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Jean-Martin Charcot, born on November 29, 1825, in Paris, France, is known as the father of neurology. During a time when neurology was not yet a recognized medical specialty, Charcot's pioneering contributions significantly advanced the field. Charcot's use of the anatomo-clinical method, which correlates clinical symptoms with anatomical findings, led to the discovery and characterization of numerous neurological conditions, including multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), Charcot's joint, and Charcot-Marie-Tooth (CMT) disease. His methodical approach to documenting clinical signs and conducting post-mortem examinations revolutionized neurological research and diagnosis, laying the groundwork for modern neurology. The anatomo-clinical methods continue to be a vital tool in neurological research and practice today. Charcot's work extended beyond clinical practice, influencing the study of neurology through his role as an educator and mentor to many, including Sigmund Freud. Despite some controversies and a reputation for being difficult to work with, Charcot's legacy endures, with his initial discoveries fostering greater awareness and the development of therapies for various neurological disorders.
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Jean-Martin Charcot (1825-1893) showed little interest in mental disorders, the domain of nineteenth-century alienists. But hallucinations are not confined to the field of psychiatry, and Charcot, who had once tested the hallucinogenic effects of hashish in his youth, went on to describe hallucinations in the course of various neurological conditions as just another semiological element. Most of his or his disciples' writings on hallucinations can be found in his work on hysteria. Hallucinations and delusions were part of "grand hysteria" and occurred at the end of the attack (third or fourth phase). Hypnosis or chemical agents could also induce hallucinations. Charcot and his disciples did not go so far as to emphasize the importance of hallucinations when they evoked past trauma, especially sexual trauma. Charcot's materialistic orientation led him and his disciples-especially D. M. Bourneville (1840-1909), G. Gilles de la Tourette (1857-1904), and the neurologist and artist P. Richer (1849-1833)-to seek hysteria in artistic representations of "possessed women" and in the visions of nuns and mystics. Finally, Charcot recognized the importance of hallucinations in neurological semiology, by means of precise and relevant observations scattered throughout his work. Preoccupied with linking hysteria to neurology, Charcot only scratched the surface of the possible significance of hallucinations in this context, paving the way for the work of his students Pierre Janet (1859-1947) and Sigmund Freud (1856-1939).
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Jean-Martin Charcot (1825-1893) did not show much interest in the peripheral nervous system and its associated pathologies. He found it difficult to place the peripheral nerve within his classification of disorders; it appeared to be an exception to his theories. Even the pathology that he described in 1886 with Pierre Marie (1853-1940), at the same time as Henry Tooth (1856-1925), and which is now known as Charcot-Marie-Tooth neuropathy, was considered by Charcot to be a potential myelopathy. Charcot, like other physicians, paid little heed to the observations made by Louis Duménil (1823-1890) to support the existence of primitive damage to the peripheral nerve. Charcot approached peripheral nerve pathologies through two indirect routes: amyotrophies not explained by spinal or muscular damage, and the trophic cutaneous consequences of what he called névrites (neuritis), the lesional site of which remains debated. It is noteworthy that Charcot's approach to peripheral nervous system disorders differed from that of other neurologists of the same time. Augusta Dejerine-Klumpke (1859-1927) in France was more precise than Charcot in her anatomical and clinical descriptions, and Hugo von Ziemssen (1829-1902) in Germany made effective use of electrodiagnostics. Charcot supported the electrical work of Guillaume Duchenne de Boulogne (1806-1875), whom he sometimes presented as one of his mentors. The German physician Wilhelm Erb (1840-1921) developed electrodiagnosis by galvanic and faradic currents. Charcot never made use of Erb's electrological advancements. With his electrophysiologist Romain Vigouroux (1831-1911), Charcot used medical electricity only for electrotherapy in hysteria.
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Jean-Martin Charcot, often lauded for his seminal contributions, is seldom critiqued for his blunders. One such blunder was his double-semidecussation scheme for the retinocortical visual pathways, proposed in 1875 to explain, on neuroanatomic grounds, cases of hysteria that manifest hysterical amblyopia accompanied with ipsilateral hemianaesthesia. Charcot's scheme was inconsistent with the older, broadly correct scheme of Prussian ophthalmologist Albrecht von Gräfe. Charcot failed to perform clinicopathologic correlation studies. His analysis relied on a series of mistaken conclusions he made in conjunction with Swiss-French ophthalmologist Edmund Landolt: (1) only an optic tract lesion could produce a homonymous hemianopsia; (2) cerebral lesions, if they ever produced homonymous hemianopsia, did so by secondary effects (e.g. pressure) on the optic tracts; and (3) damage to the cortical projections from the lateral geniculate produces a crossed amblyopia. Challenges to Charcot's theory came from within France by 1880. By 1882, Charcot recognized that his scheme was erroneous, and he approved a thesis by his pupil Charles Féré that reverted to Gräfe's scheme with an ill-conceived modification to accommodate Charcot's concept of hysterical cerebral amblyopia. A critique by American neurologist Moses Starr in 1884 argued for Gräfe's scheme and refuted Charcot's erroneous scheme and its subsequent derivatives.
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Much has been written, mostly in overly critical terms, about Jean-Martin Charcot's use of images in his hysteria research. Besides the images of patients Charcot produced for his clinical research, one other image has preoccupied present-day scholars-André Brouillet's painting Une leçon clinique à la Salpêtrière. Unveiled at the 1887 Salon in Paris, this life-sized painting depicts Charcot lecturing on hysteria to his male audience while presenting a swooning female patient. For many present-day critics, Brouillet's painting symbolizes Charcot's purported misuse of his female hysteria patients. Contrary to such interpretations, this article shows that Brouillet's painting did not merely serve as an iconic visual representation of Charcot's hysteria research but was also used by Charcot as an active epistemic tool in his research on hysterical amnesia. Through a close reading of Charcot's only published lecture on hysterical amnesia, which he held on December 22, 1891, I analyze the process through which Charcot generated new medical insights into hysterical amnesia. I thereby trace the decisive role that Une leçon clinique played in this process.
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Dr. Jean-Martin Charcot (1825-1893) pioneered the use of visual aids in his lectures at the Hôpital de la Salpêtrière. He deployed photographs, casts, diagrams, graphs, drawings, lantern slides, and even patients to help the audience understand his innovative diagnoses, but that same visual imagery also informed his own conceptualizations of pathology. Charcot, whom Sigmund Freud famously called a "visuel," made drawings of his patients and their autopsied organs while also encouraging the art-making of his many collaborators and protégés at the Salpêtrière in the last quarter of the nineteenth century. Their "scientific artworks" epitomize the entanglement of art and medical science at the hospital. This article examines the role of visual media in diagnosing pathology under Charcot's aegis, bringing to light images and objects that catalogue the case of Ambroise Bourdy. Here was a perfect example of the male hysteric, according to Charcot: a "robust" blacksmith and father who developed a hysterical contracture after a workplace injury. In 1882, Charcot's Salpêtrière colleagues-including Dr. Henri Parinaud, Dr. Paul Richer, Louis Loreau, and Albert Londe-tested Bourdy's eyes, made drawings and a cast of his contracted left hand, and photographed him in various poses. The surfeit of visual imagery of Bourdy purports to illustrate traumatic hysteria-however, it more effectively, if unintentionally, reveals a delight in art-making at the Salpêtrière.
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The establishment of neurology schools in Latin America during the late-nineteenth and early-twentieth centuries profoundly influenced the French neurology school. In the latter half of the nineteenth century, the neurology department at the Salpêtrière Hospital in Paris held a preeminent position as the global hub of neurology. Professor Jean-Martin Charcot, widely acclaimed as the father of modern neurology, was the most revered neurology professor of the nineteenth century. Many physicians from diverse countries across South America (notably Argentina, Uruguay, Peru, Brazil, and Colombia), the Caribbean (Cuba), and Mexico pursued specialized training in neurology under Charcot's tutelage, and even after his passing in 1893, they continued their training with his numerous disciples. As a result, nearly two centuries after the birth of Charcot, his enduring contributions to the field of neurology remain vibrantly influential, particularly in Latin America.
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Biographies, articles, and meetings devoted to the founder of modern neurology, Jean-Martin Charcot, are typically dithyrambic, if not hagiographic. It seems that the striking professional and familial qualities of Charcot have erased any other characteristic of the person, and scratches on the Master image commonly have not been well accepted. With this in mind, it is interesting to present and evaluate the rather negative opinions on Charcot by the famous French writer Léon Daudet, who initially was very close to the Charcots through his father, Alphonse Daudet, and who wrote rather extensively on Charcot in his diary and memoirs. Our point is not to underline these writings as the "truth" about Charcot's personality and life (Daudet, who was a prominent extreme right-wing figure, was known to exaggerate and play with his sharp opinions), but Daudet's criticisms paradoxically provide a fascinating perspective, which may help to reconstruct better who Charcot really was in counterbalancing a bit the overcrowded, politically correct, praising group.
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In the scientific world, Professor Jean-Martin Charcot is known for his contribution to the establishment of the anatomo-clinical method in neurology in Paris at the Salpêtrière hospital. However, media attention in the late 1800s has focused on his work on hysteria. In this article, we aim to review how he has been depicted in two recent French movies: Augustine (2012) and Le Bal des Folles (The Mad Women's Ball) (2021). We will compare his image in those two films to articles at the time of his death and contrast how he is represented in other biographical works. Both in the newspapers and in the movies, Charcot's public lessons and experimental work on hypnosis in hysteria are put forward. The two movies offer a new perspective, as both directors were women, and both movies focus on a woman patient's journey at La Salpêtrière. His depiction remains superficial in Le Bal des Folles, portraying a cold, insensitive, and despotic approach to patients. He plays a more central role in Augustine, in which he develops intimacy with one of his patients and a more human and caring side is displayed, in parallel to his authoritative and meticulous figure. Both movies refer to him as a divine authority, but they also allude to his scientific method. In summary, Charcot's recent representations in cinema add a woman's perspective to life under Charcot at La Salpêtrière, which continues to shape further the image we have of this founder of modern neurology.
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Jean-Martin Charcot is considered the founding father of modern neurology. There are many general and specialized biographies about him, the result being that a new text is unexpected or would likely amount to plagiarism. However, part of the duties for Charcot's medical professorship have not, to date, been studied at all. This article will focus on the role of Charcot as a member of doctorate juries and, in particular, as the president of these juries. I have reviewed around 12,500 theses one by one. These were defended at the Paris medical school from 1862, Charcot's first year as an agrégé (assistant professor), to his death in 1893. Among the theses, I have selected all of those that discuss neuropsychiatry in the broadest terms (3,663). I have paid particular attention to all of those for which Charcot was part of the jury. This involves 608 theses. All of the data were entered in a database (Filemaker) to facilitate identifying those theses corresponding to one or more of the criteria. Statistical comparisons were then carried out (Excel spreadsheet). In addition to these results, brief individualized surveys were conducted on theses selected for their representativeness, either for the subject matter (multiple sclerosis, aphasia, tabes, general paralysis, etc.) or for specific criteria (foreigners, women, etc.), but all of the theses were defended before a jury that included Charcot. This makes it possible to track how the areas of study in the medical world changed over time, and particularly those of Charcot. The juries Charcot was obliged to be a part of, without any particular ties to the candidate and/or any involvement in the selection and supervision of the work, must be differentiated from the thesis juries for his students. In the latter case, the thesis subjects were most often linked to Charcot's researches. Providing a thesis subject was motivated, in certain cases, by the desire to disseminate new data in the medical profession, not only by dint of the theses themselves but also through the reports that the medical press published regularly (e.g. the diagnosis of various types of shaking) and through the commercial publication of these data, in some cases with a preface by Charcot. In other cases, the thesis was a step in the long process of developing a theory (hysteria). Or it led to a flowering of new ideas, insufficiently proven, which Charcot would only cover in his Lessons once there was convincing confirmation (amyotrophy). This rich cornucopia gives rise to certain neglected nuggets, as well as works that have entered the classical corpus-for example, the theses of Léopold Ordenstein, Ivan Poumeau, Isaac Bruhl, Albert Gombault, and Pierre Janet.
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Abstract The establishment of Russian neurology in the late 19th century was significantly shaped by the neurology department at La Salpêtrière Hospital under Professor Jean-Martin Charcot's leadership. A group of Russian neurologists, guided by Professor Kozhevnikov and featuring his disciples such as Korsakov, Minor, Darkshevich, and Bekhterev, had the privilege of being mentored by Professor Charcot. Subsequently, they played pivotal roles in founding various neurology services in Russia, greatly influenced by the teachings and insights they acquired under Charcot's tutelage.
Resumo A criação da neurologia russa no final do século XIX foi significativamente moldada pelo departamento de neurologia do Hospital La Salpêtrière, sob a direção do Professor Jean-Martin Charcot. Um grupo de neurologistas russos, orientado pelo Professor Kozhevnikov e com discípulos como Korsakov, Minor, Darkshevich e Bekhterev, teve o privilégio de ser orientado pelo Professor Charcot. Posteriormente, desempenharam papéis fundamentais na fundação de vários serviços de neurologia na Rússia, muito influenciados pelos ensinamentos e conhecimentos que adquiriram sob a tutela de Charcot.
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Current scientific literature often defines gout as morbus dominorum, in agreement with the Greek-Roman representation of podagra (ποδάγρα, literally "foot-trap") as a consequence of gluttony and libertinage. Several authors place the origins of this expression with the Roman writer Suetonius, without however quoting any specific primary source. We have investigated this problem again and scrutinized primary sources ranging from the Roman World to the early Middle Ages. A search on the database of Latin texts for the expression morb* domin* failed to identify any positive correspondence, not only in Suetonius' works but also in those of other Latin authors. As a matter of fact, the expression morbus dominorum appeared for the first time in the literature on podagra in 1661 in Jakob Balde's book Solatium Podagricorum. Since then, this definition has been endlessly repeated in seventeenth- to eighteenth-century literature on gout. In 1866, while lecturing on the diseases of the elderly, the French neurologist Jean-Martin Charcot first ascribed the expression morbus dominorum to Suetonius. However, this attribution is unsupported by primary sources. In conclusion, Suetonius never used the wording morbus dominorum, which was probably coined by Jakob Balde in 1661. The origin of this erroneous ascription dates to Jean-Martin Charcot's lectures in 1866. Key Points ⢠Albeit a much-quoted sentence in rheumatology,the Roman author Suetonius never called gout morbusdominorum. ⢠When referencing historical point in rheumatology, a careful perusal of the primary sources should beimplemented to avoid misquoting and false myths.
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Gota , Neurologia , Reumatologia , Humanos , Idoso , Ligante de CD40 , Bases de Dados Factuais , FrançaRESUMO
PURPOSE OF REVIEW: This overview of the history of diagnosis and treatment of multiple sclerosis serves as an introduction to the rich history of multiple sclerosis, and shows we are on a continuum of incremental advances that date back centuries. RECENT FINDINGS: The current understanding of MS demonstrates a dramatic series of advances and this brief historical overview will provide some context for these discoveries. Although cases we would now recognize as multiple sclerosis can be found in older literature and diaries, the contribution of Jean-Martin Charcot at the Salpêtrière in Paris in 1868 was to frame the clinical and pathological features of a disorder he called la sclérose en plaque disséminées. Soon after, reports came from many countries. Over the next half-century, the diagnosis was a clinical conclusion with no confirmatory tests. Some CSF and evoked potential tests later helped but it remained for the MRI imaging and oligoclonal banding to substantially aid the clinical diagnosis. It is tempting to think that therapy is new in MS, but in previous centuries, hundreds of drugs, procedures, and surgeries were applied to patients with MS, many more than we use today. It remained for the development of the randomized clinical trial to show which therapies were beneficial and safe. Everything changed in 1993 when the first of a long list of new therapies was approved, therapies that were shown to alter the activity and outcome of the disease.
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Esclerose Múltipla , Neurologia , Idoso , História do Século XIX , Humanos , Masculino , Esclerose Múltipla/diagnóstico , Esclerose Múltipla/terapia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Jean-Martin Charcot coined the term Duchenne-Aran atrophy. The inversion of names compared to standard practice shows the respect Charcot had for Guillaume Duchenne de Boulogne, who had encouraged him to study nervous disease. Using innovative localised electrification, Duchenne identified various types of muscular atrophy which he distinguished from paralysis. But it was François-Amilcar Aran who, published the observations that he had compiled and studied with Duchenne's help first in 1848 and again in 1850. The result was the seminal articles that led to the eponym "Aran-Duchenne hand". Focusing on the second half of the nineteenth century in Paris, this article will explore how knowledge evolved around the nosography of different types of muscular atrophy, starting with Duchenne and Aran and then with Charcot and his students, notably Albert Gombault, Joseph Babinski, Fulgence Raymond, and Jean-Baptiste Charcot. This historical overview is accompanied by a biographical account aimed at rescuing Aran from the sea of oblivion and covering the other subjects he wrote about, especially in neurology: including cerebral hydatid disease, skull base fractures and "cancer of the dura mater".
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Atrofia Muscular Espinal , Doenças do Sistema Nervoso , Neurologia , Epônimos , França , História do Século XIX , Humanos , Masculino , Atrofia Muscular , Neurologia/históriaRESUMO
Albert Pitres (1848-1928) was an internist, neuropsychiatrist, professor of anatomy, pathology, and histology. He never really had a biography in English. However, the development of neurology and neurosciences in Bordeaux owes a lot to him, as to the psychiatrist Emmanuel Régis (1855-1918). The fact that his career was so closely linked with Charcot (1825-1893) should have secured him a more prominent place in neurology and the history of aphasiology. Pitres went on to co-author clinical and experimental research papers with Charcot that are considered some of the most notable ones among Charcot's publications. Both carried out studies about pathological correlations between cortical lesions and hemiplegia, published series of articles and two major books about neurophysiology of motor control. To convey the atmosphere and the importance of the neurological clinic of Pitres in the heyday, we illustrate this article with unpublished photos of him.
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Neurologia , Neurociências , Médicos , França , História do Século XIX , História do Século XX , Humanos , Masculino , Neurologia/história , Neurofisiologia , Médicos/história , EstudantesRESUMO
Jean-Martin Charcot was one of the most influential physicians of the nineteenth century and is now rightly considered the father of Neurology. The aim of this paper was to review and describe Charcot's close relationships to Britain and the influence of this particular affinity on his career.
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Neurologia , Médicos , França , História do Século XIX , Humanos , Neurologia/história , Médicos/históriaRESUMO
Louis-Stanislas Duménil (1823-1890) was a surgeon from Normandy who was a contemporary of Jean-Martin Charcot (1825-1893). Throughout his career, Duménil published annotated observations of neurological pathologies. One year before Guillaume Duchenne de Boulogne (1806-1875), he reported a case of "progressive muscular paralysis of the tongue, soft palate, and lips". He added five other cases of progressive muscular atrophy in 1867, together with histological examinations which showed atrophy in the anterior horns of the spinal cord. Charcot, who described amyotrophic lateral sclerosis, did not fail to pay homage to Duménil for his contribution. In 1862, Duménil added clinical observations of progressive locomotor ataxia, one of the first to do so. This included anatomopathological examinations, thus significantly completing the clinical picture presented by Duchenne in 1858. He confirmed the damage to the roots and posterior tracts of the spinal cord. Finally, by providing multiple observations of the syndrome described by Octave Landry (1826-1865) in 1859, he contributed to the clinical picture of "acute ascending paralysis" which has come down to us as Guillain-Barré syndrome, with no mention of the perspicacious physicians of the previous century who had already perfectly recognised this disease. Finally, Augusta Dejerine-Klumpke (1859-1927) paid a warm tribute to Duménil in her 1889 thesis, calling him one of the pioneers in understanding "the individuality and autonomy of the peripheral nervous system." He was indeed a pioneer, although he has been often overlooked.
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Esclerose Lateral Amiotrófica , Síndrome de Guillain-Barré , Neurologia , Neurossífilis , Cirurgiões , França , História do Século XIX , Humanos , Masculino , Neurologia/história , ParalisiaRESUMO
The "Alice in Wonderland syndrome" (AIWS) is a neurological disorder characterized by altered body schema perception, visual, or somesthetic symptoms, which is frequently associated with migraine. In this article, we present the earliest known description of symptoms attributable to AIWS in the medical literature. During a lecture held on November 22, 1887, at the Salpêtrière, Jean-Martin Charcot (1825-1893) examined a patient with somesthetic symptoms (partial macrosomatognosia) in the context of migraine with aura. Although this condition was not known at the time, Charcot tried to provide an accurate semiological and nosographic framework of this case, attributing the complex of symptoms to migraine with aura and epilepsy with sensory symptoms. With intellectual honesty and clinical prudence, Charcot correctly pointed to a disturbance in the excitability of cortical areas responsible for processing and perceiving sensory stimuli.
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Síndrome de Alice no País das Maravilhas , Transtornos de Enxaqueca , Síndrome de Alice no País das Maravilhas/diagnóstico , Humanos , Transtornos de Enxaqueca/diagnósticoRESUMO
Two students of Jean-Martin Charcot, Paul Blocq and Georges Marinesco, presented a case of hemi-parkinsonism to the Société de Biologie on 27 May 1893. A tuberculoma was found at post-mortem in the cerebral peduncle contralateral to the side of the body affected by Parkinson's disease. A year later, in one of his lessons, Édouard Brissaud suggested that damage to the substantia nigra caused by the granuloma might have been responsible for the physical signs. This article provides brief biographical accounts of both Blocq and Marinesco and a detailed review of their seminal paper before going on to discuss how the substantia nigra was eventually established as the most consistent pathological substrate for Parkinson's disease and its role in the dopamine miracle which led to striatal dopamine replacement therapy in 1967.
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Neurologia , Doença de Parkinson , Humanos , Substância NegraRESUMO
In the famous painting La Leçon Clinique à la Salpêtrière (A Clinical Lesson at the Salpêtrière) by André Brouillet (1857-1914), the neurologist Jean-Martin Charcot (1825-1893) is shown delivering a clinical lecture in front of a large audience. A hysterical patient, Marie Wittman (known as "Blanche"; 1859-1912) is leaning against Charcot's pupil, Joseph Babinski (1857-1932). Lying on the table close to Charcot are some medical instruments, traditionally identified as a Duchenne electrotherapy apparatus and a reflex hammer. A closer look at these objects reveals that they should be identified instead as a Du Bois-Reymond apparatus with a Grenet cell (bichromate cell) battery and its electrodes. These objects reflect the widespread practice of electrotherapeutic faradization at the Salpêtrière. Furthermore, they allow us to understand the moment depicted in the painting: contrary to what is sometimes claimed, Blanche has not been represented during a hysterical attack, but during a moment of hypnotically induced lethargy.