[Should we still publish in French?].
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France↗
Biomedical subjects
Gabriel Richet
Publications and source records attributed to Gabriel Richet.
[Linking of blood urea and renal diseases].
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History, 19th Century↗
Constructing clinical science.
Clinical practice became clinical science in the years 1720-1820. There were many reasons for this transformation. The discoveries by Santorio Santorio, William Harvey, Marcello Malpighi, Giovanni Alfonso Borelli, Lorenzo Bellini, Thomas Sydenham, Giovanni Maria Lancisi, were perceived by students who asked for changes in the medical curriculum. In 1761 Morgagni centered the study of diseases on morbid anatomy, a way to control at autopsy the validity of diagnosis. J.P. Frank who worked on public health and John Locke who supported a method of scientific reasoning based on asking questions were also instrumental for changes. Hospitals, formerly hospices for the poor, became places for curing and healing. Military hospitals represented models to be followed. In Vienna Marie Therese inaugurated the Allegemein Krankenhaus in 1785. In revolutionary France Fourcroy with the law Frimaire An III, 1794 gave a new rationale. Medicine and surgery were unified in the curriculum. Basic sciences were introduced. Dissection became compulsory, practical teaching became the rule. But it was with John Hunter, Domenico Cotugno and P. Joseph Desault that the great advancement was achieved. They were anatomists and therefore they made the knowledge of human body the core of medical curriculum. However experimentation on animals, as well as practical bedside teaching at the hospital also became important. Through their work hospitals and universities were associated in a common goal.
Anatomy↗
Nephrolithiasis at the turn of the 18th to 19th centuries: biochemical disturbances. A genuine cascade giving rise to clinical chemistry.
This report will discuss the relationship between urinary calculi, urine composition and urinary sediment and the link to chemistry unveiled during the years 1775-1840. It was by this interconnection that physicians, who were also chemists, introduced some basic sciences into medicine particularly in studying normal and diseased metabolism. The chemistry of urinary stones definitely influenced the progress of medicine in the post-Enlightment period. "We would probably still not have chemistry, botany, or anatomy had not physicians studied and taught them." G. Cuvier Report on Natural Sciences, Paris 1980.
Chemistry, Clinical↗
[Dark cells: from morphology to function].
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Animals↗
[Rayer's studies on the contagion of glanders (1837-1843)].
P. Rayer (1795-1867) had never thoroughly published his experimental studies on the contagion of glanders. His recently un-earthed hand written papers allow us to depict his experimental approach and its results. He was not the first who transmitted glanders from a patient to horses or donkeys. But he did it systematically with glander secretions from acute and chronic cases. Whatever was the disease of the donors the transmitted forms were unpredictably either chronic or acute. His conclusion was that the two forms were two symptomatic aspects of a unique disease. Clinically dormant states were shown to be also contagious. He demonstrated it through deliberately altering healthy and sick horses inside the stable and by using saddles, bridles and brushes of sick horses on healthy ones. Moreover he excluded other causative factors tentatively proposed, peculiarly food products. The systematically logical and rigorous experimental approach used by Rayer for this research is a mile stone, 30 years before Pasteur. This methodology is still nowadays used to study the epidemiology of diseases such as Prion Diseases, Mad Cow for instance.
Animals↗
[Bonaparte's expedition in Egypt].
Bonaparte's expedition in Egypt was not only a military operation. It was also a tentative colonial move which was used as a model for over a century as well as a cultural and scientific adventure, quite unique for its time. The evacuation of the Oriental Army stands as a milestone in the history of civilisations because the protocols which marked its achievement - to which Desgenettes and Larrey contributed-displayed outstanding humanitarian and medical dimensions. The humanitarian dimension is highlighted by the remarkable contribution of the British Authorities in taking care of the wounded, sick and disabled as well as in ensuring that the French troops safely got home or dealing with the various civilian people not following the army back to France. These agreements between belligerents clearly anticipated what became, 63 years later, the cornerstone of the Red Cross. The medical dimension is illustrated with all the sanitary measures which were taken in order to keep away from any risk of plague epidemics which were rightly feared at the time. Scurvy was also an issue. Although Lind had stated its "deficiency" characteristic 50 years earlier scurvy was still considered as an infectious and contagious disease. Not surprisingly the remarkable 3000 case study made by Larrey, which undoubtedly led up to the conclusion that the disease stemmed exclusively from nutritional deficiencies, had been almost neglected.
Altruism↗
Pierre-Joseph Desault (1738-1795)--a forerunner of modern medical teaching.
Pierre-Joseph Desault (1738-1795) was the first French professor of clinical surgery. He was chief surgeon at La Charité and Hôtel-Dieu in Paris, where he developed a new method for teaching anatomy and modified the teaching of surgery. His fame was due to his dedication and to the number and quality of fellows, who included Bichat, Louis, Corvisart, Dupuytren, Percy, Richerand, Petit, Chopart, and Gavard. He taught while performing surgery, and his school included up to six hundred fellows at a time, practicing in the 1200-bed Hôtel-Dieu. He "imprinted" his pupils with his professional teaching, his surgical procedures and his personal charm.
Anatomy↗
P.J. Desault and the birth of nephrology (between 1785 and 1795).
Desault's genius and methods opened up a field: the medical diseases of the urinary tract. Though he was a surgeon and therefore an anatomically based clinician, his most important contributions were in renal pathophysiology: separation of diseases regarding the formation of urine from those regarding the excretion; comparison of anuria with urine retention; polyuria of atrophic kidney; fatal dehydration due to polyuria in diabetic patients; oligo anuria following excess waterloss from the gut, the lungs...etc. In the last two conditions the kidneys might look normal and therefore might be presumed healthy. If Desault's work had survived this physiological eruption into renal disorders would have been a definitive step of modern nephrology. From a historical point of view, one could suspect that Bichat shifted from anatomy and surgery to medicine and physiology after having posthumously compiled and edited the Desault's book, "Traité des Maladies des voies urinaires".
France↗
[The discovery of anaphylaxis, a brief but triumphant encounter of two physiologists (1902)].
In 1901, during one of his oceanography cruises, Prince Albert the First of Monaco asks Paul Portier and Charles Richet to study the toxicity of small jellyfish fishing filaments (Coelentera). In the course of their work on the effects of a hypnotoxin extracted from various coelentera, they observe mortal accidents that are not a function of the dosage of the injections. Dogs that respond this way have all received a preparative injection, yet some dogs have no reaction to a second injection. In contrast the injection are activating when they occur more than 10 to 12 days after the first. This phenomenon is independent of the administered dosage, which may well be inferior to a toxic quantity. They call this phenomenon anaphylaxis, the contrary of protection, and analyze its primary characteristics. Paul Portier eventually returns to the Faculty of Sciences where he is Dastre's assistant. Charles Richer pursues research on anaphylaxis on his own in his laboratory at the Medical Faculty. By showing that an immune response could be pathogen as well as healing, these two scientists - who did not know each other before, working together for a few short months - made a discovery that opened up new venues in the growing field of medical immunology.
Anaphylaxis↗
[The life and times of Charles Richet].
In 1913 Charles Richet received the Nobel Prize of Medicine and Physiology for his work on anaphylaxis, which he discovered with Paul Portier in 1902. The 335 letters received by Charles Richet shortly thereafter shed some light on his position in the European world at the time. In the field of biomedical sciences, he distinguished himself with his constant determination to blend physiology, and clinical studies, which irritated the fundamentalists and clinicians at the time; The circumspection of the latter in regard to anaphylaxis is evident in their letters. For wasn't anaphylaxis an experimental pathogen occurence, devoid obvious clinical correlations, in comparison to Pasteur's immunology with its serums and vaccinations, firmly relevant to modern medicine? An abundant non-biological correspondence arrived from various horizons-cultural, literary, metapsychistnatalist, pacifist, as well as those concerned with civil justice and civil liberties, the Intellectuals. Strangely, Charles Richet, who was actively engaged in such struggles, is barely mentioned in the index of recent works devoted to the role played by these Intellectuals. Was Charles not an Intellectual? Or has the expression come to mean something different today?
Anaphylaxis↗
[The translation of Diseases of the Artisans by B. Ramazzini, key of the clinical training of the Fourcroy decree in 1794].
In his decree of 1794, Fourcroy renewed the medical education of the medicine students as he introduced their participation in the hospitals. Why did he intervene in the clinical education of medicine students as he was a lawmaker and skilled in chemistry? Actually he had been influenced by the book - Essays about the illnesses of Craftmen - written in 1702 by Ramazzini from Padoue he translated in 1777. Not only did he translate the text but he completed the whole through the experience of the 18th century got in the clinical, physiological and chemical domains according to the scientfic mind of the "Grande Encyclopédie". Thus it was the introduction of science in clinical domain as Corvisart was appointed in Cardiology by Fourcroy at the start of the new School of Medicine in 1804.
Chemistry↗
The build-up of clinical science.
In the years 1720-1820 medicine changed from an art into a science. The slow construction of clinical science, a process still to be completed, has many founding fathers. Here the transition is analyzed through the biographic studies of John Hunter (1728-1793), Domenico Cotugno (1736-1824) and Pierre Joseph Desault (1738-1795) who respectively taught in London, Naples and Paris. Because of their scientific stature they were able to plan, build and foresee the impact of these changes.
Education, Medical↗
Bilateral nephrectomy in the 19th century. Uremic toxicity: from urea to potassium.
The paper describes potassium toxicity as it emerged in the 19th century following the studies of J.N. Comhaire (1778-1837), to these of V. Feltz (1835-1893) and F. Ritter (1837-1884).
Animals↗