Jean-Martin Charcot and the Clinical Foundations of Amyotrophic Lateral Sclerosis: A Historical Case Revisited

This article revisits an original case of bulbar-onset amyotrophic lateral sclerosis (ALS) recorded by Jean-Martin Charcot in 1877-78, highlighting his clinical methodology and its enduring significance. The case of Eugénie Florentine P., a 62-year-old patient at the Salpêtrière, illustrates Charcot's rigorous approach: precise observation of clinical signs, longitudinal documentation of disease progression, and anatomoclinical correlation confirmed by autopsy findings. Charcot identified the combined role of anterior horn and lateral column lesions, establishing ALS as a distinct nosological entity. While predecessors such as Aran, Cruveilhier, and Duchenne contributed key observations, Charcot synthesized clinical and pathological data to define the disease later known as "Charcot's disease." This historical perspective underscores the lasting value of bedside examination in an era dominated by neuroimaging and biomarkers. By comparing 19th-century clinical reasoning with current diagnostic and therapeutic challenges, the article demonstrates how Charcot's work continues to inform the modern multidisciplinary management of ALS.