Pierre Marie: Gifted Intellect,Poor Timing and Unchecked Emotionality

Pierre Marie was a prominent member of the French neurological world of the early twentieth century. Having been trained by the celebrated physician, J-M Charcot, Marie remained influenced by his teacher throughout his career. Because of this influence, his career can be logically divided into three phases: first, the early years under the direct mentorship of Charcot (1878-1893); secondly, the aftermath of Charcot’s death when Marie left his teacher’s institution, the Salpêtrière hospital and established himself at the Bicêtre hospital in southern Paris (1893-1918); and finally, Marie’s return to the Salpêtrière to assume the original Charcot chaired professorship, albeit as an aged man (1918-1925). This essay examines Marie’s career with an emphasis on documentation of the combined attributes of a gifted intellect as well as a heated emotionality. In the context of his time, these elements prompted Marie to enter into controversies and medico-political battles that advanced neurological knowledge, but likely disadvantaged him in his career successes.     

Charcot in contemporary literature

Charcot and his medical observations remain an enduring topic of scientific study in neurology, but he is also the topic of modern literary works. This essay examines the depiction of Jean-Martin Charcot (1825-1893) as a character in late-twentieth-century literature as an index of the contemporary nonmedical literary public's interest in neurology and Charcot. It focuses on three contemporary works that involve Charcot as a central figure with comparison between primary source documents and the rendered context, character development, and plot lines of these literary works. The two French novels [Slumbers of Indiscretion and Dr. Charcot of the Salpêtrière] and one American play [Augustine (Big Hysteria)] approach Charcot and neurology with differing levels of historical accuracy. All create a figure of authority, each with a different coloration of the balance between power and its abuse. Two focus almost exclusively on his work with hysteria and inaccurately amplify Charcot's concern with symbolic sexual conflict as the origin of hysteria and fictionalize more extensive interactions with Freud than historical documents support. The three works demonstrate that Charcot retains an enduring fascination with an enigmatic personality, a controversial career, and a pivotal role in the development of studies involving the brain and behavior. Neurologists should not look to these works as replacements for more seriously composed historical studies, but as enrichments anchored in the imaginative possibilities of Charcot and his fin de siècle era.     

Jean-Martin Charcot and the epilepsy/hysteria relationship

Research from many perspectives has been made on the work of the French neurologist, J.-M. Charcot (1825-1893) with particular reference to his fame for his studies and "construction" of hysteria. What has not been demonstrated so far is the extent to which Charcot's construction can be explained by the perceived relationship between hysteria and epilepsy and Charcot's access to epileptic patients at La Salpêtrière. From the confusion that reigned concerning hysteria and epilepsy, both separately and in relation to each other, Charcot claimed to have isolated hysteria as a distinctive and universal pathology. This claim was partly based on the "grande attaque", representing the most intense degree of hysteria. A comparison with Gowers, the contemporary English neurologist suggests that diagnosis was the function of the practitioners' preferences; and a linguistic analysis pinpoints Charcot's problems in describing an isolated pathology in terms of its relation to its neighbour, epilepsy.     

Making distinctions: the contribution of Hector Landouzy to differential diagnosis in relation to hysteria and epilepsy

Hector Landouzy (1818-1864) is known for his Traité Complet de l'Hystérie (1846), which was crowned by the Académie de Médecine, but this work is not given much importance in historical accounts. It deserves more attention because it was more than an orthodox statement about the nature of hysteria. In the context of the diagnostic confusion between epilepsy and hysteria, it introduced a method of presenting criteria to facilitate diagnosis. An examination of French authors on epilepsy and hysteria in the second half of the nineteenth century suggests that this method probably set the example which was to be followed by later clinicians, including Charcot at the Salpêtrière.     

From photography to cinematography: recording movement and gait in a neurological context

The major challenge of photography has been freezing movement, to transform it into a fixed image or series of images. Very soon, photographers became interested in movement itself and tried to use photography as a tool to analyze movement. At the early stages, physicians interested in movement, perhaps surprisingly, made important technical contributions. Mécanisme de la physionomie humaine, by Duchenne, the first book with physiological experiments illustrated by photographs, is a landmark in this historical development. At the Salpêtrière, thanks to Charcot, photography officially entered clinical neurology. Medical journals with photographs were actively developed by Bourneville. Londe established a clinical photographic laboratory and published the first book on medical photography. The study of animal and human movement by Muybridge and Marey in the 1880s led to chronophotography and later cinematography. Clinicians such as Dercum and Richer took advantage of these new techniques to study pathological movement and gait in neurological diseases.     

Hallucinations and pathological visual perceptions in Maupassant's fantastical short stories--a neurological approach

Maupassant excelled as a realist writer of the nineteenth century, with fantastical short stories being an outstanding example of his literary genius. We have analysed four of his fantastical stories from a neurological point of view. In "Le Horla," his masterpiece, we have found nightmares, sleep paralysis, a hemianopic pattern of loss and recovery of vision, and palinopsia. In "Qui sait" and in "La main" there is also an illusory movement of the objects in the visual field, although in a dreamlike complex pattern. In "Lui," autoscopy and hypnagogic hallucinations emerge as fantastical key elements. The writer suffered from severe migraine and neurosyphilis involving the optic nerve, which led to his death by general paralysis of the insane (GPI). Visual loss and visual hallucinations affected the author in his last years, before a delirant state confined him to a nursing home. Our original hypothesis, which stated that he could have translated his sensorial experiences coming from this source to his works, had to be revised by analyzing some of his earliest works, notably "Le Docteur Héraclius Gloss" and "La main d'écorché" (1875). We found hallucinatory symptoms, adopting the form of autoscopy and other elaborated visual misperceptions, in stories written at age 25, when Maupassant was allegedly healthy. Therefore, we hypothesize that they may be related to his hypersensitive disposition, assuming that no pathology is necessary to experience such vivid experiences. In addition, Maupassant's abuse of drugs, as illustrated in "Rêves," could have provided an additional element to outline his painstaking visual depictions. All these factors, in addition to his up-to-date neurological knowledge and attendance at Charcot's lectures at "La Salpêtrière," armed the author for repetitive and enriched hallucinatory experiences, which were transferred relentlessly into his works from the beginning of his career.     

Charcot and Les névroses traumatiques: scientific and historical reflections

Between 1878 and 1893, Jean-Martin Charcot published over twenty detailed case histories dealing with what he termed 'traumatic hysteria' and what today would be labelled the psychoneurology of trauma. Charcot's cases record a highly diverse clinique tableau of symptoms. Etiologically, Charcot posited a dual model of a hereditary diathèse, or constitutional predilection to nervous degeneration, and an environmental agent provocateur. Increasingly during the 1880s, he emphasized the role of 'psychical shock'. These writings of Charcot also exhibit many of the same, superb clinical qualities that distinguish his work on other medical topics. Charcot isolated several hystero-traumatic formations and provided outstanding clinical depictions of subgenres of the disorder, most notably brachial monoplegias. His clinical demonstrations of the differential diagnosis of organic and functional post-traumatic pathologies represent Charcot the virtuoso neurologist at his finest. Taken together, these writings offer a penetrating exploration of the complex and elaborate functional sequelae of minor bodily injury and the phenomenon of traumatic psychogenic somatic symptom-formation. The revival today of medical interest in psycho-traumatic pathology, including the traumatic origins of certain dissociative states, provides an important context for the renewed appreciation of Charcot's work in this area.     

George Sigerson: Charcot's translator

Senator George Sigerson (1836-1925), Dublin's first neurologist, was also a significant contributor to Anglo-Irish literature. His medical career and literary accomplishments are outlined, the focus of the article being Sigerson's friendly relationship with Charcot (with whom he corresponded), and whose Le?ons sur les maladies du système nerveux he translated.     

Neurology and Literature, 1860–1920 by Anne Stiles (ed.)

Abstract

Research from many perspectives has been made on the work of the French neurologist, J.‐M. Charcot (1825–1893) with particular reference to his fame for his studies and “construction”; of hysteria. What has not been demonstrated so far is the extent to which Charcot's construction can be explained by the perceived relationship between hysteria and epilepsy and Charcot's access to epileptic patients at La Salpêtrière. From the confusion that reigned concerning hysteria and epilepsy, both separately and in relation to each other, Charcot claimed to have isolated hysteria as a distinctive and universal pathology. This claim was partly based on the “grande attaque”;, representing the most intense degree of hysteria. A comparison with Gowers, the contemporary English neurologist suggests that diagnosis was the function of the practitioners’ preferences; and a linguistic analysis pinpoints Charcot's problems in describing an isolated pathology in terms of its relation to its neighbour, epilepsy.     

Instrument transfer as knowledge transfer in neurophysiology: François Magendie's (1783-1855) early attempts to measure cerebrospinal fluid pressure

Fran?ois Magendie's (1783-1855) experimental model for measuring blood pressure in animals, which he developed in 1838, had a major impact on French physiology in the nineteenth century, especially upon Etienne-Jules Marey (1830-1904) in Paris. In due course it was also adopted by other European investigators, such as the Leipzig physiologist Carl Ludwig (1816-1895), and by clinicians who developed it into a major measuring tool. Historians of science, however, have paid hardly any attention to Magendie's further laboratory investigations conducted with the assistance of Jean-Louis Marie Poiseuille's (1799-1869) sphygmomètre (blood pressure meter). After having used the apparatus to conduct his experiments on a variety of blood vessels, Magendie also applied the sphygmomètre in 1840 to the ventricular system of the brain in order to measure cerebrospinal fluid (CSF) pressure. But the scope of this new procedure had yet to be defined: the new measuring device invited many speculative interpretations about the meaning of CSF flow for the physiology of the ventricular system in healthy and diseased brain function. As such, Magendie's experiments produced phenomena in very heterogeneous knowledge areas, and CSF measurement was situated at the interface of quite disparate investigative spaces regarding the structure and function of the brain. In his textbook Le?ons sur les Fonctions et les Maladies du Système Nerveux (Lectures on the Functions and Diseases of the Nervous System), Magendie described extending application of the measuring "apparatus of Poiseuille" from blood vessels to parts of the brain. The instrument thus became something of a liquidodynamomètre (liquor dynamometer), that paved the way for later applications, including (after 1896) diagnostic intracranial pressure (ICP) measurement by Theodor Kocher (1841-1917) and Harvey Cushing (1869-1939). The current paper focuses on the experimental contingencies that prompted the instrument transfer in Magendie's laboratory and opened up new epistemological perspectives for research in neurophysiology.     

Vincenzo Neri and His Legacy in Paris and Bologna

Italian neurologist Vincenzo Neri was able to discover cinematography at the beginning of his career, when in 1908 he went to Paris to learn and improve his clinical background by following neurological cases at La Pitié with Joseph Babinski, who became his teacher and friend. While in Paris, Neri photographed and filmed several patients of famous neurologists, such as Babinski and Pierre Marie. His stills were published in several important French neurological journals and medical texts. He also collaborated with Georges Mendel, who helped Doyen film the first known surgical operation in the history of cinema. In 1910, when he came back to Bologna, he continued in his clinical activities and, for 50 years, slowly developed a huge archive of films, images, and prints of neurological, psychiatric, and orthopedic cases. This archive was extremely helpful to Neri, who especially needed to analyze neurological disorders and to differentiate them from functional conditions in order to understand clinical signs, rules, and mechanisms.     

Charcot and aphasia

Whereas the beginning part of Charcot's career was occupied with a rigorous and unerring devotion to the anatomo-clinical method, his later career shared attention with physiologic and psychological analyses of hysteria. The seeming paradox between these differing approaches to neurologic study can be better understood by an analysis of Charcot's work on aphasia. This area of study grew out of Charcot's larger research effort on cerebral localization, but was not well known, because most of his lectures on aphasia were never widely published or distributed in either French or English. In analyzing aphasia, Charcot began with anatomic lesions, but gradually incorporated cases of hysterical aphasia, as evidence of dynamic lesions of the same brain areas. Although aphasia never represented a prominent area of study for Charcot, it held a particularly important place in his career first because it provided this transition between anatomic and physiologic approaches to neurologic research, and second because it permitted a natural two-way passage between the topics of cerebral localization and hysteria.     

On the life and work of Korbinian Brodmann (1868–1918)

This study describes the life and work of early-twentieth-century German scientist Korbinian Brodmann (1868–1918). His medical training at universities in Munich, Würzburg, Berlin, and Freiburg and his further education are illustrated. His early Leipzig career and cooperation with brain researchers Oskar and Cécile Vogt in Berlin are portrayed, as are his contributions to a localization theory of the cerebral cortex—namely, Brodmann’s cytoarchitectonic approach—and the invention of a cortex area nomenclature, further developed until the beginning of World War I. His Tübingen professorship and being nominated to manage a major department of Emil Kraepelin’s Munich research unit represent further aspects of this study, a promising career ahead, harshly interrupted by an early and unexpected death.     

The cannonade of Valmy

Abstract

The eccentric American zoologist Richard Lynch Garner (1848–1920) spent almost two decades living with Nkomi people in southern Gabon between 1893 and 1918. His essays often discussed the connections between occult beliefs and political change during the chaotic era of concessionary companies in the colony. This period is often seen by historians as a violent period that destroyed pre-colonial political institutions in equatorial Africa. However, Garner described how he engaged with local occult beliefs in ways that reveal the continued use of landlord/stranger relationships in the colony. While Garner employed chemicals and phonographs as a means of gaining authority over his African hosts, Gabonese people sought to incorporate Garner into their communities through healing rituals and boycotts backed by supernatural threats. Although the American constructed Gabonese people as gullible and backward, a close reading of his writings demonstrates how southern Gabonese communities placed Garner and his technology into a long tradition that tied together European wealth, supernatural forces, and rights of local people over foreigners. The nineteenth century Nkomi kingdom might have crumbled, but links between occult forces and political power survived and adapted to the new realities of the early colonial era.     

Founding years of clinical neurology in Berlin until 1933

During the so-called "Gründerjhare" or "founding years" in Berlin it became necessary to build new hospitals because of the rapid growth of population. As a result, several infirmaries, asylums for the insane and institutions for epileptics were build between 1877 and 1912. The new building of the University of Neuropsychiatric Clinic ("Nervenklinik") of the Charité was opened in 1905 according to plans made by Friedrich Jolly (1844-1904), the physician who named myasthenia gravis pseudoparalytica. A "Neurological Central Station", under the direction of Oskar and Cecil Vogt, in existence since 1898, was a research center dedicated more to morphology. There the study of the structure of the cerebral cortex by Korbinian Brodmann (1868-1925) and research into basal ganglia diseases by the Vogts began. The Kaiser-Wilhelm Institute for Cerebral Research, which moved into a new building in 1931, also had its origin here. Hermann Oppenheim (1858-1919) promoted independent clinical neurology, as did his younger contemporary, Max Lewandowsky (1876-1918), who was already advising physician for neurology at the Berlin-Friedrichshain Hospital. Hug Liepmann (1863-1925), the creator of apraxia theory, worked at the asylums for the insane in Dalldorf (Berlin-Wittenau) and Berlin-Herzberge. In 1911, the first neurological unit was established in the large hospital in Berlin-Buch under the direction of Otto Maas. Not until after World War I were further neurological hospital units founded, under the direction of Paul Schuster (1867-1940), Kurt Goldstein (1878-1965), Kurt L?wenstein (died in 1953) and Friedrich Heinrich Lewy (1885-1950). These Jewish physicians, as well as C.E. Benda and Otto Maas, had to leave their posts in 1933 and emigrate. The clinical institutions and scientific achievements of these pioneers of independent clinical neurology will be presented up to the point of its violent dissolution.     

Elite migrations in modern Italy: patterns of settlement,integration and identity negotiation

Abstract

Francesco Crispi has often appeared a paradoxical figure. In the earlier part of his life he was a revolutionary republican and a friend of Mazzini. After 1860 he accepted the monarchy, but remained very much a man of the Left and in many ways a quintessential democrat. Yet he ended his career as an authoritarian Prime Minister, a vigorous opponent of the Far Left, and an imperialist, who prorogued parliament and contemplated dispensing with representative government altogether. This article contends that Crispi's career has more coherence than is commonly suggested; it focuses on an important but hitherto neglected aspect of his thinking, namely the problem of how to achieve a sense of national consciousness in Italy through ‘political education’. The article traces the development of the idea of national political education throughout Crispi's career and argues that his two terms as Prime Minister in 1887–91 and 1893–6 can only be fully understood in the context of his long‐standing concern with this problem.     

S. Weir Mitchell's prose and poetry on the American Civil War

The prose and poetry of S. Weir Mitchell (1829-1914)--related to the American Civil War--encompass a very significant portion of his non-medical writings. The Civil War, more than any other single event, shaped his future career as one of the founders of American neurology. Indeed, it should not be surprising how the war was also such a driving force in his non-medical writings. His novels, once widely read, now are scarcely noted. His accounts of the social, political and economic events of the Civil War are of historical interest to students of the period. Neuroscientists as a group, like others, are apt to be unfamiliar with these writings, with the possible exception of "The Case of George Dedlow." A major purpose of this essay is to introduce readers, especially neuroscientists, to Weir Mitchell's fictional works in which neurological cases so often appear. One appreciates more the medical aspects of his novels, written as they were by a first-hand observer. His non-medical writings, poetry and prose, are to a large extent timeless and can be appreciated by today's readers.     

From Photography to Cinematography: Recording Movement and Gait in a Neurological Context

The major challenge of photography has been freezing movement, to transform it into a fixed image or series of images. Very soon, photographers became interested in movement itself and tried to use photography as a tool to analyze movement. At the early stages, physicians interested in movement, perhaps surprisingly, made important technical contributions. Mécanisme de la physionomie humaine, by Duchenne, the first book with physiological experiments illustrated by photographs, is a landmark in this historical development. At the Salpêtrière, thanks to Charcot, photography officially entered clinical neurology. Medical journals with photographs were actively developed by Bourneville. Londe established a clinical photographic laboratory and published the first book on medical photography. The study of animal and human movement by Muybridge and Marey in the 1880s led to chronophotography and later cinematography. Clinicians such as Dercum and Richer took advantage of these new techniques to study pathological movement and gait in neurological diseases.     

Thomas Laycock and a trophic nervous system

A short introduction is given to Thomas Laycock (1812-1876), and attention drawn to the development of neurological understanding in the nineteenth century. The main text describes a postulated part of the nervous system, the trophic, which was thought to govern nutritive functions of the body. Thomas Laycock appears as a lone figure in British medicine in giving serious consideration to a trophic nervous system. His discussions are based on clinical observations but his theories are speculative. He devised an instrument (an aesthesiometer) which he hoped would identify abnormalities of the trophic nervous system. The demise of a trophic nervous system is described with quotations from Charcot and Gowers and the use of the word trophic in current practice is mentioned.