Lilian Gleave
Cork, Ireland

While some students of Jean-Martin Charcot like Sigmund Freud and Joseph Babinski achieved enduring fame, the legacy of others is just as foundational. In André Brouillet’s 1887 painting A Clinical Lesson at the Salpêtrière,¹ a man stands by the window, his head supported by his hand, lit from behind. Some medical historians assert that figure is Alix Joffroy (1844–1908).²

Joffroy trained at Charcot’s Salpêtrière. He learned histology and pathological anatomy with Alfred Vulpian³ and then studied with Rudolf Virchow in Berlin before returning to Paris at the outbreak of the Franco-Prussian War,⁴ where he served as a medical intern at Lariboisière’s Hospital during the siege of Paris and the subsequent Paris Commune.⁵ He earned his doctorate in 1873; his thesis was “De la pachyméningite cervicale hypertrophique.”⁴ Those early choices set the pattern for a career of careful clinicopathological work.

Joffroy emphasized cellular observation in the study of spinal and bulbar disease. Working with Charcot, he correlated motor symptoms with lesions of anterior horn cells, a line of inquiry that helped distinguish progressive muscular atrophy from other muscle diseases and later advanced the understanding of amyotrophic lateral sclerosis. He applied the same microscope-driven logic to infantile paralysis, labio-glosso-laryngeal syndromes, syringomyelia, and peripheral neuritis.³ Those studies argued that nerve cell lesions are primary and that anatomy explains clinical patterns.

Joffroy also described clinical signs that once carried his name. Textbooks record Joffroy’s sign: absent forehead wrinkling on up-gaze in patients with thyroid ophthalmopathy.⁴ These bedside maneuvers are less often taught now,³ but they show a clinician who translated histology into clear, testable bedside observations.

After Charcot’s death, Joffroy took important academic roles.⁴ He worked at the Salpêtrière,³ became professor of pathological anatomy,³ founded an experimental psychology laboratory⁴ in the late 1890s, published widely, and chaired major medical societies in Paris (serving as founding president of the Society of Neurology of Paris, for example).³ He served as a bridge between neuropathology and neuropsychiatry.

Seen in Brouillet’s painting,¹ Joffroy’s posture reads like a pathologist at work: a scientist who pauses between microscopic inquiry and macroscopic observation. That pause contains a lifetime of careful dissections, of linking cell to symptom, and of insisting that visible lesions explain the speaking body.

References

1. Brouillet, André. Une leçon clinique à la Salpêtrière. 1887. Painting.
2. Harris, J. C. “A Clinical Lesson at the Salpêtrière.” Archives of General Psychiatry 62, no. 5 (2005): 470–472. https://doi.org/10.1001/archpsyc.62.5.470
3. Tiberghien, Dominique. “A Pioneer in Neuropathology: Alix Joffroy (1844–1908), J.-M. Charcot’s Pupil.” Neuromuscular Disorders: NMD 20, no. 3 (2010): 207–213. https://doi.org/10.1016/j.nmd.2009.10.004
4. Teive, H. A. G., Coutinho, L., Germiniani, F. M. B., Camargo, C. H. F., & Walusinski, O. Alix Joffroy (1844-1908). Journal of neurology, 272(7), 470. (2025). https://doi.org/10.1007/s00415-025-13198-7
5. Tiberghien, Dominique. “The Letters of Alix Joffroy (1844–1908), a Medical Intern at Lariboisière’s Hospital at the Time of the Commune of Paris.” Journal of Medical Biography 24, no. 1 (2014): 76–84. https://doi.org/10.1177/0967772013513102