Charcot’s irony and sarcasm

A ironia e o sarcasmo de Charcot

ABSTRACT

Jean-Martin Charcot is considered the father of modern neurology and was the first neurologist to hold a professorship of international stature devoted to the study of the diseases of the nervous system. His biographers paint an image of an austere presence, reserved manner, shyness, economy of gestures and an impenetrable, impassive face. However, a wry and sarcastic side of Charcot can be demonstrated in several situations, and these examples help to clarify the intricacies of his personality and work style.

neurology; Jean-Martin Charcot

RESUMO

Jean-Martin Charcot é considerado o pai da moderna neurologia e o primeiro professor de doenças do sistema nervoso em todo o mundo. Os seus biógrafos o descrevem com uma imagem austera, reservado, tímido, com uma economia de gestos e uma face impassiva e impenetrável. Entretanto o lado sarcástico e irônico de Charcot pode ser demonstrado em diversas situações, com exemplos que ajudam a clarificar a sua complexa personalidade e o seu estilo de trabalho.

neurologia; Jean-Martin Charcot

Jean-Martin Charcot (1825-1893) is regarded as the most influential researcher in the field of clinical neurology in the nineteenth century (Figure). He is considered the father of modern neurology and held the first professorship devoted to diseases of the nervous system at the Salpêtrière and the University of Paris^1,2,3,4,5.

(Extracted from Google Images: PBS, October, 15th, 2016).

From a personal standpoint, his biographers paint an image of an austere presence, reserved manner, shyness, economy of gestures and an impassive, impenetrable, and immobile face^1,2,3,4,5.

Beyond this classic description, however, more subtle character traits can be discovered in his writings and case presentations.

This paper describes his subtle sarcasm and irony and analyzes his use of sarcasm and irony to foster his medical and scientific career.

CHARCOT’S IRONY AND SARCASM

What Oscar Wilde once called “the lowest form of wit but the highest form of humor” constitutes a sophisticated and witty form of expressing disdain and contempt in most Western cultures, but is considered subversive in China, and does not exist in Japan⁶.

Besides the well-known taciturn features of Professor Charcot, particularly while in the hospital and medical school environments, he was also quoted by members of his inner circle of friends as a highly humorous man with a paradoxical spontaneity, a charming laugh, and a behavior reminiscent of a joker, or even buffoon, when the appropriate opportunity presented itself^1,2,3,4,5. In this instance, his sarcasm was personally distinctive and professionally valuable.

Charcot versus Duncan

In 1880, during a meeting of the British Medical Association that took place in Cambridge, Professor Matthews Duncan, a famous London obstetrician, questioned Charcot’s studies on hysteria, with a very aggressive attack on Charcot’s observations, particularly the concept of ovarian hysteria, trigger zones, and ovarian compression therapy. After the discussion, Charcot, privately commented about Duncan as:

“Someone whose knowledge did not extend beyond the pelvis” ⁷ .

Charcot considered Duncan’s approach an aggressive attack on the hysteria project, as well as the French School of Neurology, and in this situation, he made use of his sarcasm as a powerful scientific weapon⁷.

Charcot and Sydenham’s chorea treatment

Talking about therapeutic options in neurology, Charcot discussed the famous Sydenham’s treatment, saying:

“Let us throw a veil over Sydenham’s therapeutic discussions on bleeding, bleeding, and more bleeding. It makes your hair stand on end. How did those little English children survive all that?” ^2,8.

Charcot – tics and chorea

During one of his Tuesday Lessons, Charcot was discussing a patient with tics and Tourette’s syndrome. He outlined the differences between tics and chorea, and then he asked the patient:

“What did the doctor in Normandy call this?”

The patient’s answer was:

“Chorea.”

Charcot then commented:

“It seems that chorea is the answer to everything!”^2,8.

Charcot’s sarcastic commentary is, in a way, related to his great importance to the study of movement disorders, particularly his interest in observing and describing their phenomenology, which can best be described as a refined neurological evaluation of these patients.

Charcot and hysteria

In another famous Tuesday Lesson, a young woman with nonepileptic seizures (hysteroepilepsy) was presented by Charcot. A young woman in the auditorium was having a convulsive attack. Charcot was describing to the audience the phases of the classical hysteroepilepsy attack, and at the end of the attack, the patient cried:

“Oh, mother.”

Charcot said: “Again, note these screams. You could say it is a lot of noise over nothing. True epilepsy is much more serious and also much more quiet”⁸.

Charcot and male hysteria

The description of male hysteria by Professor Charcot became a controversial issue, with the German School of Neurology resisting the idea of the existence of such a condition, suggesting that if it occurred in males, it occurred only in French males. Charcot became very upset with this argument, finding delightful relief when he diagnosed hysteria in a male German grenadier^2,8! A very interesting conversation, ensuing between Charcot and his friend Alphonse Daudet, is cited in Léon Daudet’s book (with Goetz’s translation):

“This tale is about one of my most famous colleagues. Yes, a German. He had traveled far to see me. The case was not a trifle – a sudden sexual inversion quite characteristic, brought on by his prolonged contemplation of a Renaissance statue of a fawn on his deck. Gentlemen, works of art can often have their own venom. Yes, quite often.”

“How did you treat this poor patient?” Charcot asked Daudet.

“Peuh, I told him to seek out women, if it was still possible… but you know a German… at age 55… and from the country of Winckelmann…”^8,9.

Charcot and Brown-Séquard

Examples of genuine sarcasm are evident in the relationship between Professor Charcot and Professor Brown-Séquard. Professor Brown-Séquard, a famous neurophysiologist, had developed new experimental work on hormone replacement therapy¹⁰. He presented this research in June 1889—at the meeting of the Société de Biologie, in Paris, France—in which he injected himself subcutaneously with the liquid obtained by gridding the testicles of dogs and guinea pigs and mixing it with water. Professor Brown-Séquard reported a marked increase in his strength and stamina, and improved mental, intestinal and urinary functions. Since then, “The elixir of life”, was associated with Professor Brown-Séquard’s name¹⁰. This testicular extract was marketed as “Brown-Séquard’s elixir” and was considered, to a certain extent, “the universal panacea.”

Professor Charcot, at that time a scientific rival of Professor Brown-Séquard, considered that this elixir was ineffective and said:

“...injections of distilled water were as effective as injections of testicular extracts”¹⁰.

FINAL REMARKS

Professor Jean-Martin Charcot had a complex personality: authoritarian, austere, shy, but he also had some characteristics of sarcastic behavior. This sarcastic and ironic behavior could have had a scientific advantage or even self-protection role as a personal and scientific weapon, and could have been used to promote himself and the French School of Neurology in the competitive world of Neurology.

ACKNOWLEDGMENT

The authors thank Professor Christopher G. Goetz (Department of Neurological Sciences, Rush University Medical Center, USA) for his critical review, and kind suggestions for this paper.

References

• ¹
  Guillain G. J-M. Charcot, 1825–1893: his life- his work. New York: Paul B. Hoeber; 1959.
• ²
  Goetz CG, Bonduelle M, Gelfand T. Charcot: constructing neurology. New York, Oxford University Press; 1995.
• ³
  Guinon G. Charcot intime. Paris Med. 1925:511-6.
• ⁴
  Souques a. Charcot intime. Presse Med. 1925:693-8.
• ⁵
  Bonduelle M. The intimate Charcot. Rev Neurol (Paris). 1994;150:524-8.
• ⁶
  Okamoto S. Social context, linguistic ideology, and indexical expressions in Japanese. J Pragmat. 1997;28(6):795-817. https://doi.org/10.1016/S0378-2166(97)81491-9
  » https://doi.org/10.1016/S0378-2166(97)81491-9
• ⁷
  Clifford RF. A short history of neurology: the British contribution 1660-1910. Oxford: Butterworth Heinemann; 1999.
• ⁸
  Goetz CG. Charcot: the clinician: the tuesday lessons. New York: Raven Press; 1987.
• ⁹
  Daudet L. Devant la douler: souvenirs des milieu littéraries, politiques, artitiques et médicaux de 1880 á 1905. Paris: Nouvelle Librarie Nationale; 1917.
• ¹⁰
  Aminoff MJ. Brown-Séquard. An improbable genius who transformed medicine. Oxford: Oxford University Press; 2011.

Publication Dates

• Publication in this collection
  June 2017

History

• Received
  30 Oct 2016
• Accepted
  14 Mar 2017