Friday, February 26, 2016

1772-1832: Napolian's army surgeon recommended leaches for asthma

Napoleon Bonaparte (1769-1821)
When the American colonists fought for their independence from Britain, the general feeling among most Europeans at the time was that there was no way a disconnected military was going to defeat the greatest military in the world.  Yet it happened.

Perhaps inspired by this, the French began a revolution of their own.

Napoleon Bonaparte was the brilliant politician who became Emperor of France in 1804, thus gaining control of the French military during the later portions of this revolution.  

In order to obtain money to pay for his wars, which were his attempt to gain power for France, but mainly for himself, in 1803 he sold French lands in the Americas to the United States in what would become known as the Louisiana Purchase.  The purchase became known as a brilliant move by President Thomas Jefferson. However, the only reason Bonaparte made the sale was because he had all the intent on taking over the world, which included the United States. So France would end up with the land back anyway.

Broussais was army surgeon under Napoleon,
and he believed the best remedy for all diseases,
including asthma I'm sure, was to cover the entire
body of the patient with leeches.  (1, page 426)
Of course, after his ill fated conquest into Russia, Napoleon, the greatest military general of his time, was defeated and then ousted as Emperor in shame. The French Revolution had failed.

In retrospect, some surmise it failed because, while the founding fathers in the United States fought for the rights of individual men, the French fought for the rights of man, or of the collective.  While fighting for their individual natural and inalienable rights, the American colonists were more inspired to fight.  Whether this was the case may be forever debated.

Regardless, our quest is to determine what life would be like if you had asthma during the Napoleonic Wars?  Well, thanks to his army surgeon Francois Joseph Victor Broussais (1772-1838) chances are pretty good you'd be treated with leeches, and lots of them.

Broussais expounded upon an older doctrine called the "Doctrine of Irritation."  The doctrine stated that "life depends on irritation -- in particular heat -- which excises the channel processes of the body.  Disease, however, depends on localized irritation of some viscus organ, i.e. the heart, or , above all, the stomach and intestines." 

Prior to Broussais disease were often referred to as fevers.  This was no more once Brousais's theory was accepted by society, as he replaced the idea of fevers with the idea of diseases organs.  There were no longer diseases like syphilis,  you simply had a diseased organ instead. 

Pierre-Charles-Alexandre Louis (1787-1872).
He came to the conclusion that there were better
remedies for diseases than leeches.  His analysis
pretty much put an end to bleeding, at least for
pneumonia patients (1, page 428-429)
Instead of trying to find a remedy for specific diseases, such as asthma, the sick, which more than likely would have included the asthmatic, would undergo a "powerful antiphlogistic regime*" which included:
  1. Depriving the person of the proper food
  2. Leeching him all over the body
His remedy was used to such an extent in 1833 alone that some 41,500,000 leeches were imported into France.

His ideas started to fade when Pierre-Charles-Alexandre Louis (1787-1872) realized that the remedy of Broussais failed the many victims of an epidemic of diphtheria, and realized the "necessity of deeper study." 

Perhaps based on the all the blood letting performed as a result of the theories of Broussais, Louis came to the realization that blood letting wasn't as useful as once thought, and he proved that blood letting was of little value in cased of pneumonia.  This pretty much did away with its use for that disease.

Louis was also the first physician since Sir John Floyer to use the pulse watch (invented by Floyer) to monitor the pulse rate of his patients.  He also performed research on pthisis in 1825, based his observations on over 358 dissections and observing 1460 clinical cases.  He thus concluded "good statistics could do away with old theories like Broussais."

The ideas of Broussais, however, faded as "good sense and temperate judgement took over."  Could you imagine if you went to your doctor because you couldn't breathe, only to end up with leeches covering your body? 

*Phlogistic is Greek for inflammation and fevers, according to Merriam-Webster, so the remedies of Broussais were basically to reduce inflammation in a particular organ.

  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1913, 1st edition, Philadelphia and London, W.B. Saunders and Company, page 340-3
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