The Man Behind the Eponym Tourette Syndrome

Georges Albert Eduardo Brutus Gilles de la Tourette, a French neurologist was born on October 30, 1857 in a place called Saint-Gervais-les-Trois-Clochers in France. Gilles was the eldest among four children. There was no enough documentation to describe how Gilles was in his early childhood. But reports said that Gilles started his education where he was already known to be an exceptionally talented young student.

In as early as 16 years of age, Gilles started his medical education in Poitiers, France. He continued this in Paris in Salpêtrière Hospital where he became a student, secretary and in-house physician of his professor and mentor, Jean- Martin Charcot. Charcot was impressed by Gille’s intelligence so he helped Gilles in so many ways. Since 1884, Gilles had been exposed to Charcot’s work. And at this time, Charcot had begun his studies about hypnosis and hysteria, a complex neurosis that can take in many forms (J.P Chaplin,1985). Charcot used the technique of hypnosis to study the symptoms of his patients. Gilles soon became the consultant physician of Charcot and his primary work for Charcot was to instruct and prepare the patients for public presentations. Gilles’ interest in the subject of neurology grew more and more and had been even influenced by Charcot so much that Gilles started to publish articles about Charcot’s field of interest which were hypnosis and hysteria, one of which is a documentation of Charcot’s theories. Charcot’s marked success also became one huge accomplishment for Gilles as he became a contributor to Charcot’s work that became widely known throughout Europe. Sigmund Freud even became a part of his sector at that time.

1885, when Gilles became the permanent instructor of forensic medicine, this year also became the start of the research for Tourette syndrome.
Early encounters with Tourette syndrome had been reported in 1825 by Itard who was also a French physician and educationalist. He reported a very peculiar behavior of a French woman called the Marquise de Dampière. The behavior included strange body movements accompanied by echolalia or the repetition of words or phrases (J.P. Chaplin, 1985) and coprolalia or obsessive use of obscene words (J.P. Chaplin, 1985). After Itard’s death, 60 years later, Gilles de la Tourette published a study called “Étude sur une affection nerveuse caracterisée par l'incoordination motrice accompagnée d'écholalie et de coprolalie' or the disorder of the nervous system characterized by motor incoordination in combination with echolalia and coprolalia according to the archives of neurology in France. This was the publication that documented the behavior of Marquise de Dampière and eight other similar cases which he called 'Maladie des Tics'. Because of his careful study of motor disorders since 1881, he was the first one to understand the connections between the various manifestations of the symptoms described in his publication. And in honor of this understanding, Charcot who was the director of the Salpêtrière Hospital, named the disorder after Gilles and so the eponym Gilles de la Tourette came about.

After his published work in 1885 about Tourette syndrome, he was awarded Godard Award the next year because of his thesis that found a neurological diagnosis by analyzing the patient’s footprints.

The following years became much more satisfying for Dr. Tourette when Charcot appointed him to be the chief physician. His duties included developing new therapies and making them suitable for practice, teaching medical students, managing the wards in the hospital and publishing articles in the medical journals. He also had various interests beyond the medical field when he became the literary critic of a weekly newspaper. Gilles undoubtedly had very fruitful practice as a doctor in neurology but settling down and having a family of his own were not far away from his plans. During the same year, he was married to his cousin who was ten years younger than him and with whom he had four children, two sons and two daughters.

Dr. Gilles de la Tourette could have gone a lot better in terms of his practice and contributions as a neurologist in France. But because of his reported shortcomings, the years thereafter provided no significant accomplishments for Dr. Tourette as he became so intensely absorb in only the things he was interested in specifically neurological disorders that lead him to overlook at some of the other important things to consider in his practice like neurological pathologies and experiences in other clinical cases which are also pertinent to his practice. Historical reports say that he became so critical which prevented him from gaining friends over the years. Despite this, he continued his work as a regular lecturer and chief physician under Charcot in the Salpêtrière Hospital.

In 1893 Gilles had experienced the most poignant times of his life when his son died because of meningitis followed by his mentor Jean- Martin Charcot to acute lung edema or a disease marked by excessive fluid volume in the lungs. Subsequently, during the same year Gilles was shot at the back of his head by a former female patient at Salpêtrière who alleged that Gilles had hypnotized her which caused her to lose her mental state. This was investigated and it was found out that the woman had been suffering from what we now call paranoid schizophrenia. It was then reported that hypnosis was not the cause of her loose mental state. The woman was treated at St. Anne in Paris and died in the hospital of St. Rémy at the age of 92. With Gilles’ wound at the back of the head, it was found out that it was only superficial. A surgeon by the name of Pierre Delbet treated him and Dr. Tourette recovered completely from it.

After that terrible year, Gilles de la Tourette continued his work in neurology and published two more volumes about hysteria. And in 1899, he changed his assumption that Tourette syndrome would result in mental illness in a person’s later life. The change in opinion was influenced by an associate named Louis Guinon. With Gilles’ determination and perseverance that despite his shortcomings with his behavior, he once again proved to other medical professionals that he was really an extraordinary and very talented physician. More years added to his accomplishments when he was appointed chief official physician of the world exhibition in Paris 1900 and was awarded “Honorary Officer of the Legion”.

Later on, Gilles’ health declined. In the year 1901, his health was forced to be criticized in the hospital. Although, historical resources knew little about what could really be Dr. Tourette’s disease, his disease had caused him to be more and more incoherent which left him psychotic for the remaining years of his life. Later on, neurological examinations revealed a diagnosis of paretic neurosyphilis, also known as general paresis or a disease of the central nervous system that begins with gradual loss of cognitive functions that leads to personality changes and eventually dementia. The disease involved many psychotic manifestations. He died at the age of 46 and was remembered by fellow colleagues as one of the most talented and assiduous physicians in Salpêtrière Hospital.With the development of Tourette syndrome later after his death, there were only 50 more cases of the disorder being documented between the years 1885- 1965. Because of this, physicians became skeptical of the disorder’s existence. But in 1978, there were four scientists in New York who reported 485 cases of Tourette Syndrome which they called “Gilles de la Tourette Syndrome”. Included in the study were intensive descriptions of 250 examination results and very detailed studies of 145 patients. Because of this breakthrough in Tourette syndrome research, interests concerning the disorder were raised up again and Hermann Krämer even mentioned that the new American behavioral neurologists embraced Dr. Gilles de la Tourette works and saw that the paradigm in this illness is the connection between the movement and the emotion.