Plagues and epidemics have cut bloody swathes across the face of the world as far back as humanity can record or remember, but some are as disquieting as they are brutal.
Originally the site of the Carnutes city of Cenabum before being conquered in 52BC by Julius Caesar and later rebuilt by the Roman Emperor Aurelian as Aurelianum or Aureliana Civitas, the city that later became known as Cité d'Aurélien and, finally, Orléans has a storied, illustrious and sometimes bloody history. Still, despite a legacy stretching back over 2000 years, its strangest season undoubtedly came between 1791 and 1794 when the French city was consumed by an outbreak of an acute but transient psychological disorder, becoming known as The City of the Living Death for its suffers’ insistence that they were - despite evidence to the contrary - dead. The affliction spread like a plague, leading to the closure of one of the era’s great universities in the all-encompassing chaos of its wake, but would not be investigated in meaningful detail or even formally named for nearly a century when it was finally studied and more properly defined by a French neurologist, Dr. Jules Cotard, in 1880.
The first few places where the sickness took hold were centred around the bars and dwellings on the North shore of the Loire, although no particular places or persons were ever more than speculatively identified as the source of the outbreak. Over the course of the next few months the sickness spread, its reach like tendrils winding through the alleys and backstreets until there were few corners of Orléans that weren’t affected. The city’s doctors, even the lecturers and students from the University all came together to try and combat the outbreak, and there were rumours of experiments, even vivisections, performed on the victims of the delusion who would not otherwise be missed. People who had no friends or family caught up in the epidemic lived in fear that theirs would be next, and those who believed that they were already dead were bemoaning their living, anhedonic hell.
The most fervent and wilful of those affected made efforts to redress the ignominy of being, as they believed, grossly disrespected in their passing. They paid gravediggers, some of whom were themselves sympathetic sufferers, to secure them plots and bury them alive. For others, whose ability or will to care for themselves was severely diminished by their belief that that had already died and, in some cases, the feeling that their remaining essence required no sustenance, a true death followed closely after. These unfortunates, drawn and gaunt as they disinterestedly starved to death, haunted the streets, bemoaning their pain as the severing of the cord between body and spirit or the purgatorial pangs of their souls being cleansed or judged in preparation for passage to their final resting places. Seldom has a society of such plenty seen such unrepentant and indiscriminate misery, with paupers and the aristocracy weeping side by side for the lives they believed they had lost.
With symptoms lasting anywhere between nine and eighteen months, even those sufferers who could be persuaded or cajoled to maintain something resembling a normal life throughout the course of their illness were prone to fits of paralysing depression or crying jags: A death whose reward was an endless repetition of life’s daily toil proving too crushing for many to handle. As a result, many of the vital civil institutions and functions ground slowly to a halt as the outbreak wore on, the speed at which the sickness spread far more consistent than the slow ebb of those for whom it passed. Eventually Orléans was trapped in a siege even more crippling and demoralising than that which came to its walls during the Hundred Years War, with no army at its gates and only its bleak new moniker and reputation - The City of the Living Death - keeping its inhabitants trapped and all but the most desperate travellers and merchants away.
At its worst, in the winter of 1792, the streets were essentially ceded to the afflicted for almost a month, with many sufferers forced out by families who could not cope with their continued care. This was argued at the time and after the fact to be a mercy even, and perhaps especially, by those who had come through the sickness and found themselves kept and cared for well enough to allow for their abrupt rebirths, talking about the sickness as a living hell in which all light and happiness had been drained from the world. Despite the brutality of this response, however earnestly argued for, it reduced the number of extant cases dramatically and, although isolated pockets of Cotard’s Delusion continued to flare up, the hold it had over the city was broken. By late June in 1794 Orléans was completely free of the sickness, if not the guilt of how that freedom was bought.
The condition was later called Cotard’s Delusion or Cotard’s Syndrome - though there are doctors and medical historians who believe that the infectious nature of the illness seen in Orléans, whether physical or psychological in cause, as well as the spontaneous remission in those who did not receive any treatment differentiate it enough that it should be recategorised as a separate disorder - and caused those affected to believe that they were already dead. Described by Cotard as “The Delirium of Negation”, in its mildest form it encompasses severe depression with concomitant self-loathing through to, in its most acute presentation, derealisation and the depersonalisation leading to delusions that the sufferer and, sometimes, everyone and everything around them are dead, even that the world is ending. The physiological causes vary somewhat, but previous and pre-existing psychotic conditions or damage to one or more of several areas of the brain have been found in the majority of cases.
Although there is evidence that examples of Cotard’s Delusion were seen earlier in the 1700s, these cases were extremely scarce and scattered across the world, a pattern to which new occurrences returned following the outbreak in Orléans. Given that no other incidence of the syndrome has been recorded as being communicable, apparently being strictly psychological, researchers have looked to other occasions where other afflictions, such as the Tanganyika laughter epidemic of 1962 or Dancing Plague of 1518 in Strasbourg, Alsace, have spread from the domain of the mind and out into the world. As yet neither the cause nor any saviour or salve which may have played a part in the eventual disappearance of the outbreak has been identified but crisis plans, however futile, have been drawn up by some governments. If a virulent, transmittable version of Cotard’s Delusion were to reappear it could, potentially, become a global pandemic, choking the world in a malaise of the living dead.