The pathological alterations, considered by themselves, are simply curiosities, and are not of the slightest utility to anybody who may feel disposed to study them; because they are all either the products of simple inflammation, or else they owe their origin to some cause which does not fall legitimately in the domain of physiological pathology.
(Copied from pp. 674, 676, 677, and 679 of Vol. II., edition of 1821.)
Further on in the same volume, speaking of melanotic cancers, Broussais says:—
... this is all that it is important for the physician to know; and, as to what Monsieur Laënnec has written about black cancers, I may say that it is simply the product of his imagination, a gloomy romance, which I found difficulty in reading from the beginning to the end.
It seems proper that I should furnish some information concerning Broussais’ methods of treatment in different diseases. In the last analysis it will be found that in nearly all cases he adopted such remedial measures as tended to allay or arrest inflammatory action. Thus, in beginning pulmonary consumption he prescribed the application of leeches to the infraclavicular region; in jaundice they were to be applied in the hypochondriac region, in pharyngitis and tonsillitis to the side of the neck, in dysentery to the anus, in articular rheumatism to the neighborhood of the affected joint, and, in maladies that were not distinctly localized, the epigastrium was the region to be chosen by preference. When simple irritation was present Broussais prescribed revulsives—such, for example, as blisters, emetics and laxatives. As a rule, however, he gave the preference to direct antiphlogistic measures. He is credited with having had a profound contempt for the vis medicatrix naturae. It was said that his pupils showed a tendency to push his pathologic teachings to an extreme. Desruelles, for instance, was in the habit of treating his syphilitic cases, not with mercury or any other of the specific remedies commonly employed at that period, but with leeches applied locally.
As early as in 1816 Broussais announced that, as a result of his doctrine, “the mortality of Val-de-Grâce had greatly diminished, to the grand astonishment and admiration of the world.” This assertion not having been noticed, Monsieur Broussais, in 1821, went a step further. He then predicted, in the Preface to his “Examen des Doctrines,” that his doctrine would soon exert an influence on population more marked than that exerted by vaccination. This was pretty strong, but not, however, sufficient; for in 1822, “the Prospectus of Les Annales de la Médecine Physiologique declared that, in the hospitals where the physiological doctrine was adopted, the mortality was only one in thirty, while in the others it amounted to one in five.” These results, which caused great astonishment, induced Monsieur Brasquet, a physician, to inspect the records with a view to ascertaining the exact facts. Thus it was discovered that, during the five years from 1815 to 1819, Monsieur Broussais had lost more patients than his contemporaries had lost during the same period; his mean mortality having been one in thirteen. (The results of Monsieur Brasquet’s inquiry were published in the Revue Médicale.) “Monsieur Broussais replied in Les Annales de la Médecine Physiologique, but his reply was not at all satisfactory. He did not deny the correctness of the figures published in the Revue Médicale, but he maintained that they proved nothing against him.” The proof, however, that he had lost one patient in thirteen, and not one in thirty, as he had claimed, remained unshaken.
It was probably this experience that marked the beginning of the downfall of the doctrine known as “Broussaism”; but many years had to elapse before this doctrine vanished entirely from the accepted medical textbooks. August Hirsch, in his “History of the Medical Sciences in Germany” (1893), passes the following judgment upon Broussais’ work: “Under the title of ‘Physiological Medicine’ Broussais presented to the world a system which for narrowness of scope, for arbitrariness and for the perniciousness of the treatment which was deduced from the premisses that grew out of the theory, could be compared only with Rasori’s therapeutic method.”
Broussais died in 1835.
BOOK XI