A Clinical Lesson at the Salpêtrière
|Artist||Pierre Aristide André Brouillet|
|Dimensions||290 cm × 430 cm (110 in × 170 in)|
|Location||Paris Descartes University, Paris|
A Clinical Lesson at the Salpêtrière ("Une leçon clinique à la Salpêtrière"), a group tableau portrait painted by the genre artist Pierre Aristide André Brouillet (1857-1914), is one of the best known paintings in the history of medicine. It hangs in a corridor of the Descartes University in Paris.
Although "rather undistinguished … artistically … the painting is remarkable for its dimensions, the figures being nearly life size".
The work was created by the academic history painter André Brouillet at the age of thirty, from individual studies of the thirty participants, and presented in the prevailing tradition of academic group portraits. It was first displayed (with favourable notices) at the salon d'art of 1 May 1887, and later purchased by the Academy of Fine Arts for 3,000 francs.
Brouillet was a pupil of Jean-Léon Gérôme who was, himself, also renowned for the fact that his illustrative paintings, such as Phryne before the Areopagus (1861), were so popular as lithographic prints that it seemed they were "painted in order to be reproduced".
The painting represents an imaginary scene of a contemporary scientific demonstration, based on real life, and depicts the eminent French neurologist Jean-Martin Charcot (1825-1893) delivering a clinical lecture and demonstration at the Pitié-Salpêtrière Hospital in Paris (the room in which these sorts of lesson took place no longer exists at the Salpêtrière).
On the rear wall of the lecture room is the (1878) large charcoal work, drawn by the anatomist and medical artist Paul Richer, which reproduces the hysterical pose captured in one of the many photographs taken in the Salpêtrière.
Entitled Periode de contortions ("During the contortions"), it depicts "a woman convulsing and assuming the arc-in-circle" posture: the arc en circle, or Opisthotonus, "the hysteric's classic posture".
Morloch (2007, p. 133), from his study of the actual painting, remarks on the striking and dramatic coincidence that, "in 1878 Richer reproduced the pose in [his] drawing from a photograph … [and] now, 1887 … the hysteric is reproducing in life the pose from the drawing."
Resting on the table to Charcot's right "are a reflex hammer and what is thought to be a Duchenne electrotherapy apparatus".
Except for the four individuals to Charcot's left, the participants are arranged in two concentric arcs: the inner circle displaying "sixteen of his current and former physician associates [arranged] in reverse order of seniority", and the outer, depicting "the older generation of [physician associates] … along with philosophers, writers, and friends of Charcot".
Both Signoret (1983, p. 689) and Harris (2005, p. 471) have identified each of the individuals depicted in Brouillet's tableau; and Signoret (passim) provides substantial biographical details of each.
The Charcot group
The Charcot group of five are (from right-to-left): Mlle. Ecary, a nurse at the Salpêtrière; Marguerite Bottard, the Salpêtrière's nursing director; Joseph Babinski (1875-1933), Charcot's chief house officer; Marie "Blanche" Wittman, Charcot's patient; and Jean-Martin Charcot himself.
The inner window-side group
The six sitting in the window-side of the painting are (from right to left): Paul Richer (1849-1933), medical artist, anatomist and physician (who created the painting on the back wall); Charles Samson Féré (1852-1907), psychiatrist, Charcot's assistant, and Charcot's secretary; Pierre Marie (1853-1940), neurologist; Édouard Brissaud (1852-1909), neurologist and pathologist; Paul-Adrien Berbez (1859-?), physician, student of Charcot, and neurologist; and Gilbert Ballet (1853-1917), destined to be one of Charcot's last chief residents.
The outer window-side group
The six standing at the window-side of the painting are (from right to left): Alix Joffroy (1844-1908), anatomical pathologist, neurologist and psychiatrist; Jean-Baptiste Charcot (1867-1936), Charcot's son, at the time a medical student and, later, a polar explorer; Mathias Duval (1844-1907), Professor of anatomy and histology; Maurice Debove (1845-1920), later Dean of the medical school; Philippe Burty, art collector, critic, and writer (see Philippe_Burty); and Victor Cornil (1837-1908), pathologist, histologist, and politician.
The remaining group
The remainder are either sitting parallel to the back wall, or on the side of the lecture theatre immediately opposite the windows. The remaining thirteen individuals are (from left to right): Théodule Ribot (1839-1916), psychologist; Georges Guignon (1839-1932), neuropsychiatrist, and one of Charcot's last chief residents; Albert Londe (1858-1917), medical photographer, and chronophotographer (wearing an apron); Léon Grujon Le Bas (1834-1907), chief hospital administrator; Albert Gombault (1844-1904), neurologist and anatomist; Paul Arène (1843-1896), novelist; Jules Claretie (1840-1913), journalist and literary figure; Alfred Joseph Naquet (1834-1916), physician, chemist, and politician; Désiré-Magloire Bourneville (1840-1909), neurologist and politician; Henry Berbez, younger brother of Paul-Adrien Berbez (sitting opposite), and a student of Charcot; Henri Parinaud (1844-1905), ophthalmologist and neorologist; Romain Vigouroux, chief of electrodiagnostics, discoverer of the electrical activity of the skin; and, finally, in the apron, Georges Gilles de la Tourette (1857-1904), neurologist and physician.
Apparently the painting has only recently returned to Paris, having "spent most of its life in obscurity in Nice and Lyon".
Today it hangs, unframed, in a corridor of the Descartes University in Paris, near to the entrance of the Museum of the History of Medicine, which houses one of the oldest collections of surgical, diagnostic, and physiological instrumentation in Europe.
In the nineteenth century, a considerable number of different versions of the original painting were produced.
Morloch's approximation (2007, p. 135) is that there were at least fifteen uniquely different reproductions produced by techniques as varied as "engraving, etching, lithograph(y), photogravure, along with other photomechanical processes" between the painting's first appearance in 1887, and its disappearance from public view in 1891.
| Freud's lithograph
Source: Freud Museum, London.
| Freud's London treatment couch
Source: Freud Museum, London.
| Freud's London couch (uncovered)
Source: Freud Museum, London.
Once Freud reached England, it was immediately placed directly over the analytical couch in his London rooms.
- HIMETOP: History of Medicine Topographical Database: "Un Leçon Clinique à la Salpêtrière" (1887) by André Brouillet.
- Micale (2004), p. 74.
- Morlock (2007), p. 129.
- Signoret (1983), p. 689.
- Morlock (2007, p. 135) argues that most of these individual studies would have been taken by a photographer, rather than sketched by an artist. In support of his claim, Morlock draws attention to the "lack of interaction between the figures in the scene and the marked failures of their sightlines to meet".
- Harris (2005), p. 471.
- Morloch (2007), p. 134.
- Telson (1980), p. 58.
- A "chevalier de la Légion d'honneur", he was the illegitimate son of Philippe Le Bas. Originally known as Léon Grujon (Grujon was his mother's family name), he legally changed his name to Léon Grujon Le Bas on 25 June 1860 (Paris, L., État présent de la noblesse française, Bachelin-Deflorenne, 1866, p. 1169.)
- The vertical crease in the middle of this image indicates that it has been taken from an (otherwise unidentified) bound volume.
- Morlock (2007), p. 131.
- History of Medicine Topographical Database.
- Morlock (2007), p. 130.
- According to Morlock (2007, p. 130) — who suggests that "[it is almost] as if the painting itself was painted in order to be reproduced" — Pirodon's lithographic reproduction of Brouillet's original "was so successful that it was published at least three times by two separate printers".
- Alvarado, C., "Nineteenth-Century Hysteria and Hypnosis: A Historical Note on Blanche Wittmann", Australian Journal of Clinical and Experimental Hypnosis, Vol. 37, No. 1, (May 2009), pp. 21–36.
- Geisler, S., "Une Leçon Clinique à la Salpêtrière (A Clinical Lesson at the Salpêtrière), Andre Brouillet (1887)", The Journal of Physician Assistant Education, Vol.22, No.3, (2011), pp. 41–42.
- Harris, J.C., "A Clinical Lesson at the Salpêtrière", Archives of General Psychiatry, Vol.62, No.5, (May 2005), pp. 470–472. doi=10.1001/archpsyc.62.5.470
- Kemp, M. & Wallace, M., Spectacular Bodies: The Art and Science of the Human Body from Leonardo to Now, University of California Press, (Berkeley Way), 2000.
- Marshall, J., "Dynamic Medicine and Theatrical Form at the fin de siècle: A formal analysis of Dr Jean-Martin Charcot's pedagogy, 1862–1893", MODERNISM/modernity, Vol.15, No.1, (January 2008), pp. 131–153.
- Micale, M.S., "Discourses of Hysteria in Fin-de-Siècle France", pp. 71–92 in Micale, M.S. (ed.), The Mind of Modernism: Medicine, Psychology, and the Cultural Arts in Europe and America, 1880-1940, Stanford University Press, (Redwood City), 2004.
- Morlock, F., "The Very Picture of a Primal Scene: Une leçon clinique à la Salpêtrière", Visual Resources: An International Journal of Documentation, Vol.23, Nos.1-2, (March–June 2007) pp. 129–146. doi=10.1080/01973760701219594
- Signoret, J.L., "Une leçon clinique à la Salpêtrière (1887) par André Brouillet", Revue Neurologique, Vol.139, No.12, (December 1983), pp. 687–701.
- Telson, H.W., "Une leçon du docteur Charcot à la Salpêtrière", Journal of the History of Medicine and Allied Sciences, Vol.35, No.1, (January 1980), pp. 58–59. doi=10.1093/jhmas/XXXV.1.58
- Walusinski O., "Marguerite Bottard (1822–1906), Nurse under Jean-Martin Charcot, Portrayed by G. Gilles de la Tourette", European Neurology, Vol.65, No.5, (May 2011) pp. 279–285. doi=10.1159/000327313