Jules Dejerine Research Articles

Joseph Hersey Pratt (1872–1956): An early proponent of cognitive-behavioural therapy in America

The treatment of mild psychoneuroses in America began shifting in the 1950s from Freudian psychoanalysis to various forms of psychotherapy that do not delve into patient's subconscious. Some of the new approaches were termed cognitive, behavioural or cognitive behavioural therapy and in America were practised notably by Joseph Wolpe, Albert Ellis and Aaron T Beck. Modern psychiatric literature makes little mention of two prior innovators in this area - the French neurologist Jules Dejerine and his Boston disciple Joseph H Pratt. In the early 1900s, Dejerine treated patients at La Salpêtrière in Paris using techniques adopted subsequently by Pratt during the 1930s and employed by the trio some decades later. This paper revisits the early history of psychotherapy in America and includes a brief summary of Pratt's medical career.

Aids to the Investigation of Peripheral Nerve Injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty's Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with Aids to the Examination of the Peripheral Nervous System. By Michael O'Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures

It was at the request of William Hammond (1828–1900), Surgeon-General of the United States Army, that, in 1863, Silas Weir Mitchell (1829–1914) and Dr George Morehouse (1829–1905) established a 400 bed hospital at Christian Street (moving later to Turner’s Lane) in Philadelphia to which was referred ‘a vast collection of wounds and contusions of nerves including all the rarest forms of nerve lesion of almost every great nerve in the human body’ suffered during the American Civil War. Writing in 1917, Jules Dejerine (1849–1917) introduced to the medical public the work of his pupil Jules Tinel (1879–1952) on Nerve Wounds : ‘all surgeons and neurologists still remember how surprised they were during the early months of the War, at the numerous cases of peripheral nerve wounds brought into our hospitals… we had… to connect each of the symptoms with the determining lesion… my pupils and myself have been enabled to set up the main syndromes of nerve interruption, of compression, irritation or regeneration, and the syndromes of dissociated or partial lesions’. And lest any reader doubted wherein lay the authority for Dr Tinel’s work, Professor Dejerine points out that ‘ … written, so to speak, in my very presence, it is a faithful resume of the investigations entered upon in my service by all my fellow-workers of the Charcot Clinic’. Of the 639 cases, 408 affect the arm (in descending order of frequency—musculo-spiral, ulnar, median, combined lesions, brachial plexus, circumflex and musculo-cutaneous nerves) and 231 affect the leg (sciatic, external popliteal, internal popliteal, posterior tibial, long saphenous, anterior crural, short saphenous, lumbo-sacral plexus, musculo-cutaneous, anterior tibial, external cutaneous, ilio-inguinal and obturator nerves, respectively). Major Gordon Taylor [Sir Gordon Gordon-Taylor, KBE, CB, MD, FRCS (1878–1960), surgeon to the Middlesex Hospital, London] had with him a copy while serving with the British …

Localization of Language Function in the Twentieth Century

In the twentieth century the method of identifying pathology in patients with aphasia has fluctuated between localizing and holistic theories. The practical localization of sensation and voluntary movement became a clinical commonplace in the beginning of the century, but the mental component of aphasia made its localization controversial. In Paris before the war, Pierre Marie made the localization of aphasia the centerpiece of his personal feud with Jules Dejerine. After the war Konstantin von Monakow used the phenomenon of recovery from aphasia to support his holistic views of localization. Henry Head, in a 1926 study that remains influential today, took a neo-Jacksonian approach to localization and the physiology of language. Kurt Goldstein led the postwar anti-localizationists, asserting that physicians must look after the whole person and that brain function was inherently unified. Norman Geschwind reflected 1960s physiological thought in analyzing aphasia as a type of disconnection of distinct functional areas. In the twenty-first century the localization of aphasia remains dependent on theory, with competition between holistic and localizing ideas.

On aphasia due to atrophy of the cerebral convolutions. By Dr G. Mingazzini, Professor of Neuropathology at the Royal University of Rome. Brain 1914: 36; 493-524.

Giovanni Mingazzini (1859–1929) is not slow to point out that he, Arnold Pick and Jules Dejerine had each described independently, and at about the same time, cases of aphasia that, at autopsy, were attributable to atrophy of the relevant cortical convolutions and not stroke or tumour. Since these and subsequent reports were scanty, he proposes to describe in detail the case of Pio Marini, a gilder, studied in life and post mortem at the lunatic asylum in Rome. In 1907 Sr Marini became impulsive and showed difficulty in speaking and understanding what was said. He used paraphasic substitutions and managed his frustrations with threats and rage. The symptoms progressed without sudden change such that his relatives had him committed to the asylum early in 1909. Examination shows no physical abnormalities of significance but his speech is extremely limited and characterized by echolalia, perseveration or meaningless reciting of his name (as Marino Pio) or that of one ‘Don Antonio’ in reply to questions, and when reading more than a few words aloud, writing to dictation, copying or following commands. He repeats with greater accuracy and versatility. Dr Mingazzini considers him to have ‘signs of partial sensory aphasia, amnesia verborum, verbal paraphasia, paralexia and almost complete agraphia’. By late 1910, Pio Marino remains physically able but he cannot navigate his environment, use household objects and cutlery, or dress. And his verbal output and response to attempts at communication remain limited to ‘Don Antonio’: ‘word-blindness and agraphia are complete, and word deafness is almost complete … the slow progress of the symptoms of aphasia, the absence of strokes or any focal symptoms, together with ever-increasing dementia, led me to conclude that the patient was developing progressive atrophy of the cerebral convolutions … this diagnosis was confirmed by his death, which occurred on December …

Der Binswanger-Lotmar-Disput über Aphasie (1926-1963)

The at the time famous but now practically forgotten controversy between the psychiatrist Ludwig Binswanger (1881-1966) and the neurologist and neuropathologist Fritz Lotmar (1878-1964) about the concept of aphasic disorders dragged on - with a few interruptions - over a period of more than 30 years. This controversial issue was dealt with mainly in the journal Swiss Archives of Neurology and Psychiatry and at meetings of the Swiss Neurological and Psychiatric Society. Furthermore, the dispute triggered off an exchange of letters between Binswanger and Lotmar; this correspondence is evaluated here for the first time. The specific point of dispute was the extent and degree to which amnestic aphasia (aphasic anomia) can lead to a change in the patient's overall personality and thus, in a broader context, became a controversial question concerning the subject-object split of mind and brain. Binswanger did not consider amnesic-aphasic performance impairments as primarily linguistic anomia but rather as changes in the total personality, in the overall function of the brain. For Lotmar, however, aphasic disorders were purely a matter of brain pathology, strictly localist and primarily explainable as linguistic. Binswanger, approaching the problem from the perspective of a new holism, sought to overcome the subject-object split. Lotmar, however, espousing the view that in aphasias no intelligence disorder is present, attempted to further develop the classical aphasia doctrine; to this end he utilised the dissection of speech into its constituent parts and their localisation in distinct areas of the brain. The controversy between Binswanger and Lotmar concerning the concept of aphasic disorders can be understood within the broader context of the body-mind problem, the question of the relationship between body and soul, and can also be regarded as a continuation of the famous debate between Pierre Marie and Jules Dejerine about the classical doctrine of aphasia. In the background of this discussion are two processes whose intense interrelationship affects us even today: on the one hand, the establishment of scientific medicine as a primarily body-oriented discipline, the position represented by Lotmar; on the other hand, the opposite process propagated by Binswanger, entailing a rediscovery of the mental-spiritual connection that, inter alia, is associated with the development of modern psychotherapeutic and psychosomatic medicine and, above all, with the name Sigmund Freud. Which interpretation of aphasia doctrine might ultimately prevail - according to Minkowski in the discussion following Lotmar's lecture on Newer Conflicts Concerning the Concept of Aphasic Disorders 1935 - will be revealed by the history of science. After the contentual dismantlement of classical doctrine begun by Marie was continued until the Second World War, the work of Norman Geschwind in the sixties resulted in the recurrence of an anatomically based, and also by Lotmar advocated, connectionistic aphasia doctrine, one which was assumed would become the dominant paradigm for the remainder of the century. Despite Binswan-ger's improved work environment and the justified criticism of Lotmar's overly rigorous separation of physis (organism) and psyche, Lotmar's position on aphasia doctrine, which was primarily body oriented, mostly prevailed.

AN AMERICAN WOMAN IN SALPÊTRIÈRE: AUGUSTA DEJERINE-KRUMPE (1859- 1927) AND THE BRAIN MAPPING

Augusta Dejerine-Krumpke was the first woman to be admitted to the boarding school of Parisian hospitals. He had a cosmopolitan upbringing and was born in the United States of America. The residency is still today a very important institution in the hospital career of French doctors. The most important work of his life was done with the neurologist Jules Dejerine; a study on the anatomy of the nervous system.

The 'Dejerines': an historical review and homage to two pioneers in the field of neurology and their contribution to the understanding of spinal cord pathology.

Our purpose, in this number of Spinal Cord devoted to the French speaking Society of Paraplegia (AFIGAP), is to render homage to two very distinguished doctors, who by their work at the end of the XIXth and the beginning of our century contributed greatly to our knowledge of the nervous system and in particular the spinal cord (SC). This was at the time a field of considerable interest in France and abroad. Professor Jules Dejerine was from 1911-1917 the holder of the Chair for Nervous System Diseases created for Charcot. Dejerine and his American born wife, Augusta Klumpke, and had very limited means for investigation compared to actual technological advances. They relied mainly on their superb clinical observations and neuropathological examinations. Dejerine was also a pioneer in the growing field of neuroanatomy. In 1895 he published a treatise on the anatomy of the nervous system, which is still considered worldwide to be a masterpiece. Augusta Dejerine-Klumpke, the first woman Intern in Paris Hospitals, was not only a fine clinician, neuroanatomist and pathologist, but also contributed greatly to her husband's work. Amongst other things she is known for the 'Klumpke palsy'. She was also a pioneer in France, during the First World War and subsequent following years, in the treatment and rehabilitation (medical and vocational) of the large number of soldiers afflicted by wounds of the nervous system and especially of the SC. During the same period, many authors contributed to SC pathology, but only a few to the treatment and rehabilitation of these patients. This was brought to our attention, in the sixties, by Professor Pierre Houssa, pioneer in Belgium in the field of comprehensive care of those who have SC lesions. Augusta Dejerine-Klumpke also contributed to our present knowledge of heterotopic ossification following a SC injury, including its pathogenesis. Most of their clinical and pathological findings and discussions are recorded in Dejerine's famous monograph which was published in 1914: La séméiologie des Affections du Système Nerveux (The Semiology of the Diseases of the Nervous System).

Jules Dejerine and his interpretation of pure alexia

Jules Dejerine and his interpretation of pure alexia

The Classic

Jean-Martin Charcot (Fig. 1) was born in Paris, where his father was a carriage builder. He was educated in Paris and, after deciding to become a doctor, entered medical school at the age of 19. At that time, Paris was the world center of medical thought and activity; Charcot was exposed to some of the best teachers available. As he progressed through his training, he continued to develop his skills at drawing. His doctoral thesis, illustrated by his own drawings, dealt with the differential diagnosis of gout and other forms of acute rheumatism. Moving up the academic ladder, Charcot, in 1862, was appointed chief physician of l'Hospice de la Salpêtrière, an ancient hospital that contained 5000 chronically ill patients of all types. It was from this voluminous material that he described various conditions that established his reputation as the founder of the specialty of neurology. Perhaps his greatest contribution was the recognition that “locomotor ataxia,” a frequent cause of disability, was caused by tabes dorsalis, a form of neurosyphilis. Charcot was a great teacher, whose clinics became world famous. His relationship with Duchenne was very productive and his students, Jules Dejerine, Pierre Marie, and J. Babinski, carried on his great tradition. The following description of neuropathic joint disease is contained in one of his lectures on the subject of locomotor ataxia. It is interesting to note that he did not associate diabetes in any way with the development of this condition, relating it only to locomotor ataxia. LEONARD F. PELTIER, M.D., PH.D.

Jules Dejerine and His Interpretation of Pure Alexia

Dejerine′s interpretation of pure alexia is routinely mentioned in all neuropsychological textbooks, yet the details of his account and the evidence on which it is based have never been subjected to a critical analysis. We provide such an evaluation in this paper, summarizing the behavioral data that Dejerine presented in his now famous case report and the theoretical framework he adopted to explain the phenomenon of alexia without agraphia. We also provide a link between Dejerine′s work and current hypotheses on the nature of the syndrome.

Jules Dejerine and the third alexia.

Modern concepts of pure alexia and alexia with agraphia are derived from Dejerine's eloquent clinicopathologic studies of the late 19th century. More recently, a third variety of alexia has been described in association with left frontal lesions causing Broca's aphasia. Dejerine also recognized this "third alexia." For Dejerine, alexia with Broca's aphasia was indispensible to his view of a left-hemisphere language zone in which cortical lesions disrupt all language modalities (speech, reading, and writing). Viewed in light of modern neurolinguistic advances, Dejerine's descriptions of the third alexia are surprisingly prescient.

Letter: Augusta Dejerine-Klumpke.

Comments1 July 1974Augusta Dejerine-KlumpkeJULIUS BAUER, M.D.JULIUS BAUER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-1-128_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Nobody could have enjoyed Richard Satran's interesting biography of Mme. Klumpke more than I (Ann Intern Med 80:260-264, 1974).In 1914, before World War I, she was President of the French Neurological Society; she was one of its original members. Probably I am one of the few survivors who attended and remembers a solemn meeting of the Society and admired its president. With a fellowship granted by French and Austrian (Vienna) universities, I was at that time a student of Augusta's husband, Professor Jules Dejerine. Their daughter was a teenager who later became Mme. Y. Sorrel-Dejerine, when... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 615 North Bedford Dr. Beverly Hills, California 90210 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byScapula nach geburtstraumatischer PlexusläsionFigures and institutions of the neurological sciences in Paris from 1800 to 1950. Part III: Neurology 1 July 1974Volume 81, Issue 1Page: 128-128KeywordsAdolescentsFellowships Issue Published: 1 July 1974 PDF downloadLoading ...

The thalamic syndrome.

FEW physicians have been more honored by eponyms than Jules Dejerine (1849 to 1917), the French neurologist.^1-3Among the diseases that bear his name are facioscapulohumeral muscular dystrophy (Landouzy-Dejerine), hypertrophic interstitial neuritis (Dejerine-Sottas), olivopontocerebellar atrophy (Dejerine-Thomas), and the thalamic syndrome (Dejerine-Roussy). His American wife, Augusta Klumpke, was also a talented neurologist whose name is now associated with lower brachial plexus palsy.⁴ Beginning in 1903, Dejerine and his associates discovered and studied the clinical and pathological features of the thalamic syndrome.^5-7Little has been added to their thorough presentations. Twenty years after Dejerine's initial paper on the subject, Foix, Masson, and Hillemand demonstrated the most common cause of the syndrome—occlusion of the thalamogeniculate branches of the posterior cerebral artery.^8-10 The most distressing feature of the thalamic syndrome is the intense pain, which may be related to release of the thalamus from cortical inhibition.¹⁰As Dejerine