[Success and Failure during Three Centuries of Charcot's Clinical Neuropathology: From Amyotrophic Lateral Sclerosis...

Clinical neuropathology was advanced by Charcot at la Salpêtrière Hospital in the 19th century. The lower and upper motor signs of amyotrophic lateral sclerosis were corroborated at autopsy by degeneration of the anterior horns and lateral columns, respectively. The redefinition of paralysis agitans as Parkinson's disease was substantiated in the 20th century through a series of pathological, biochemical, and genetic studies that provided definitive, museum-like evidence of neurological diseases. In contrast to these scientific achievements, the phenomenology of hysteria was publicly evaluated and recognized in front of the audiences that included non-medical professionals. This theater-like format, which encouraged interaction between patients and spectators, might have influenced the clinical presentation of hysteria and complicated its interpretation. Contrary to Charcot's expectations, attempts to identify the causative lesions of hysteria were unsuccessful. Paradoxically, however, this failure paved the way for the development of dynamic psychiatry by Freud and Janet, and later, the conceptualization of functional neurological disorders in the 21st century.