Jean-Martin Charcot

Jean-Martin Charcot
Born (1825-11-29)29 November 1825
Paris, France
Died 16 August 1893(1893-08-16) (aged 67)
Lac des Settons, Nièvre, France
Residence France
Nationality French
Fields Neurologist and professor of anatomical pathology
Institutions Pitié-Salpêtrière Hospital
Known for Studying and discovering neurological diseases

Jean-Martin Charcot (/ʃɑːrˈkoʊ/; French: [ʃaʁko]; 29 November 1825 – 16 August 1893) was a French neurologist and professor of anatomical pathology.[1] He is known as "the founder of modern neurology",[2] and his name has been associated with at least 15 medical eponyms, including Charcot–Marie–Tooth disease and Charcot disease (better known as amyotrophic lateral sclerosis, motor neurone disease, or Lou Gehrig disease).[1] Charcot has been referred to as "the father of French neurology and one of the world's pioneers of neurology".[3] His work greatly influenced the developing fields of neurology and psychology; modern psychiatry owes much to the work of Charcot and his direct followers.[4] He was the "foremost neurologist of late nineteenth-century France"[5] and has been called "the Napoleon of the neuroses".[6]

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.[6] In 1882, he established a neurology clinic at Salpêtrière, which was the first of its kind in Europe.[1] Charcot was a part of the French neurological tradition and studied under, and greatly revered, Duchenne de Boulogne.[7][8]

"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".[9]

He was accused of being an atheist.[10]

Career

Neurology

Charcot uses hypnotism to treat hysteria and other abnormal mental conditions. All materials from "Iconographie photographique de la Salpêtrière" (Jean Martin Charcot, 1878)

Charcot's primary focus was neurology. He named and was the first to describe multiple sclerosis.[1][11] 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.[1]

Charcot was among the first to describe Charcot–Marie–Tooth disease (CMT). The announcement was made simultaneously with Pierre Marie of France (his resident) and Howard Henry Tooth of England. The disease is also sometimes called peroneal muscular atrophy.[12]

Charcot's studies between 1868 and 1881 were a landmark in the understanding of Parkinson's disease.[13] Among other advances he made the distinction between rigidity, weakness and bradykinesia.[13] He also led the disease formerly named paralysis agitans (shaking palsy) to be renamed after James Parkinson.[13] He also noted apparent variations on PD, such as Parkinson's disease with hyperextension.[14] Charcot received the first European professional chair of clinical diseases for the nervous system in 1882.[15]

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,[6][16] but near the end of his life he concluded that hysteria was a psychological disease.[17]

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.[18] His interest in hysteria and hypnotism "developed at a time when the general public was fascinated in 'animal magnetism' and 'mesmerization'",[19] which was later revealed to be a method of inducing hypnosis.[20] His study of hysteria "attract[ed] both scientific and social notoriety".[21] Bogousslavsky, Walusinski, and Veyrunes write:

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 (in hysterics) should be differentiated from petit hypnotisme, which corresponded to the hypnosis of ordinary people.[19]

Charcot argued vehemently against the widespread medical and popular prejudice that hysteria was rarely found in men, presenting several cases of traumatic male hysteria.[22] He taught that due to this prejudice these "cases often went unrecognised, even by distinguished doctors"[23] 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.[24]

The Salpêtrière School's position on hypnosis was sharply criticized by Hippolyte Bernheim, another leading neurologist of the time.[19] Bernheim argued that the hypnosis and hysteria phenomena that Charcot had famously demonstrated were in fact due to suggestion. However, Charcot himself had had longstanding 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,[21] and that the quarrel with Bernheim, amplified by Charcot's pupil Georges Gilles de la Tourette, had "damaged" hypnotism.[19]

Arts

Charcot demonstrating hypnosis on a "hysterical" Salpêtrière patient, "Blanche" (Blanche Wittmann), who is supported by Dr. Joseph Babiński (rear). Note the similarity to the illustration of opisthotonus (tetanus) on the back wall.[25]

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.[26]

Distorted views of Charcot

Distorted views of Charcot as harsh and tyrannical have arisen from some sources that rely on a fanciful autobiographical novel by Axel Munthe, The Story of San Michele (1929). Munthe claimed to have been Charcot's assistant, but in fact, Munthe was just a medical student among hundreds of others. Munthe's most direct contact with Charcot was when Munthe helped a young female patient "escape" from a ward of the hospital and took her into his home. Charcot threatened to report this to the police, and ordered that Munthe not be allowed on the wards of the hospital again.[27]

In a 1931 letter to The New York Times Book Review, Charcot's son Jean-Baptiste Charcot, who had, himself, been a formal student of his father at the Salpêtrière, emphatically stated:

I can certify that Dr Munthe never was trained by my father"; and, further, that "[although Munthe] may have [incidentally] followed, like hundreds of others, some courses of Charcot, ...he was not trained by him and certainly never had the intimacy of which he boasts [in his recently reviewed work, Memories and Vagaries]. ...I was, myself, a student at the Salpetriere then, and can certify that he was not one of his students and that my father never knew him. Everything he says about professor Charcot is false....[28]

Bengt Jangfeldt, in his 2008 biography, Axel Munthe: The Road to San Michele, states that "Charcot is not mentioned in a single letter of Axel's out of the hundreds that have been preserved from his Paris years" (p. 96).[29]

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.[30] This led to the first clear delination of various neurological diseases and classic description of them. For example, amyotrophic lateral sclerosis.[31]

Charcot is just as famous for his influence on those who had studied with him: Sigmund Freud,[6] Joseph Babinski,[1] Pierre Janet,[6] William James, Pierre Marie, Albert Londe, Charles-Joseph Bouchard,[1] Georges Gilles de la Tourette,[1] Alfred Binet,[6] Jean Leguirec[1] and Albert Pitres. Charcot bestowed the eponym for Tourette syndrome in honor of his student, Georges Gilles de la Tourette.[5][32]

Although, by the 1870s, Charcot was France's best known physician, his ideas about hysteria were later refuted, and French psychiatry did not recover for decades. An example of the dismissal of Charcot's views can be found in Edward Shorter's History of Psychiatry: Shorter states that Charcot 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 the fact that Charcot never claimed to be a psychiatrist or to be practising psychiatry, a field that was separately organized from neurology within France's educational and public health systems.[33] After Charcot's death, the phenomenon of "hysteria" that he had described was no longer recognized as a real neurological condition, but was considered to be an "artifact of suggestion".[34] However, Charcot continued to have a "prominent" position in French psychiatry and psychology.[35] The negative evaluation of Charcot's work on hysteria was influenced by a significant shift in diagnostic criteria and understanding of hysteria which occurred in the decades following his death.[36] The historical perspective on Charcot's work on hysteria has also been distorted by viewing him as a precursor of Freud. After Charcot's death, Freud and Janet wrote articles on his importance.[37] However, Charcot's work on hysteria and hypnotism was at odds with the perspective Freud made famous, since Charcot believed in neurological determinism.

The Charcot-Janet school, which formed from the work of Charcot and his student Janet, contributed greatly to knowledge of multiple personality disorders.[38][39]

Eponyms

Charcot's name is associated with many diseases and conditions including:[1]

A song "Let Yourself Go" from The Alan Parsons Project's album Freudiana is dedicated to Doctor Charcot.

Charcot appears, along with Madame Curie and Charcot's patient "Blanche" (Marie Wittman), in Per Olov Enquist's 2004 novel The Book about Blanche and Marie (English translation, 2006, ISBN 1-58567-668-3). He also appears in the 2005 novel by Sebastian Faulks, Human Traces.

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".[42][43]

Miscellaneous

A collection of Charcot's correspondence is held at the United States National Library of Medicine.[44]

Charcot Island in Antarctica was discovered by his son, Jean-Baptiste Charcot, who named the Island in honor of his father.[45]

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.[46]

Quotations

See also

Notes

  1. 1 2 3 4 5 6 7 8 9 10 Enerson, Ole Daniel. "Jean-Martin Charcot". Who Named It?. Retrieved 13 October 2008.
  2. ↑ Lamberty (2007), p. 5
  3. ↑ Teive HA, Chien HF, Munhoz RP, Barbosa ER (December 2008). "Charcot's contribution to the study of Tourette's syndrome". Arq Neuropsiquiatr. 66 (4): 918–21. PMID 19099145. doi:10.1590/S0004-282X2008000600035.
  4. ↑ Bogousslavsky (2010), p. 7
  5. 1 2 Kushner (2000), p. 11
  6. 1 2 3 4 5 6 "Jean-Martin Charcot". A Science Odyssey: People and Discoveries. Public Broadcasting Service (PBS). 1998. Retrieved 13 October 2008.
  7. ↑ Siegel IM (Summer 2000). "Charcot and Duchenne: Of mentors, pupils, and colleagues". Perspectives in Biology and Medicine. 43 (4): 541–7. PMID 11058990. doi:10.1353/pbm.2000.0055.
  8. ↑ Haas LF (October 2001). "Jean Martin Charcot (1825–93) and Jean Baptiste Charcot (1867–1936)". J. Neurol. Neurosurg. Psychiatr. 71 (4): 524. PMC 1763526 Freely accessible. PMID 11561039. doi:10.1136/jnnp.71.4.524.
  9. ↑ Tan SY, Shigaki D (May 2007). "Jean-Martin Charcot (1825–1893): pathologist who shaped modern neurology". Singapore Med J. 48 (5): 383–4. PMID 17453093.
  10. ↑ Kugelmann, Robert. Psychology and Catholicism: Contested Boundaries. Cambridge: Cambridge UP, 2011. Print.
  11. ↑ Charcot JM (1868). "Histologie de la sclérose en plaques". Gazette des hopitaux, Paris (in French). 41: 554–55.
  12. ↑ Enersen, Ole Daniel. "Charcot–Marie–Tooth disease". Whonamedit.com. Retrieved October 16, 2008.
  13. 1 2 3 Lees AJ (September 2007). "Unresolved issues relating to the shaking palsy on the celebration of James Parkinson's 250th birthday". Mov. Disord. 22 (Suppl 17): S327–34. PMID 18175393. doi:10.1002/mds.21684.
  14. ↑ Jean-Martin Charcot and Movement Disorders: Neurological Legacies to the 21st Century
  15. ↑ Jeste (2007) p. 4
  16. ↑ Charcot (1889), p. 85
  17. ↑ Bogousslavsky (2010), p. 108
  18. ↑ Shorter (1997), p. 134
  19. 1 2 3 4 Bogousslavsky J, Walusinski O, Veyrunes D (2009). "Crime, hysteria and belle époque hypnotism: the path traced by Jean-Martin Charcot and Georges Gilles de la Tourette" (PDF). Eur. Neurol. 62 (4): 193–9. PMID 19602893. doi:10.1159/000228252.
  20. ↑ Plotnik (2012) p. 170.
  21. 1 2 Goetz (1995), p. 211
  22. ↑ Bogousslavsky (2010), p. 203
  23. ↑ Goetz (1987), p. 116
  24. ↑ Goetz (1987), p. 117
  25. ↑ The identities of each of the thirty separate individuals that are represented in this composite (1887) presentation painting by Pierre Aristide, André Brouillet (1857-1914) have been clearly identified at p.471 of Harris, J.C., "A Clinical Lesson at the Salpêtrière", Archives of General Psychiatry, Vol.62, No.5, (May 2005), pp.470-472.
  26. ↑ Goetz CG (April 1991). "Visual art in the neurologic career of Jean-Martin Charcot". Arch. Neurol. 48 (4): 421–5. PMID 2012518. doi:10.1001/archneur.1991.00530160091020.
  27. ↑ Hierons R (1993). "Charcot and his visits to Britain". BMJ. 307 (6919): 1589–91. PMC 1697759 Freely accessible. PMID 8292949. doi:10.1136/bmj.307.6919.1589.
  28. ↑ Charcot, J.-B. (18 January 1931). "Objection & Reproof". Letters to the Editor. The New York Times Book Review. p. 23, col. A.
  29. ↑ Jangfeldt, Bengt (2008). Axel Munthe: The Road to San Michele. London; New York: I. B. Taurus. p. 96. ISBN 9780857710680.
  30. ↑ Goetz (1995), p. 103
  31. ↑ See:
    • Charcot, J. M. (1874) "De la sclérose latérale amyotrophique," Le Progrès médical, series 1, 2 : 325-327, 341-342, 453-455.
    • Jean Martin Charcot with Désiré Magloire Bourneville, ed., Oeuvres complètes de J.M. Charcot (Complete works of J.M. Charcot), (Paris, France: Fèlix Alcan, 1894), , volume 2, "Douzième Leçon: Amyotrophies spinales deutéropathiques, — Sclérose latérale amyotrophique." (Twelfth lesson: Deuteropathic spinal amyotrophies — amyotrophic lateral sclerosis), pp. 234-248 ; "Treizième Leçon: De la sclérose latérale amyotrophique. Symptomatologie." (Thirteenth lesson: On amyotrophic lateral sclerosis. Symptomology), pp. 249-266.
  32. ↑ Black, KJ (22 March 2006). Tourette Syndrome and Other Tic Disorders. eMedicine. Retrieved on 27 June 2006.
    * Enerson, Ole Daniel. Georges Albert Édouard Brutus Gilles de la Tourette. Who Named It? Retrieved on 28 June 2006.
  33. ↑ Goetz (1995), p. 208
  34. ↑ Shorter (1997), pp. 84–86
  35. ↑ Gardner (1999), p. 145
  36. ↑ Goetz (1987), p. 115
  37. ↑ Bogousslavsky (2010), p. 120
  38. ↑ Gardner (1999), p. 389
  39. ↑ The Charcot-Janet school was later extended by Morton Prince in his book on Dissociation of a Personality (1905),
  40. ↑ "Souques-Charcot gerodema". Whonamedit.com.
  41. ↑ Jurado I, Andreu X, Martin J, et al. (1997). "Biliary infarct (Charcot-Gombault necrosis): CT and pathologic features". J Comput Assist Tomogr. 21 (1): 106–7. PMID 9022779. doi:10.1097/00004728-199701000-00020.
  42. ↑ Scott AO (16 May 2013). "Doctor and patient: a gothic love story". The New York Times. Retrieved 21 December 2013.
  43. ↑ Olsen M (21 May 2013). "French actress-singer Soko finds quiet showcase in 'Augustine'". Los Angeles Times. Retrieved 21 December 2013.
  44. ↑ "J.M. Charcot correspondence and draft 1870-1892". US National Library of Medicine. Retrieved 1 January 2014.
  45. ↑ Mills (2003), p. 135
  46. ↑ "Charcot Awards". 2015-03-10. Retrieved 2015-03-17.
  47. 1 2 3 Kundu AK (September 2004). "Charcot in medical eponyms". J Assoc Physicians India. 52: 716–8. PMID 15839450.
  48. ↑ Goetz CG (August–September 2009). "Jean-Martin Charcot and movement disorders: neurological legacies to the 21st century". International Parkinson and Movement Disorder Society. Retrieved July 15, 2013.
  49. ↑ Jeste (2007) p. 8

References

  • Bogousslavsky J, ed. (2010). Following Charcot: a Forgotten History of Neurology and Psychiatry. Frontiers of Neurology and Neuroscience. S Karger Pub. ISBN 978-3-8055-9556-8. 
  • Charcot JM (1889) [1878]. Clinical Lectures on Diseases of the Nervous System [Leçons sur les maladies du système nerveux]. 3 (Thomas Savill, translator ed.). London: The New Sydenham Society. Retrieved 21 October 2010. 
  • Goetz CG (1987). Charcot, the Clinician. New York: Raven Press. ISBN 0-88167-315-3. 
  • Goetz CG, Bonduelle M, Gelfand T (1995). Charcot: Constructing Neurology. Oxford University Press. ISBN 0-19-507643-5. 
  • Harris, J.C., "A Clinical Lesson at the Salpêtrière", Archives of General Psychiatry, Vol.62, No.5, (May 2005), pp. 470–472.
  • Jeste DV, Friedman JH (2007). Psychiatry for Neurologists. Springer. ISBN 1592599605. 
  • Kushner HI (2000). A Cursing Grain? The Histories of Tourette Syndrome. Harvard University Press. ISBN 0-674-00386-1. 
  • Lamberty GJ (2007). Understanding Somatization in the Practice of Clinical Neuropsychology. Minneapolis Oxford University. ISBN 9780195328271. 
  • Mills WJ (2003). Exploring Polar Frontiers: a Historical Encyclopedia. Santa Barbara, Calif: ABC-CLIO. ISBN 1-57607-422-6. 
  • Moskowitz BG, ed. (1998). The Princeton Symposium on the Legacy and Future of Social Cognition. Cengage Learning. p. 170. ISBN 1135664242. 
  • Murphy G (1999). An Historical Introduction to Modern Ssychology. Routledge. ISBN 0415-21034-8. 
  • Plotnik R, Kouyoumdjian H (2010). Introduction to Psychology. Cengage Learning. ISBN 0495903442. 
  • Shorter E (1997). A History of Psychiatry. John Wiley & Sons. ISBN 0-471-24531-3. 

Further reading

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