Jean-Martin Charcot's Role in the 19th Century Study of Music Aphasia

Julene K. Johnson; Marjorie Lorch; Serge Nicolas; Amy Graziano

Disclosures

Brain. 2013;136(5):1662-1670. 

In This Article

Abstract and Introduction

Abstract

Jean-Martin Charcot (1825–93) was a well-known French neurologist. Although he is widely recognized for his discovery of several neurological disorders and his research into aphasia, Charcot's ideas about how the brain processes music are less well known. Charcot discussed the music abilities of several patients in the context of his 'Friday Lessons' on aphasia, which took place at the Salpêtrière Hospital in Paris in 1883–84. In his most comprehensive discussion about music, Charcot described a professional trombone player who developed difficulty copying music notation and playing his instrument, thereby identifying a new isolated syndrome of music agraphia without aphasia. Because the description of this case was published only in Italian by one of his students, Domenico Miliotti, there has been considerable confusion and under-acknowledgement of Charcot's ideas about music and the brain. In this paper, we describe Charcot's ideas regarding music and place them within the historical context of the growing interest in the neurological underpinnings of music abilities that took place in the 1880s.

Introduction

Jean-Martin Charcot (1825–93) is considered the founder of both French neurology and the Salpêtrière School of Neurology (Goetz et al., 1995; Broussolle et al., 2012). He is widely celebrated for the discovery of a number of neurological disorders and is remembered for his exceptional teaching skills. While Charcot's contribution to aphasia research is well documented (Brais, 1993; Bonduelle and Goetz, 1996; Tesak and Code, 2008), less well known are his ideas on how the brain processes music, which were informed by his clinical observations of music agraphia and motor amusia. Charcot discussed the music abilities of several patients in the context of his 'Friday Lessons' on aphasia, which took place at the Salpêtrière Hospital in Paris during 1883–84. In his most comprehensive discussion about music, Charcot described a professional trombone player who developed difficulty copying music notation and playing his instrument, thereby identifying a new, isolated syndrome of music agraphia without aphasia. Charcot's case history of the trombone player was only recorded in Italian by one of his students, Domenico Miliotti, in 1885 (Miliotti, 1885). The case of the trombonist was cited by other 19th century neurologists in discussions of acquired music impairments; however, few details were typically provided, and its primary source was often missing. This contributed to confusion about the source of the case, and Charcot is rarely acknowledged in these discussions. Owing to the rarity of music agraphia, the full details of Charcot's cases are provided here. His theoretical ideas regarding music processing are also placed within the historical context of the growing interest in the neurological underpinnings of music abilities that took place during the 1880s.

Jean-Martin Charcot was born in Paris in 1825. He worked and taught at the Salpêtrière Hospital in Paris for 33 years, starting as the Chief of Service in 1861 and becoming the Chair in Pathologic Anatomy in 1873 (Goetz et al., 1995). His career was characterized by numerous distinctions and discoveries, and there are over a dozen medical eponyms attributed to him, the best known of which are Charcot–Marie–Tooth disease and Charcot's disease, also called amyotrophic lateral sclerosis. During the 1860s and 1870s Charcot's clinical focus was primarily on diseases of the elderly, and his research focus was on the localization of motor function in the brain (Charcot, 1875; Charcot and Pitres, 1877).

In 1882, a new Clinical Chair for the Diseases of the Nervous System was created for Charcot at the Faculty of Paris. The following year he established a neurology clinic at the Salpêtrière. His inaugural series of lectures at the clinic in the summers of 1883 and 1884 was on the topics of aphasia and related disorders. It was in the context of these lectures about aphasia that Charcot also considered aspects of music and the brain. Whereas there has been a great deal written about Charcot's interests in art and literature (Goetz, 1991; Goetz et al., 1995; Bogousslavsky, 2004), little is known about his ideas on music. Guillain (1959) states that while he did not have music training or play a musical instrument, he did attend both the Folies Bergères and the opera. He had a preference for 18th and early 19th century composers, such as Ludwig van Beethoven (1770–1827), Christoph Willibald von Gluck (1714–87), Jean-Philippe Rameau (1683–1764), Wolfgang Amadeus Mozart (1756–91), as well as Carl Maria von Weber (1786–1826) (Daudet, 1922; Guillain, 1959; Goetz et al., 1995). There is a great deal of information regarding the inclusion of painters, sculptors, architects and writers in his social network (Goetz et al., 1995), but there is little mention of any particular friendships with musicians. However, Charcot did appear to have set aside Thursday evenings for social activities and the appreciation of music, in particular (Daudet, 1915).

Studies of Music Agraphia Before Charcot

Prior to Charcot's investigations in 1883–84, two case descriptions about an acquired difficulty writing music notation (music agraphia) had received attention. In 1867, a German medical student, Alexander Fischer, studied a 42-year-old composer and music teacher as part of his thesis on aphasia (Fischer, 1867). The composer had difficulty reading and writing music notation in addition to word blindness (alexia), aphasia, and verbal agraphia. In 1870, Karl Finkelnburg, a professor of Psychiatry from Bonn, Germany, described an amateur violinist with aphasia and verbal agraphia who also had difficulty reading and writing music notation although he could still play melodies by ear (Finkelnburg, 1870; Duffy and Liles, 1979). The patient died 6 months later, and the autopsy revealed lesions in the right hemisphere, including the anterior gyrus of the 'central lobe' and corpus striatum. Finkelnburg used this case to argue that aphasia may extend beyond speech impairment to include deficits in comprehension, reading, writing, and use of non-verbal symbols, including music. While Fischer's and Finkelnburg's cases each had verbal agraphia and music agraphia, three other cases reported had both verbal aphasia and agraphia but a preserved ability to write music notation (Bouillaud, 1865; Trousseau, 1865; Proust, 1872). All of these cases differ from Charcot's trombone player, presented below, who had music agraphia but without aphasia.

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