of the will" that leads to recuperation (Marce i860: 834).

SLG/Jessica Rissman See also Anorexia; Brillat-Savarin; Gull

References and Further Reading

Blewett, Andrew and Bottero, Alain (1995) "L.-V. Marce and the Psychopathology of Eating Disorders," History of Psychiatry 6 (21): 69-85. Halmi, Kathrine (1999) "Eating Disorders: Defining the Phenotype and Reinventing the Treatment," American Journal of Psychiatry 156 (11): 1673-5. Marce, Louis-Victor (i860) "On a Form of

Hypochondrial Delirium Occurring Consecutive to Dyspepsia and Characterized by Refusal of Food," Journal of Psychological Medicine and Mental Pathology 13: 264-6. Silverman, Jason (1989) "Louis-Victor Marce, 1828-64: Anorexia Nervosa's Forgotten Man," Psychological Medicine i9 (4): 833-5.

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