Augusta Déjerine-Klumpke (1859-1927)
One of the first female neuropathologists, she revolutionized localization in neurology - but was kicked out of the Salpêtrière after the death of her husband.
In 1883, the young doctor Augusta Klumpke saw a patient with brachial plexus palsy at the Salpêtrière in Paris, France. She had seen this kind of palsy before, but this patient had an unusual finding: miosis of the pupil on the same side as the palsy. She was intrigued.
In the late 1800s, the Salpêtrière was the crucible in which the specialty of neurology was developed. Jean Martin Charcot (1825-1893), the “founder of neurology,” held Tuesday lessons on findings in clinical neurology; Alfred Vulpian (1826-1887), the dean of the Faculty of Medicine, experimented in the laboratory, working toward the discovery of the synapse; Guillaume Duchenne de Boulogne (1806-1875) studied progressive muscular dystrophy and facial expression of emotion.
Klumpke was an American in Paris, born in San Francisco, California, the second of six children. After her parents separated, her mother moved the family to Europe. Her mother encouraged Klumpke’s interest in medicine and the sciences – and fortunately for the multilingual young woman, Paris was the perfect place to study.
While training at the Faculty of Medicine in Paris, she applied for an externship at the l'Hôpital de Lourcine, and for the first time, the institution allowed women to participate. In 1883, she began her work with on palsy involving the brachial plexus, and soon met the child with an unusual lower brachial plexus palsy who would become the basis of years of study. With the mentorship of Vulpian, Klumpke performed neuropathological studies in the laboratory, localizing the lesion to the lower roots of the brachial plexus, and published her work in 1885. The article won the Godard Prize of the Academy of Medicine, and the condition of lower brachial palsy with pupillary involvement became known as Klumpke’s palsy.
In 1888, she married Joseph Jules Déjerine (1849-1917) – a neurologist at the hospital where she studied, and ten years her senior. Together the two became a neurology power couple. Déjerine-Klumpke was particularly skilled at conceptualization, and understanding how pathways fit together in three dimensions. The Déjerines published Anatomie des Centres Nerveux (Anatomy of the Central Nervous System) and Sémiologie des Affections du Système Nerveux (Semiology of the Diseases of the Nervous System) – on which Déjerine-Klumpke is listed as a collaborator, though Déjerine's student Andre-Thomas wrote that she contributed significantly to the work in both illustrations and concepts.
Between the years of 1885-1926, Déjerine-Klumpke published 56 publications on neuroanatomy, including her MD thesis on neuropathy. In 1914, she was elected the first female president of the French Neurological Society.
During this time, the neurologist Pierre Marie (1853-1940) was a fierce competitor of Déjerine. He studied under Charcot; Déjerine, like his wife, was a student of Vulpian. In 1892, Déjerine challenged Marie to a duel over their publications on sensory ataxia – but their seconds managed to calm the men and prevent the duel from occurring. They later competed in a “scientific duel” on the anatomy of aphasia in 1908. In a final coup, Déjerine was selected over Marie as the Chaire de Clinique des Maladies du Système Nerveux (Chair of Nervous System Diseases) at the Salpêtrière, after the death of Fulgence Raymond (1844-1910), who had succeeded Charcot.
When Déjerine died in 1917, Marie finally stepped into the role of Chair. He promptly expelled his rival’s wife from the Salpêtrière, giving her 15 days to leave the institution with all of her husband’s documents and pathological samples. Undaunted, she transferred Déjerine’s collection to the pathology department, and started working as a medical officer in the Hôtel National des Invalides. There she rehabilitated soldiers wounded in the first World War – earning first the French Medal of Honor, and then a promotion to Officer of the Legion of Honor.
With their neurologist daughter, Yvonne Sorrel-Dejerine (1891-1986), Déjerine-Klumpke started a foundation to protect and preserve her husband's work, which you can still find at Jussieu University in Paris.
Déjerine-Klumpke died of breast cancer in 1927, and was buried beside her husband, mother, and younger brother in Paris’s Père Lachaise Cemetery.
Bogousslavsky J. The Klumpke family--memories by Doctor Déjerine, born Augusta Klumpke. Eur Neurol. 2005;53(3):113-20. doi: 10.1159/000085554. Epub 2005 Apr 28. PMID: 15860915.
Essay by Alison Christy, MD, PhD