BICHAT
Marie François-Xavier Bichat was born on November 11, 1771, at Thoirette, France, in the Department of the Jura. His father, who was a practicing physician at the neighboring town of Poncin, and who at the same time held the office of mayor, was a man of considerable cultivation. Cherishing, as he did, the hope that his son might eventually adopt medicine as his vocation, he planned the latter’s education with special reference to this possibility; and, as medicine proved to be the very vocation which the son preferred, all this well-planned training counted as so much valuable time gained. François, who showed himself to be an apt scholar, made most satisfactory progress in all the prescribed studies of early boyhood, and after passing creditably through the regular course of the Collège de Nantua, a thriving town among the western foot-hills of the Jura range of mountains, he began the study of medicine at Lyons, in 1791. At first he devoted himself almost exclusively to anatomy and surgery. Marc-Antoine Petit, the celebrated surgeon of the Hôtel-Dieu of Lyons, was his teacher in these branches of medical science, and from the very first took special pains to aid his pupil in his studies in every possible manner. François manifested an unusual degree of interest in anatomy, a branch of medical science to which at that period only those who had the intention of practicing surgery paid any attention; and in addition he developed, almost at the very start, a strong disposition to learn the precise purpose of each tissue and organ as it was encountered in the course of his dissections. In other words, François-Xavier Bichat was already, at the early age of twenty, making original investigations in the department of physiology. This fact, says his biographer, should be classed as something very remarkable, for, at the period which we are now considering, practically not one of the students of medicine was giving any thought except to the wonderful surgical work that had been accomplished, a few years earlier, by the famous Parisian surgeon, J. L. Petit (1674–1750), by F. de Lapeyronie of Montpellier (1678–1747), by S. F. Morand of Paris (1697–1793), by the famous lithotomist, Frère Côme (1703–1781), of whose achievements I gave a brief account in “The Growth of Medicine,” and by another celebrated teacher of surgery in Paris, viz., Pierre-Joseph Desault, who, during the period which we are now considering occupied by far the most conspicuous position among the men classed as healers of disease, and who, by the very prominence of his position, compelled almost everybody who took any interest in medicine to keep their eyes riveted on him. These and other circumstances that happened to exist at that period strongly favored among the younger men a leaning toward the career of surgeon. One of these favoring circumstances was the need of army surgeons, for France was in the throes of the French Revolution. It was therefore not strange that at first Bichat devoted the greater part of his time and thought to the fundamental work of a surgeon’s training. A little later he accepted a subordinate position at the Hôtel-Dieu of Lyons, under Marc-Antoine Petit, the head surgeon of that great hospital. Favored in every legitimate way by this eminent and most kindly surgeon, young Bichat made rapid progress. But there arrived a time, shortly after the siege of Lyons, when it was no longer safe for a young man to remain in Lyons, and so Bichat was forced to flee to Paris. There he joined the crowd of students who were regularly following the practical instruction given by Desault.
It was at that time an established custom in the medical school for certain pupils, who had been previously selected for this work, to read (in turn) to the assembled group of students, just before the arrival of the attending surgeon, a résumé of the previous day’s lecture. In this way the man whose turn it was to read the résumé which he had prepared, secured a most valuable bit of training, and those who simply listened were afforded an excellent opportunity for refreshing their memories with regard to the lecture of the previous day. On these occasions the First Assistant was always present and was therefore in a position to report to his Chief just how successfully each reader of such a review had performed the duty assigned to him. At one of his lectures Desault entered more elaborately than usual into a description of his manner of treating fracture of the clavicle, demonstrating among other things the proper manner of applying what has since become known as “Desault’s bandage.” The student who had been assigned to the duty of preparing a résumé of that day’s lecture happened to be absent on that particular occasion, and so the First Assistant asked the members of the class whether perhaps one of their number would be willing to act as a substitute. Bichat volunteered his services, and he thereupon prepared a résumé which, when read on the following day, proved to be so clearly expressed and covered the ground so thoroughly that the class, after listening to it in profound silence, expressed its approval by the most pronounced applause. When Desault was told by his First Assistant, Manouty, of what had happened he was very impatient to make Bichat’s acquaintance; and, after he had talked with the latter for a short time, he became so impressed with the extent of the knowledge which he had already acquired, with his earnestness of purpose, and with his amiability of character, that he did not hesitate to invite him to become one of his household. Indeed, the favorable impression which Bichat made upon him led him promptly to decide that, if nothing happened later to change the impression which he had first received, he would do all in his power to make this young man his successor.
This kindly reception on the part of his honored preceptor made a deep and most cheering impression on Bichat and stimulated him to put forth his best powers to justify the confidence shown by Desault. At the latter’s request he took charge of part of Desault’s private practice, and he also accepted the position of Hospital Attending Physician to the Outside Poor. Furthermore, he acted as Desault’s corresponding secretary, answering for him all the requests for advice that came to him from every district of France. Then, in addition, he assisted him in all his operations in private practice. Finally, as if he were not already burdened to the limit of his strength with all this mass of work, he not infrequently spent a portion of the night in aiding Desault to solve various problems in experimental surgery, problems relating chiefly to diseases of the bones. Whenever a lull occurred in this series of engrossing labors he devoted all the available time to the performance of operations upon the cadaver and to experiments in relation to physiological problems that suggested themselves to his own mind.
Already as early as in 1797—that is, when he was twenty-six years of age—Bichat gave his first course in anatomy. The room in which the instruction was given was quite small, for he was confident that only a few pupils would feel disposed to subscribe for such a course, and in addition no provision for laboratory work had been made. At first, the teaching was limited to simple demonstrations, but very soon discussions with regard to physiological questions began to occupy some of the time of the sessions. Finally, Bichat found it desirable now and then to carry out experiments on living animals, in order to verify certain seemingly well-known facts and also to determine the exact points at which new investigations should be instituted. When this first course in anatomy came to an end he surprised his friends by beginning a course on operative surgery. “I wish,” he remarked to one of his intimates, “to demonstrate that even a young man may be quite as capable as one of mature age, to operate with the requisite degree of precision.” The course proved a great success, and demonstrated perfectly the truth of his statement.
Under all this strain upon his vital energy, it soon began to be apparent that Bichat’s health was giving way, and it was not long before a pulmonary or bronchial hemorrhage forced him to desist from his work. At one time, indeed, his physical condition was such as to make his friends fear for his life. In the course of a few months, however, he seemed to regain his health; and then he forthwith made arrangements for a much more complete course in anatomy than that which he had carried through so successfully the year before. A laboratory provided with accommodations for eighty dissectors was constructed, and, before the course began, every one of these eighty seats was engaged. (This was in 1798.)
It was a great source of amazement to his friends—and it continues to be a great source of amazement to the physicians of the present day—how Bichat managed to accomplish successfully such a number of things as he, at this early period of his life and with a decidedly precarious state of health, had taken in hand.
One thing was now very noticeable, namely, that he was devoting a much larger part of his time and attention to experimental physiology—that is, to the phenomena and the laws of life—than he had hitherto done to anatomy. After he had finished the work which belonged properly to the daylight hours he devoted no small portion of the nighttime to the work of revising the writings of his beloved teacher and friend, Desault.
Among the anatomical structures about which almost nothing was known toward the end of the eighteenth century, but of which the structure and functions were fully exposed to light by Bichat’s labors, the synovial membranes deserve to receive the very first mention. His researches concerning these membranes were first made known in the public lectures which he was giving at that time to the medical students, but they did not appear in print until a later date, viz., in the second volume of the “Recueil de la Société Médicale d’Émulation.”