Reviewed by: Charcot: Constructing Neurology Howard I. Kushner Christopher G. Goetz, Michel Bonduelle, and Toby Gelfand. Charcot: Constructing Neurology. Oxford: Oxford University Press, 1995. xx + 392 pp. Ill. $55.00. The reputation of Jean-Martin Charcot (1825–93) remains attached to his work on hysteria. Although one-dimensional portrayals of his views on hysteria have been revised by a number of recent scholars, including Jan Goldstein, Mark Micale, and Daniel Widlöcher, the neurological context in which hysteria emerged has received much less attention. Two recent French doctoral theses, subsequently published as monographs—Alain Lellouch’s Jean Martin Charcot et les origines de la gériatrie (Paris, 1992), and Jacques Gasser’s Aux origines du cerveau moderne (Paris, 1995)—have helped to move the focus from hysteria to Charcot’s other contributions and concerns. Predating these efforts, however, was Christopher Goetz’s 1987 translation of and commentary on portions of Charcot’s Leçons du mardi, Michel Bonduelle’s 1982 study of Charcot’s identification of amyotrophic lateral sclerosis, and Toby Gelfand’s articles on Charcot’s influence on Freud and on the wider neurological community. All three authors (along with Lellouch, Gasser, and others) participated in a 1993 Salpêtrière conference focusing on Charcot’s contributions to neurology, whose presentations were published in Revue Neurologique (1984). Goetz, Bonduelle, and Gelfand’s Charcot: Constructing Neurology was thus the next logical step in their individual attempts to present a contextualized portrait of Charcot’s neurology. They have succeeded in their aims and, as a result, their study should be required reading for others who wish to make claims about Charcot. Moreover, their work supplants all previous biographies in French and English. This richly illustrated book is divided into nine topical essays—each author having written three—that move in general chronological order. Although each chapter stands on its own as a completed statement of an aspect of Charcot’s career, they also fit together well and read as if written by a single author. With the exception of Gasser’s study, this is the first publication that has been able to draw on the Charcot papers and collection of Charcot’s books housed at the Bibliothèque Charcot at the Salpêtrière. [End Page 164] The book begins with a textured discussion of Charcot’s medical education. The discussion that follows reveals his early allegiance to an anatomical-clinical method, and how that method was viewed by him as a way of “defending the French tradition of the hospital clinic against the modern German scientific laboratory” (p. 56). This early experience framed the three areas of Charcot’s medical concern—chronic illness, geriatrics, and neurology—that informed his development of the Salpêtrière into a neurological center of international renown. Along the way, his enormous talent as an illustrator helped him and his students to visualize not only their patients’ illnesses, but also specific anatomical pathologies. Charcot’s role in helping to establish eleven medical journals in the fields of general medicine, laboratory science, and neurology reminds readers of the wide range of his concerns and his active career-long participation in medical innovations. The authors also provide detailed explanations of Charcot’s contributions in neurology, especially his work on muscular atrophies and amyotrophic lateral sclerosis (ALS). In doing so, they reveal the great neuroanatomical sophistication of his work. Clearly, he did not come to his views on hysteria out of ignorance about the central nervous system. Rather, he reached his conclusions about hysteria because he could not fit these symptoms into the framework of his understanding of the neurophysiology of other paralytic disorders. More important, as Goetz, Bonduelle, and Gelfand remind us, Charcot’s identification and classification of neurological disorders, such as ALS and multiple sclerosis, remain major contributions to neurology. However, the authors also acknowledge that Charcot, tied as he was to classification, often resisted the connection between diseases and neurological symptoms. Thus, even as evidence mounted, he refused to connect locomotor ataxia (tabes dorsalis) to syphilis. It was this context of classification, as well as the British medical literature on “railway spine,” that led Charcot to his theories about and treatments of hysteria. The authors...
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Dec 1, 2003
J Hobart 
Open Access
