Jean-Martin Charcot

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French neurologist (1825–1893)

Parisian-born Charcot studied medicine in his native city and received his MD in 1853. His interest in disease of the nervous system led to his appointment, in 1862, to the Salpêtrière Hospital for nervous and mental disorders. This marked the beginning of a long and distinguished association. Charcot described the pathological changes associated with several degenerative conditions of the nervous system, including the disintegration of ligaments and joint surfaces (known as Charcot's disease) that occurs in advanced stages of locomotor ataxia. His studies of brain damage in cases of speech loss (aphasia) and epilepsy supported the findings of his contemporary, Paul Broca, that is, different bodily functions are controlled by different regions of the cerebral cortex.

In 1872, Charcot was appointed professor of pathological anatomy at the faculty of medicine and later (1882) became professor of neurology at the Salpêtrière. He was increasingly concerned with the link between mind and body in cases of hysteria and trauma. With his eloquent manner and a dramatic presentation of his lectures on a small stage, he became a widely celebrated teacher. Among many famous students was Sigmund Freud, who was influenced by Charcot's use of hypnosis on patients.

Charcot's son, Jean, became a famous polar explorer.

The French psychiatrist Jean Martin Charcot (1825-1893) specialized in the study of hysteria, using hypnosis as a basis for treatment.

Jean Martin Charcot was born in Paris on Nov. 29, 1825, the son of a carriage maker. He took his medical degree at the University of Paris in 1853 and was appointed professor of pathological anatomy there in 1860. In 1862 he was appointed senior physician at the Salpêtrière, a hospital for the treatment of the mentally ill. It became a center for psychiatric training and psychiatric care, for Charcot had a flair for theatrics in addition to his reputation for sound science, and his lectures and demonstrations attracted students from all over Europe.

Charcot's contributions fall largely into three categories. First, he studied the etiology and cure of hysterical disorders (psychoneuroses). These disorders involve what appear to be physiological disturbances such as convulsions, paralyses, blindness, deafness, anesthesias, and amnesias. However, there is no evidence of physiological abnormalities in psychoneuroses since the root of the problem is psychological. In Charcot's time hysteria was thought to be a disorder found only in women (the Greek word hysterameans uterus), but his demonstrations were eventually influential in correcting this idea. Charcot, however, continued to think of hysteria as a female disorder. Freud was later to associate hysterical symptoms with sexual problems.

Charcot's second area of contribution was the correlation of various behavioral symptoms with physiological abnormalities of the nervous system. One of the major problems for early psychiatry was that of determining whether certain behavioral abnormalities had their origins in psychological or in physiological disturbances and, if physiological, where in the central nervous system the abnormality might be located. Charcot became noted for his ability to diagnose and locate the physiological disturbances of nervous system functioning.

Finally, Charcot made popular the use of hypnotism as a part of diagnosis and therapy. Hypnotism, known at the time as "mesmerism" (named for Franz Anton Mesmer), was regarded by the medical profession as charlatanism. Charcot found hypnotism useful in distinguishing true psychoneurotics from fakers and, like Mesmer, found that hysterical symptoms could be relieved through its use. In the hypnotic state the patient falls into an apparent sleep. While in this condition, the patient can sometimes recall events in his life which are not recalled in the waking state, and he is susceptible to the suggestions of the therapist. In 1882 Charcot presented a summary of his findings to the French Academy of Sciences, where they were favorably received. Scientific psychiatry was thus well on its way to being accepted by the medical profession. Charcot died on Aug. 16, 1893.

Further Reading

A biography of Charcot is Georges Guillian, I-M Charcot, 1825-1893: His Life-His Work (trans. 1959). For general background material see Fielding H. Garrison, An Introduction to the History of Medicine (1913; 4th ed. 1929).

Additional Sources

Goetz, Christopher G., Charcot, New York: Oxford University Press, 1995.

Charcot, Jean-Martin (1825-93). The founder of modern neurology, Charcot established the classic descriptions of numerous nervous diseases, and pioneered new diagnostic techniques. He was particularly noted for his studies of hysteria, which he refused to categorize as an exclusively female disorder, and for the use of hypnosis in its investigation. While emphasizing organic factors and thereby underestimating the role of suggestion in the development of hysteria, he acknowledged the relevance of psychological traumas, dissociated from the patient's consciousness, in determining the nature of its symptoms. Freud was indebted to Charcot, having attended his celebrated clinical examinations in 1885 and 1886 [see Psychoanalysis].

[Rhiannon Goldthorpe]

1825-1893

Jean Martin Charcot was born in Paris in 1825, the son of a coach builder, and died of a heart attack near Lake Settons (Nièvre) on August 16, 1893. He was a physician with the Hôpitaux de Paris, a professor of clinical medicine for nervous disorders, and a member of the Académie de Médicine.

He was appointed a physician with the Hôpitaux de Paris in 1856, associate professor of medicine in 1860, senior physician at the Salpêtrière in 1862, professor of pathological anatomy in the School of Medicine at the University of Paris in 1872 (succeeding Alfred Vulpian), and in 1882 was appointed to the first chair of neurology, a position created for him at the request of Léon Gambetta, as professor of diseases of the nervous system. He was made a member of the Académie de Médicine in 1873 and the Académie des Sciences in 1883,

Charcot had an impressive career and received numerous academic honors, but the accuracy of his theories on hysteria, which he began working on in 1865 after the "department of epilepsy" was placed under his supervision, had begun to be seriously questioned at the time of his death. The work of his student, the neurologist Joseph Babinski; the rise of Pierre Janet's dynamic psychology; and especially the success of psychoanalysis all contributed to bringing down a theoretical structure that had nurtured these developments at the beginning of the twentieth century.

Charcot was an attentive observer, which helped establish methods of neurological description and classification still in use (Charcot's disease, Charcot-Bouchard aneurysm, and so on), and possessed an almost magical talent as a speaker. He attracted a diverse group of personalities to his presentations: his public "Leçons Cliniques," held on Wednesdays, and his "Grandes Leçons," held on Fridays. His patients, it was learned after his death, had to some extent been prompted to exhibit to the audience the typical "hysterical crises" that the Master expected of them. He was particularly interested in paralysis, anesthesia, and other symptoms considered to be "hysterical," and attempted to demonstrate their "functional"—rather than anatomical—origin, a belief that contradicted a number of other practitioners, who were proponents of the surgical removal of their patients' ovaries.

He succeeded in isolating a clinical entity he referred to as the "grande hystérie" or "hystero-epilepsy." He described a crisis, or "attack," as occurring in four successive phases: the epileptiform phase, clonic spasms, emotional "acting out," and terminal delirium. In addition to these attacks patients exhibited "stigmata" (narrowing of the visual field, anesthesia)—conditions that could only exist if there were some form of "diathesis," that is, a predisposition to hereditary degeneration.

To demonstrate his ideas, Charcot publicly performed hypnosis to provoke or eliminate such symptoms, which proved they were not connected to organic lesions, unlike true neurological disorders. This was a step toward a "psychological" conception of the origin of hysterical symptoms, but Charcot wrote in 1887, "What I call psychology is the rational physiology of the cerebral cortex." He gave encouragement to the new field with the creation, in 1890, of the Laboratory of Psychology at the hospital, with Pierre Janet as its head. He supported Janet in his work on his dissertation, "L'État mental des hystériques" (The Mental State of Hysterics; 1893), and ensured publication of the work of Sigmund Freud in French medical reviews.

Freud's work with Charcot at the Salpêtrière contributed greatly to Freud's later work and the birth of psychoanalysis. Arriving in Paris on October 13, 1885, with the help of a grant from the School of Medicine of the University of Vienna to study anatomic pathology, he was introduced to hysteria and its "psychological" etiology, which had a decisive influence on his decision to treat patients privately, which he did when he returned to Vienna in the spring of 1886.

A month after his arrival in Paris, on November 24, 1885, he wrote to his fiancée, "Charcot, who is one of the greatest of physicians and a man whose common sense borders on genius, is simply wrecking all my aims and opinions. I sometimes come out of his lectures as from out of Nôtre Dame, with an entirely new idea about perfection. . . . Whether the seed will ever bear fruit, I don't know; but what I do know is that no other human being has ever affected me in the same way." Before he left Paris at the end of February 1886, Freud obtained Charcot's approval to translate his Leçons cliniques into German. He took with him a number of expressions that proved useful to him later on: "theory is good, but that doesn't prevent its existence," "in those cases, it's always genital," "the wonderful indifference of hysterics," "the refusal of the sexual is enormous, like a house."

Freud and Charcot maintained their relationship through correspondence, even though the personal comments Freud added to the Poliklinische Vorträge (1892-1894a), his translations of the Leçons du mardi, left a somewhat bittersweet residue (Mijolla). Although Charcot was not interested in the cathartic method Freud had spoken to him about, Freud left the hospital with a draft for an article on hysterical paralysis that took him seven years to complete, but when published in French in the Archives de neurologie (1893c), represented the first "psychoanalytic" approach to the phenomenon. Freud named his first son Jean Martin, and throughout his life kept a reproduction of André Brouillet's painting Une leçon cliniqueà la Salpêtrière.

In his homage to Charcot at the time of his death, Freud confirmed his rejection of Charcot's theories but at the same time expressed his gratitude: "He was not a reflective man, not a thinker: he had the nature of an artist—he was, as he himself said, a 'visuel,'—a man who sees" (1893e). In February 1924, at the request of the review Le Disque vert, he wrote, "Of the many lessons lavished upon me in the past (1885-6) by the great Charcot at the Salpêtrière, two left me with a deep impression: that one should never tire of considering the same phenomena again and again (or of submitting to their effects), and that one should not mind meeting with contradiction on every side provided one has worked sincerely" (1924a).

Bibliography

Didi-Huberman, Georges. (2003). The invention of hysteria:Charcot and the photographic iconography of the Salpêtrière (Alisa Hartz, Trans.). Cambridge: MIT Press.

Ellenberger, Henri F. (1970). The discovery of the unconscious. The history and evolution of dynamic psychiatry. New York: Basic Books.

Freud, Sigmund. (1893e). Charcot. SE, 3: 7-23.

——. (1924a). Letter to "Le Disque Vert," SE, 19: 290-290.

Gauchet, Marcel, and Swain, Gladys. (1997). Le Vrai Char-cot. Paris: Calmann-Lévy.

Mijolla, Alain de. (1988). Les lettres de Jean-Martin Charcot à Sigmund Freud, 1886-1893. Le crépuscule d'un dieu. Revue française de psychanalyse, 52 (3), 703-726.

—ALAINDE MIJOLLA

(1825-1893)

French physician who studied hypnotism in relation to hysteria. Born November 29, 1825, in Paris, Charcot became a doctor of medicine and was later appointed physician at the Central Hospital Bureau, Paris. In 1860 he became a professor of pathological anatomy in the medical faculty, and two years later he became closely associated with the development of the Saltpêtrière, the great neurological clinic of Paris.

Charcot was responsible for notable researches in the fields of muscular disease and mental disturbance. His work, together with that of his student Pierre Janet, the director of the psychological laboratory of the Saltpêtrière from 1889 to 1898, marked the beginning of serious medical and scientific study of the phenomena of hypnotism (in contrast to the earlier studies of mesmerism, which had occult connotations). Their research forced the French Academy of Sciences to accept hypnosis as a new therapeutic instrument.

Among Charcot's most famous students was Sigmund Freud. Charcot died August 16, 1893.

Sources:

Charcot, Jean Martin. Les demoniaques dans l'art. Paris, 1887. Reprint, Amsterdam: B. M. Israel, 1972.

——. Lectures on the Diseases of the Nervous System. London, 1881. Reprint, New York: Hafner, 1962.

Didi-Huberman, Georges, and J. M. Charcot. Invention de l'hysterie: Charcot et l'iconographia photographiqe de la Salpetriere.Paris: Macula, 1982.

(1825–93). French neurologist, born in Paris, where he qualified in medicine. In 1853 he began to work at the Salpêtrière, becoming physician-in-chief in 1866 and professor of clinical neurology in 1882. He was a brilliant diagnostician and was the first to recognize a number of nervous diseases including multiple sclerosis and the 'lightning pains' of tabes dorsalis. Towards the end of his life, he became much interested in hysteria and its treatment by hypnosis, in which he likewise became deeply interested. Among the many who studied with Charcot was Sigmund Freud, upon whom he made a lasting impression.

(Published 1987)

— O. L. Zangwill

Bibliography
• Guillain, G. (1959). J. M. Charcot: His Life, his Work. trans. P. Bailey.

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