FIG. 27. JEAN BASEILHAC, COMMONLY KNOWN IN FRANCE AS FRÈRE CÔME.
(From the steel engraving in Pascal Baseilhac’s treatise.)
FIG. 28. CONCEALED LITHOTOME INVENTED BY FRÈRE CÔME IN 1748.
(From the steel engraving in Pascal Baseilhac’s treatise.)
(b) Frère Jean de Saint-Côme,—or Brother John of Saint Cosmas,—whose real name was Jean Baseilhac, was born in 1703 at Poyestruc, Department of Hautes-Pyrenées, France. He received his instruction in the principles of medicine from his father and his grandfather, both of whom were regularly enrolled Masters in Surgery. In 1722, when there could no longer be any doubt about young Baseilhac’s settled purpose to fit himself for the practice of medicine, his father sent him to Lyons, where his uncle, who was himself a surgeon, would be able to superintend the boy’s further training. Through the latter’s influence, young Baseilhac was allowed to enter the Hôtel-Dieu of that city as one of its regular pupils. At the end of two years—i.e., in 1724—he left Lyons and went to Paris, where he hoped to add materially to his stock of professional knowledge. His first step, after reaching the metropolis, was to enter the service of a surgeon in active practice; and then, aided by the latter’s influence, he succeeded (in 1726) in entering the Paris Hôtel-Dieu as one of the regular pupils. Soon after he had completed his term of service at the hospital, he was appointed Physician-in-Ordinary to the Prince-Bishop of Bayeux, in Normandy. The death of the latter in 1728, less than two years after Baseilhac had entered his service, came as a great blow to the young surgeon, for he had learned to esteem him very highly. In his will the Bishop left a small legacy to Baseilhac—that is, a sum of money sufficient to pay for the regular course of instruction at the Medical School of Saint Cosmas in Paris, and also to procure a complete outfit of surgical instruments. In 1740 he became a member of the Feuillants Branch of the Franciscan monks, it being understood, however, that he was to be allowed the special privilege of practicing surgery among the poorer classes. Through accidental circumstances he was led gradually to drop general surgery and to confine his work to operations for stone. His official name at this time was “Frère Jean de Saint-Côme,” or simply “Frère Côme.” (Fig. 27.) As he gained in experience as a lithotomist, he became convinced that the method which his predecessor, Frère Jacques, had practiced with such great success, was preferable to the more complicated and more dangerous plan commonly pursued by surgeons at that time, and thereafter he adopted it in all his cases. But he modified the procedure to a certain extent; that is, he invented an instrument by means of which the actual cutting of the perinaeum was accomplished with a concealed knife (see Fig. 28). The chief advantage to be gained by the employment of this instrument consisted—as was claimed by Frère Jean and his nephew, Pascal Baseilhac,—in the fact that in this way the danger of making the incision in the wrong place, or of too great length, was materially diminished.
The first patient upon whom the new instrument was tried (October 8, 1748), was a dealer in lime, sixty years of age and in rather delicate health. In less than three weeks after the operation, he was entirely cured. Subsequently the instrument was employed in a large number of instances, and the method was found to be most satisfactory; successful results being obtained—on the average—in twelve out of thirteen cases, whereas the best results previously obtained by the method commonly employed at that period was 50 per cent of cures. At a still later date the statistics showed even better results—viz., 96 cures in one group of 100 cases, and 316 cures in a second group of 330 cases.
Owing to the rapidly increasing number of patients affected with stone in the bladder who wished to be operated upon by Frère Jean himself, he established in Paris in 1753, near the Saint Honoré gateway, a special hospital for lithotomy cases, and kept it in active service up to the time of his death. The laboring classes, and the poor in general, were not expected to pay any fees, and indeed money was often bestowed upon these people when they left the hospital, to enable them to return comfortably to their villages; those in moderate circumstances were asked to pay only the expenses that had been incurred in their behalf; and the well-to-do made such voluntary contributions as they thought proper toward the support of the hospital. The registers of the institution showed that, first and last, over one thousand operations had been performed there, either by Frère Jean or by his nephew, Pascal Baseilhac. Our monk’s death occurred on July 8, 1781.
THE END