Charcot on Parkinson's disease

Charcot saluted Parkinson for his early observations, but condemned his use of the term "paralysis agitans." He emphasized that patients were neither dramatically weak nor were they necessarily plagued with tremor. Charcot suggested the name "Parkinson's disease," although he could not resist the comment in his amphitheater lecture series at the Salpêtrière that French physicians (unnamed) had probably described the disorder before 1817. Tremor, rigidity, postural instability, and bradykinesia were all recognized by Charcot. He classified the disorder as a "névrose," meaning a neurologic disorder without a known pathologic lesion, and found little benefit from therapies available at the time, including belladonna and ergot products.     

Living his writings: The example of neurologist G. Gilles de la tourette

Gilles de la Tourette is known for the disease which now bears his name. As one of the closest followers of Jean‐Martin Charcot, he always remained faithful to his mentor's views and was one of the most vehement defenders of La Salpêtrière. His activities in the management of hysterics and in hypnotism helped build his reputation during his lifetime, but are now largely forgotten. Gilles de la Tourette had an unusual personality, with hypomanic and histrionic traits. We present some ignored aspects of his life based on the discovery of personal letters which illuminate the hidden side of this famous neurologist. © 2010 Movement Disorder Society     

Multiple sclerosis From Charcot and Vulpian to the present time

The present paper reports the isolation of multiple sclerosis and the evolution of ideas about this disease since the end of the 19th century. Charcot and Vulpian were close friends during their university years and both were appointed physicians at the Salpêtrière in 1862. It is difficult to sort each other part in the beginning of researches which both devoted to "tremors". When Vulpian left the Salpêtrière in 1865 the main point was settled: a clear cut distinction between paralysis agitans vs patients whose tremor appeared during movement and in whom post-mortem had disclosed disseminated lesions "en plaques". For the 20 ensuing years Charcot built up an impressive corpus of pathological and clinical data which were the basis of his celebrated "Le?ons". This history shows the pathological clinical method at ist acme in the hands of a physician of genius. Pathogenetic hypotheses, from vascular to toxic and infectious, the role of immunological, genetic and viral factors are also briefly reviewed.     

Charcot and the myth of misogyny.

OBJECTIVE: To evaluate Jean-Martin Charcot's attitudes toward women and evaluate contemporary and modern accusations of misogyny. BACKGROUND: During the last quarter of the nineteenth century, issues of women's health and feminism became increasingly a medical and political priority. Early neurologists, and specifically Charcot, have been criticized for retarding the advancement of women, but the issue has never been studied in detail. METHODS: Review of original documents from the Bibliothèque Charcot, archives of the Sorrel-Dejerine and Leguay families, and materials from the Académie de Médecine, Paris. RESULTS: Several lines of evidence demonstrate that Charcot, although highly authoritarian and patronizing toward patients and colleagues in general, fostered the concepts of advancing women in the medical profession and eliminating former gender biases in neurologic disorders. The first woman extern in Paris, Blanche Edwards, worked directly under Charcot, and he later became her thesis advisor. When women lobbied for entrance rights to the intern competition, Charcot was one of the few professors to sign the original petition of support. Charcot worked extensively with hysteria and female patients, although he energetically rejected the idea that the disorder was restricted to women. He categorically deplored ovariectomy as a treatment for women with hysteria. His most important scientific contribution in the study of hysteria was his identification of the disorder in men. CONCLUSIONS: Although overtly apolitical throughout his life and certainly not a feminist in the modern definition of the term, Charcot worked to incorporate women professionally into neurology, advanced areas of women's health through his long-term commitment to work in a largely women's hospital (the Salpêtrière), and dispelled the prejudice that hysteria was a woman's malady.     

The return of neurasthenia

This history of neurasthenia has been reviewed with special attention to the sociocultural factors that have affected our understanding of the term. The suggestion has been made that neurasthenia is a stress-intolerance syndrome, thus linking it to the post-traumatic syndromes and external stress. It has also been shown that periods of heightened interest in neurasthenia in the psychiatric literature coincide with periods and locales of decreased cohesion of the larger group. Recent developments, particularly neurasthenia's reinstatement in the United States, appear to fit in with historical patterns.     

Visual art in the neurologic career of Jean-Martin Charcot

Jean-Martin Charcot, the world's first chaired professor of neurology, incorporated visual art into his daily practice of neurology. Art served as scientific documentation and was a pivotal tool in the development and dissemination of Charcot's clinicoanatomic method. Although Charcot drew extensively in clinical and laboratory studies, very few of these visual documents have ever been published or are currently available for public study. Charcot was central to the incorporation of medical photographs into the study of neurologic disease and relied heavily on visual material in his capacity as an international teacher. Art also misguided Charcot's career when he relied heavily on artwork in his attempt to convince critics that disorders seen at the Salpêtrière Hospital, Paris, France, were independent of his suggestive influence.     

Trends in the teaching of neurology to family practice residents, 1981-1990.

A decade ago, less than one-half of the family practice (FP) residency programs surveyed provided a defined rotation in neurology. To learn how neurology is currently being taught in FP residencies, we sent questionnaires to 384 approved FP residencies in the United States, receiving responses from 241 (63%). Seventy-eight percent provide a defined rotation in neurology, usually in the form of a preceptorship with a community neurologist, and 57% systematically present the core curriculum recommended by the American Academy of Neurology and the American Academy of Family Physicians in 1987. Asked about the level of cooperation they encounter in recruiting neurologists to teach, 54% of the respondents reported "too little" or "no" cooperation from academic neurologists, while just 20% reported these responses in regard to community neurologists. Most (87%) reported that involvement in the residency program leads to increased patient referrals for the participating neurologist. Most (81%) respondents would welcome more participation by neurologists.     

Georges Gilles de la Tourette. The man and his times

Georges Albert Edouard Brutus Gilles de la Tourette (1857-1904), one of Charcot's favourite pupils and his self-appointed amanuensis made several valuable contributions to medicine and literature. His most substantial achievements were in the study of hysteria and the medico-legal ramifications of hypnotism, but he was also a competent neuropsychiatrist with a particular interest in therapeutics. He was a dynamic, passionately outspoken man whose prodigious literary output reflected his own restless compulsions as well as the interests of his beloved chiefs Brouardel and Charcot. His love of Loudun, his ancestral home strongly influenced his subject matter which included a biography of Theophraste Renaudot and with his colleague Gabriel Legué a perceptive analysis of Soeur Jeanne des Anges' account of her hysterical illness induced by her unrequited love for the Loudun priest Urbain Grandier. In 1893 shortly after the tragic death of his young son and of his mentor Charcot, Gilles de la Tourette was shot by a deluded woman who had been a patient at the Salpêtrière. Her claims that she had been hypnotised by Gilles de la Tourette against her will causing her to lose her sanity bore a macabre resemblance to the accusation of Soeur Jeanne des Anges against Grandier. The bizarre episode became a "procès célèbre" seeming superficially to vindicate the Nancy School's views that criminal suggestion was possible under hypnotism, a view Gilles de la Tourette had vehemently rejected. Despite his colourful life and varied achievements only an incomplete biographical account by his friend Paul le Gendre, a few informative orbituaries and some caustic sketches by Leon Daudet exist.     

Charcot and Babinski: beyond a simple teacher-student relationship

Jean-Martin Charcot (1825-1893) is now considered to be the father of clinical neurology in France. He trained a generation of eminent neurologists, among them Joseph Babinski, with whom he had a special relationship. Babinski was undoubtedly Charcot's favorite pupil and they enjoyed an excellent collaboration at la Salpétrière. Even though both men felt tremendous respect for each other, it is sad that this relationship may, in one instance, have been detrimental to Babinski. This is probably the reason why Bouchard denied him full professorship, a decision with eventual consequences for both men. In spite of this, the neurologist of Polish origin held his master in tremendous admiration, even as he pursued Charcot's research on hysteria after his death. Even though Babinski eventually contradicted his master on many fundamental issues, it did not affect his devotion to him. The relationship between the two men can be considered as more than a simple relationship between a teacher and his pupil and may be compared to a father-son relationship, which is a reminder of the original model of Hippocratic teaching.     

Complications from “Stem Cell Tourism” in Neurology

“Stem cell tourism,” the practice of offering unproven cellular preparations to patients as approved therapy, is rising in neurology. Currently, the experiences of patients and reported complications from these procedures are unknown in the United States. We evaluate academic neurologists' experiences with stem cell tourism and assess perceived competency on discussing this topic with patients. We found a lack of neurologist preparedness to discuss stem cell therapies with patients and an alarming list of unreported complications from these unregulated procedures. We also identified an urgent need for neurologist education and the creation of a national registry for reporting patient complications resulting from experimental stem cell interventions. ANN NEUROL 2020;88:661–668     

The Salpêtrière in the wake of Charcot's death

After Charcot died in 1893, the students of his immediate circle did not fare well academically in the French medical system. Fatigue and bitterness toward the authoritarian Charcot may have contributed to the change in the scientific and social ambience of the Salpêtrière of Paris in the generation after Charcot died. Clearly, however, the faculty were not invested in energetically overturning the system that Charcot had established, and their choice of Fulgence Raymond as Charcot's successor was an effective means of permitting a passive waning in the Salpêtrière's magnetic influence in world neurology.     

Amyotrophic lateral sclerosis: early contributions of Jean-Martin Charcot

Amyotrophic lateral sclerosis is historically an important entity because its manifestations involve distinct signs that can be correlated with gray and white matter lesions at specific sites within the central nervous system. Working at the end of the nineteenth century, the celebrated neurologist, Jean-Martin Charcot, used this disorder as a prototypic example of the power of his research method, termed "méthode anatomoclinique." Using clinical cases and autopsy material, he showed how anatomical lesions in the nervous system could be accurately determined by the presence of carefully analyzed clinical signs. Charcot's work on amyotrophic lateral sclerosis brought together neurological entities formerly considered as disparate disorders, primary amyotrophy and primary lateral sclerosis. In addition, these studies contributed to the understanding of spinal cord and brain stem anatomy and the organization of the normal nervous system. Because of Charcot's fundamental contributions, the eponym "Charcot's disease" has been used internationally in association with amyotrophic lateral sclerosis.