The tic douloureux of Alexis Pujol (1739-1804)

Abstract

In 1787, Alexis Pujol (1739-1804) wrote the first monograph exclusively on trigeminal neuralgia which he called "tic douloureux", or painful tic. Although it was not a seminal description, his monograph was a valuable clinical summary that helped his contemporaries make an exact diagnosis, even though it did not offer proven treatments. Unlike most in his day, Pujol adhered to the theory of electricity, seeing it as the vector of information transmission by the nerve. This made him a precursor and put him in a position to propose a novel pathophysiological theory of pain, not yet qualified as neuralgic. His thinking illustrates that, at the dawn of the nineteenth century, a provincial physician working alone was able to make his contribution to building medical knowledge, particularly in the field of neurology. After a brief biography of Pujol, this article will cite from his book to show the relevance of his clinical observations, which are still valuable today. Without omitting the inspiration, he took from his predecessors, this article also mentions the work of those who followed in his footsteps.

Keywords: Alexis Pujol; Dystonia; Facial pain; Painful tic; Tic douloureux; Trigeminal Neuralgia.