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Art and Images in Psychiatry |

A Clinical Lesson at the Salpêtrière

James C. Harris, MD
Arch Gen Psychiatry. 2005;62(5):470-472. doi:10.1001/archpsyc.62.5.470.
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In June 1870, Jean-Martin Charcot (1825-1893) delivered his first lecture on hysteria, a lesson on hysterical contractures, at the Salpêtrière in Paris, France.2 His lecture emphasized a scientific approach to hysteria and focused on not only the physical features but also the psychological aspects. Thus, he expressed doubt about reports of miraculous religious cures and likened them to the sudden recovery of hysterical patients. Charcot was influenced by the work of Pierre Briquet (1776-1881),3,4 who in 1859, based on clinical assessments, published a systematic epidemiologic study describing 430 cases of hysteria seen over a 10-year period. Briquet considered “hysteria as the product of suffering of the part of the brain destined to receive affective impressions and feelings,”4(p60)suggested a role for heredity, proposed a predisposing temperament, and identified male cases but noted that they were far less common than female cases. The previous July, Charcot attended the British Medical Society meeting in Leeds, England, where Russell Reynolds delivered a paper that had intrigued him, “Paralysis, and other disorders of motion and sensation, dependent on idea.”5 Reynolds wrote “that some of the most serious disorders of the nervous system, such as paralysis, spasm, pain, and otherwise altered sensations, may depend upon a morbid condition of emotion, of idea and emotion, or of idea alone . . . they sometimes associate themselves with distinct and definite diseases of the nervous centres, so that it becomes very important to know how much a given case is due to an organic lesion, and how much to morbid ideation.”5(p483)

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Pierre Andre Brouillet (1857-1914), French. Cover: A Clinical Lesson at the Salpêtrière, 1887. Oil on canvas. 300 × 125 cm. Musée d’Histoire de la Médicine, Paris, France. Photo credit: Erich Lessing, Art Resource, New York, NY.

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A Clinical Lesson at the Salpêtrière is a large group portrait that hung in the salon de Paris in 1887. The following individuals are shown: Jean-Martin Charcot, Professor, Diseases of the Nervous System; Marie (Blanche) Wittman, patient; Joseph Babinski (1857-1933), chief house officer; Marguerite Bottard, nursing director; Mlle Ecary, nurse; Paul Richer (1849-1933), medical artist and physician; Charles Samson Féré (1852-1907), psychiatrist and Charcot’s assistant and secretary; Pierre Marie (1853-1940), assumed Charcot permanent chair in 1917; Alix Joffroy (1844-1908), anatomical pathologist; Edouard Brissaud (1852-1909), interim professor for one year after Charcot’s death; Paul Berbez, physician and student of Charcot; Jean-Baptiste Charcot (1867-1936), son and medical student; Gilbert Ballet (1853-1917), Charcot’s last chief resident; Mathias Duval (1844-1907), professor of anatomy; Maurice Debove (1845-1920), eventual dean of the medical school; Philippe Burty (1830-1890), art collector and writer; Victor Cornil (1837-1908), politician; Georges Gilles de la Tourette (1857-1904), assistant neurologist, described Tourette syndrome; Romain Vigouroux, chief of electrodiagnostics; Henri Parinaud (1844-1905), ophthalmologist who described oculoglandular syndrome; Henry Berbez, extern; Désiré-Magloire Bourneville (1840-1909), Charcot publisher, physician who described tuberous sclerosis complex; Alfred Joseph Naquet (1834-1916), physician and politician; Jules Claretie (1840-1913), journalist and writer; Paul Arène (1843-1896), novelist; Albert Gombault (1844-1904), anatomist; Léon le Bas, chief hospital administrator; Georges Guignon (1859-1932), Charcot’s last chief resident; Théodule Ribot (1838-1916), psychologist; Albert Londe (1858-1917), chief medical photographer.

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