Jean-Martin Charcot was a French neurologist and professor of anatomical
pathology. He is known as "the founder of modern neurology", and his name has
been associated with at least 15 medical eponyms, including Charcot-Marie-Tooth
disease and Charcot disease. Charcot has been referred to as "the father of
French neurology and one of the world's pioneers of neurology". His work greatly
influenced the developing fields of neurology and psychology; modern
psychiatry owes much to the work of Charcot and his direct followers. He was
the "foremost neurologist of late nineteenth-century France" and has been
called "the Napoleon of the neuroses". Personal life
Born in Paris, Charcot worked and taught at the famous Salpêtrière Hospital for
33 years. His reputation as an instructor drew students from all over
Europe. In 1882, he established a neurology clinic at Salpêtrière, which
was the first of its kind in Europe. Charcot was a part of the French
neurological tradition and studied under, and greatly revered, Duchenne de
Boulogne. "He married a rich widow, Madame Durvis,
in 1862 and had two children, Jeanne and Jean-Baptiste, who later became a doctor
and a famous polar explorer". Profession
= Neurology= Charcot's primary focus was neurology.
He named and was the first to describe multiple sclerosis. Summarizing previous
reports and adding his own clinical and pathological observations, Charcot
called the disease sclérose en plaques. The three signs of Multiple sclerosis
now known as Charcot's triad 1 are nystagmus, intention tremor, and
telegraphic speech, though these are not unique to MS. Charcot also observed
cognition changes, describing his patients as having a "marked
enfeeblement of the memory" and "conceptions that formed slowly". He was
also the first to describe a disorder known as Charcot joint or Charcot
arthropathy, a degeneration of joint surfaces resulting from loss of
proprioception. He researched the functions of different parts of the
brain and the role of arteries in cerebral hemorrhage.
Charcot was among the first to describe Charcot-Marie-Tooth disease. The
announcement was made simultaneously with Pierre Marie of France and Howard
Henry Tooth of England. The disease is also sometimes called peroneal muscular
atrophy. Charcot's studies between 1868 and 1881
were a landmark in the understanding of Parkinson's disease. Among other
advances he made the distinction between rigidity, weakness and bradykinesia. He
also led the disease formerly named paralysis agitans to be renamed after
James Parkinson. He also noted apparent variations on PD, such as Parkinson's
disease with hyperextension. Charcot received the first European professional
chair of clinical diseases for the nervous system in 1882.
= Studies on hypnosis and hysteria= Charcot is best known today, outside the
community of neurologists, for his work on hypnosis and hysteria. He initially
believed that hysteria was a neurological disorder for which patients
were pre-disposed by hereditary features of their nervous system, but near the
end of his life concluded that hysteria was a psychological disease.
Charcot first began studying hysteria after creating a special ward for
non-insane females with "hystero-epilepsy"; he discovered two
distinct forms of hysteria among these women; minor hysteria and major
hysteria. His interest in hysteria and hypnotism "developed at a time when the
general public was fascinated in ‘animal magnetism’ and ‘mesmerization’", which
was later revealed to be a method of inducing hypnosis. His study of hysteria
"attract[ed] both scientific and social notoriety".
"Charcot and his school considered the ability to be hypnotized as a clinical
feature of hysteria ... For the members of the Salpêtrière School,
susceptibility to hypnotism was synonymous with disease, i.e. hysteria,
although they later recognized ... that grand hypnotisme should be
differentiated from petit hypnotisme, which corresponded to the hypnosis of
ordinary people". The Salpêtrière School's position on
hypnosis was sharply criticized by Hippolyte Bernheim, a leading
neurologist of the time. Charcot himself long had concerns about the use of
hypnosis in treatment and about its effect on patients. He also was
concerned that the sensationalism hypnosis attracted had robbed it of its
scientific interest, and that the quarrel with Bernheim, furthered mostly
by his pupil Georges Gilles de la Tourette, had "damaged" hypnotism.
= Arts= Charcot thought of art as a crucial tool
of the clinicoanatomic method. He used photos and drawings, many made by
himself or his students, in his classes and conferences. He also drew outside
the neurology domain, as a personal hobby. Like Duchenne, he is considered a
key figure in the incorporation of photography to the study of neurological
cases. Eponyms
Charcot's name is associated with many diseases and conditions including:
Charcot's artery Charcot's joint
Charcot's disease Charcot–Marie–Tooth disease, named with
Pierre Marie and Howard Henry Tooth. Charcot–Wilbrand syndrome, named with
Hermann Wilbrand. Charcot's intermittent hepatic fever
Charcot–Bouchard aneurysms, named with Charles-Joseph Bouchard.
Charcot's triad of acute cholangitis Charcot's triad of multiple sclerosis
Charcot–Leyden crystals due to the lysis of eosinophils in cases of allergic
diseases, named with Ernst Viktor von Leyden.
Souques–Charcot geroderma: a variant of Hutchinson-Gilford disease, named with
Alexandre-Achille Souques. Charcot–Gombault necrosis: a biliary
infarct, named with Albert Gombault. Legacy
One of Charcot's greatest legacies as a clinician is his contribution to the
development of systematic neurological examination, correlating a set of
clinical signs with specific lesions. This was made possible by his pioneering
long-term studies of patients, coupled with microscopic and anatomic analysis
derived from eventual autopsies. This led to the first clear delination of
various neurological diseases and classic description of them. For
example, amyotrophic lateral sclerosis. Charcot is just as famous for his
influence on those who had studied with him: Sigmund Freud, Joseph Babinski,
Pierre Janet, William James, Pierre Marie, Albert Londe, Charles-Joseph
Bouchard, Georges Gilles de la Tourette, Alfred Binet, Jean Leguirec and Albert
Pitres. Charcot bestowed the eponym for Tourette syndrome in honor of his
student, Georges Gilles de la Tourette. Although by the 1870s, Charcot was
France's best known physician, according to Edward Shorter, his ideas in
psychiatry were refuted, and France did not recover for decades. Shorter wrote
in his A History of Psychiatry that Charcot himself understood "almost
nothing" about major psychiatric illness, and that he was "quite lacking
in common sense and grandiosely sure of his own judgement". This perspective
overlooks that Charcot never claimed to be practicing psychiatry or to be a
psychiatrist, a field that was separately organized from neurology
within France's educational and public health systems. After his death, Shorter
said the illness "hysteria" that Charcot described was claimed to be nothing more
than an "artifact of suggestion", however American psychologist Gardner
Murphy referred to Charcot's position in French psychiatry and psychology as
"prominent". After Charcot's death, Freud and Janet
wrote articles on his importance. The Charcot-Janet school, which formed from
the work of Charcot and his student Janet, contributed greatly to knowledge
of double and multiple personality, before being extended by Morton Prince's
Dissociation of a personality. The judgment of Charcot's work on hysteria
is influenced by a significant shift in diagnostic criteria and understanding of
hysteria which occurred in the decades following his death. The historical
perspective on Charcot's work on hysteria has also been distorted by
viewing him as a precursor of Freud. Charcot argued vehemently against the
widespread medical and popular prejudice that hysteria was rarely found in men,
presenting several cases of traumatic male hysteria. He taught that due to
this prejudice these "cases often went unrecognised, even by distinguished
doctors" and could occur in such models of masculinity as railway engineers or
soldiers. Charcot's analysis, in particular his view of hysteria as an
organic condition which could be caused by trauma, paved the way for
understanding neurological symptoms arising from industrial-accident or
war-related traumas. A song "Let Yourself Go" from The Alan
Parsons Project's Freudiana is dedicated to Doctor Charcot.
A 2012 French historical drama film, Augustine, is about a love affair
between Charcot and a patient. The New York Times film review describes Charcot
as "a complicated figure in retrospect, at once a charlatan and a pioneer, a
monster and a modernizer". Charcot appears, along with Maria
Skłodowska-Curie and Charcot's patient "Blanche", in Per Olov Enquist's 2004
novel The Book about Blanche and Marie. He also appears in the 2005 novel by
Sebastian Faulks, Human Traces, and in Axel Munthe's 1929 autobiographical
novel The Story of San Michele. In a letter to the New York Times Book Review
of January 18, 1931, however, Charcot's son wrote that "Dr Munthe never was
trained by my father." And in his 2008 biography of Munthe, Bengt Jangfeldt
says that 'Charcot is not mentioned in a single letter of Axel's out of the
hundreds that have been preserved from his Paris years.' Distorted views of
Charcot as harsh and tyrannical have arisen from some sources that mistakenly
identify Munthe as Charcot's assistant and take Munthe's autobiographical novel
as a factual memoir. In fact, Munthe was just a medical student among hundreds of
others. Munthe's most direct contact with Charcot was when he helped a young
female patient "escape" from a ward of the hospital and took her into his home.
Charcot threatened to advise the police and ordered that Munthe not be allowed
on the wards of the hospital again. A collection of his correspondence is
held at the United States National Library of Medicine.
Charcot Island in Antarctica was discovered by his son, Jean-Baptiste
Charcot, who named the Island in honor of his father.
The Charcot Award is given every two years by the Multiple Sclerosis
International Federation for a lifetime of outstanding research into the
understanding or treatment of multiple sclerosis.
Quotations "In the last analysis, we see only what
we are ready to see, what we have been taught to see. We eliminate and ignore
everything that is not a part of our prejudices".
"To learn how to treat a disease, one must learn how to recognize it. The
diagnosis is the best trump in the scheme of treatment.
"Symptoms, then, are in reality nothing but a cry from suffering organs."
"If you do not have a proven treatment for certain illnesses, bid [sic] your
time, do what you can, but do not harm your patients."
"... perfectly legitimate pathological phenomena, in which the will of the
patient counts for nothing, absolutely nothing"; in reference to the clinical
features of hysteria". See also
A Clinical Lesson at the Salpêtrière Notes
References Further reading
External links Biography and bibliography in the
Virtual Laboratory of the Max Planck Institute for the History of Science
Works by or about Jean-Martin Charcot at Internet Archive