Keywords:
Neurology - History - Pierre Marie
Palavras-chave:
Neurologia - História - Pierre Marie
Georges-Eugène Haussmann, nominated prefect de la Seine on June 23, 1853, altered dramatically and definitely the Paris urban plan. Pierre
Marie, a remarkable physician born in the ville des lumières two months and 18 days later, would open new avenues on our understanding of neurology.
THE MAN
Pierre Marie, one of the greatest French neurologists of the 19th - early 20th centuries, together with Duchenne and Charcot[1],[2], was unique for his qualities as a pathologist, neurologist, researcher, writer,
editor, and outstanding teacher. He defended his ideas passionately, always committed
to integrity, searching obsessively for the truth.
As the only child of a wealthy family, Marie received excellent classical education,
becoming fluent in Latin and Greek. He entered the Paris School of Medicine after
fulfilling his father’s wish - a law degree[3],[4],[5]. His strong and authoritarian traits contrasted with his average height. The square-cut
gray hair and beard could give this actually pleasant and affable physician a false
snobbish look ([Figure 1]); however, he had a deep, bright, and insightful mind[1]. He considered coffee unpalatable, sipped small doses of plum liquor with relish,
and always rolled his own cigarettes. Marie learned about religion and developed a
taste for arts, becoming a great collector of sculptures, tapestries, furniture, and
paintings. He enjoyed golfing, fencing, and excelled in hunting.
Figure 1 Doctor Pierre Marie, 1889. Extracted from: https://upload.wikimedia.org/wikipedia/commons/8/84/Docteur_Pierre_Marie.jpg
[accessed in June 18, 2020].
After graduating in 1883, he became Charcot’s chef de clinique until 1885. Charcot was impressed by Marie’s unique gifts of observation and discernment,
besides his incredible accuracy in diagnosing obscure diseases. This brilliant clinician
would sometimes stop his chauffeur just to recommend some treatment to a passerby[4].
The loathing Marie felt for Jules Déjerine resulted in a dramatic episode[3]. In 1892, enraged by the harsh and rude words published against him by Marie, Déjerine
sent messengers to Marie’s house asking him to either retract his statements or set
a time and place for a duel. Marie responded with a letter denying any attack to Déjerine’s
scientific integrity, so the duel never occurred beyond their dispute on aphasia localization
in the brain. Notwithstanding, shortly after Marie took over the Chair of nervous
system diseases at La Salpêtrière following Déjerine’s death (1917), he advised Déjerine’s wife - Augusta Déjerine
Klumpke - that she had 14 days to leave La Salpêtrière with all Déjerine’s staff and students[3].
The work-addicted Pierre Marie and Édouard Brissaud founded the Revue Neurologique (1893) and the Société de Neurologie de Paris (1899)[6]. Most of his contributions occurred between his appointment to the Hospice de Bicêtre in 1897 ([Figure 2]) and 1907, when he accepted the position of Chair of Anatomical Pathology, school
of Medicine, revolutionizing the hitherto teaching methods[1]. The worldwide renowned Neurology clinic Marie established at the Hospice attracted physicians from France and abroad, among whom was the young Brazilian doctor
Aloysio de Castro, who wrote: “It was 1906. Eight o'clock in the morning, 211 Boulevard Saint Germain, and there
I was in a carriage on my way to the old Hospice de Bicêtre, next to Pierre Marie.
Arriving at the ward, where his senior assistants and foreign doctors were already
waiting, he wasted no time, taking his coat and heading to the nearest laboratory.
Putting on his glasses, with a brain in his hand, he simply mentioned: “I was a Broca’s intern, I was Charcot's assistant, but I firmly deny (…) the existence
of an aphasia center at the foot of the third left frontal circumference...”[7]. Marie had published extensively on aphasias, rejecting Broca’s and Wernicke’s views
on language localization.
Figure 2 Kremlin-Bicêtre l’Hospice. Paris, 1906. Extracted from: http://www.leplaisirdesdieux.fr/LePlaisirDesDieux/NosAncetresLesInternes/Hopitaux/bicetre/bicetre1.jpg
[accessed in June 18, 2020]
It is worth mentioning that back in Brazil, Aloysio de Castro established the first
outpatient clinic-school in the country[8] and published the book “Tractado de Semiótica Nervosa” in 1914[9], the first Brazilian book devoted to neurosemiotics, introducing the formal study
of this subject in Brazil.
The neuropathologist Gustave Roussy, Marie's assistant, wrote: ‘‘Not only was he undeniably
authoritarian to the point of intransigence and pride, [but] he liked to apply the
ideas he developed, if only over the course of a discussion, to which he brought formidable
skills”[10]. The American neurosurgeon Percival Bailey said: “I remember him as a dignified
old gentleman. Only rarely did he enter the wards and never the laboratory. He was
at his best in clinical consultation in which his discussion was short and pithy.
His teaching was always simple and clear”[5].
THE FAMILY
Marie preserved his private life, scorning public acclaim, honors, and titles. He
married Blanche Savard (1888), an intellectually privileged, elegant, and charming
woman from a wealthy Parisian family[4]. Marie, Savard, and their two children, Juliette and André, enjoyed a happy life,
either in their mansion at 76 rue de Lille or in their two other properties, in Normandie and Le Pradet, French Riviera. Eventually, Juliette (10 years old) died from acute appendicitis;
then Marie lost his devoted wife because of a thigh scratch turned into uncontrollable
erysipelas; finally, his son, a 38-year-old doctor who was studying botulism at the
Pasteur Institute, succumbed to this terrible infection[4].
Marie retired (1925, 72 years old) and got involved with the education of his grandchildren,
Françoise, Juliette, and Alain, to whom he loved teaching mythology[1].
THE END
After retirement, Marie spent winters in Côte d'Azur - where he wrote Travaux et memoires (1926–1928) - and summers in Normandie[5]. The last part of his life was marked by loneliness in southern France, rarely meeting
friends or former pupils, following politics and his assets in stock markets[4]. Despite his preserved cognition, he developed progressive pain while walking, eventually
needing a wheelchair.
In late 1939, Marie became anxious and stressed by the imminent war. A progressive
abdominal discomfort brought him to Paris, where Thyerry Martel unsuccessfully operated
him. Marie died in southern France (April 13, 1940) shortly before the Nazis invaded
Paris. Just as his life - free of boasting or glory, despite his plentiful honors
-, his passing was unremarkable. A small obituary was published in Nature (June 1940)[11]. Years later, the Revue Neurologique dedicated an issue to his immense contribution not only to Neurology but also to
Medicine in general.
