Charcot and Duchenne: Of Mentors, Pupils, and Colleagues

I learned much Torah from my teachers, and from my colleagues more than from them, but from my disciples more than from all of them.--TALMUD, Tractate Makkot-10a.

Introduction

In the history of medicine, there have been notable mentors, famous pupils, and celebrated colleagues. Seldom, however, have two renowned physicians simultaneously been mentors, pupils, and colleagues to each other, as was the case with Jean-Martin Charcot (Fig. 1) and Guillaume Benjamin Amand Duchenne (Fig. 2). Notwithstanding a 19-year difference in age and the fact that each was a well-published neurological scientist in his own right, these investigators developed a multifaceted relationship which served to reciprocally foster their separate vocations, enhance their mutual endeavors, and enrich the field of neurology. This study examines the teaching, learning, and scientific sharing that uniquely marked the careers of Charcot and Duchenne.

Charcot

Jean-Martin Charcot (1825-1893) was the eldest son of a Paris coach builder. He was sent to school with his three brothers for a year with the understanding that the one receiving the best report would study for one of the learned professions. Jean-Martin won the prize, electing to study medicine. Although he did not graduate until age 28, he was soon earning enough money to repay his parents for the sacrifices they made on his behalf [1]. In 1862, Charcot was appointed physician to the Salpêtrière Hospital in Paris, where his great work was accomplished over the next 30 years and with which his name will always be associated. At the Salpêtrière, Charcot created the greatest neurological clinic of his time. His demonstrations and lectures drew students from all parts of the world, including Sigmund Freud from Vienna, Ludwig Hirt from Breslau and S. Weir Mitchell from the United States. Charcot, using his celebrated "anatomico-clinical" method, correlated characteristic neurologic signs with specific neurologic lesions, and played a major role in establishing neurology as a medical specialty.

Charcot's studies of the localization of functions in cerebral disease (1876) are among his many important contributions to clinical science. In 1866, with Henri Bouchard, he described miliary aneurysms, emphasizing their importance in cerebral hemorrhage; with Alexis Joffroy, the lesions in muscular atrophy (1869); and with Pierre Marie, peroneal muscular atrophy (1886). His ideas on hysteria and hystero-epilepsy were elaborated in the clinical studies of Richer (1879-1885) and Gilles de la Tourette (1891). He differentiated the essential lesions of locomotor ataxia, describing both the gastric crises and the joint affections (Charcot's joints) [2]. "No writer," Osler said, "has more graphically described the trophic troubles following spinal and cerebral disorders" [3].

Charcot was a learned man, quite apart from his mastery of medicine. He read modern and ancient languages, interspersing his teaching with quotations from the classics. With his Napoleonic presence, he was imperious in voice and manner. His lectures were prepared with meticulous care and delivered with dramatic intensity. His sarcasm was cutting, and he brooked no contradiction. He was indefatigable in his work. When following an interesting problem, he gave no thought to food or sleep. Charcot was careless of money, often forgetting to take his fees. However, he had no need for concern as he married a rich woman and lived in great style. His sumptuous house and garden in the boulevard St. Germain were the scene of lavish entertainments. He loved music and painting and was himself a talented artist who studied the influence of medical history on the graphic and plastic arts. In 1890, at the zenith of his fame, Charcot was stricken with angina. He seemed to recover and even resumed work, but died suddenly three years later on 16 August 1893 [1].

Duchenne

Guillaume Benjamin Amand Duchenne was born in the town of Boulogne-sur-Mer on 17 September 1806. He referred to himself as Duchenne de Boulogne to avoid confusion with a fashionable...