Guillaume Dupuytren was born at Pierre Buffière, France, October 5, 1778. He commenced the study of anatomy and physiology at an unusually early age, and was appointed Prosector at the Paris École de Santé before he had reached his eighteenth year. In 1802, very soon after he had received the degree of Doctor of Surgery, he was given the appointment of Attending Surgeon to Hôtel-Dieu. Of this early period of his career very little need be said. He lost none of his enthusiasm for his chosen work and was recognized by all his associates as a surgeon of great promise. From the position of simple attending surgeon at Hôtel-Dieu he rose in 1808 to that of Adjunct Surgeon-in-Chief. Finally, in 1815, after the death of Pelletan, he was made full Surgeon-in-Chief of that great hospital. So far as it was possible for Dupuytren to advance in the endeavor to gain official recognition as a surgeon, he had by this time risen to the highest point that it was practicable for him to reach. Let us now consider some of the other aspects of his career.
DUPUYTREN
After the death of Bichat in 1802 Dupuytren turned his attention from what was supposed to be normal anatomy to pathological anatomy. The change was greatly favored by the fact that, in the course of his regular work as prosector, he was constantly encountering all sorts of pathological conditions, and thus he gradually acquired a strong interest in pathological problems. Pathological anatomy, as newly interpreted, was no longer a mere observing of the abnormal changes which take place in different structures and organs of the body,—the sort of “cold work” which had occupied in large measure the minds of Bartholinus, Mangetus, Bonnet of Geneva, Morgagni of Bologna, and Lieutard, and which involved practically no study of the origin of such changes,—but what might be termed a living pathological anatomy, in which the effort is made to ascertain the beginning, the gradual progress and the termination of the process. Ample material for this sort of study was constantly passing through Dupuytren’s hands, and he made the most of his opportunities. Professor LeClerc, who is my chief authority for the present sketch of Dupuytren, says that by means of this new pathological anatomy much light was thrown upon both diagnosis and symptomatology. At first the courses which Dupuytren gave in the École de Santé ran in large degree parallel with those of Bichat, but after the latter’s death Dupuytren had the field almost entirely to himself. He taught anatomy, pathological anatomy, and physiology, and increased the interest in his teaching, on the part of the pupils, by furnishing a variety of facts drawn from his wide experience. His great skill as a dissector enabled him to demonstrate all sorts of fine details—as, for example, not merely a limited portion of a nerve, but nerves throughout their entire course.
After Dupuytren became full Surgeon-in-Chief at Hôtel-Dieu he ceased teaching operative surgery and devoted himself largely to clinical surgery. He adopted the habit of visiting the hospital at an early hour, long before the time appointed for the arrival of the class, and thus he was able to examine the patients leisurely and to give all the necessary instructions to his assistants. By the time the class arrived he was entirely ready to receive them. He was extremely punctual in attending to his hospital duties.
In 1814 Dupuytren took an active part in caring for the wounded soldiers on the field of battle; and again in 1830, during the civic disorders of that period, he had the care, at Hôtel-Dieu, of many cases of wounds from firearms.
A French physician whose identity is concealed under the initials J. L. H. P., has published a very complete pen-portrait of Dupuytren’s most prominent personal and professional characteristics, and Elisha Bartlett, M.D., of Boston, has furnished us with an excellent English translation of this work. From this book I shall take the liberty of quoting here several sections that seem to me to be particularly interesting.
Monsieur Dupuytren is, in my opinion a surgeon of the most exalted merit.... He has a coup d’oeil of most admirable precision, a sure and steady hand, a coolness and self-possession always imperturbable, and that innate instinct or tact so necessary in all the arts. A man is born surgeon or physician, as a man is born poet or painter.... Monsieur Dupuytren is particularly remarkable for his diagnostic foresight.... Arrived at the bedside of the patient, his fine senses are all awake; in a few minutes of question and researches, his examination is finished. One might often believe that he has given to the case only a superficial attention, but his subsequent lecture will prove that he has seen everything and seen it thoroughly.... He describes a pathological alteration, yet hidden in the interior of an organ, as though it were visible, and, when the scalpel has dissected and uncovered it, the truth of his description is verified by all who witness it.... Monsieur Dupuytren is not less skilful in treating surgical diseases than he is in detecting them.... I do not fear that I shall be accused of exaggeration in saying that very few surgeons have given proof of so much surgical genius in the invention of modes of operating or so much expertness in their execution. Monsieur Dupuytren possesses in the highest degree a creative and inventive spirit....
So much for Monsieur Dupuytren as a practitioner; Let us now consider him as an instructor....