NEURAL CONTROL OF THE PITUITARY

LIFE OF CHARCOT J.-M. Charcot, 1825-1893: sa Vie, son UEuvre. By Georges Guillain. (Pp. 188. 1,400 fr.) Paris: Masson et Cie. 1955. Ask the man in the street-even Wimpole Street-who was the founder of neurology, and you will be told, Charcot. And rightly so, for Charcot above all his contemporaries dominated the academic scene and firmly established the study of organic nervous disease. As a teacher he was supreme, for as his disciples scattered they in turn founded departments of neurology throughout the world. We have had to wait many years for a serious biography of this great man, and Professor Guillain's book gives us a fascinating and intimate aper u of Charcot's professional and personal life. Born in 1825, he was thus 10 years older than our national pioneer Hughlings Jackson, and 20 years older than Gowers. A Parisian of middle-class origin, with an outstanding student career, he was influenced early by Rayer, Napoleon III's private physician and dean of the faculty. Close friendship with Vulpian, and later with Duchenne, perhaps directed his interests towards chronic maladies, and especially those which we would to-day term geriatric. Gradually Charcot's attention became focused more closely upon the mysterious terrain of organic nervous disease. It seemed inevitable that he should abandon his professoriate of pathological anatomy in order to assume, at the age of 57, the newly created chair of clinical neurology. Charcot established his service at the Salpetriere, that unique institution the history of which we already owe to Professor Guillain, who himself succeeded to Charcot's chair some years later. Here he would drive each morning, a cold and aloof figure, to watch in silence his assistants displaying the clinical phenomena of the new admissions. The original consulting-room is still preserved with its antique furnishings; and on the wall there still hangs the one portrait that Charcot chose-that of Jackson. Later, Charcot instituted a Friday afternoon teaching session, where a series of patients, all typifying a particular syndrome, would be demonstrated as a group. Still later a Tuesday morning clinic was established, where Charcot would examine and teach upon new patients. Thus began one of the institutions of French neurology, the le ons de mardi. To these two teaching occasions would come a throng of fascinated visitors-not all of them medical men. In this manner Charcot and his pupils disinterred many clinical treasures among the oddities who lingered as reposantes in the " Cite grise," as the hospital came to be called. At midday Charcot would return to his magnificent home-now a bank-in the Boulevard Saint-Germain. In his vast sombre cabinet, with its book-lined walls and stained-glass windows, he would work far into the night attending to his clientele, for he was at that time the most authoritative as well as the most fashionable neurologist in private practice. Among our own forebears in neurology Charcot must be contrasted with Hughlings Jackson. Charcot was a much greater formal teacher than Jackson, though he had none of the latter's foresight or profundity of thought. Charcot had broader interests and greater culture than Jackson, but lacked his warmth and sheer benevolence. Charcot inspired the many, and was the better propagandist for neurology; Jackson wrote for the elect among his contemporaries, and indeed mainly for future generations. Where Charcot was crystal-clear, simple, and didactic, Jackson was obscure, involved, and allusive. In this biography by Guillain details of Charcot's scientific work, his debatable conception of hysteria, his quarrel with Bouchard, his generosity towards his erstwhile vilifier "Ignotus " when helplessly paralysed, and many other intriguing topics are clearly and dispassionately narrated. Neurologists and medical historians will be deeply grateful to the author for this delightful addition to their library shelves. MACDONALD CRITCHLEY. NEURAL CONTROL OF THE PITUITARY