Jean-Martin Charcot

Jean-Martin Charcot
Born	29 November 1825(1825-11-29) Paris, France
Died	16 August 1893(1893-08-16) (aged 67) Lac des Settons, Nièvre
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 (29 November 1825 – 16 August 1893; English pronunciation: /ʃɑrˈkoʊ/, US dict: shâr·kō′) was a French neurologist and professor of anatomical pathology.^[1] He is known as "the founder of modern neurology" and is "associated with at least 15 medical eponyms", including Charcot-Marie-Tooth disease and amyotrophic lateral sclerosis (motor neurone disease).^[1] Charcot has been referred to as "the father of French neurology and one of the world's pioneers of neurology".^[2]

His work greatly influenced the developing fields of neurology and psychology. He was the "foremost neurologist of late nineteenth-century France"^[3] and has been called "the Napoleon of the neuroses".^[4]

Life

Personal life

Born in Paris, France, Charcot worked and taught at the famous Salpêtrière Hospital for 33 years. His reputation as an instructor drew students from all over Europe.^[4] 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.^[5][6]

"He married a rich widow, Madame Durvis, in 1862 and had two children, Jeanne and Jean-Baptiste, the latter becoming both a doctor and a famous polar explorer".^[7]

Neurology

Charcot's primary focus was neurology. He named and was the first to describe multiple sclerosis.^[1][8] Summarizing previous reports and adding his own clinical and pathological observations, Charcot called the disease sclerose 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.^[9]

Charcot's studies between 1868 and 1881 were a landmark in the understanding of Parkinson's disease.^[10] Among other advances he made the distinction between rigidity, weakness and bradykinesia.^[10] He also led the disease, which was formerly named paralysis agitans (shaking palsy), to be re-named on behalf of James Parkinson.^[10]

Studies on hypnosis and hysteria

Charcot is best known today, outside the community of neurologists, for his work on hypnosis and hysteria. He believed that hysteria was a neurological disorder for which patients were pre-disposed by hereditary features of their nervous system.^[4][11] Charcot's interest in hysteria and hypnotism "developed at a time when the general public was fascinated in 'animal magnetism' and mesmerization' ... 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".^[12]

The Salpêtrière School's position on hypnosis were sharply criticized by Hippolyte Bernheim, a leading neurologist of the time.^[12] 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,^[13] and that the quarrel with Bernheim, further mostly by his pupil Georges Gilles de la Tourette, had "damaged" hypnotism.^[12]

Arts

Drawing by Charcot of a Parkinson's disease patient during a trip to Morocco

Charcot thought of art as a crucial tool of the clinicoanatomic method. He used extensively 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. He is considered key in the incorporation of photography to the study of neurological cases.^[14]

Eponyms

Charcot demonstrates hypnosis on a "hysterical" Salpêtrière patient, "Blanche" (Marie Wittman), who is supported by Dr. Joseph Babiński (rear).

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

• Charcot's artery (lenticulostriate artery)
• Charcot's joint (diabetic arthropathy)
• Charcot's disease (amyotrophic lateral sclerosis, the most-common subtype of motor neurone disease- also known as Lou Gehrig's disease.
• Charcot's douche, a very energetic form of massage with a water jet, offered at many spas, especially popular in eastern Europe.^[15]
• Charcot-Marie-Tooth disease (peroneal muscular atrophy)
• Charcot Wilbrand syndrome (visual agnosia and loss of ability to revisualise images)
• Charcot's intermittent hepatic fever (intermittent pain, intermittent fever, intermittent jaundice, and loss of weight)
• Charcot-Bouchard aneurysms (tiny aneurysms of the penetrating branches of middle cerebral artery in hypertensives)
• Charcot's triad
• Charcot arthropathy
• Charcot-Leyden crystals due to eosinophils white blood cells lysis in cases of allergic diseases.
• Souques-Charcot geroderma: a variant of Hutchinson-Gilford disease;^[16] named with Alexandre-Achille Souques.

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.^[17] This led to the first clear delination of various neurological diseases and classic description of them. For example, amyotrophic lateral sclerosis.^[18]

Charcot is just as famous for his students: Sigmund Freud,^[4] Joseph Babinski,^[1] Pierre Janet,^[4] William James, Pierre Marie, Albert Londe, Charles-Joseph Bouchard,^[1] Georges Gilles de la Tourette,^[1] Alfred Binet,^[4] and Albert Pitres. Charcot bestowed the eponym for Tourette syndrome in honor of his student, Georges Gilles de la Tourette.^[3][19]

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". However, 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.^[20] After his death, the illness "hysteria" that Charcot described was claimed to be nothing more than an "artifact of suggestion".^[21]

However, the negative judgment of Charcot's work on hysteria is influenced by a significant shift in diagnostic criteria and conception of hysteria which occurred in the decades following his death.^[22] The historical perspective on Charcot's work on hysteria has also been distorted by viewing him as a precursor of Freud (whose markedly different conception of hysteria was extensively addressed by feminist historians in the last decades of the 20th century).

In fact, Charcot argued vehemently against the widespread medical and popular prejudice that hysteria was rarely found in men. 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]

Charcot appears, along with Maria Skłodowska-Curie (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, 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."^{[citation needed]} And in his 2008 biography of Munthe (ISBN 978-1-84511-720-7), 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.'^{[page needed]} 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^[1] 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.^[25]

Charcot Island in Antarctica was discovered by his son, Jean-Baptiste Charcot, who named the Island in honor of his father.^[26]

Notes

1. ^ ^{a b c d e f g h i j} Enerson, Ole Daniel. "Jean-Martin Charcot". Who Named It?. http://www.whonamedit.com/doctor.cfm/19.html. Retrieved 13 October 2008. 
2. ^ 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. doi:10.1590/S0004-282X2008000600035. PMID 19099145. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2008000600035&lng=en&nrm=iso&tlng=en. 
3. ^ ^{a b} Kushner (2000), p. 11
4. ^ ^{a b c d e f} "Jean-Martin Charcot". A Science Odyssey: People and Discoveries. Public Broadcasting Service (PBS). 1998. http://www.pbs.org/wgbh/aso/databank/entries/bhchar.html. Retrieved 13 October 2008. 
5. ^ Siegel, Irwin M (Summer 2000). "Charcot and Duchenne: Of mentors, pupils, and colleagues". Perspectives in Biology and Medicine 43 (4): 541–7. doi:10.1353/pbm.2000.0055. PMID 11058990. http://muse.jhu.edu/login?uri=/journals/perspectives_in_biology_and_medicine/v043/43.4siegel.html. 
6. ^ Haas LF (October 2001). "Jean Martin Charcot (1825-93) and Jean Baptiste Charcot (1867-1936)". J. Neurol. Neurosurg. Psychiatr. 71 (4): 524. doi:10.1136/jnnp.71.4.524. PMC 1763526. PMID 11561039. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1763526. 
7. ^ Tan SY, Shigaki D (May 2007). "Jean-Martin Charcot (1825-1893): pathologist who shaped modern neurology" (PDF). Singapore Med J 48 (5): 383–4. PMID 17453093. http://smj.sma.org.sg/4805/4805ms1.pdf. 
8. ^ (French) Charcot JM (1868). "Histologie de la sclerose en plaques". Gazette des hopitaux, Paris 41: 554–55. 
9. ^ Enersen, Ole Daniel. Charcot-Marie-Tooth disease. Who Named It? Retrieved on 16 October 2008.
10. ^ ^{a b c} 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. doi:10.1002/mds.21684. PMID 18175393. 
11. ^ Charcot (1889), p. 85
12. ^ ^{a b c} 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. doi:10.1159/000228252. PMID 19602893. http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000228252&Ausgabe=250341&ProduktNr=223840&filename=000228252.pdf. 
13. ^ Goetz (1995), p. 211
14. ^ Goetz CG (April 1991). "Visual art in the neurologic career of Jean-Martin Charcot". Arch. Neurol. 48 (4): 421–5. PMID 2012518. 
15. ^ "Hydrotherapy", Royal Medical Centre, Truskavets, Ukraine.[1]
16. ^ http://www.whonamedit.com/synd.cfm/1739.html Who Named It- Souques-Charcot gerodema
17. ^ Goetz (1995), p. 103
18. ^ (French) Charcot J (28 March & 4 April). "Des rapports de l'anatomie pathologique avec la clinique". Progès médical: 165, 181. 
19. ^ 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.
20. ^ Goetz (1995), p. 208
21. ^ Shorter (1997), pp. 84–86
22. ^ Goetz (1987), p. 115
23. ^ Goetz (1987), p. 116
24. ^ Goetz (1987), p. 117
25. ^ Hierons R (1993). "Charcot and his visits to Britain". BMJ 307 (6919): 1589–91. doi:10.1136/bmj.307.6919.1589. PMC 1697759. PMID 8292949. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1697759. 
26. ^ Mills (2003), p. 135

References

• 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. http://books.google.com/books?id=DwQJAAAAIAAJ&printsec=frontcover#v=onepage&q&f=false. Retrieved 21 October 2010. 
• Goetz, Christopher (1987). Charcot, the Clinician. New York: Raven Press. ISBN 0881673153. 
• Goetz, Christopher; Bonduelle, Michel; Gelfand, Toby (1995). Charcot: Constructing Neurology. Oxford University Press. ISBN 0195076435. 
• Kushner, HI (2000). A cursing brain?: The histories of Tourette syndrome. Harvard University Press. ISBN 0-674-00386-1. http://books.google.com/books?id=9dQEB_MbhKEC&printsec=frontcover&dq=isbn:0674003861&cd=1#v=onepage&q&f=false. 
• Mills, William James (2003). Exploring Polar Frontiers: A Historical Encyclopedia. Santa Barbara, Calif: ABC-CLIO. ISBN 1576074226. 
• Shorter, Edward (1997). A History of Psychiatry. John Wiley & Sons. ISBN 0-471-24531-3. 

Further reading

• Bogousslavsky J, ed (2010). Following Charcot: A Forgotten History of Neurology and Psychiatry (Frontiers of Neurology and Neuroscience). S Karger Pub. ISBN 978-3805595568. 
• Bogousslavsky J, Paciaroni M (2010). "Did jean-martin charcot contribute to stroke?" (PDF). Eur. Neurol. 64 (1): 27–32. doi:10.1159/000317073. PMID 20588046. http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000317073&Ausgabe=254328&ProduktNr=223840&filename=000317073.pdf. 
• Clanet M (June 2008). "Jean-Martin Charcot. 1825 to 1893" (PDF). Int MS J 15 (2): 59–61. PMID 18782501. http://www.msforum.net/Site/ViewPDF/ViewPDF.aspx?ArticleID=E80DC748-5048-4BD2-9393-18BCAE0A1514&doctype=Article. 
• Ekbom K (January 1992). "The man behind the syndrome: Jean-Martin Charcot". J Hist Neurosci 1 (1): 39–45. doi:10.1080/09647049209525513. PMID 11618414. 
• Goetz CG (2009). "Chapter 15 Jean-Martin Charcot and the anatomo-clinical method of neurology". Handb Clin Neurol. Handbook of Clinical Neurology 95: 203–12. doi:10.1016/S0072-9752(08)02115-5. ISBN 9780444520098. PMID 19892118. 
• Goetz CG (March 2006). "Charcot in contemporary literature". J Hist Neurosci 15 (1): 22–30. doi:10.1080/096470490944707. PMID 16443570. 
• Goetz CG (July 2007). "J.-M. Charcot and simulated neurologic disease: attitudes and diagnostic strategies". Neurology 69 (1): 103–9. doi:10.1212/01.wnl.0000265061.46526.77. PMID 17606887. 
• Goetz CG (May 2010). "Shaking up the Salpetriere: Jean-Martin Charcot and mercury-induced tremor". Neurology 74 (21): 1739–42. doi:10.1212/WNL.0b013e3181e0439e. PMID 20498442. 
• Goetz CG, Chmura TA, Lanska DJ (May 2001). "Seminal figures in the history of movement disorders: Sydenham, Parkinson, and Charcot: Part 6 of the MDS-sponsored history of Movement Disorders exhibit, Barcelona, June 2000". Mov. Disord. 16 (3): 537–40. doi:10.1002/mds.1113. PMID 11391755. 
• Goetz CG, Harter DH (October 2009). "Charcot and Pasteur: intersecting orbits in fin de siècle French medicine". J Hist Neurosci 18 (4): 378–86. doi:10.1080/09647040802536967. PMID 20183219. 
• Guillain, Georges (1959). J.-M. Charcot 1825-1893: His Life-His Work. Paul B. Hoeber, Inc.. 
• Hustvedt, Asti (2011). Medical Muses: Hysteria in Nineteenth-Century Paris. Bloomsbury. 
• Rowland LP (March 2001). "How amyotrophic lateral sclerosis got its name: the clinical-pathologic genius of Jean-Martin Charcot". Arch. Neurol. 58 (3): 512–5. doi:10.1001/archneur.58.3.512. PMID 11255459. http://archneur.ama-assn.org/cgi/content/extract/58/3/512. 
• Teive HA, Almeida SM, Arruda WO, Sá DS, Werneck LC (June 2001). "Charcot and Brazil" (PDF). Arq Neuropsiquiatr 59 (2–A): 295–9. doi:10.1590/S0004-282X2001000200032. PMID 11400048. http://www.scielo.br/pdf/anp/v59n2A/a32v592a.pdf. 
• Teive HA, Arruda WO, Werneck LC (September 2005). "Rosalie: the Brazilian female monkey of Charcot" (PDF). Arq Neuropsiquiatr 63 (3A): 707–8. doi:/S0004-282X2005000400031. PMID 16172730. http://www.scielo.br/pdf/anp/v63n3a/a31v633a.pdf. 
• Teive HA, Munhoz RP, Barbosa ER (June 2007). "Little-known scientific contributions of J-M Charcot" (PDF). Clinics (Sao Paulo) 62 (3): 211–4. PMID 17589659. http://www.scielo.br/pdf/clin/v62n3/a03v62n3.pdf. 
• (Portuguese) Teive HA, Zavala JA, Iwamoto FM, Sá D, Carraro H, Werneck LC (September 2001). "[Contributions of Charcot and Marsden to the development of movement disorders in the 19th and 20th centuries"] (in Portuguese). Arq Neuropsiquiatr 59 (3–A): 633–6. doi:10.1590/S0004-282X2001000400030. PMID 11588652. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2001000400031&lng=en&nrm=iso&tlng=en. 

External links

Psychiatry portal

• Biography and bibliography in the Virtual Laboratory of the Max Planck Institute for the History of Science
• Charcot lectures on diseases of the brain and nervous system

Persondata
Name	Charcot, Jean-Martin
Alternative names
Short description
Date of birth	29 November 1825
Place of birth	Paris, France
Date of death	16 August 1893
Place of death	Lac des Settons, Nièvre