In 1880, a middle-aged woman paid a visit to the French neurologist, Jules Cotard, complaining of an unusual predicament. She believed she had ‘no brain, no nerves, no chest, no stomach, no intestines’. Mademoiselle X, as Cotard dubbed her in his notes, told the physician she was ‘nothing more than a decomposing body’. She believed neither God nor Satan existed, and that she had no soul. As she could not die a natural death, she had ‘no need to eat’.
Mademoiselle X later died of starvation. 
Although this peculiar condition eventually became known as ‘Cotard’s Delusion’ the French neurologist was not the first to describe it. In 1788—nearly 100 years earlier—Charles Bonnet reported the case of an elderly woman who was preparing a meal in her kitchen when a draught ‘struck her forcefully on the neck’ paralyzing her one side ‘as if hit by a stroke’. When she regained the ability to speak, she demanded that her daughters ‘dress her in a shroud and place her in her coffin’ since she was, in fact, dead.
[T]he ‘dead woman’ became agitated and began to scold her friends vigorously for their negligence in not offering her this last service; and as they hesitated even longer, she became extremely impatient, and began to press her maid with threats to dress her as a dead person. Eventually everybody thought it was necessary to dress her like a corpse and to lay her out in order to calm her down. The old lady tried to make herself look as neat as possible, rearranging tucks and pins, inspecting the seam of her shroud, and was expressing dissatisfaction with the whiteness of her linen. In the end she fell asleep, and was then undressed and put into bed.
Hoping to break her spell, a physician attended her bedside and administered a ‘powder of precious stones mixed with opium’. Eventually, the woman did awake from her delusional state; however, she continuously redeveloped her paroxysm every three months for the rest of her life. During the periods when she thought that she was dead ‘she talked to people who had long been dead, preparing dinners for them and hosting the occasion somberly and constantly’. 
Today, the condition is sometimes referred to as ‘Walking Corpse Syndrome’. Although rare, people are still diagnosed as suffering from nihilistic delusional beliefs that they are dead and no longer exist. Occasionally, the condition is characterised by a belief that one is missing essential body parts or organs, as in the a case of a 28-year-old pregnant woman who thought her liver was ‘putrefying’ and that her heart was ‘altogether missing’ in 2007.
Very little is known about Cotard’s Delusion. Researchers now believe it could be linked to bipolar disorder in young people, as well as severe depression and schizophrenia in older patients. Treatment of the condition is varied. Typically, those suffering from it are put on a combination of anti-depressants and anti-psychotic drugs, although electroconvulsive therapy has also been known to be successful.
One thing is for certain: Cotard’s Delusion, or ‘Walking Corpse Syndrome,’ illustrates just how little we still know about the human brain in the 21st century.
1. Berrios G.E & Luque R, ‘Cotard’s Delusion or Syndrome: A Conceptual History’, Comprehensive Psychiatry, 36:3 (May/June, 1995), p. 218.
2. Hans Forstl and Barbara Beats, ‘Charles Bonnet’s Description of Cotard’s Delusion and Reduplicative Paramnesia in an Elderly Patient (1788)’, British Journal of Psychiatry (1992), p. 417.