Jean-Martin Charcot. A Short Biography

Appreciated by kings and princes, Jean-Martin Charcot was the most famous physician of his time, adopting the nickname “Napoleon of Neurosis.”.

Charcot started his scientific studies in the fields of internal medicine and anatomopathology. His research helped in understanding kidney and lung diseases.

Later, his interest shifted to neurology. He studied neurological diseases, developing a classification system based on symptoms observation and their comparison with the anatomical findings. He became internationally renowned for identifying multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), raising awareness of polio, and describing Parkinson disease.

Charcot’s third area of interest, the studies on hypnosis and hysteria, immortalised his name. It was Charcot’s research that created the foundation for the development of psychoanalyses. As a young physician, Sigmund Freud participated in Charcot’s lectures. Freud was fascinated by Charcot’s brilliance and mesmerising personality. He translated some of his work into German and even called his son after Charcot’s first name.

Charcot enjoyed significant authority and influence in English medical circles and immense popularity in Russia. He was called upon multiple times to serve as a consultant physician to the czar and his family. Russian physicians welcomed him as he liberated them from their heavy reliance on German scientists.

Martine Charcot’s. Biographical Note

Jean-Martin Charcot (29.11.1825–16.08.1893) was born after the French Revolution as the son of a Parisian coachman. Due to limited financial means, his father decided that the most gifted of his sons would study at a university. Martin surpassed his three brothers and, in 1848, completed his medical studies at the University of Paris.

In 1862, Charcot married a wealthy widow and became the father of two children. The wealth of his wife and the substantial fees he charged his patients allowed him to lead a life befitting the wealthy class. Aside from his villa in Neuilly, in 1884 he acquired a splendid residence on Boulevard Saint-Germain.

Harmonious and happy, his family life involved his supportive wife, who actively assisted him in his work. Great care was given to the education of his son, who also became a physician to please his father.

L’Hôpital Salpêtrière

Salpêtrière was a vast 40-hectare complex with buildings, streets, squares, and gardens. The hospital was inhabited by 5,000 destitute, senile, and insane women. The institution held historical significance, having been associated with Saint Vincent de Paul’s charitable endeavours. It was later transformed by Louis XIV into an asylum for beggars, prostitutes, and the mentally ill. The infamous September Massacres of the French Revolution took place there. It was in Salpêtrière that Pinel implemented revolutionary reforms in mental healthcare, liberating the mentally ill from chains.

Martine Charcot at Salpêtrière

As a young doctor, Martine Charcot began his internship at L’Hôpital Salpêtrière. At that time the hospital was affectionately known as “the great asylum of human suffering.” For most doctors, Salpêtrière was a hell, and they tried to avoid working there.

However, for Charcot, as a passionate neurologist, this environment was a paradise. He recognised the hospitals’ scientific potential as a valuable resource for researching rare and unidentified neurological diseases.

While his medical journey progressed slowly and laboriously, a pivotal moment arrived in 1862. At the age of thirty-six, Charcot assumed the role of chief physician in a significant section of Salpêtrière. He commenced ambitious plans, turning the hospital into a major centre for neurological and psychiatric research. Charcot’s research at Salpêtrière paved the road to epochal discoveries in neurology and dynamic psychiatry.

Charcot diligently recorded case histories, conducted autopsies, and established laboratories, simultaneously assembling a team of dedicated collaborators. Over the course of two decades, he introduced laboratories, museums, research rooms, and teaching units. In the span of eight years, from 1862 to 1870, Charcot made groundbreaking discoveries that catapulted him to become the leading neurologist of his era.

Jean-Martin Charcot. The Prince of Science

Charcot personified a “Prince of Science.” He possessed not only a high scientific reputation but also significant power and wealth. His residence resembled a private museum adorned with Renaissance furniture, stained-glass windows, tapestries, paintings, antiques, and rare books.

Charcot’s artistic prowess extended to excellent drawings and expertise in painting on china and enamel. His passion for art history and masterful command of French prose showcased his profound knowledge of French literature. Remarkably, he possessed rare linguistic skills in English, German, and Italian. He admired Shakespeare, whom he often quoted in English, and Dante, whom he quoted in Italian.

Every Tuesday night, he hosted lavish receptions in his splendid home, inviting the crème de la crème of scientists, politicians, artists, and writers. With artistic inclinations and a large collection of old books on witchcraft and demonic possession, he proved an attractive teacher. 

Among his fruitful clinical efforts, Charcot devoted Thursday evenings to his passion for music, strictly forbidding any discussion related to his profession during those hours.

He was a frequent traveller, meticulously planning annual journeys to different European countries. During these trips, he visited museums, made drawings, and wrote travelogues. Despite his already immense prestige, Charcot was shrouded in an air of mystery, which gradually grew after 1870 and peaked with his renowned paper on hypnotism in 1882.

Charcot’s Affection for Animals

Despite being described as cold, reserved, austere, and impatient in his interactions, Charcot harboured a deep affection for animals. He categorically refused to experiment with them.

At his residence on 217 Boulevard Saint-German, Paris, he kept two dogs named Carlo and Sigurd, along with a beloved female monkey named Rosalie. Rosalie, a gift from Dom Pedro II, Emperor of Brazil, belonged to the species tufted capuchin, known for their intelligence, friendliness, and playful nature.

An amusing tale mentioned in the renowned book “Charcot: Constructing Neurology” by Goetz et al. involves Rosalie’s mischievous antics during a dinner attended by esteemed international figures. The monkey managed to climb onto the elegantly adorned dining table and dismantled the centrepiece. Surprisingly, instead of causing distress, the incident fostered a sense of ease among the guests.

Charcot’s Peculiar Moral Standard

Charcot’s fondness for animals went beyond mere professional concern and reflected personal ethics. He opposed hunting, bullfighting, vivisection, and experiments involving animals at La Salpêtrière Hospital. A sign in his office proclaimed, “You will find no dog laboratory here.”

Charcot’s contradicting ethics were that while he disapproved studies involving animals, he conducted autopsies on deceased patients. His commitment to accurate observation and human autopsies contributed immensely to the advancement of neurology. Prior to his research, extrapolating anatomical observations from animals to humans had led to conceptual errors. By focusing on human autopsies, Charcot rectified these misconceptions and established his prominent position in the field.

Charcot’s Appointment to Professor of Anatomy and Neurology

In 1872, Charcot became a professor of pathological anatomy at the University of Paris, and in 1882, a professor of neurology. His laboratory at L’Hôpital Salpêtrière had several thousand patients, more than half of whom suffered from neurological disorders. Charcot developed his own classification method for neurological disorders, describing clinical features and performing autopsies.

As a skilled pathologist, Charcot recognised the relationship between clinical and anatomical findings. This method allowed him to correlate the clinical signs of multiple sclerosis (MS) with the pathological changes observed at autopsy. Gifted as an artist, Charcot described MS visually and supplemented his stories with illustrations of sclerotic plaques. He was not only extremely humane but also devoted to his patients. In his presence, he wouldn’t tolerate anything unkind being said about anyone.

He became the first physician to diagnose MS in a living patient, identifying the triad of symptoms: nystagmus, intention tremor, and reading speech. Today, the Charcot Prize is awarded every two years for advances in MS research.

Charcot also documented cases of progressive motor symptoms characterised by convulsions, rigidity, contracture, bulbar involvement, and respiratory failure leading to death. He labelled this condition Primary Amyotrophic Lateral Sclerosis (ALS) and correctly identified anterior horn cell dysfunction as the underlying pathology.

In collaboration with his student Pierre Marie, Charcot studied patients whose pathology was incompatible with ALS, calling them neuropathy rather than myopathy. This led to the recognition of Charcot-Marie-Tooth, a peroneal form of muscular dystrophy, bearing their names.

Charcot’s Immortalizing Studies on Hysteria

Charcot, along with his disciple Paul Richer, utilised his method for organic neurological diseases to investigate hysteria. In 1878, Charcot’s friend Charles Richet, the 1913 Nobel Prize recipient in medicine, convinced him to experiment with hypnosis on his patients. Several gifted female hysterical patients became his subjects, progressing through stages of “lethargy,” “catalepsy,” and “somnambulism” with distinct symptoms.

The Nature of Hysteria

Investigating the nature of hypnosis, Charcot sought to establish further connections, given his previous association of hysteria with suggestibility. Remarkably, he discovered that his patients entered three distinct states of hypnosis: lethargy, catalepsy, and somnambulism. Lethargy resembled the state of fainting, transitioning to catalepsy, resulting in limbs retaining any imposed position. Additionally, somnambulism exhibited a connection to hysteria through the manifestation of anaesthesia, often observed as “glove anaesthesia” or “sleeve anaesthesia.”.

Based on these observations, Charcot came to the conclusion that hypnosis represented an artificially induced modification of the nervous system exclusive to hysterical patients. It was primarily this scientific discourse that bestowed scientific credibility upon the previously taboo subject of hypnotism. Furthermore, the progressive aspect of Charcot’s work challenged the prevailing notion that only women were prone to hysterical conditions.

Chairman of Diseases of the Nervous System

Because of his ground-breaking achievements in neurology, Charcot received in 1882 a prestigious appointment to the newly established Chair of Diseases of the Nervous System. This chair was specifically created by governmental decree to accommodate his expertise.

In early 1882, Charcot presented his findings about hypnosis to the Academie des Sciences. It was an impressive achievement considering the Academie’s prior condemnation of hypnotism. His election to the Academy in 1883 signalled a breakthrough, shattering the barriers that surrounded hypnosis. It rendered hypnosis a legitimate subject for scientific exploration. Charcot’s assimilation of hypnosis to hysteria and his belief that hysteria constituted an organic disease granted him a measure of respectability.

This moment was the pivotal point that marked the emergence of psychology as an independent academic discipline.

Traumatic Versus Psychogenic Paralyses

Among Charcot’s remarkable achievements were his investigations on traumatic paralyses in 1884 and 1885. During his time, paralyses were predominantly attributed to nervous system lesions caused by accidents. Charcot had previously examined the disparities between organic and hysterical paralyses. In 1884, three men with trauma-induced monoplegia of the arm were admitted to Salpêtrière. Charcot showcased that while these paralyses differed from organic ones, they precisely aligned with hysterical paralyses. In the next step, he experimentally reproduced similar paralyses under hypnosis. To demonstrate the effect of trauma, Charcot selected easily hypnotisable individuals and suggested that their arms would be paralysed upon receiving a slap on the back in their waking state. The subjects exhibited posthypnotic amnesia and instant paralyses when slapped, identical to posttraumatic paralyses.

Charcot deemed the nervous shock following trauma akin to a hypnotic state, enabling individual autosuggestion. Charcot concluded that his experimental research accurately depicted the condition he aimed to study. He classified hysterical, posttraumatic, and hypnotic paralyses as dynamic paralyses, distinct from organic paralyses caused by nervous system lesions.

In 1892, he distinguished “dynamic amnesia” with recoverable memories under hypnosis from “organic amnesia,” where recovery was impossible.

Charcot’s Three Stages of Hypnosis

Remarkably, Charcot discovered that his patients entered three distinct states of hypnosis: lethargy, catalepsy, and somnambulism. Lethargy resembled the inert state of fainting in hysteria, transitioning to catalepsy once the subject’s eyes opened, resulting in limbs retaining any imposed position. Charcot noted that with limbs positioned in aggressive gestures, aggressive thoughts and actions followed.

Additionally, somnambulism exhibited a connection to hysteria through the manifestation of anaesthesia, often observed as “glove anaesthesia” or “sleeve anaesthesia” among hysterics. Thus, Charcot concluded that hypnosis represented an artificially induced modification of the nervous system exclusive to hysterical patients, manifesting in the aforementioned distinct phases. It was primarily this scientific discourse that bestowed scientific credibility upon the previously taboo subject of hypnotism.

Charcot challenged the prevailing medical opinion that hysteria rarely afflicted men. He argued that hysteria, an organic disorder, could arise from trauma and manifest itself in “models of masculinity,” such as railroad engineers or soldiers. This pioneering perspective paved the way for understanding neurological symptoms resulting from trauma.

The “Drama Teacher”

Charcot revolutionised traditional ward lists by performing dramatic clinical demonstrations on the brilliantly lit stage of the Salpêtrière amphitheatre. His hypnotic experiments and clinical manifestations attracted public attention. The “Hysteria Show” seduced Parisian intellectuals and aristocracy, giving birth to hysteria fashion.

Shrouded in an aura of mystery and known as a “miracle” cure, his insights into his patients’ ailments seemed unsettling. In the case of hysterical paralysis, he simply told the patient to take off his crutches and walk.

Charcot the “Magician of Hypnosis“

The public perceived Charcot as a man with almost magic abilities, earning him the nickname “Napoleon of Neuroses.” His name became closely associated with the discovery and interpretation of various neurological conditions, including hysteria, hypnotism, dual personality, catalepsy, and somnambulism.

Charcot was adored by both his students and patients. On his patron saint’s day, Saint Martin, the entire Salpêtrière celebrated with entertaining festivities.

Curious tales circulated about Charcot’s influence over the hysterical young women of the Salpêtrière. During a patients’ ball, for example, the unintended sound of a gong caused many hysterical women to instantly fall into cataleptic states.

With his piercing gaze, Charcot was able to penetrate the depths of the past. He was able to diagnose neurological conditions retrospectively in cripples depicted in artworks. He founded journals like the Iconographie de la Salpêtrière and the Nouvelle Iconographie de la Salpêtrière, pioneering the fusion of art and medicine.

Charcot’s Thursday Lectures

Charcot’s lectures, attended by high society and reporters, boosted hypnosis into the popular press. Consequently, vivid descriptions of cataleptic patients filled the media, followed by sensational, often false, tales of clairvoyance and sexual seduction during hypnosis. The stage hypnotists even rode the wave of Charcot’s fame, advertising their shows as “in the manner of Charcot at the Salpêtrière.”

The spellbinding effect of Charcot’s teaching extended to laymen, many physicians, and foreign visitors like Sigmund Freud, who spent several months at the Salpêtrière.

Charcot and Sigmund Freud

Trained initially as a neurologist at the Vienna University in 1885, Freud visited Paris and its famous hospital, Salpêtrière. During his stay in Paris, Freud had the opportunity to work with Jean-Martin Charcot. Charcot, an eminent neurologist, was renowned for his work with neurological disorders and his innovative use of hypnosis in treating hysteria.

Charcot’s Influence on Freud

Charcot’s work with hysteria using hypnosis showcased the potential psychological roots of physical symptoms, which was a revolutionary concept at the time. Also, Charcot’s dynamic understanding of neurological diseases contrasted sharply with the static anatomical focus of Freud’s Viennese medical training.

The trip to Paris marked a significant turning point in Freud’s career, leading to a profound shift in his approach to neurology and laying the groundwork for his future exploration of psychology. Charcot’s innovative technique influenced Sigmund Freud in his research into the psychological origins of neuroses.

Freud’s studies under Charcot were not just an educational experience but a radical reorientation of his approach to medicine and science. It laid the foundational knowledge and philosophical approach that would become central to psychoanalysis.

Charcot had such an influence on Freud that he named his first son after his revered teacher.

Charcot’s Enemies

Visitors who envied Charcot during their brief encounters in Paris remained unaware of the powerful enemies surrounding him. The clergy and Catholics branded him an atheist, partly due to his replacement of nuns with lay nurses at the Salpêtrière. However, even some atheists found him too spiritual. Magnetists publicly accused him of charlatanism, while political and societal circles harboured fierce animosity towards him.

Among neurologists, some who admired Charcot while he focused on neuropathology deserted him when he delved into the study of hypnotism and conducted dramatic experiments with hysterical patients.

Charcot faced an ongoing battle against the Nancy School, gradually losing ground to his opponents. Bernheim sarcastically proclaimed that among the thousands of patients he hypnotised, only one displayed the three stages described by Charcot—a woman who had spent three years at the Salpêtrière. Charcot also faced intense hatred from some of his medical colleagues and even his former disciples.

The extreme opinions and fascination surrounding Charcot, combined with the intense enmities he garnered, hindered a true assessment of the value of his work during his lifetime. Even with the passage of time, this task remains challenging. Hence, it is necessary to distinguish the various fields of his activity.

Jean-Martin Charcot. A Critical Review

Charcot believed he made new discoveries on hypnosis, overlooking the early history of magnetism and hypnotism. He did not pioneer the use of hypnosis for treating hysteria. Beginning with Anton Mesmer, the early hypnotists had already observed the profound hypnotisability of hysteric patients achieving spectacular healings.

Charcot’s Biased Judgment

Charcot believed that the three phases of hypnosis occurred spontaneously. However, his approach lacked scientific rigor. The hypnotised subjects might have confirmed their preconceived notions. It’s likely that both patients and assistants merely presented what Charcot anticipated. Selecting about a dozen female hysterics as their subjects, all inpatients of the hospital, they displayed the desired three phases of hypnosis.

Janet’s Criticism on Charcot

Janet demonstrated that the alleged “three stages of hypnosis” were merely the result of training by the hypnotist. Another distortion was the collective spirit prevalent in the Salpêtrière. The hospital was a closed community housing not only elderly women but also young, attractive, and cunning hysterical patients. This environment fostered mental contagion, ideal for demonstrations to students and during Charcot’s.

Due to Charcot’s paternalistic attitude and despotic treatment of students, his staff dared not contradict him. They presented what they believed he wanted to see after rehearsing demonstrations, even discussing cases in front of patients. This created an atmosphere of mutual suggestion among Charcot, his collaborators, and patients, warranting a thorough sociological analysis. Janet emphasised that Charcot’s descriptions of hysteria and hypnotism were based on a limited number of patients.

Final Years of Jean-Martin Charcot

Charcot’s final years were overshadowed by his heart disease, a result of his sedentary lifestyle, lack of exercise, and excessive cigar smoking.

Jean-Martin Charcot died suddenly on the 29th of November 1825 of a heart attack. His funeral took place in the chapel of his alma mater, Salpêtrière. He was buried in the Montmartre cemetery.

His son Jean-Baptise (1867–1936) initially followed in his father’s footsteps and became a doctor. However, later he became a seafarer and explorer of the South Pole. Jean-Baptise named one of the islands in Antarctica “Charcot Island” as an honour and a testament to his father’s legacy.

In 1895, his former students financed and installed Charcot’s bronze statue at the entrance to the Salpêtrière. Unfortunately, after the Germans occupied Paris during World War II, the statue was removed and melted down for munitions.

Charcot’s Scientific Achievements

Jane Martine Charcot’s exceptional personality, his scientific achievements, his broad interests, and his artistic gifts are comparable to the geniuses of the Renaissance era. His various fields of activities can be distinguished in three phases:

Firstly, his contributions as an internist and anatomopathologist to the understanding of pulmonary and kidney diseases. His lectures on diseases of old age became classics in geriatrics.

Secondly, in neurology, his second career, he made remarkable discoveries that solidified his enduring fame. These include the delineation of multiple sclerosis, amyotrophic lateral sclerosis, locomotor ataxia, and more.

However, Charcot’s “third career,” his exploration of hysteria, proves immensely challenging. Despite controversies, this particular aspect contributed significantly to his contemporary acclaim. It is this breakthrough that will endure in the memory of mankind, even if his neurological work fades over centuries.

Through hypnosis, Charcot made noteworthy discoveries, including the proof that psychological factors alone could induce certain paralyses. He achieved this by suggesting paralysis to hypnotised patients, showcasing their identical symptoms to organic paralyses. Furthermore, he distinguished between “dynamic amnesia,” allowing memory recovery, and “organic amnesia,” where memories remained irretrievable.

Charcot, the Father of Modern Neurology

Charcot is known as the father of modern neurology. One of his greatest legacies is the development of systematic neurological examination, connecting clinical signs with specific lesions of the brain or nerves. Throughout his career, he also pioneered novel approaches to classify neurological diseases. Even today, more than a century later, many of his methods and concepts remain the cornerstones in the field of neurology.

Charcot’s influence on the field of neurology is evident through numerous conditions that bear his name. He discovered amyotrophic lateral sclerosis (Charcot’s disease), hereditary sensory-motor neuropathy (Charcot-Marie-Tooth disease), tabes dorsalis arthropathy (Charcot’s arthropathy), and primary intracerebral haemorrhage (microaneurysms of Charcot-Bouchard).

He also described other significant conditions such as multiple sclerosis, Parkinson’s disease, and Tourette syndrome. As Joseph Babinski, one of his students, remarked, removing Charcot’s discoveries from neurology would render it unrecognisable.

A notable contribution of Charcot’s was his utilisation of the anatomo-clinical method in neurology, highlighting the relationship between anatomy and clinical presentations.

Jean-Martin Charcot’s Legacy

The publication of his complete works, which had been planned in fifteen volumes, was abandoned after volume IX. Charcot also had left a considerable amount of literary works: memoirs, illustrated travelogues, and critical studies on philosophical and literary works, all of which he did not want published in his lifetime.

His son, Jean-Baptise, donated Charcot’s precious library to the Salpêtrière, which gradually fell into oblivion, as did the Musee Charcot.

The extreme opinions surrounding Charcot, both fascination and fierce enmities, hindered a true assessment of his work and his personality during his lifetime. Contrary to expectations, time hasn’t made this task much easier. Charcot’s true personality could be properly evaluated only by reading his writing; however, none of them has ever been published.

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