Jean-Martin Charcot

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

Jean-Martin Charcot (29 November 1825 – 16 August 1893) (shär-ˈkō,) was a French neurologist and professor of anatomical pathology. 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 (Lou Gehrig's 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. He was the "foremost neurologist of late nineteenth-century France" and has been called "the Napoleon of the neuroses".

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. In 1882, he established a neurology clinic at Salpêtrière, which was the first of its kind in Europe.

Charcot's primary focus was neurology. He named and was the first to describe multiple sclerosis. 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 (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.

In 1861 and 1862, Charcot, with Alfred Vulpian, added more symptoms to James Parkinson's clinical description and then subsequently attached the name Parkinson's disease to the syndrome.

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. He used hypnosis to induce a state of hysteria in patients and studied the results, and was single-handedly responsible for changing the French medical community's opinion about the validity of hypnosis (it was previously rejected as Mesmerism).

Charcot's works about hypnosis and his public demonstrations of "hypnotized" persons for medical students in an auditorium were 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.

Distorted views of Charcot as harsh and tyranical have arisen from some secondary sources, that mistakenly identify Axel Munthe as Charcot's assistant and take Munthe's autobiographical novel The Story of San Michele 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.

In 1870 Charcot married Caroline Johnson. They had one child whom they named Jean-Baptiste.

Charcot was a part of the French neurological tradition and studied under, and greatly revered, Duchenne de Boulogne, whom he referred to as mon maitre ("my teacher") - Charcot sat with Duchenne as he lay dying in 1875.

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:

• 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-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.

Also, Charcot Island in Antarctica was named in his honor by his son, Jean-Baptiste Charcot.

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 students: Sigmund Freud, Joseph Babinski, Pierre Janet, William James, Pierre Marie, Albert Londe, Charles-Joseph Bouchard, Georges Gilles de la Tourette, Alfred Binet, and Albert Pitres. Charcot bestowed the eponym for Tourette syndrome in honor of his student, Georges Gilles de la Tourette.

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'. 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.'

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. After his death, the illness "hysteria" that Charcot described was claimed to be nothing more than an "artifact of suggestion".

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. 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" 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.

References

• Charcot JM (1889) [1878]. Clinical lectures on diseases of the nervous system. Vol. 3 (Thomas Savill, translator ed.). London: The New Sydenham Society. Retrieved 21 October 2010. {{cite book}}: Unknown parameter |trans_title= ignored (|trans-title= suggested) (help)
• Goetz, Christopher G (1987). Charcot, the Clinician. New York: Raven Press. ISBN 0881673153.
• Goetz, Christopher G.; Bonduelle, Michel; Gelfand, Toby (1995). Charcot: Constructing Neurology. Oxford University Press. ISBN 0195076435.{{cite book}}: CS1 maint: multiple names: authors list (link)
• Kushner, HI (2000). A cursing brain?: The histories of Tourette syndrome. Harvard University Press. ISBN 0-674-00386-1.
• Shorter, Edward (1997). A History of Psychiatry. John Wiley & Sons. ISBN 0-471-24531-3.

Further reading

• Bogousslavsky J, Paciaroni M (2010). "Did jean-martin charcot contribute to stroke?". Eur. Neurol. 64 (1): 27–32. doi:10.1159/000317073. PMID 20588046.
• 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". Eur. Neurol. 62 (4): 193–9. doi:10.1159/000228252. PMID 19602893.{{cite journal}}: CS1 maint: multiple names: authors list (link)
• Clanet M (2008). "Jean-Martin Charcot. 1825 to 1893" (PDF). Int MS J. 15 (2): 59–61. PMID 18782501. {{cite journal}}: Unknown parameter |month= ignored (help)
• Tan SY, Shigaki D (2007). "Jean-Martin Charcot (1825-1893): pathologist who shaped modern neurology" (PDF). Singapore Med J. 48 (5): 383–4. PMID 17453093. {{cite journal}}: Unknown parameter |month= ignored (help)
• Teive HA, Almeida SM, Arruda WO, Sá DS, Werneck LC (2001). "Charcot and Brazil". Arq Neuropsiquiatr. 59 (2-A): 295–9. PMID 11400048. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Teive HA, Arruda WO, Werneck LC (2005). "Rosalie: the Brazilian female monkey of Charcot". Arq Neuropsiquiatr. 63 (3A): 707–8. doi:/S0004-282X2005000400031. PMID 16172730. {{cite journal}}: Check |doi= value (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Teive HA, Munhoz RP, Barbosa ER (2007). "Little-known scientific contributions of J-M Charcot". Clinics (Sao Paulo). 62 (3): 211–4. PMID 17589659. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
• Template:Pt icon Teive HA, Zavala JA, Iwamoto FM, Sá D, Carraro H, Werneck LC (2001). "[Contributions of Charcot and Marsden to the development of movement disorders in the 19th and 20th centuries]". Arq Neuropsiquiatr (in Portuguese). 59 (3-A): 633–6. PMID 11588652. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)

External links

• 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