Jean-Martin Charcot (1825-1893) described an ailment first known as Charcot's fever in 1877. His original description mentioned recurrent episodes of dull or colicky pains in the right hypochondrium, accompanied by chills and hyperthermia (1). Over the years, Charcot's fever was renamed Charcot's triad, consisting of fever, right upper quadrant pain and jaundice and described patients suffering from cholangitis. In clinical practice, only 25% of patients with common duct stones exhibit all three symptoms (2).
Charcot is known as the father of Neurology and spend most of his life researching hysteria and was one of the first physicians to suggest that this syndrome was caused by degenerative brain disease. He trained many greats in the fields of neurology and psychiatry, including Sigmund Freud. In fact, there are two Charcot's triads in the medical literature. The second triad consists of nystagmus, intention tremor, and scanning or staccato speech and describes Multiple Sclerosis. Charcot's other contributions include Charcot's joint and Charcot-Marie Tooth disease.
Reynold's pentad consists of charcot's triad, but adds hypotension and mental status changes. This addition refers to symptoms of sepsis from cholangitis (3). Although Reynold's pentad is seen in only 14% of patients with common duct stones (4), the inclusion of hypotension and mental status changes is an important reminder that cholangitis is a systemic disease that can frequently result in sepsis.
(1) Charcot JM: Lecons sur les maladies du foie des voices bilars et des reins. Faculte de Medicine de Paris. Recueillies et publiees par Bournville et Sevestre, 1877.
(4) Boey JH, Way LW: Acute cholangitis. Ann Surg 191:264-270, 1980.