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A note on Pierre Marie (1853–1940)
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  1. J M S Pearce
  1. 304 Beverley Road, Analby, HULL HU10 7BG, UK; jmspearcefreenet.co.uk

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    It is perhaps a reflection of the great pace of medical advance in the 19th and early 20th century that Charcot, Gowers, Foix, Parkes Weber, and others had so many diseases to commemorate their names. Much has been written about the merits and drawbacks of eponyms1 but the habit lingers. For assiduous collators, one of the most impressive lists attributed to a single individual is associated with Pierre Marie.

    Pierre Marie was born of a wealthy Parisian family. He attended a boarding school in Vauves. Under coercion from his father he read law before deciding on a medical career. He became an intern in 1878 and under the spell of Charcot soon developed an interest in nervous diseases at the Salpêtrière and Bicêtre. An outstanding student, he worked as special clinical assistant. In 1883 he received his doctorate with a dissertation on Basedow’s disease, which included his observations on static tremor of the outstretched arms in hyperthyroidism. He described the neurological sequelae of exanthemata, including neurological symptoms complicating smallpox, which he attributed to insular sclerosis (multiple sclerosis), which we would recognise as post-infective encephalomyelitis. He was promoted to agrégé at the Paris Faculty of Medicine in 1889 where he delivered a remarkable series of lectures on diseases of the spinal cord,3 published in 1892, that included a comprehensive account of amyotrophic lateral sclerosis and tabes. Pierre Marie published pathological studies in two acromegalic patients in 1886,4 establishing its clinicopathological status5 to which his name is linked; he mentioned Saucerotte’s earlier report.

    He was also, with Charcot and Tooth,6 the first to define familial peroneal muscular atrophy (HMSN)7 in 1886; pulmonary hypertrophic osteoarthropathy8 (Marie–Bamberger disease); cerebellar heredo ataxia9; cleidocranial dysostosis; and ankylosing spondylitis,10 originally reported by Strümpell (1884) and Bechterev, and known as Marie Strümpell disease.

    In 1897 Marie was appointed to the Hospice de Bicêtre, where he instigated a neurological service of international repute. There, he critically studied the aphasiacs (L’évolution du langage considéré au point de vue de l’étude de l’Aphasie, 1897) and was opposed to the views both of Broca (1824–1880) and Wernicke (1848–1905) on the localisation of speech. In a crushing critique he assailed the work of Broca, under the provocative title of The third left frontal convolution has no special role in the function of language. Re-examining Broca’s original specimen, he showed that the lesion extended considerably beyond Broca’s area. His three papers on aphasia appeared in 1906 in Semaine Médicale. This controversy provoked three designated sessions of the Société Française de Neurologie de Paris convened in 1908 to debate the arguments.

    However, his work on aphasia dwindled after he obtained, in 1907, the Chair of Pathological Anatomy. Charles Foix continued it until his early death aged 45. Marie devoted his energies to advancing both pathology and its teaching, greatly helped by Gustave Roussy, who would succeed him. Not until 1918, aged 64, was Marie appointed to Charcot’s Chair of Neurology at Salpêtrière, recently occupied by Fulgence Raymond, Édouard Brissaud, and Joseph Jules Dejerine. But the first world war had taken its toll. Laboratory facilities had not been maintained. The neurologists of the Charcot school had been preoccupied by the investigation and treatment of war injuries. Not surprisingly, Marie’s original work declined, but his Neurologie two volumes, 1923, was deservedly admired.

    A brilliant clinician rooted firmly in the tradition of Charcot, Marie was an outstanding, demanding teacher, yet courteous and dignified. Percival Bailey11 described him “at his best in clinical consultation in which his discussions were short and pithy; his teaching was simple, clear, with plain exposition”.

    Although he received many honours Marie was a private man of independent means. He avoided publicity but remained involved in Revue Neurologique, which he had founded in 1893 with Brissaud, and the Société Française de Neurologie, which he had served as first secretary. He was a member of the Académie de Médecine. After resigning his chair in 1925, aged 72, he retired to his estate on the Côte d’Azur where he wrote Travaux et mémoires, 1926 and 1928.

    But his life was saddened by the death of his wife from erysipelas and his only son from botulism contracted at work in the Pasteur Institute. After this, he lived a solitary existence and died aged 86.

    References

    Footnotes

    • Hyperthyroidism, goitre, and exophthalmos were first described by the English physician Caleb Hillier Parry in 1786 and 1815, but are named in Europe after Carl Adolph von Basedow whose report was in 1840, and in England after Robert Graves 1835.(See ref 2))