neurology - history - Charcot
neurologia - história - Charcot
Jean-Martin Charcot (1825-1893) ([Figure 1 ]) is considered the founder, and first formal professor, of modern neurology. It was as a result of his dedicated work, and that of his many disciples, that neurology emerged as an internal medicine specialty during the latter half of the nineteenth century at La Salpêtrière Hospital, in Paris[1 ]-[3 ]. At that time, the French school of neurology was famous worldwide, and La Salpêtrière Hospital was respected as a reference center for the many physicians who visited Charcot and his service[1 ],[2 ],[3 ]. From 1862 to 1893, Charcot had 32 house officers (interns), including Charles Bouchard (1864 and 1866), Jules Cotard (1865), Désiré-Magloire Bourneville (1868), Alix Joffroy (1869), Edouard Fulgence Raymond (1875), Albert Pitres (1876), Edouard Brissaud (1879), Charles Féré (1881), Pierre Marie (1882), Georges Gilles de la Tourette (1884), Georges Guinon (1885), Paul Blocq (1887), Jean-Baptiste Charcot (1891) and Achille Souques (1893). Jean-Martin Charcot also had several chefs de clinique , who eventually became his disciples: Marie (1883-1884), Babinski (1885-1886), Gilles de la Tourette (1887-1888) and Guinon (1889-1890)[1 ],[2 ],[4 ]. Of these, Charles Féré, Pierre Marie, Georges Gilles de la Tourette and Georges Guinon became his personal secretaries[1 ],[2 ],[4 ] and are the subject of this review.
Figure 1 Professor Jean-Martin Charcot (1825-1893).(From the private collection of the author - OW)
CHARCOT’S SECRETARIES
At the peak of his career, starting from 1881, Professor Charcot was involved in a range of neurological research activities and had a thriving private practice. Some of his patients were very important personalities such as the Queen of Spain, the Grand Duke Nicholas of Russia and the Brazilian Emperor, Dom Pedro II. To help him deal with his heavy workload, he decided to take on a secretary for his private practice[1 ],[2 ],[3 ],[4 ]. Among other things, the secretary prepared the Master’s consultations at La Salpêtrière, but also at his home on Boulevard Saint-Germain. He collated articles and observations. He wrote summary reports that were useful to Charcot, especially in preparing his lessons. Among his several assistants at the Neurology Service at La Salpêtrière hospital, he chose those he considered the most brilliant, friendly and trustworthy. During this period, the position of secretary in his private office was occupied by four different physicians: Charles Féré, Pierre Marie, Georges Gilles de la Tourette and Georges Guinon. Désiré-Magloire Bourneville (1840-1909), a neurologist who described tuberous sclerosis, also known as Bourneville’s syndrome, and a follower of Charcot who, as a journalist, contributed significantly to his scientific publications, was his personal assistant but not a true secretary[1 ],[2 ],[4 ].
CHARLES FÉRÉ
Charles Féré (1852-1907) was a house officer at La Salpêtrière Hospital under Professor Charcot’s supervision in 1883 and joined his department in 1885, later becoming director of Charcot’s laboratory ([Figure 2 ]). He defended his thesis “Contribution of brain lesions and hemianopsia to the study of functional vision problems” under Charcot’s direction[4 ]. Profoundly influenced by Charcot, Féré published various psychiatric studies as well as papers on hysteria, epilepsy and neuroses. He was the first secretary chosen by Charcot to work with him in his private clinic[4 ].
Figure 2 Charles Féré (1852-1907).(Extracted from Google images: Baillement.com, December 18th, 2016)
PIERRE MARIE
Pierre Marie (1853-1940) was one of Charcot’s most important pupils, working with him first as an intern, then as chef de clinique and head of laboratory and as a special assistant (second secretary) in his private office on Boulevard Saint-Germain[4 ],[5 ],[6 ],[7 ] ([Figure 3 ]). Although Pierre Marie lost the selection process to succeed Fulgence Raymond at La Salpêtrière Hospital in 1911, he replaced Jules Dejerine after the latter’s death in 1917, and took up Charcot’s chair at the hospital[4 ],[6 ]. Marie was responsible for describing various diseases, in particular, acromegaly, hereditary cerebellar ataxia, pulmonary hypertrophic osteoarthropathy, ankylosing spondylitis and the hereditary neuropathy known as Charcot-Marie-Tooth’s disease. He also studied the aphasias and foreign accent syndrome[4 ],[5 ],[6 ],[7 ]. Marie belonged to Charcot’s inner circle and was known for his unusual behavior and taste for controversy and debate[4 ]-[7 ]. Although mostly an introvert, Marie was, at times, unstable and aggressive, even combative, which proved to be a disadvantage in his highly productive career[4 ],[5 ],[6 ],[7 ]. After Charcot’s death, Marie had an intense, aggressive competition with his rival, the famous neurologist Jules Dejerine[4 ]. The climax of this competition was the famous debate known as the Paris aphasia debate , which took place in Paris in 1908[6 ],[7 ]
.
Figure 3 Pierre Marie (1853-1940).(December 18th , 2016)
GEORGES GILLES DE LA TOURETTE
GEORGES GILLES DE LA TOURETTE
Georges Gilles de la Tourette (1857-1904) started working with Charcot in 1884 and became a very close disciple of the world-famous neurologist ([Figure 4 ])[1 ],[2 ],[8 ],[9 ]. Charcot’s amanuensis, he was considered by some to be one of Charcot’s favorite pupils and revered the great physician as a god[1 ],[2 ],[9 ]. A very intelligent neuropsychiatrist with a great interest in therapeutics, including hypnosis, Gilles de la Tourette became a chef de clinique under Charcot (1877-1888) and worked as Charcot’s secretary in his private office[1 ],[2 ],[4 ],[9 ]. Gilles de la Tourette’s most important works were about tics, the famous disease called Tourette’s syndrome (“Étude sur une affection nerveuse caractérisée par de l’incoordination motrice accompagnée d’écholalie et de coprolalie ”)[8 ]and hysteria. After Charcot’s death, Gilles de la Tourette begin suffering a megalomaniacal delirium due to general paralysis (neurosyphilis), and he died in an asylum in Switzerland after almost three years of care[1 ],[2 ],[9 ].
Figure 4 Georges Gilles de la Tourette (1857-1904).(Extracted from Google images: Baillement.com, December 18th, 2016)
GEORGES GUINON
Georges Guinon (1859-1932) succeeded Georges Gilles de la Tourette as chef de clinique from 1888 to 1890 ([Figure 5 ]). He had great affection for and was very devoted to Professor Charcot (“le patron ”) and wrote the famous paper “Charcot intime ”[1 ],[2 ],[10 ]. Guinon contributed to the papers published by Charcot at La Salpêtrière Hospital, including the famous “Lessons on nervous system disorders given at La Salpêtrière Hospital”, and published several of his own papers, including a study on convulsive tic disorder, named “Gilles de la Tourette’s syndrome ” by Charcot, and another on hysteria[1 ],[2 ],[10 ]. He was Charcot’s last secretary and worked for him in his private clinic and at La Salpêtrière Hospital, becoming a very close friend of his family, particularly Charcot’s wife, whom he referred to as “la patronne ”[4 ].
Figure 5 Georges Guinon (1859-1932).(Extracted from Google images: Baillement.com, December 18th , 2016)
CONCLUSION
Professor Charcot had four secretaries who worked with him when he was at the peak of his career: Charles Féré, Pierre Marie, Georges Gilles de la Tourette and Georges Guinon. They worked with Charcot in La Salpêtrière Hospital as well as in his private clinic, examining patients before they were seen by him. This led to the popular belief among neurologists around the world that Charcot never examined or touched his patients, but only heard their histories and then made a diagnosis. During their time as Charcot’s secretary in his private clinic, Féré, Marie, Tourette and Guinon became very close friends with his family and played an important role in his personal and professional life[1 ],[2 ],[4 ],[5 ],[9 ],[10 ].
