Romanian Journal of Morphology and Embryology 2008, 49(2):263–269 IN MEMORIAM BABINSKI, histologist and anatomo-pathologist J. POIRIER Faculty of Medicine Pitié-Salpêtrière, University Pierre and Marie Curie – Paris VI, Paris, France Abstract Joseph Babinski (1857–1932), a French neurologist of Polish origin, médecin des hôpitaux de Paris, is well known for the discovery of the Sign (the toes phenomenon) which bears his name. Beyond the Sign, his semiological work in the field of neurology is also important (particularly cutaneous and osteo-tendinous reflexes, cerebellar and vestibular semiology, hysteria and pithiatism) as well as his role in the birth of the French neurosurgery. On the contrary, the implication of Babinski in pathological anatomy and histology is usually unrecognized. However, in the beginning of his career, Babinski worked as an Interne in the clinical departments of Victor Cornil (1837–1908), professor of pathological anatomy and president of the Société d’Anatomie de Paris, Alfred Vulpian (1826–1887), past professor of pathological anatomy and then professor of experimental physiology, and in the laboratory of Louis Ranvier (1835–1922), professor of general anatomy at the Collège de France. Babinski beacame préparateur at the chair of pathological anatomy, member then treasurer of the Société Anatomique, member of the Société de Biologie. He reported on several clinico-pathological observations of general pathology (liver cirrhosis, cancer of the kidney, cancer of a buttock, squamous epithelioma, tuberculosis, multiple cysts of the liver and the kidneys, bowel occlusion), of neuropathology (embolic brain softenings, hydatic cysts of the brain, multiple sclerosis, spinal cord combined sclerosis, tabetic arthropathies, adiposo-genital syndrome due to a pituitary tumor) and of human neuro-muscular histology (neuro-muscular spindles, muscular histology after nerve sectioning, diphtheria paralysis, peripheral neuritis). Keywords: History of Medicine, Histology, Pathological Anatomy, Babinski. The celebrity of Joseph Babinski (1857–1932) [1] At the beginning of his career, during the fourth is principally due to his discovery in 1896 of the toe years of his internat (1880–1885), Babinski appeared as phenomenon, later known as the Babinski reflex or a future anatomo-pathologist and histologist. However, Babinski sign. after his meeting with Charcot, during his clinicat, French neurologist from Polish origin, he was, due to an unforeseeable concourse of circumstances, during two years (1885–1887), chef de clinique at the Babinski gave up histology and pathologic anatomy, Clinique des maladies du système nerveux, headed by and preferred the study of the living to that of the Jean-Martin Charcot (1825–1893) at the Salpêtrière dead [2]. Then he became a pure clinician and he no Hospital. Babinski was promoted médecin des hôpitaux more put his eyes on the ocular of a microscope [3]. de Paris in 1890, and was head of a Medical He left the histopathological work to two disciples, Department at La Pitié Hospital from 1895 to his Jumentié and mainly Nageotte. Henceforth, his credo retirement in 1922. and only goal was to make clinical distinction between In addition to the Sign, Babinski produced many organic and hysteric disorders, which resulted in a real important contributions to neurological switch in his career. symptomatology, essentially with regard to cutaneous and osteo-tendinous reflexes, precise localization of The three masters of Babinski in spinal cord compression, cerebellar (asynergy, pathological anatomy and in histology adiadochokinesia, hypermetria, cerebellar catalepsia) and vestibular signs. He also proposed a new concept of Three highly charismatic personalities surrounded hysteria under the term of pithiatism. the histological and anatomo-pathological period of the Several syndromes were termed according to his Babinski’s career (i.e. during his internat): Victor name such as the Babinski–Frölich, Anton–Babinski, Cornil, Alfred Vulpian and, more indirectly, Louis Babinski–Nageotte, Babinski–Vaquez syndromes. Ranvier. Four institutions were daily attended by He also was the main initiator of French Babinski: hospital, the chair of Pathological Anatomy of neurosurgery, by stimulating and supporting the two the Faculty of Medicine (head Professor Cornil), the pioneers of this new discipline: his closest disciple Société Anatomique de Paris (President Cornil) and the Clovis Vincent (1879–1947) and his friend Thierry de Collège de France (where Ranvier was head of the chair Martel (1875–1940). of General Anatomy). On the other hand, he did not On the other hand, his contribution to anatomo- attend the chair of Histology of the Faculty of Medicine, pathology and histology is often ignored, although it founded in 1862 for Charles Robin (1821–1885), and deserves attention and is far from to be neglected. headed by Mathias Duval (1844–1907) since 1886. 264 J. Poirier Victor Cornil (1837–1908) presidency, Charcot spoke highly of Cornil: “Aren’t you, in this pathological-anatomical beautiful science Victor Cornil [4] had a double brilliant career as a that you love with a true passion and that you have famous physician and as a Republican politician close to enriched with so many first-rate papers, aren’t you one the Left wing. The oldest interne of Charcot, Victor of our initiators, one of our great masters in pathological Cornil was médecin des hôpitaux (1869), head of histology, one of those finally that we can rightly department at La Pitié Hospital (1881) and professor of become proud of in front of foreigners” [8]. Pathological Anatomy. He succeeded to Charcot when On the other hand, Cornil occupied many political Charcot occupied the chaire de Clinique des maladies functions as Deputy, Senator, Mayor, Prefect and du système nerveux created for him in 1882. General-Councilor. He was a Republican, at the Left The Progrès Médical, a weekly paper directed by wing, and became President of the Ligue républicaine Désiré Bourneville (1840–1909), close disciple of du VIè arrondissement during the Commune de Paris Charcot, supporter of scientific medicine and defender (May 1871). He also was a member of the French of pathological anatomy, advocated Cornil’s work. Public Health Committee, and was Chevalier, then The great clarity of his lessons was emphasized, as well Officier, of the Légion d’honneur. as their modernity. By example, when Paris was In addition to be a teacher and a politic man, Victor affected by cholera in 1884, he introduced in his lessons Cornil had a remarkable personality, which certainly the state of the art concerning the Vibrio cholerae from made a profound impression on his interne Babinski. the works of Robert Koch. In his teaching, Victor Cornil used to start the lectures by the description of normal Alfred Vulpian (1826–1887) anatomy then normal histology of the organs before During the third year of his internat, Babinski showing the lesions, macroscopically and worked in the department of Vulpian. Alfred Vulpian microscopically, to the students. Therefore, during his [9] began his medical studies under the influence of lessons, he used drawings, schemas and projections of Pierre Flourens (1794–1867), professor at the Muséum. slides (by oxhydric light lanterns). In addition, each He was promoted médecin des hôpitaux (1857) and morning, in his department at the Pitié Hospital, he head of the chair of Pathological Anatomy (1866) where performed one autopsy and commented the lesions for he succeeded to Jean Cruveilhier (1791–1874) and will the students. Students could also undertake post-mortem be later succeeded by Charcot. examination, under the direction of the professor. In 1862, at the same time than Charcot, he was Moreover, once a week, in his laboratory, the students promoted Head of department at the Salpêtrière. were allowed to microscopically examine the lesions, Vulpian, like Cornil and many other famous physicians which have been presented during the theoretical at that time, was work-addict, and his life has been lessons. Cornil was fond of autopsies and entirely devoted to science and query of scientific truth. histopathology. Though slightly occulted by the glory of his friend Work-addict, he published many papers and, in Charcot and of his pupil Dejerine, his works are worthy collaboration with Ranvier, a Manuel d’histologie in the field of clinical-anatomy, physiology and pathologique [5], “a marvelous and clear condensation physiopathology of the nervous system. He was of his observations” [6]. At the chair of Pathological appointed Dean of the Faculty of Medicine of Paris Anatomy, under the authority of the professor Victor (1875–1881). Cornil, there were the chef des travaux (Albert Gombault, during many years), some préparateurs and Louis Ranvier (1835–1922) sometimes some moniteurs. Though not directly affiliated with the Collège de During his two last years of his internat (1883–1884 and 1884–1885), Babinski was préparateur, France, Babinski frequently met Louis Ranvier and position that he left when he became the chef de mainly Nageotte. His friend Suchard was préparateur de cours and his intimate friend Jean Darier répétiteur clinique of Charcot. The Romanian physician Victor Babès (1854–1926), for Ranvier. former professor of Pathological Histology at the Born in Lyon, where he started his medical studies, Louis Ranvier [10] became interne des hôpitaux de University of Budapest, then professor of Pathological Anatomy and Bacteriology at Bucharest,