Echoes of La Salpêtrière in Tamil Soil: Mapping Male Hysteria from Charcot’s Clinic to Padugalam’s Stage
Ilaiyabharathi Thulasimani1, Aishwarya Jaikrishnan2, Nirumal Khumar M3, Isha Senthil Velmurugan4, Shrimahitha Duraiyarasan5, Sai Kumar Reddy Pasya6
1Madras Medical College, Chennai, 2Saveetha Medical College and Hospital, Chennai, 3Neurology, Saveetha Medical College and Hospital, Chennai, 4Stanley Medical College, Chennai, 5Internal Medicine, Saint Mary’s Hospital Waterbury, Connecticut, 6University of Kansas Medical Center
Objective:
We aim to explore the neurohistorical evolution of male hysteria, tracing its origins in 19th-century neurology through to its contemporary ritual expressions, and to investigate the age-old tradition of Padugalam of Tamil Nadu, India as a culturally framed manifestation of collective functional neurological disorder.
Background:
Once a purely female condition, hysteria got a fresh coat of paint when Charcot documented extensive male cases at La Salpêtrière. Although the term fell out of vogue during recent times, its essential components—conversion, collapse, and revival—persist under newer diagnostic labels. Contemporary data show that men constitute nearly one-third of all functional neurological disorder and psychogenic non-epileptic seizure cases, with symptom profiles and psychosocial triggers comparable to women. Anthropological accounts describe male-exclusive trance states such as the Gurage awre of Ethiopia, the Malay amok, and the Theyyam of Kerala— culturally sanctioned dissociations. Within this continuum, the Padugalam ritual, wherein men from a single community reenact the death and resurrection of the deified brothers Ponnar and Sankar, exemplifies the intersection of functional neurology and spiritual expression.
Design/Methods:
A comprehensive scoping review from PubMed, historical neurology archives, and ethnographic literature on male hysteria, conversion disorders, and possession trance was done to situate Padugalam within this broader neuro-anthropological framework.
Results:
Historical analyses indicate that male hysteria paralleled female presentations once we remove diagnostic bias. Modern studies reveal little inherent sex based differences in dissociative or conversion phenomena, with familial clustering and plausible genetic susceptibility suggesting a biological foundation alongside psychosocial conditioning. The synchronous collapse and recovery observed during Padugalam mirroring conversion-like trance states may reflect both a learned ritual response and a latent predisposition.
Conclusions:
Padugalam reframes male hysteria as a culturally codified expression of stress and identity. This synthesis underscores the enduring interplay between neurology, genetics, and ritual, revealing that functional disorders, though refracted through culture, rest on shared neurobiological ground.
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