Jean-Martin Charcot Biography (1825-1893)

physician, neurologist, teacher

Jean-Martin Charcot was born on November 29, 1825 in Paris, France; he died at Auberge des Settons, near Vézelay, France on August 16, 1893. He isremembered as a physician, neurologist, and teacher who succeeded in relatingmany neurological disorders to physical causes. He held the position of professor at the University of Paris for 33 years. In 1862, he began an association with the Salpetrière Hospital, an ancient and famous hospital in Paris, that lasted throughout his life (eventually Charcot would become director of this hospital).

Charcot studied medicine in Paris. After failing a competitive examination in1847, he was elected Interne at the Salpetrière in 1848. Charcot's M.D. thesis (1853) contributed to the understanding of the difference between rheumatoid arthritis, and gout and other joint diseases. Charcot was the firstto describe intermittent claudication (1858). When he began practicing at the Salpetrière in 1862, he found many long-term patients suffering fromundiagnosed or unknown chronic afflictions of the nervous system. Over the next eight years, made systematic clinical observations of their physical symptoms, which he succeeded in correlating with actual lesions by conducting autopsies.

Charcot made classical descriptions of multiple or disseminated sclerosis andin 1869 of amyotrophic lateral sclerosis, subsequently known as Maladie de Charcot (Charcot's disease), Lou Gehrig's disease, and ALS. (Amyotrophic refers to a loss of muscle mass; lateral refers to the nerve tracks that run downboth sides of the spinal cord, where many neurons affected by ALS are found;sclerosis refers to the scar tissue that remains following disintegration ofthe nerves). Charcot was the first physician to link symptoms of ALS to a group of nerves specifically affected by the disease, i.e., the motor neurons that originate in the spinal cord).

Charcot's important contributions to medicine included his recognition of theimportance of small arteries in cerebral hemorrhage (a familial neuropathy now known as Charcot-Marie-Tooth disease involving a progressive degenerationof the muscles in the foot, lower leg, hand and forearm, and a mild loss of sensation in the limbs, fingers and toes. He also made contributions to the understanding of tabes dorsalis (a type of neurosyphilis), as well as of a destructive and painless arththritis know as Charcot's joint. Still other studiesfocused on poliomyelitis, cerebral localization and aphasia. Charcot never lost his interest in general medicine, however, and wrote about thyroid and liver disease.

Although he conducted laboratory experiments, Charcot was opposed to animal experimentation. He did, however, defend Pasteur's rabies vaccination. He wasa popular lecturer at the Salpetrière, and his Leçons sur les maladies du système nerveux faits à la Salpetrière (1872to 1873) was translated into many languages. In 1872, he was appointed Professor of Pathologic Anatomy at the Sorbonne; ten years later he became Professor of Disease of the Nervous System at the University of Paris.

Charcot also had a special interest in the malady then known as hysteria, which seemed to be a mental illness with physical symptoms. He was convinced that hysteria came about because of a weak neurological system, and that the disease had a familial origin. He was intrigued because the malady could be triggered by a traumatic event like an accident, but it then became progressive and irreversible. To study patients, he applied the technique of hypnosis to induce and study their symptoms. By using a large accordion-sized camera to capture the "fits" of his patients, Charcot was able to demonstrate that hysteria, like organic diseases, was associated with a set of distinguishing symptoms. Charcot's research on hysteria enhanced his reputation outside his own discipline, but his critics argued that he was using the power of suggestion tobring about his patients' crises. In retrospect, however, it appears that many of Charcot's ideas on hysteria were well founded. Not surprisingly, Charcot attracted students from all over Europe, including Pierre Marie, J. F. F. Babinski, V. M. Bechterew, Alfred Binet, and Pierre Janet, and Sigmund Freud.

Freud, who had applied for and received the University Jubilee Travel Grant to Paris for 1884/5 to study with Charcot, remarked in a letter to his fianceethat Charcot had the air of "a worldly priest from whom one expects a readywit and an appreciation of good living." Freud was especially struck by Charcot's brilliance, and by his lively interest in all that took place around him. Although Freud was favorably impressed with Charcot's person, he disagreedwith Charcot's idea that hypnosis is a neurological phenomenon, and went on to argue that the hypnotic state is a psychological phenomenon.

An accomplished artist, Charcot's drawings and caricatures have been preserved at the Salpetrière. He is also remembered for his books about demons, the deformed, and the sick, and their relationship to art. Charcot's only son, Jean, abandoned medicine after his father's death, and went on to becomeFrance's foremost polar explorer.

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