The tic douloureux of Alexis Pujol (1739-1804).

In 1787, Alexis Pujol (1739-1804) wrote the first monograph exclusively on trigeminal neuralgia which he called "tic douloureux", or painful tic. Although it was not a seminal description, his monograph was a valuable clinical summary that helped his contemporaries make an exact diagnosis, even though it did not offer proven treatments. Unlike most in his day, Pujol adhered to the theory of electricity, seeing it as the vector of information transmission by the nerve. This made him a precursor and put him in a position to propose a novel pathophysiological theory of pain, not yet qualified as neuralgic. His thinking illustrates that, at the dawn of the nineteenth century, a provincial physician working alone was able to make his contribution to building medical knowledge, particularly in the field of neurology. After a brief biography of Pujol, this article will cite from his book to show the relevance of his clinical observations, which are still valuable today. Without omitting the inspiration, he took from his predecessors, this article also mentions the work of those who followed in his footsteps.

From hysteria to gait dementia: History of the concept of astasia-abasia.

Paul Blocq (1860-1896) and his teacher Jean-Martin Charcot (1825-1893) introduced the expression "astasia-abasia" into medical terminology in 1888 to designate a pathology they believed to be caused by hysteria. This condition makes it impossible to remain erect and to walk, whereas the ability to move the legs while lying down remains normal. At the turn of the 20th century, and now almost exclusively, this motor disturbance is recognised as a syndrome with multiple possible organic causes, and now described as "higher-level gait disorder". After briefly mentioning earlier descriptions by other authors, I will review Charcot's Tuesday lessons in 1889 that covered astasia-abasia and elucidated the beginnings of the breakdown into organic aetiologies: medial-frontal and corpus callosum tumors, damage to the cerebellar vermis, lacunar state as described by Pierre Marie (1853-1940), Parkinson's disease, and Parkinson-plus syndrome. The long history of astasia-abasia reveals a cluster of neurologists, often emerging from oblivion herein and all of whom, through the precision of their clinical examinations and their pathophysiological findings, helped advance the understanding of the mechanisms by which human beings are the only erect, constantly bipedal mammals, whether immobile or walking.

Voices from the past: The pioneering use of the phonograph in neurology.

Since its discovery by the American inventor and industrialist Thomas Alva Edison (1847-1931) in 1877, the phonograph attracted much interest in the field of medicine. This article describes the earliest pioneering examples of the use of the phonograph in neurology. In France, the use of the phonograph for obtaining audio recordings of delusions and speech or language disturbances was first proposed by Victor Maurice Dupont (1857-1910) in 1889 and in Italy by the physician Gaetano Rummo (1853-1917), who had studied at La Salpêtrière under Jean-Martin Charcot (1825-1893). The applicability of the phonograph to the record of speech disturbances was illustrated in England by John Hughlings Jackson (1835-1911) and William Halse Rivers (1864-1922), and by William Hale White (1857-1949) and Cuthbert Hilton Golding-Bird (1848-1939) in 1891. Since then, audio recordings have been used rarely in neurology, a branch of medicine where the visual aspects dominate, to the extent that inspection can be enough to reach a definite clinical diagnosis. In the mid-20th century, the advent of audio and video recordings supplanted audio recordings alone, relegating them to a very marginal role.

A history of oculogyric crises during the encephalitis lethargica pandemic.

A pandemic of what came to be known as encephalitis lethargica spread starting in the winter of 1916-1917 and continued into the 1930s. Neurological after-effects, namely permanent parkinsonian syndromes and various abnormal movements, permanently disabled the survivors of the one or two million victims, often children or young adults. Among them, a small proportion developed a symptom that was little known up to that point and that is currently exceptional: oculogyric crises; that is, a lateralised, dystonic upward movement of the eyes known as a tonic eye fit. This paper proposes a history of the recognition of this symptom, its inclusion in the neurological nosography, and the pathophysiological hypotheses postulated a century ago.

François-Amilcar Aran (1817-1861) and the recognition of spinal muscular atrophy.

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".

The curious synalgia of Henri Gourdan de Fromentel (1858-1914).

In 1883, Henri Gourdan de Fromentel defended his thesis on an original topic that has not really been studied since. He examined the simultaneous perception of pain in two distinct and distant, but homolateral, areas of the body following a single stimulation on himself. In the discussion he compared his synalgia with other types of synaesthesia that did not involve pain and concluded that it was likely to be of central nervous system origin. After a brief account of Fromentel's life, this article discusses his thesis and a book on the subject he published five years later in the light of current understanding of the phenomenon and the proximity of synalgia and allachaesthesia.

Louis Tanquerel des Planches (1810-1862) and the history of discovering lead poisoning in the nervous system.

Louis Tanquerel des Planches (1810-1862) only left us with one significant medical work, his Traité des maladies de plomb ou saturnines (treatise on lead or saturnine diseases), published in 1839. The work served as a reference for diagnosing and treating lead poisoning throughout the second half of the nineteenth century. The word "encephalopathy" that he coined at that time referred to toxic damage to the central nervous system. Whereas for two millennia and for most physicians, lead poisoning was considered lead colic, i.e. paroxysms of abdominal pain, Tanquerel collected seventy-two observations of damage to the central nervous system in workers exposed to lead in Parisian workshops (which no longer exist). He then inventoried and described forms of paralysis, delirium, coma, and convulsions related to lead poisoning. Having no qualms about stepping away from La Charité Hospital where he had treated patients with lead poisoning, he inspected their workplaces and unambiguously presented the deplorable conditions that caused so many patients to die. His "preservative" advice was an initial attempt at medical-social prophylaxis with the goal of helping the working class exposed in workshops without any respect for human life. With support from chemists and pharmacists, Tanquerel showed the presence of lead in brain tissue and thus demonstrated its neurological toxicity as early as 1839. This article is also an opportunity to note the contributions on this topic of some other physicians: François-de-Paule Combalusier (1713-1762), François Victor Mérat de Vaumartoise (1780-1851), Jean-Louis Brachet (1789-1858), Auguste Mirande (1802-1865), Vincent Nivet (1809-1893), Augustin Grisolle (1811-1869), and Ferdinand de Bernard de Montessus (1817-1899).

Louis Duménil (1823-1890), surgeon and pioneer in neurology.

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.

Arnold Netter Netter (1855-1936) and infectious pathology of the nervous system.

Arnold Netter (1855-1936) was a paediatrician who clinically applied the progress that his Pasteurian contemporaries had made possible through their bacteriological discoveries. From a neurological point of view, he brought looking for Kernig's sign into mainstream use to confirm the clinical diagnosis of meningitis and made diagnostic lumbar puncture systematic. He was one of the first to cure meningococcal and pneumococcal meningitis, long before the era of antibiotics, using subtractive lumbar puncture and intraspinal serotherapy. Netter's attentive vigilance enabled him to recognise, from its onset, the first poliomyelitis epidemic of the 20th century which took place in the summer of 1909. He described the clinical and epidemiological characteristics, identifying the viral rather than microbial origin. Netter detected the first cases of encephalitis lethargica in Paris in 1918. The disease had been described by Constantin von Economo (1876-1931) in Vienna the previous year. Netter spent fifteen years studying this new disease, which caused a pandemic a century ago. He filled in the clinical picture and used his understanding of cerebrospinal fluid and pathological anatomy to enhance knowledge and improve treatment of this neurological pathology.

Percivall Pott (1713-1788) on the curvature of the spine and the French contribution.

Physicians remember the name of the surgeon Percivall Pott (1713-1788) because of the eponym "Pott's disease", described as "paralysis in the lower limbs, which is often accompanied by curvature of the spine". Pott's writings on surgical subjects are far vaster. For example, he described the fracture-dislocation of the ankle, or Pott's fracture, and determined the cause of scrotum cancer in chimney sweeps. He attributed this disease to contact with tar that contaminated the clothing of workers, often very young children because they were small enough to fit into chimney conduits. His work led to the first law addressing the employment of children. After a brief account of Pott's life, this article presents the description of Pott's paraplegia, for which both Jean-Martin Charcot and Yvonne Sorrel-Dejerine paid him homage. The contribution of some of his predecessors and of French contemporaries is highlighted. Pott was also a pioneer in neurosurgery, describing the non-symptomatic interval between cranial trauma and coma and the indication for trepanation to remove a haematoma.

Gayet-Wernicke Syndrome: The eye surgeon in a French neurologic eponym.

Gayet-Wernicke syndrome is an eponym mainly used in France. In this article, we revisit Charles Gayet's (1833-1904) speciality and his patient example that gave rise to the eponym. Charles Gayet attributed the anatomical lesions to inflammation. However, they were mainly due to hemorrhage, as Wernicke's term "polioencéphalite supérieure aiguë hémorragique" (polio-encephalitis superior haemorrhagica) explicitly indicates. The pathology of Gayet's case did not involve the mamillary bodies, colliculi, or cerebellum. Gayet did not mention abnormal memory functions, which are also cardinal signs of Wernicke-Korsakoff's disease. We argue that the Gayet-Wernicke eponym is not merited and that the more common international term "Wernicke-Korsakoff syndrome" should be used in France as elsewhere in the world.

The locked-in syndrome: The early French descriptions.

The classic 1966 description of locked-in syndrome was performed by Plum and Posner. Here, we revisit the world's first case report of this condition, which was presented in 1875 by Camille Darolles, an intern supervised by François Damaschino, at a monthly meeting of the Société Anatomique de Paris chaired by Jean-Martin Charcot. We also review the fascination of classic writers with this syndrome, including Alexandre Dumas, a genius of literature and known admirer of the medical sciences who, in the book "The Count of Monte Cristo" published in 1846, described a character with this condition.

The landmark contributions of Paul Blocq, Georges Marinesco, and Édouard Brissaud in Parkinson's disease.

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.

A historical approach to hereditary spastic paraplegia.

Hereditary spastic paraplegia (HSP) is a group of rare neurological disorders, characterised by their extreme heterogeneity in both their clinical manifestations and genetic origins. Although Charles-Prosper Ollivier d'Angers (1796-1845) sketched out a suggestive description in 1827, it was Heinrich Erb (1840-1921) who described the clinical picture, in 1875, for "spastic spinal paralysis". Jean-Martin Charcot (1825-1893) began teaching the disorder as a clinical entity this same year. Adolf von Strümpell (1853-1925) recognised its hereditary nature in 1880 and Maurice Lorrain (1867-1956) gained posthumous fame for adding his name to that of Strümpell and forming the eponym after his 1898 thesis, the first review covering twenty-nine affected families. He benefited from the knowledge accumulated over a dozen years on this pathology by his teacher, Fulgence Raymond (1844-1910). Here I present a history across two centuries, leading to the clinical, anatomopathological, and genetic description of hereditary spastic paraplegia which today enables a better understanding of the causative cellular dysfunctions and makes it possible to envisage effective treatment.

Armand Trousseau (1801-1867), a neurologist before neurology.

Armand Trousseau is the emblematic figure of the prominent mid-19th century clinician, owing to the quality of his teaching and the influence of French medicine, which during his time brought students from around the world to Paris. A student of Pierre Bretonneau (1778-1862), the famous physician from the western French city of Tours, Trousseau carried forward Bretonneau's clinical description of infectious diseases, developing the notion of their contagion and paving the way toward the discovery of their microbial aetiology by Louis Pasteur (1822-1895) at the end of the century. His teachings, Les Leçons cliniques de l'Hôtel-Dieu, transcribed by his students, played a role in training young physicians for half a century. In this work, Trousseau covered several neurological diseases such as apoplexy, epilepsy, chorea, Parkinson's disease, and amyotrophic lateral sclerosis. The rich, Balzac-like detail of his clinical pictures would be unthinkable today. While he cannot be credited with any seminal descriptions in particular, some of his observations contain significant nuggets, such as a case of Gilles de la Tourette syndrome, twenty years before the seminal publication. After a biographical account, we will present the main lessons given by Trousseau on neurological subjects. One of Trousseau's little-known contributions is to have invited Guillaume Duchenne de Boulogne (1806-1875) to his department at the Hôtel-Dieu hospital, setting Duchenne on the path to becoming a pioneer of Parisian neurology.

Jean-Charles Chatelin (1884-1948), counted among the "Righteous", but forgotten as a neurologist who studied under Pierre Marie.

Charles Chatelin (1884-1948) studied under Pierre Marie (1853-1940) at hôpital La Salpêtrière and went on to a career profoundly affected by World War I. He wrote a remarkable thesis on the clinical aspects and radiography of hereditary craniofacial dysostosis, which had been recently described by Octave Crouzon (1874-1938). A few days after the publication of Georges Guillain (1876-1961) and Alexandre Barré (1880-1967), Chatelin published a comprehensive study of the eponymous syndrome. His study was prepared before that of Guillain and Barré, but only their names are remembered. After examining patients with spinal injuries, Chatelin and Pierre Marie gave the first description of what would become, in 1924, "Lhermitte's sign." The eponym was first used after this sensory symptom was added by Lhermitte to the clinical picture of multiple sclerosis. In 1915, Chatelin and Pierre Marie used a technique based on radiographic overlays to localize intracranial projectiles. They coupled this with precise examinations of the visual field of wounded soldiers, in order to map out the intra-cerebral visual pathways with accuracy. During World War II, Chatelin and his wife demonstrated their empathy by hiding a Jewish family in their home until Paris was liberated.

The Marquise de Dampierre identified at last, the first described clinical case of Gilles de la Tourette syndrome.

Among the observations of patients suffering from abnormal movements, Jean-Gaspard Itard (1775-1838) published the case of Madame D. in 1825. It was republished in 1885 as the first clinical case characteristic of the disease described by Georges Gilles de la Tourette in the seminal article leading to his eponym, still in use today. However, the actual identity of Madame D., known throughout the 19th century as the Marquise de Dampierre, has remained a mystery, until now. The 17 July 1884 edition of the literary periodical Gil Blas provided an important lead by detailing the behavioural disturbances in society of the "Countess Picot de Dampierre". Information from diarists at that time make it possible to confirm that this patient, known for her involuntary verbal outbursts, typical of coprolalia, in salons frequented by the 19th-century Parisian aristocracy was in fact Ernestine Émilie Prondre de Guermantes, her maiden name. She was born on 22 August 1800, and her married name was Countess Picot de Dampierre. She died on 08 July 1884. This article examines the life of this woman, her disease, her identification and the connection with the Duchesse de Guermantes, heroine of LaRecherchedutempsperdu written by Marcel Proust.

Jules Sottas (1866-1945) forgotten despite the eponym: "Dejerine-Sottas syndrome".

The eponym "Dejerine Sottas" makes 21st-century neurologists think of a form of heredity peripheral neuropathy leading to amyotrophy and secondary to a mutation of one of the many genes responsible for the formation of myelin. The seminal description was the work of Sottas and Jules Dejerine (1849-1917); Dejerine was the prestigious second successor of Jean-Martin Charcot at the Clinic of Nervous System Diseases at the La Salpêtrière hospital. Jules Sottas (1866-1945) has almost been forgotten, but as a young man he was a brilliant resident under Dejerine. However, Sottas eventually gave up medicine, even though he could have had a successful career as a neurologist, to devote himself to his passion for history, especially the history of navigation. But during his time as a physician he published several original works, always supported by detailed neuro-pathological studies, the result of his very close collaboration with Dejerine at Bicêtre then at La Salpêtrière. After a brief biography of Sottas, we will analyse his neurological work and then highlight the quality of his publications on naval and maritime history, which are still relevant today.

Adolphe Gubler (1821-1879) or Parisian neurology outside La Salpêtrière in the age of Jean-Martin Charcot.

Adolphe Gubler (1821-1879) is a typical example of a 19th century hospital physician in Paris. Head of a medical unit at Beaujon hospital in 1855, he was nominated to the treatment and pharmacognosia Chair in 1868. He trained many students who became his disciples and remained very close to him. Gubler published prolifically in all areas of medicine. His most well-known work is clearly his contribution to the study of vascular accidents affecting the brain stem, which Auguste Millard worked on simultaneously; hence the eponymous Millard-Gubler syndrome, an example of crossed hemiplegia. Following a brief biography, we will present Gubler's main publications in the area of neurology: on migraine, neurological damage during acute rheumatic fever, aphasia, and the autonomic nervous system. Much of this work was carried out through student theses that Gubler directed. The fame of his contemporary Jean-Martin Charcot (1825-1893) eclipsed that of Gubler, even though the latter was well known and respected among Parisian professors. By tying together the diverse threads of his work, we hope to renew interest in this 19th century neurologist.