Jean Martin Charcot
1825-1893
French Physician, Neurologist and Teacher
Jean-Martin Charcot was a pioneer of modern neurology and psychotherapy. Psychologists remember him for his investigations of hypnosis and hysteria, and his influence on Sigmund Freud (1856-1939). Among his contemporaries Charcot was highly respected as a teacher at La Salpêtrière and the creator of a unique neurological clinic. A prolific author and indefatigable researcher, he published many important clinical descriptions of nervous disorders and histological observations of lesions associated with various disorders.
Charcot was born in Paris, where he studied medicine and established an international reputation as a clinician, neurologist, and teacher. Although Charcot failed the competitive examinations in 1847, he became an Interne at the Salpêtrière, a major Parisian hospital and mental asylum, the next year. In 1853 he was awarded his M.D. for a thesis based on studies that differentiated rheumatoid arthritis from gout and other diseases of the joints. His mentor was French physician G. B. A. Duchenne de Boulongne (1806-1875). In 1859 Charcot published a study of intermittent claudication in humans. He was among the first to report on this phenomenon. Although Charcot is mainly remembered for his work in neurology, he remained interested in the degenerative diseases of the joints. He also described various aspects of liver and thyroid disease. In 1863 Charcot and André Victor Cornil published important observations of the renal lesions in gout. Five years later Charcot published a detailed description of a form of arthritis associated with the form of neurosyphilis known as tabes dorsalis. The condition is now known by his name, and tabetic joints are known as "Charcot's joints."
When Charcot joined the staff of the Salpêtrière he began a systematic clinical study of the unclassified, unknown chronic conditions that afflicted many of the hospital's long-term patients. He also performed painstaking postmortem examinations in order to correlate lesions found at death with the clinical symptoms observed in patients. This research program resulted in classical descriptions of diseases such as cerebral hemorrhage, diseases of the aged, chronic diseases, Menière's syndrome (a form of vertigo), multiple sclerosis, amyotrophic lateral sclerosis, Charcot-Marie-Tooth disease, tabes dorsalis (neurosyphilis), infantile paralysis, and hysteria. Despite his dedication to pathological research, Charcot was generally opposed to animal experimentation. Nevertheless, he was not a rigid antivivisectionist and he defended Louis Pasteur's experiments with rabies vaccinations. In 1872 Charcot was appointed Professor of Pathologic Anatomy at the Sorbonne. Ten years later he became the first Professor of Disease of the Nervous System at Paris. His landmark work Lectures on the Diseases of the Nervous System was published in 1877. His published lectures provide an invaluable overview of his work, thought, and approach to teaching.
Like his contemporaries J. Hughlings Jackson (1835-1911) and Paul Broca (1824-1880), Charcot was intrigued by the problem of cerebral localization and aphasia. Charcot and Jean Albert Pitres published a series of papers that provided rigorous proof of the existence of the cortical motor center in human beings. Charcotdifferentiated between Aran-Duchenne type muscular atrophy and amyotrophic lateral sclerosis, now known as Lou Gehrigs's Disease, but previous called Charcot's disease. In 1886 Pierre Marie (1853-1940) and Charcot published the first description of the form of muscular atrophy now known as Charcot-Marie-Tooth disease.
Although his use of hypnotism and his dramatic demonstrations of hysteria were greeted with some skepticism, including the possibility that Charcot had suggested or provoked the "crises" and symptoms in their patients, his basic ideas about hysteria provided fruitful insights into the psychopathology of traumatic experiences. Charcot thought that hysteria was a progressive, irreversible mental disease that might be caused by a weak neurological system and triggered by traumatic events. According to Charcot, only hysterics could be hypnotized, because the condition was itself similar to an attack of hysteria. Ultimately, even though many of his most distinguished students concluded that hypnosis was a psychological phenomenon rather than a neurological condition, his methods and ideas had a profound impact on the development of psychoanalysis.
Charcot was a talented artist and caricaturist as well as an outstanding scientist. Many of his drawings were preserved at the Salpêtrière. Charcot collaborated with Paul Marie Louis Pierre Richer, an artist at the Salpêtrière, in the development of books on disease and deformity as portrayed by artists. These books had a significant influence on subsequent studies of the relationship between medicine and art. Charcot's complete works were published in nine volumes between 1888 and 1894.
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