Tuesday, 10 June 2014

JEAN MARTIN CHARCOT - PIONEER IN NEUROLOGY- ALSO A PATHOLOGIST AND A RHEUMATOLOGIST- BEST KNOWN FOR HIS 18 EPONYMOUS CONTRIBUTIONS TO MEDICINE

     Jean Martin Charcot is considered the father of Neurology. But he was much more than that. He was also a trained Pathologist. He was also interested in Rheumatology. He is considered to be one of the most influential physicians of all times.
     He was born on 29 November 1825. His father was a cottage builder. Being better than his brothers, his father supported only him to persue the higher education in Medicine. A keen observer, a good painter, he had a good visual memory. He was good in German, Italian and English languages.
     He graduated from the medical school of Paris at the age of 23. He was an intern at Salpetriere hospital, Paris. He held various positions at that hospital  including Chef de Clinique(1853), Physician t the hospital of Paris (1856), Professor of Pathological Anatomy at the University of Paris (1872). A position of Professor of the diseases of the nervous system was specially created for him. He established the neurology clinic in 1882. Classical French Neurology was founded by him.
     He would work uninterruptedly into the night and was a prolific writer. He articles regularly appeared in Lancet and BMJ. He also authored many books. He was a popular teacher and his students came from all over Europe. He  adopted theatrical techniques and lectures to teach the students. His famous students included Babinski, Bechterew, Pierre Marie, Freud, and Bouchard, Bornville.
     Bouchard was one of his good students. Bouchard being egoistic felt that he should get equal glory if not more for their joint activities - Charcot- Bouchard aneurysms was an example of this. Bouchard felt very neglected because his name came after that of Charcot!
     He was the teacher of Babinski. Babinski was thought to succeed him. Unfortunately for the crucial selection examination, Charcot could not come and Bouchard replaced him as the chairman. Babinski was not selected and it cahnged his life completely. He became very famous but never became a teacher officially.
     His contribution to the understanding of Multiple Sclerosis and differentiating it from Paralysis Agitans was then considered outstanding. He was a clinical wizard and was variously nicknamed as the 'Napoleon of the Neurosis' and 'Caesar of Salpetriere'.
     His 18  eponymous contributions include - Charcot -Leyden crystals seen in the stools of patients with Amoebiasis and the sputum of patients with asthma; Charcot's (Neuropathic ) joint seen in leprosy, diabetes, Tabes dorsalis, syringomyelia - a non inflammatory hypermobile painless joint; Charcot - Neumann crystals in semen; Charcot's (cerebral ) triad - Nystagmus, Intention tremor, staccato speech seen in Multiple sclerosis; Charcot's( Biliary) triad - Right upper quadrant pain, Jaundice, intermittant fever in cholangitis. Charcot's artery of cerebral Haemorrhage - Lenticulo striate branch of MCA; Charcot - Buochard aneurysms - aneurysms of the perforating branches of MCA  which can result in cerebral haemorrhage.;
Charcot's edemma - a painful edema seen in hysterical paralysis; Charcot's disease or Charcot's sclerosis -Lou Gehrig's disease a rare disease from which the baseball player of that name died; Charcot - Marie - Tooth disease - Peroneal muscular atrophy;  Charcot's hysterogenic zones; Charcot - Wilbrand syndrome - Visual agnosia due to PCA occlusion; Erb - Charcot paralysis - a rare from of spinal syphilis; Charcot's angina cruris - Intermittent claudication; Charcot - Joffroy syndrome of epidural ascending spinal paralysis.
     His pastime was music and Beethoven was his favorite composer. In 1882, University of Wurzberg honored him with a doctorate. He started to get attacks of angina pectoris and his health deteriorated. He died in 1893 of pulmonary edema at Morvan in France.His famous quote inclded " symtoms then ,are in reality nothing but cry from suffering organs". and "to learn how to treat a disease one must learn how to recognize it. The diagnosis is the best trump in the scheme of treatment".  So true!

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