Journal of the History of the Neurosciences最新文献

Jean-Martin Charcot (1825-1893) showed little interest in mental disorders, the domain of nineteenth-century alienists. But hallucinations are not confined to the field of psychiatry, and Charcot, who had once tested the hallucinogenic effects of hashish in his youth, went on to describe hallucinations in the course of various neurological conditions as just another semiological element. Most of his or his disciples' writings on hallucinations can be found in his work on hysteria. Hallucinations and delusions were part of "grand hysteria" and occurred at the end of the attack (third or fourth phase). Hypnosis or chemical agents could also induce hallucinations. Charcot and his disciples did not go so far as to emphasize the importance of hallucinations when they evoked past trauma, especially sexual trauma. Charcot's materialistic orientation led him and his disciples-especially D. M. Bourneville (1840-1909), G. Gilles de la Tourette (1857-1904), and the neurologist and artist P. Richer (1849-1833)-to seek hysteria in artistic representations of "possessed women" and in the visions of nuns and mystics. Finally, Charcot recognized the importance of hallucinations in neurological semiology, by means of precise and relevant observations scattered throughout his work. Preoccupied with linking hysteria to neurology, Charcot only scratched the surface of the possible significance of hallucinations in this context, paving the way for the work of his students Pierre Janet (1859-1947) and Sigmund Freud (1856-1939).

Jean-Martin Charcot (1825-1893) did not show much interest in the peripheral nervous system and its associated pathologies. He found it difficult to place the peripheral nerve within his classification of disorders; it appeared to be an exception to his theories. Even the pathology that he described in 1886 with Pierre Marie (1853-1940), at the same time as Henry Tooth (1856-1925), and which is now known as Charcot-Marie-Tooth neuropathy, was considered by Charcot to be a potential myelopathy. Charcot, like other physicians, paid little heed to the observations made by Louis Duménil (1823-1890) to support the existence of primitive damage to the peripheral nerve. Charcot approached peripheral nerve pathologies through two indirect routes: amyotrophies not explained by spinal or muscular damage, and the trophic cutaneous consequences of what he called névrites (neuritis), the lesional site of which remains debated. It is noteworthy that Charcot's approach to peripheral nervous system disorders differed from that of other neurologists of the same time. Augusta Dejerine-Klumpke (1859-1927) in France was more precise than Charcot in her anatomical and clinical descriptions, and Hugo von Ziemssen (1829-1902) in Germany made effective use of electrodiagnostics. Charcot supported the electrical work of Guillaume Duchenne de Boulogne (1806-1875), whom he sometimes presented as one of his mentors. The German physician Wilhelm Erb (1840-1921) developed electrodiagnosis by galvanic and faradic currents. Charcot never made use of Erb's electrological advancements. With his electrophysiologist Romain Vigouroux (1831-1911), Charcot used medical electricity only for electrotherapy in hysteria.

Jean-Martin Charcot is perhaps best remembered for his contributions to organic neurology. However, his pursuit of hysteria, the most prevalent diagnosis in his hospital clinic, yielded no anatomical lesion to account for hysteria's plethora of somatic disorders assumed due to a purely functional or dynamic lesion in the cerebral cortex. This led Charcot to turn his attention to the psychology of hysteria. Taking advantage of institutional reforms at the Salpêtrière-notably, the establishment of his professorship in nervous diseases-Charcot from the early 1880s focused his teaching increasingly on case histories of hysteria in male as well as female patients. Already renown for his earlier dramatic public lessons on female hysteria, his lessons of the 1880s, of which two volumes were published at the end of the decade, elaborated the issue of psychology in terms of altered states of patient's suggestibility. By the decade's end, Charcot's worldwide reputation rested on the prospects of this work as acknowledged by numerous students, notably medical psychologists Pierre Janet and Sigmund Freud. Yet Charcot's views remained sketchy. They were discussed at length in his unpublished notes for a lesson intended for May 1893, just a few months before his sudden death. His unpublished notes reveal a detailed case for dreams as illustrating a psychological mechanism underlying hysteria in a 17-year-old Paris artisan. I conclude by considering why this significant climactic case of Charcot's might have been overlooked by his entourage.

Dr. Jean-Martin Charcot (1825-1893) pioneered the use of visual aids in his lectures at the Hôpital de la Salpêtrière. He deployed photographs, casts, diagrams, graphs, drawings, lantern slides, and even patients to help the audience understand his innovative diagnoses, but that same visual imagery also informed his own conceptualizations of pathology. Charcot, whom Sigmund Freud famously called a "visuel," made drawings of his patients and their autopsied organs while also encouraging the art-making of his many collaborators and protégés at the Salpêtrière in the last quarter of the nineteenth century. Their "scientific artworks" epitomize the entanglement of art and medical science at the hospital. This article examines the role of visual media in diagnosing pathology under Charcot's aegis, bringing to light images and objects that catalogue the case of Ambroise Bourdy. Here was a perfect example of the male hysteric, according to Charcot: a "robust" blacksmith and father who developed a hysterical contracture after a workplace injury. In 1882, Charcot's Salpêtrière colleagues-including Dr. Henri Parinaud, Dr. Paul Richer, Louis Loreau, and Albert Londe-tested Bourdy's eyes, made drawings and a cast of his contracted left hand, and photographed him in various poses. The surfeit of visual imagery of Bourdy purports to illustrate traumatic hysteria-however, it more effectively, if unintentionally, reveals a delight in art-making at the Salpêtrière.

Jean-Martin Charcot, often lauded for his seminal contributions, is seldom critiqued for his blunders. One such blunder was his double-semidecussation scheme for the retinocortical visual pathways, proposed in 1875 to explain, on neuroanatomic grounds, cases of hysteria that manifest hysterical amblyopia accompanied with ipsilateral hemianaesthesia. Charcot's scheme was inconsistent with the older, broadly correct scheme of Prussian ophthalmologist Albrecht von Gräfe. Charcot failed to perform clinicopathologic correlation studies. His analysis relied on a series of mistaken conclusions he made in conjunction with Swiss-French ophthalmologist Edmund Landolt: (1) only an optic tract lesion could produce a homonymous hemianopsia; (2) cerebral lesions, if they ever produced homonymous hemianopsia, did so by secondary effects (e.g. pressure) on the optic tracts; and (3) damage to the cortical projections from the lateral geniculate produces a crossed amblyopia. Challenges to Charcot's theory came from within France by 1880. By 1882, Charcot recognized that his scheme was erroneous, and he approved a thesis by his pupil Charles Féré that reverted to Gräfe's scheme with an ill-conceived modification to accommodate Charcot's concept of hysterical cerebral amblyopia. A critique by American neurologist Moses Starr in 1884 argued for Gräfe's scheme and refuted Charcot's erroneous scheme and its subsequent derivatives.

The history of amyotrophic lateral sclerosis (ALS)-also known as Charcot's disease, Lou Gehrig's disease, and motor neuron disease (MND)-freezes the texts of the scientist and physician Jean-Martin Charcot in a hagiographic narrative describing a brilliant discovery, based on the anatomo-clinical method. This narrative is often used by biologists and physicians as a reference point. This article shows that the use of the hagiographic register faces limitations. In particular, it obscures points of interest from Charcot's texts on ALS, such as the epistemological and ontological implications of scientific plurality in medicine. Although Charcot recognized the importance of scientific plurality in medicine, he prioritized the approaches and conferred the most important epistemic authority on clinical and pathological observations. In his view, animal modeling remains secondary to the understanding of disease. The concept of ALS and its diagnostic operability are the result of symptoms and lesions. By studying the past, we can highlight the specific features of the present. Today, although the ALS concept retains its diagnostic and clinical relevance, it is increasingly called into question in etiological and mechanistic research. Despite these differences, Charcot's reflections are a reminder of the importance of theoretical thinking on scientific plurality, all the more so today in the context of ALS research, in which combining different approaches is increasingly valued to understand the phenotypic and genetic heterogeneity of ALS.

Much has been written, mostly in overly critical terms, about Jean-Martin Charcot's use of images in his hysteria research. Besides the images of patients Charcot produced for his clinical research, one other image has preoccupied present-day scholars-André Brouillet's painting Une leçon clinique à la Salpêtrière. Unveiled at the 1887 Salon in Paris, this life-sized painting depicts Charcot lecturing on hysteria to his male audience while presenting a swooning female patient. For many present-day critics, Brouillet's painting symbolizes Charcot's purported misuse of his female hysteria patients. Contrary to such interpretations, this article shows that Brouillet's painting did not merely serve as an iconic visual representation of Charcot's hysteria research but was also used by Charcot as an active epistemic tool in his research on hysterical amnesia. Through a close reading of Charcot's only published lecture on hysterical amnesia, which he held on December 22, 1891, I analyze the process through which Charcot generated new medical insights into hysterical amnesia. I thereby trace the decisive role that Une leçon clinique played in this process.

Biographies, articles, and meetings devoted to the founder of modern neurology, Jean-Martin Charcot, are typically dithyrambic, if not hagiographic. It seems that the striking professional and familial qualities of Charcot have erased any other characteristic of the person, and scratches on the Master image commonly have not been well accepted. With this in mind, it is interesting to present and evaluate the rather negative opinions on Charcot by the famous French writer Léon Daudet, who initially was very close to the Charcots through his father, Alphonse Daudet, and who wrote rather extensively on Charcot in his diary and memoirs. Our point is not to underline these writings as the "truth" about Charcot's personality and life (Daudet, who was a prominent extreme right-wing figure, was known to exaggerate and play with his sharp opinions), but Daudet's criticisms paradoxically provide a fascinating perspective, which may help to reconstruct better who Charcot really was in counterbalancing a bit the overcrowded, politically correct, praising group.

Jean-Martin Charcot's 1883 lectures on aphasia at the Salpêtrière Hospital were seen as the starting point for the development of a psychology in the work of the famous neurologist. In his lectures, Charcot set out a theory of language function at the cerebral level, distinguishing between the different centers involved in speech production and those necessary for reading. His lectures, which also postulated the independence of ideas from words, were to resonate beyond aphasia specialists, and particularly with alienists. To document this dimension of the reception of neurology in the field of psychiatry, this article refers to Jules Séglas's synthesis on Les troubles du langage chez les aliénés, published in 1892, which summarized the knowledge acquired during the nineteenth century about modifications of expression in madness and whose original ideas were to mark the psychiatric semiology of the early-twentieth century. The analysis details how Séglas cited and adapted Charcot's conceptions to explain the production of incomprehensible speech in idiocy and the formation of hallucinations, thus contributing to the spread of the neurologist's model among his fellow alienists.

In the era after World War II, Francis (Frank) Forster (1912-2006) became a preeminent American neurologist and epileptologist, with international prominence in the study of reflex epilepsy. Forster's interest in reflex epilepsy began with a chance observation of the condition, in 1946, in a four-year-old girl. When medical measures failed to control her somatosensory-evoked seizures, Forster recommended surgery, and then facilitated transfer to Canadian neurosurgeon Wilder Penfield (1891-1976) at the Montreal Neurological Institute. Forster traveled to Montreal for the child's surgery. The surgery on February 27, 1948, proved to be curative for the child, and Forster's interactions with Penfield and epileptologist Herbert Jasper (1906-1999) made a lasting impression. This study reviews the medical and surgical history of this case, which strongly influenced Forster's career.