Popular Science Monthly/Volume 44/March 1894/Sketch of Jean Martin Charcot

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JEAN MARTIN CHARCOT


SKETCH OF JEAN MARTIN CHARCOT

A GREAT deal has been added to our knowledge of nervous disease by the labors of Charcot; and extensive fields of investigation hitherto untried have been opened by him.

Jean Martin Charcot was born in Paris, France, November 29, 1825, and died near Château Chinon, le Morvan, France, whither he had gone on a pleasure trip with a few friends, in August, 1893. He was industrious in his youth, acquitted himself brilliantly in his classical studies, and, when the time came for choosing his profession, hesitated whether to become an artist or a doctor. Against the latter was the expense of preparing for the profession, but, encouraged by the assurances of his father, who preferred that line, he began the study in 1845. He became chef de clinique in 1853, and obtained his degree in 1854. Having obtained several prizes, by which attention was drawn to him, he became a hospital physician in 1856, an adjunct professor in the University of Paris in 1860, and was appointed physician at the hospital of La Salpêtrière in 1862. Here he spent the remainder of his active life, and prosecuted the researches which have made his name famous throughout Europe and America. "In order," the Lancet says, "properly to appreciate the ability which he brought to bear upon his work and the enthusiasm which he could inspire it should be remembered that when he began his now well-known Leçons at the Salpêtrière the institution was little less than an ill-assorted collection of five thousand women, comprising the aged, the imbecile, the idiotic, the epileptic, and the paralyzed, in which scarcely an attempt had been made to extract from the wealth of material anything more than a narrow individual experience. In a few years it had been transformed into the very Mecca of neurologists, and this it has remained up to the present time." Besides teaching in his clinic at the Salpêtrière, Charcot conducted an external course in pathology at the École pratique. He was given the chair of Pathological Anatomy at the Faculty of Medicine in Paris in 1875, and filled it till 1883. Since 1877 he elucidated with a rare clearness of vision a large number of questions relating to diseases of the liver, kidney, and spinal marrow. He enriched physiology by contributing to the celebrated theory of cerebral localizations. All his studies have borne fruit; they touch a multitude of problems of cerebral pathology or of nervous affections, and have been fertile in practical results, especially as concerns locomotor ataxia, medullary perturbations, aphasia, hysteria, and epilepsy. As Dr. G. Daremburg observes in a notice of him, "He brought order and precision into a multitude of questions which were in utter disorder previous to him." His chief work was his study of nervous diseases. For years his lectures in the Salpêtrière on neurosis, hypnotism, and the different forms of hysteria attracted universal attention. In no official chair had the attempt been hazarded to take up the study of that series of occult phenomena which have excited public curiosity and baffled the sagacity of observers from ancient times. Charcot subjected these strange phenomena to the precise examination of the experimental method. He studied them with keen vision, so as to be able to reproduce them at will, and often revealed the existence of extraordinary facts which had been before regarded as chimerical. Although his conclusions may sometimes transcend the limits of scientific rigor, it is nevertheless true that he cast a new light on a whole region of investigation hitherto concealed in the dark. Besides making new medical discoveries in this line of research, he opened fresh horizons to science, initiated many pupils, and founded a new school, widely known now as the School of the Salpêtrière.

In connection with the Salpêtriére he founded a laboratory, an anatomo-pathological museum, electro-therapeutic wards, and a photographic studio, where he pictured sections of diseased brains and spinal cords, and formed a collection of portraits of neuropathic patients.

In his studies of gout and the maladies arising from it, to which he gave great attention in the early years of his practice, he discovered relations between disorders which had till then been thought independent of one another. He traced certain kinds of deafness, arthritic rheumatism, and kidney disease to gout, and found the origin of that disease in an overwrought liver and a sluggish skin. Pulmonary diseases also engaged his attention. In his lectures on phthisis he held that all caseation is essentially a tuberculous process, and assigned a secondary place to pneumonic phenomena.

Having been born at the time of the reaction in favor of clericalism, which was encouraged by the devotedly Catholic court of Charles X, and intensified the disgust of the freethinking people of Paris, Charcot grew up with a strong tendency toward extreme heterodoxy. He delighted later in life in demolishing the fetiches set up by the priests with which his investigations brought him in contact; and as Mrs. Crawford says, in the London Illustrated News, "humored the irreligious people in power by reducing the Lourdes and other miracles to suggestion. Gambetta, Naquet, Paul Bert, and other political atheists attended his lectures. He produced the phenomena of stigmates on hysterical girls.*' In like manner he pointed out analogies in other forms and manifestations of hysteria or hypnotism with various signs and wonders of religious history and tradition. Regarding them all as remarkable hypnotics, the mystics of the past were favorite subjects of contemplation with him. He accumulated the works of the mystical painters, Andrea del Sarto, Deudato Delmont, Matteo Roselli, and Van Breughel, and read the works of the great mystical writers—Thomas à Kempis, Fénelon, Pascal, and St. Francis of Sales. Hysteria had before this time been regarded as peculiarly the disease of women. He found it attendant upon many forms of disorder from which men suffer, detected it in some of their petty weaknesses and vanities, and regarded it as lying at the bottom of the literary peculiarities of some of the most popular French authors.

He was an intense materialist, and in this he and his school were directly opposed to the other school of alienists in France, that of Nancy and the Charité Hospital, who supposed a psychical force behind the phenomena which came under their observation. With this he had a touch of intolerance toward his opponents. At his demonstrations, according to Mrs. Crawford, he "seemed to command every nerve of his patients. There were but two seats in the room where he taught—one for himself and the other for the patient. The students, disciples and laics—which last came in crowds—stood, some taking notes, and others listening with profound attention. He flattered himself that he forced by the mere power of his will the idlers to be attentive. There was nothing he more resented than for persons of rank, whom he thought not competent to understand him, to compliment him. . . . He began to lose his power 'to fascinate' his pupils some time before his death, and noticed it with sorrow. Though he despised the eulogiums of the incompetent, or wanted no conventional praise, he enjoyed feeling that he was celebrated."

Charcot's literary work was considerable. He published a large number of memoirs, articles, and studies on chronic and, nervous diseases, rheumatism, and softening of the brain; and his writings are known, appreciated, and sought for in all countries. His lectures have been translated into several languages. The Lancet, in its estimate of his publications, says: "It is rather more than twenty years since the first part appeared of Leçons sur les Maladies du Système Nerveux. Modest and unpretending, with a gray paper cover and no great thickness of letterpress, the publication was somewhat long in attracting general attention among the profession in this country (England); but to those who had the good fortune to open the brochure, what a wealth of interest was laid bare! Custom has made us so familiar with M. Charcot's style that it is difficult to describe the charm of a first introduction to his writings. Putting aside for an instant the scientific value of the material, there was something in the writer's graphic power of imparting information which came with extraordinary force, even upon those who had lingered with delight upon the pages of Watson or Trousseau. In Charcot's case it was not merely that we descried an astonishing facility of picturing by the pen, but above and beyond this was the evidence of the influence of a fresh and powerful mind pervading every paragraph. Lesions of the nervous system formerly huddled together and massed under some name which, pretending to describe, had only obscured, began to emerge with a sharp outline and clearly differentiated form. . . . The written works of Charcot naturally fall into two great divisions—those dealing with nervous diseases generally, and those concerned with the more recondite and abstruse phenomena of hysteria and hypnotism. Probably his most notable works are his Lectures on Nervous Diseases and his volume on Cerebral Localization, both of which are accessible to English readers in the Sydenham Society's translations. In these are chronicled the great advances in our knowledge of nervous symptoms and nervous pathology with which Charcot's name will always be associated." A communication published in the Archives de Physiologie in 1868, on the condition known as "Charcot's joint," is also mentioned as one of his most interesting and important contributions.

Charcot's manner is described as having been short, "but in his way he was kind to his incurables," and "he felt remorse for having treated unfortunate patients as if they had no more feeling than subjects for dissection." He "was truth itself, but he wanted imagination, and was for that reason unable to look with any eyes but his own upon effects and their various causes." In private conversation he had none of the impatient vivacity frequently associated with the French manner. "He was anything rather than loquacious. An attentive, respectful, and sympathetic listener, he ever avoided any dogmatic expressions of opinion, even when dealing with subjects upon which his thought and experience had given him more than ordinary qualification for pronouncing judgment. He would listen with interest to a suggestion, conflicting perhaps with some published opinion of his own, and then, lifting his hands and shoulders with a little expressive gesture, would quietly say, 'It may be so.' He was fair and just in his references to the work of others." A resemblance has been remarked in his face and figure to the conventional type of an abbé.