J. M. Charcot, MD, with Additional Lectures by A. Loomis, MD. Translated by Leigh H. Hunt, MD. New York: William Wood Company, 1881. 280 pp

J. M. Charcot, MD, world-renowned psychiatrist and neurologist, delivered a series of lectures on The Diseases of Old Age in the Salpetriere in 1867. These were translated by Leigh H. Hunt, MD, and published in New York in 1881. Added to the Charcot material were a few lectures written by Alfred Loomis, MD, whopresented these to his classes in Bellevue Hospital in New York. Specifically, the first twentyone lectures (or Chapters), including an introduction, were written by Professor Charcot. The balance of the book (ten chapters) is the work of Professor Loomis. This brief review is intended to remind readers of this pioneering publication and to highlight Charcot’s emphases on certain diseases of old age prevalent at the end of the nineteenth century. Charcot’s concentration on the physical illness of the elderly is particularly striking. In his introduction, Charcot seeks to acquaint his listeners and students “with the general characteristics that distinguish the pathology of old age from that of adults, and to draw attention [to] some of those diseases which are more especially met with in asylums reserved for the aged” (p.1). Charcot points out the profound and radical revolution that occurred in medicine-symptoms, which were considered in an abstract manner apart from the organism, and were intimately connected with the total being. Symptoms were more than organ lesions, i.e., “the cry from suffering organs” (p.3). In contrast to focusing on the entire individual, the past emphasis on symptoms has a similarity to some beliefs of current theoreticians and clinicians. Charcot notes that the ancients considered a disease as independent of the organism, stating that “pathology can be greatly illumined by physiology, but it is just as certain that it cannot be deduced from physiology” (p.3). Understanding mechanisms can illuminate disturbed neurophysiological and biochemical pathways, but these now need to be related to organic and psychological malfunctioning and/or causality. Charcot’s topic still raises unanswered questions over 100 years later. Pathology, physiology, and the neurosciences are advancing rapidly, but their process of evolution and application continues. Charcot further asserts that “we have come to recognize that every disease has its own evolution, a special manner of development, a peculiar series of symptoms which allow a description to be made of it after a common type in the midst of variable, accessory circumstance’’ (p.7). Thus we have the idea of clusters or syndromes based on observation and experience, resulting in our current schemes of nosology. Furthermore, Charcot notes that there are differences between acute (rapid onset and course) and chronic courses which extend over a long period of