Progressive muscular atrophy  

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Demonstration of the mechanics of facial expression. Duchenne and an assistant faradize the mimetic muscles of "The Old Man." [1]

Guillaume-Benjamin-Amand Duchenne (de Boulogne) (born September 17, 1806 in Boulogne-sur-Mer; died September 15, 1875 in Paris) was a French neurologist who revived Galvani's research and greatly advanced the science of electrophysiology. The era of modern neurology progressed from Duchenne's understanding of the conductivity of neural pathways, his revelations of the effect of lesions on these structures and his diagnostic innovations including deep tissue biopsy, nerve conduction tests (NCS), and clinical photography.

The biographer Joseph Collins wrote of Duchenne that he found neurology, "a sprawling infant of unknown parentage which he succored to a lusty youth" and although it is Jean-Martin Charcot who many medical historians hold as the father of modern neurology, Charcot owed much to Duchennne, acknowledging him as, "mon maître." Duchenne's greatest contributions were made in the myopathies that immortalize his name, Duchenne Muscular Dystrophy, Duchenne-Aran spinal muscular atrophy, Duchenne-Erb paralysis, Duchenne's disease (Tabes dorsalis), and Duchenne's paralysis (Progressive bulbar palsy). He was the first clinician to practise muscle biopsy, the harvesting of in vivo tissue samples with an invention he called, "l'emporte-pièce" (Duchenne's trocar). In 1855 he established the science of electrotherapy with a textbook titled, De l'electrisation localisée et de son application à la physiologie, à la pathologie et à la thérapeutique. A companion atlas to this work titled, Album de photographies pathologiques, was the first neurology text illustrated by photographs. His monograph, Mécanisme de la physionomie humaine –also illustrated prominently by Duchenne's photographs–was the first study on the physiology of emotion and was seminal to Darwin's later work.

Duchenne's contemporaries appended "de Boulogne" to his name to avoid confusion with the like-sounding name of Edouard Adolphe Duchesne (1804–1869), a popular society physician.

Duchenne's Influence

Darwin's The Expression of the Emotions in Man and Animals, written, in part, as a refutation of Sir Charles Bell's religiously doctrinaire physiognomy, was published in 1872. This book further elaborated on Darwin's theory of evolution by natural selection, visualising the human body as a pathway for genetically determined expressions deriving from purposeful animal actions. Darwin's text carried illustrations drawn from Duchenne's photographs. It is noteworthy, also, that Darwin lent his copy of Duchenne's book to the British psychiatrist James Crichton-Browne in 1869, that Crichton-Browne seems to have lost the book for a year or so (in the West Riding lunatic asylum in Wakefield, Yorkshire) and that Crichton-Browne invited Sir David Ferrier to his asylum laboratory in 1872 to undertake experiments involving the electrical stimulation of motor centres in the brain.

Duchenne's most famous student was Jean-Martin Charcot, who became director of the insane asylum at Salpêtrière during 1862. He adopted Duchenne's procedure of photographic experiments and also believed that it was possible to attain the "truth" through direct observation. He even named an examination room at the asylum after his teacher. Like Duchenne, Charcot sought to chart the gestures and expressions of his patients, believing them to be subject to absolute, mechanistic laws. However, unlike Duchenne, who restricted his experiments to the realm of the sane, Charcot was interested almost exclusively in photographing the expressions of traumatized patients. He is also known for enabling the public to bear witness to these passions, establishing his renowned weekly "theatre of the passions" for the high society of the day to witness the expressions of the insane. Sigmund Freud, who attended Charcot's clinical demonstrations, constructed his life-work, psychoanalysis, through a demolition of Charcot's neurological theory of hysteria.