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In 1895, the journal Brain published responses to Tuke's paper. Below are some short excerpts from these responses. Tuke, an elderly man, had intended to reply to the responses, but he died suddenly.

[Dr. John Hughlings Jackson, whose views Tuke had challenged, wrote:] Although I had not the pleasure of hearing Dr. Hack Tuke's very important paper I have read it and beg to offer some comments upon it. After its perusal I find that I have several times seen cases in which there were what Dr. Tuke calls "imperative ideas." Unfortunately I paid but little attention to these cases in a scientific regard and certainly did not view them in the wide aspect Dr. Tuke so ably presents them. From his researches on this curious and important matter I feel sure neurologists will profit greatly. One thing which impresses me strongly is that Dr. Tuke deals with the cases of morbid ideation, he mentions as they are departures from normal mental states or at least as they are exaggerations and persistencies of mental states which at their origin it would be pedantic to call abnormal.

[Dr. G. H. Savage wrote:] As to their causation in my experience the most common predisposing cause has been hereditary predisposition....

...I believe that these imperative ideas are very common and that nearly everyone has some.... I have the feeling, which is common I believe, about walking along a pavement. I have an inclination to avoid the cracks and at the same time I have a tendency, I own, not irresistible, to touch the iron railings with my stick when I walk along a street....

Few of these cases need to be permanent inhabitants of asylums, in fact, many of them need never be there if their friends can afford to keep them out of asylums.

[Dr. C. Mercier, who seems to have thought a lot of himself, wrote:] The feature in Dr. Tuke's paper which impresses me most, is the complete acceptance of a doctrine that I have long held and preached....

[Dr. J. Milne Bramwell wrote:] Dr. Hack Tuke states that the mental phenomena which he has described have been more clearly recognised by French and German, than by English writers. This is undoubtedly correct; but, although the former have long recognised such conditions, it is only within comparatively recent times that they, like ourselves, have ceased to confound them with various forms of insanity.

...In 1875, Legrand du Saulle showed that the same patients could present successively the symptoms of "folie du doute" [roughly, obsessive doubting] and those of "délire du toucher" [compulsions relating to touching] and he attempted, by joining these two conditions, to form a special mental affection [i.e., affliction].... In opposition to Legrand du Saulle, Ladame demands the separation of "folie du doute" and "délire du toucher" into two distinct clinical varieties.

...As regards the connection between "folie du doute" and "délire du toucher" it is interesting to notice that the latter condition occurred in [a certain patient whom Bramwell had described earlier] as soon as the patient's doubts took a material form, but was not associated with it when his obsessions were purely intellectual. Does not this show that the appearance of the "délire du toucher" simply depends upon the nature of the "folie du doute," and that the incessant washings &c., are the patient's natural physical efforts to rid himself of his material fears, while the character of the purely intellectual obsessions renders such relief impossible.

From On imperative ideas, Brain, 1895, 18:318-351.

NOTE: For more on Tuke's paper and the responses to it, see Berrios, 1996, pp. 147-9.


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