Freud is not the first to have admitted the existence of unconscious psychic processes. Since the discovery of the reflex function of the spinal cord, many researchers had speculated that this reflex action also extended to the higher areas of the nervous system. For these psychophysiologists, reflex action is the very foundation of psychic activity, and consciousness (the ego) emerges from a background of unconscious automatisms that it inhibits, delays, and represses. Freud inherited this notion from Charcot who postulated that hysteria and hypnosis were a regression to this “unconscious cerebration” caused by a “traumatic shock.” This was the starting point of Freud’s initial theorization of the “psychical apparatus” as well of his first attempts at a therapy of the neuroses: psychical activity is governed by unconscious “primary processes” that tend towards an immediate “discharge” but are slowed down by the “secondary processes” of the conscious ego; the psychotherapy of the neuroses aims at bringing the unconscious part of the mind under the control of the conscious by lifting the pathogenic repression that caused the “dissociation” of the traumatic memory.

Foot and ankle examination begins with the patient standing. Then ask the patient to walk, observing the gait and the three rockers. If the diagnosis is pes planus or pes cavus, the relevant tests can be done at this point of the examination, a single leg tiptoe test or the Coleman block test, respectively. Inspection is then completed by asking the patient to sit and inspect the sole of the foot, between the toes and the shoes. Movements are performed in the joints from proximal to distal or distal to proximal, depending on the underlying pathology.

The chapter looks at a wide variety of pathology and the clinical examination findings related to these cases.

This chapter focuses initially on the impact of late nineteenth-century medical theory (hysteria, hypnotism, etc.) on the novel and the burgeoning of medically-inflected fiction. Post-hypnotic suggestion led to stories of crime and sexual manipulation and introduced the figure of the unscrupulous doctor/hypnotist, usually bested by a good-hearted physician expert in hypnotism techniques. Ambient medical research on mind-control and dual identity influenced Maupassant’s fiction, most notably in his story ‘Le Horla’. Substantial tales (‘Boule de suif’, ‘La Maison Tellier’) foreshadow and feed the drama, irony and humour of Maupassant’s novels. Three of these are studied here: the raucous, ferociously ironic Bel-Ami, the family drama of illegitimacy and identity, Pierre et Jean, and a story of the despondency of ageing and lost love, Fort comme la mort. The chapter closes with a discussion of the novels of Rachilde (Marguerite Eymery), seen increasingly as an important figure of France’s decadent period. Her early novels Monsieur Vénus and La Marquise de Sade played daringly with the notion of gender reversals and sadism, exercised against men; such themes suggest today an underlying feminist persuasion, an affiliation she denied. Later novels, many-textured such as La Tour d’amour, or La Jongleuse, a male/female confrontation on seduction and love, reveal the broadening of the novelist’s talent.