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For a whole number of years Charcot occupied the Chair of Pathological Anatomy in Paris, and he carried on his neuropathological studies and lectures, which quickly made him famous abroad as well as in France, on a voluntary basis and as a secondary occupation. It was a piece of good fortune for neuropathology that the same man could undertake the discharge of two functions: on the one hand he created the nosological picture through clinical observation, and on the other he demonstrated that the same anatomical changes underlay the disease whether it appeared as a type or as a forme fruste. It is very generally recognized how successful this anatomical clinical method of Charcot’s was in the field of organic nervous diseases - in tabes, multiple sclerosis, amyotrophic lateral sclerosis, and so on. Years of patient waiting were often necessary before the presence of organic change could be proved in those chronic illnesses which are not directly fatal; and only in a hospital for incurables like the Salpêtrière was it possible to keep the patients under observation for such long periods of time. Charcot made his first demonstration of this kind before he had charge of a department. While he was still a student he happened to engage a maid-servant who suffered from a peculiar tremor and could not find a situation on account of her clumsiness. Charcot recognized her condition as a paralysie choréiforme, a disease which had already been described by Duchenne, but whose basis was unknown. Charcot kept this interesting servant, although in the course of the years she cost him a small fortune in dishes and plates. When at last she died he was able to demonstrate from her case that paralysie choréiforme was the clinical expression of multiple cerebro-spinal sclerosis.

Pathological anatomy has to serve neuropathology in two ways. Besides demonstrating the presence of a morbid change, it must establish the localization of that change; and we all know that during the last two decades the second part of this task has aroused the greater interest of the two and has been more actively pursued. Charcot played a most distinguished part in this work, too, although the pioneer discoveries were not made by him. To begin with he followed in the footsteps of our fellow-countryman, Türck, who is said to have lived and carried on his researches in comparative isolation among us. When the two great innovations came - the Hitzig-Fritsch stimulation experiments and Flechsig’s findings on the development of the spinal cord - which ushered in a new epoch in our knowledge of the ‘localization of nervous diseases’, Charcot’s lectures on localization played the largest and best part towards bringing the new theories into touch with the clinical work and making them fruitful for it. As regards in especial the relationship of the somatic muscular apparatus to the motor area of the human cerebrum, I may remind the reader of the long time during which the more exact nature and topography of this relationship was in question. (Was there a common representation of both extremities in the same areas? or was there a representation of the upper extremity in the anterior central convolution and if the lower extremity in the posterior one - that is, a vertical disposition?) At last, continued clinical observations and experiments in stimulation and extirpation on living subjects during surgical operations decided the question in favour of the view of Charcot and Pitres that the middle third of the central convolutions mainly serves the representation of the arm, while the upper third and the mesial portion serve that of the leg - that is to say, that in the motor area the disposition is a horizontal one.