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Volumn 46, Issue 2, 2002, Pages 197-220

The clinician, germs and infectious diseases: The example of Charles Bouchard in Paris

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FRANCE; HISTORY; HUMAN; INFECTION; MICROBIOLOGICAL EXAMINATION; MICROBIOLOGY;

EID: 0036550051     PISSN: 00257273     EISSN: None     Source Type: Journal    
DOI: 10.1017/S0025727300069088     Document Type: Article
Times cited : (9)

References (118)
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    • Ibid., pp. 32-9. The origin of the term "immunity" that, since the middle of the nineteenth century, designates "the ability to resist often diseases that surround man" or "the ability not to contract certain diseases or to contract none" is clearly described and analysed in the book by Anne-Marie Moulin, op. cit., note 5 above, pp. 22-7.
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    • Ibid., pp. 32-9. The origin of the term "immunity" that, since the middle of the nineteenth century, designates "the ability to resist often diseases that surround man" or "the ability not to contract certain diseases or to contract none" is clearly described and analysed in the book by Anne-Marie Moulin, op. cit., note 5 above, pp. 22-7.
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    • note
    • Among those residents who made their mark in Bouchard's laboratory were also: Albert Charrin (who, along with Henri Georges Roger, discovered in 1889 the agglutination of bacteria, a phenomenon that serves as the basis of serological diagnoses), Louis Capitan, Augustin Gilbert (who replaced Landouzy in 1902 as professor of therapeutics at the Paris Faculty of Medicine and replaced Dieulafoy as professor of clinical medicine at the Hôtel-Dieu in 1910) and Henri Georges Roger (in 1895, staff physician at public hospitals and head of the laboratory of general therapeutics and pathology, and, in 1904, he replaced Chantemesse as professor of comparative and experimental pathology).
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    • See, in particular, Dagognet, op. cit., note 2 above; Pierre Darmon, Pasteur, Paris, Fayard, 1995; Patrice Debré, Louis Pasteur, Paris, Flammarion, 1995; René Dubos, Louis Pasteur, Paris, PUF, 1955 (reprinted, Paris, La Découverte, 1995); Gerald L Geison, The private science of Louis Pasteur, Princeton University Press, 1995; Moulin, op. cit., note 5 above; Anne-Marie Moulin (ed.), L'aventure de la vaccination, Paris, Fayard, 1996; Salomon-Bayet, op. cit., note 2 above; Maurice Vallery-Radot, Pasteur, Paris, Perrin, 1995. On therapeutics during the nineteenth century, see Vogel and Rosenberg (eds), op. cit., note 4 above; J H Warner, The therapeutic perspective in medical practice, knowledge and identity in America, 1820-1885, Cambridge, MA, Harvard University Press, 1986.
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    • note 2 above
    • See, in particular, Dagognet, op. cit., note 2 above; Pierre Darmon, Pasteur, Paris, Fayard, 1995; Patrice Debré, Louis Pasteur, Paris, Flammarion, 1995; René Dubos, Louis Pasteur, Paris, PUF, 1955 (reprinted, Paris, La Découverte, 1995); Gerald L Geison, The private science of Louis Pasteur, Princeton University Press, 1995; Moulin, op. cit., note 5 above; Anne-Marie Moulin (ed.), L'aventure de la vaccination, Paris, Fayard, 1996; Salomon-Bayet, op. cit., note 2 above; Maurice Vallery-Radot, Pasteur, Paris, Perrin, 1995. On therapeutics during the nineteenth century, see Vogel and Rosenberg (eds), op. cit., note 4 above; J H Warner, The therapeutic perspective in medical practice, knowledge and identity in America, 1820-1885, Cambridge, MA, Harvard University Press, 1986.
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    • See, in particular, Dagognet, op. cit., note 2 above; Pierre Darmon, Pasteur, Paris, Fayard, 1995; Patrice Debré, Louis Pasteur, Paris, Flammarion, 1995; René Dubos, Louis Pasteur, Paris, PUF, 1955 (reprinted, Paris, La Découverte, 1995); Gerald L Geison, The private science of Louis Pasteur, Princeton University Press, 1995; Moulin, op. cit., note 5 above; Anne-Marie Moulin (ed.), L'aventure de la vaccination, Paris, Fayard, 1996; Salomon-Bayet, op. cit., note 2 above; Maurice Vallery-Radot, Pasteur, Paris, Perrin, 1995. On therapeutics during the nineteenth century, see Vogel and Rosenberg (eds), op. cit., note 4 above; J H Warner, The therapeutic perspective in medical practice, knowledge and identity in America, 1820-1885, Cambridge, MA, Harvard University Press, 1986.
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    • See, in particular, Dagognet, op. cit., note 2 above; Pierre Darmon, Pasteur, Paris, Fayard, 1995; Patrice Debré, Louis Pasteur, Paris, Flammarion, 1995; René Dubos, Louis Pasteur, Paris, PUF, 1955 (reprinted, Paris, La Découverte, 1995); Gerald L Geison, The private science of Louis Pasteur, Princeton University Press, 1995; Moulin, op. cit., note 5 above; Anne-Marie Moulin (ed.), L'aventure de la vaccination, Paris, Fayard, 1996; Salomon-Bayet, op. cit., note 2 above; Maurice Vallery-Radot, Pasteur, Paris, Perrin, 1995. On therapeutics during the nineteenth century, see Vogel and Rosenberg (eds), op. cit., note 4 above; J H Warner, The therapeutic perspective in medical practice, knowledge and identity in America, 1820-1885, Cambridge, MA, Harvard University Press, 1986.
    • (1986) The Therapeutic Perspective in Medical Practice, Knowledge and Identity in America, 1820-1885
    • Warner, J.H.1
  • 65
    • 85033643328 scopus 로고    scopus 로고
    • L'effet de la bactériologie dans la fin des "théories médicales" au XIXe siècle
    • op. cit., note 6 above
    • Georges Canguilhem, 'L'effet de la bactériologie dans la fin des "théories médicales" au XIXe siècle', in Idéologie et rationalité dans l'histoire des sciences de la vie, op. cit., note 6 above, pp. 70-2.
    • Idéologie et Rationalité Dans l'Histoire des Sciences de la Vie , pp. 70-72
    • Canguilhem, G.1
  • 66
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    • Paris, Steinheil
    • Among clinical doctors, see, in particular, those mentioned in the book on antiseptic therapeutics by Paul Le Gendre, Barette and G Lepage, Traité pratique d'antisepsie appliquée àla thérapeutique et à l'hygiène, Paris, Steinheil, 1888; and that of Charles Bouchard, Thérapeutique des maladies infectieuses, Paris, Savy, 1889: B Abadie, Arthaud, Barette, L Bergeon (Lyons), FAJ Berlioz (Grenoble), P Budin, C Burlureaux, L Charpentier, L J Colin, G J Coupard, M E Courtois-Suffit, L Coze (Nancy), L David, M Debove, G Déclat, A J Descroizilles, Desesquelles, G Dieulafoy, Dubousquet-Laborderie, G Dujardin-Beaumetz, V Feltz (Nancy), C Fernet, Filleau, L Gamier, E Gaucher, JCA Gayet, A N Gilbert, H Gimbert (Cannes), Gingeot, Gohier, Gougenheim (Lyons), Guerder, J Grancher, F Guyon, F Hallopeau, V Hanot, H Hérard, Hiller, Hirtz, S Jaccoud, G Jousset de Bellesme, É Lancereaux, P Le Gendre, A Legroux, Lepage, R Lépine (Lyons), E Main, P Miquel, Moizard, P Panas, C Paul, Picot (Bordeaux), A Pinard, P Potain, F Raymond, Ritter (Nancy), H G Roger, Ruault, Rueff, Salet, Ségalas, Sevestre, Simon (Nancy), C Talamon, O Tapret, É-L Trouessart, Truc (Lyons), Verneuil, A Weil.
    • (1888) Traité Pratique d'Antisepsie Appliquée Àla Thérapeutique et à L'hygiène
    • Gendre, P.L.1    Barette2    Lepage, G.3
  • 67
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    • Paris, Savy, B Abadie, Arthaud, Barette, L Bergeon (Lyons), FAJ Berlioz (Grenoble), P Budin, C Burlureaux, L Charpentier, L J Colin, G J Coupard, M E Courtois-Suffit, L Coze (Nancy), L David, M Debove, G Déclat, A J Descroizilles, Desesquelles, G Dieulafoy, Dubousquet-Laborderie, G Dujardin-Beaumetz, V Feltz (Nancy), C Fernet, Filleau, L Gamier, E Gaucher, JCA Gayet, A N Gilbert, H Gimbert (Cannes), Gingeot, Gohier, Gougenheim (Lyons), Guerder, J Grancher, F Guyon, F Hallopeau, V Hanot, H Hérard, Hiller, Hirtz, S Jaccoud, G Jousset de Bellesme, É Lancereaux, P Le Gendre, A Legroux, Lepage, R Lépine (Lyons), E Main, P Miquel, Moizard, P Panas, C Paul, Picot (Bordeaux), A Pinard, P Potain, F Raymond, Ritter (Nancy), H G Roger, Ruault, Rueff, Salet, Ségalas, Sevestre, Simon (Nancy), C Talamon, O Tapret, É-L Trouessart, Truc (Lyons), Verneuil, A Weil
    • Among clinical doctors, see, in particular, those mentioned in the book on antiseptic therapeutics by Paul Le Gendre, Barette and G Lepage, Traité pratique d'antisepsie appliquée àla thérapeutique et à l'hygiène, Paris, Steinheil, 1888; and that of Charles Bouchard, Thérapeutique des maladies infectieuses, Paris, Savy, 1889: B Abadie, Arthaud, Barette, L Bergeon (Lyons), FAJ Berlioz (Grenoble), P Budin, C Burlureaux, L Charpentier, L J Colin, G J Coupard, M E Courtois-Suffit, L Coze (Nancy), L David, M Debove, G Déclat, A J Descroizilles, Desesquelles, G Dieulafoy, Dubousquet-Laborderie, G Dujardin-Beaumetz, V Feltz (Nancy), C Fernet, Filleau, L Gamier, E Gaucher, JCA Gayet, A N Gilbert, H Gimbert (Cannes), Gingeot, Gohier, Gougenheim (Lyons), Guerder, J Grancher, F Guyon, F Hallopeau, V Hanot, H Hérard, Hiller, Hirtz, S Jaccoud, G Jousset de Bellesme, É Lancereaux, P Le Gendre, A Legroux, Lepage, R Lépine (Lyons), E Main, P Miquel, Moizard, P Panas, C Paul, Picot (Bordeaux), A Pinard, P Potain, F Raymond, Ritter (Nancy), H G Roger, Ruault, Rueff, Salet, Ségalas, Sevestre, Simon (Nancy), C Talamon, O Tapret, É-L Trouessart, Truc (Lyons), Verneuil, A Weil.
    • (1889) Thérapeutique des Maladies Infectieuses
    • Bouchard, C.1
  • 68
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    • On the antiseptic principle in the practice of surgery
    • Joseph Lister, On the antiseptic principle in the practice of surgery', Lancet, 1867, ii: 353-6; Just Lucas-Championnière, Chirurgie antiseptique, Paris, Baillière, 1876. See also Christopher Lawrence and Richard Dixey, 'Practising on principle: Joseph Lister and the germ theories of diseases', in C Lawrence (ed.), Medical theory, surgical practice: studies in the history of surgery, London and New York, Routledge, 1992, pp. 153-215.
    • (1867) Lancet , vol.2 , pp. 353-356
    • Lister, J.1
  • 69
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    • Paris, Baillière
    • Joseph Lister, On the antiseptic principle in the practice of surgery', Lancet, 1867, ii: 353-6; Just Lucas-Championnière, Chirurgie antiseptique, Paris, Baillière, 1876. See also Christopher Lawrence and Richard Dixey, 'Practising on principle: Joseph Lister and the germ theories of diseases', in C Lawrence (ed.), Medical theory, surgical practice: studies in the history of surgery, London and New York, Routledge, 1992, pp. 153-215.
    • (1876) Chirurgie Antiseptique
    • Lucas-Championnière, J.1
  • 70
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    • Practising on principle: Joseph Lister and the germ theories of diseases
    • C Lawrence (ed.), London and New York, Routledge
    • Joseph Lister, On the antiseptic principle in the practice of surgery', Lancet, 1867, ii: 353-6; Just Lucas-Championnière, Chirurgie antiseptique, Paris, Baillière, 1876. See also Christopher Lawrence and Richard Dixey, 'Practising on principle: Joseph Lister and the germ theories of diseases', in C Lawrence (ed.), Medical theory, surgical practice: studies in the history of surgery, London and New York, Routledge, 1992, pp. 153-215.
    • (1992) Medical Theory, Surgical Practice: Studies in the History of Surgery , pp. 153-215
    • Lawrence, C.1    Dixey, R.2
  • 72
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    • MD thesis, Faculty of Medicine, Paris
    • Charles Bouchard, Henri Gimbert and Victor Cornil were loyal workers in Charles Robin's laboratory (histology). In addition, Bouchard was Jean-Martin Charcot's student and rapidly became accustomed to laboratory procedures; thereafter, he always associated clinical practice with the laboratory: specimens taken from patients and autopsies of cadavers, their anatomic-pathological examination under the microscope, chemical analyses, etc. P Chalvet, a fully certified medical doctor, staff physician at public hospitals, who died in 1871, had written his doctoral thesis on disinfectants, which undoubtedly contributed to Bouchard's interest in the study of antiseptics (P Chalvet, 'Des désinfectants', MD thesis, Faculty of Medicine, Paris, 1861). Bouchard worked with Chalvet during his residency in the department of Louis Béhier in 1868; Chalvet (a chemist) acquainted him with urology and the chemical analyses of urine. Afterwards, Bouchard systematically analysed urine samples from all the patients in his department.
    • (1861) Des Désinfectants
    • Chalvet, P.1
  • 73
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    • Opening lecture of 3 December 1872
    • 13 December
    • Charles Bouchard, Opening lecture of 3 December 1872, Gazette Hebdomadaire de Médecine et de Chirurgie, 13 December 1872, no. 50, pp. 102-7. For Bouchard, in 1872, "empirical" medicine: "limited to the pure recording of observations, led, by means of slow and laborious intellectual process, to the history of the etiology, symptomatology, disease prognoses, to which, by an abuse of language, one opposes scientific medicine . . . But, when we examine the physical forces, heat, respiration, urine, sweat, excrements, expectorations, we bring to bear the precision of the instruments of chemistry and physics, and graphic presentation of data. This observational medicine, because of the rigour of the currently applied methods, indeed has the right to be called scientific . . . Empirical medicine was able to approach the study of the nature of diseases or morbid relationships ... Systematic medicine cannot function without empirical medicine as a control and moderator."
    • (1872) Gazette Hebdomadaire de Médecine et de Chirurgie , vol.50 , pp. 102-107
    • Bouchard, C.1
  • 74
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    • 2 vols, Paris
    • Charles Adolphe Wurtz, Dictionnaire de chimie pure cl appliquée, 2 vols, Paris, 1870, vol. 1, p. 987. Concerning creosote: "It is a strong antiseptic and energetic caustic. At a high dose, it immediately whitens the epidermis and rapidly destroys it; it coagulates blood albumin and egg whites. It is used against dental caries and has been used as a good haemostatic. At the time of its appearance, it benefited from a popularity in medicine as widespread as that of phenol today."
    • (1870) Dictionnaire de Chimie Pure Cl Appliquée , vol.1 , pp. 987
    • Wurtz, C.A.1
  • 77
    • 85033654952 scopus 로고    scopus 로고
    • note 42 above
    • Le Gendre, Barette, Lepage, op. cit., note 42 above, p. 286. "Creosoted wine (Bouchard and Gimbert): pure creosote distilled from beechwood tar 13.5 g; tincture of gentian 20 g; Montpellier alcohol 250 g; Malaga wine in sufficient quantity to make 1 litre. Creosoted elixir (Dujardin-Beaumetz): creosote from beechwood tar 3 g; alcohol 100 g; sugar syrup 100 g; Banyuls wine 300 g."
    • Dictionnaire de Chimie Pure Cl Appliquée , pp. 286
    • Le Gendre1    Barette2    Lepage3
  • 84
    • 85033648108 scopus 로고    scopus 로고
    • note 42 above
    • These German studies and authors are cited in different chapters in Bouchard's book published in 1889 (op. cit., note 42 above), along with others, such as Wemrnich, G Gaffky, F Ziehl, E Klebs, etc., and next to references to the publications of French and English authors.
    • (1889) Dictionnaire de Chimie Pure Cl Appliquée
    • Bouchard1
  • 85
    • 85033655508 scopus 로고    scopus 로고
    • note
    • In this same year (1884) in Germany, Robert Koch also tested a certain number of disinfecting chemical substances in vitro and notably recommended mercuric chloride for disinfecting wounds. Taking the lead from Pasteur's studies on the attenuation of anthrax and chicken cholera germs, he tested certain chemical substances in an attempt to inhibit the growth of the tuberculosis bacillus. Around 1888, he noted the efficacy of certain products in vitro but emphasized the absence of an in vivo therapeutic effect in the tuberculous guinea pig.
  • 86
    • 85033658055 scopus 로고    scopus 로고
    • note
    • Indeed, in 1885, Pasteur and Roux were working experimentally for the first time on a human pathology, rabies, and on a treatment for this disease that affected a few rare individuals who had been bitten by rabid dogs. The responsible germ had not yet been isolated, and a means of attenuating the "virus" and eliminating its "malignancy" while conserving its integrity remained to be found. Roux and Pasteur finished by suspending the aseptically removed spinal cords of rabid dogs in a flask filled with warm dry air for fifteen days. To test the decline of virulence, they gave rabies to a healthy dog by inoculating it with spinal cord homogenates directly into the brain after trephination. Thus, we enter the realm of experimental pathology, with attenuation of the virus and therapy with a most unusual "vaccine" because it had to treat the disease but not prevent its development. This was a sophisticated and complex experimental biological methodology. The recommended means to combat the disease were not exclusively chemical.
  • 90
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    • Ibid., p. 315. The opposition of the Pastorian school to antiseptic medical treatment in infectious diseases was still illustrated in 1894 by Émile Roux: he expressly forbade local antiseptic treatment of sore throats, saying it was "harmful for serum injection" (information reported by Édouard Louis Trouessart, La thérapeutique antiseptique, Paris, Rueff, 1892, p. 6).
    • Dictionnaire de Chimie Pure Cl Appliquée , pp. 315
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    • Paris, Rueff
    • Ibid., p. 315. The opposition of the Pastorian school to antiseptic medical treatment in infectious diseases was still illustrated in 1894 by Émile Roux: he expressly forbade local antiseptic treatment of sore throats, saying it was "harmful for serum injection" (information reported by Édouard Louis Trouessart, La thérapeutique antiseptique, Paris, Rueff, 1892, p. 6).
    • (1892) La Thérapeutique Antiseptique , pp. 6
    • Trouessart, É.L.1
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    • Academic debate and therapeutic reasoning in mid-19th century France
    • Iiana Löwy (ed.), Paris, INSERM, and London, J Libbey
    • Concerning inhalations and sprays, see, in particular, Georges Weisz, 'Academic debate and therapeutic reasoning in mid-19th century France', in Iiana Löwy (ed.), Medicine and change: historical and sociological studies of medical innovation, vol. 220, Paris, INSERM, and London, J Libbey, 1993, pp. 303-11.
    • (1993) Medicine and Change: Historical and Sociological Studies of Medical Innovation , vol.220 , pp. 303-311
    • Weisz, G.1
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    • London, Macmillan
    • Thomas Lauder Brunton, An introduction to modern therapeutics, London, Macmillan, 1892, p. 80, cited by William F Bynum, 'Chemical structure and pharmacological action: a chapter in the history of 19th century molecular pharmacology', Bull. Hist., Med, 1970, 44: 518-38, p. 535.
    • (1892) An Introduction to Modern Therapeutics , pp. 80
    • Brunton, T.L.1
  • 107
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    • Chemical structure and pharmacological action: A chapter in the history of 19th century molecular pharmacology
    • Thomas Lauder Brunton, An introduction to modern therapeutics, London, Macmillan, 1892, p. 80, cited by William F Bynum, 'Chemical structure and pharmacological action: a chapter in the history of 19th century molecular pharmacology', Bull. Hist., Med, 1970, 44: 518-38, p. 535.
    • (1970) Bull. Hist. Med , vol.44 , pp. 518-538
    • Bynum, W.F.1
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    • De la créosote dans le traitement de la tuberculose pulmonaire
    • session of 14 February
    • Charles Fernet, 'De la créosote dans le traitement de la tuberculose pulmonaire', Bulletins et Mémoires de la Société médicale des Hôpitaux de Paris, session of 14 February 1896, pp. 1-11. See also J Schmitt, Diagnostic et traitement des maladies infectieuses, Paris, Baillière, 1902, pp. 261-82.
    • (1896) Bulletins et Mémoires de la Société Médicale des Hôpitaux de Paris , pp. 1-11
    • Fernet, C.1
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    • Paris, Baillière
    • Charles Fernet, 'De la créosote dans le traitement de la tuberculose pulmonaire', Bulletins et Mémoires de la Société médicale des Hôpitaux de Paris, session of 14 February 1896, pp. 1-11. See also J Schmitt, Diagnostic et traitement des maladies infectieuses, Paris, Baillière, 1902, pp. 261-82.
    • (1902) Diagnostic et Traitement des Maladies Infectieuses , pp. 261-282
    • Schmitt, J.1
  • 114
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    • Ibid., p. 292. Sixty years later, we can read in P Lebeau, Traité de pharmacie chimique, 4th ed., Paris, Masson, 1955, vol. 2, pp. 958-60: "bnaphlhol has a considerable antiseptic potency and it is not very toxic . . . It is prescribed as a gastrointestinal antiseptic, in the form of tablets or enemas. It is also used to treat typhoid fever. Its prolonged use can cause irritation of the mucosae . . . It is also applied as an antihelmintic . . . Externally, it is used as an aqueous solution or salve in dermatology to treat acne and eczema."
    • Diagnostic et Traitement des Maladies Infectieuses , pp. 292
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    • Paris, Masson
    • Ibid., p. 292. Sixty years later, we can read in P Lebeau, Traité de pharmacie chimique, 4th ed., Paris, Masson, 1955, vol. 2, pp. 958-60: "bnaphlhol has a considerable antiseptic potency and it is not very toxic . . . It is prescribed as a gastrointestinal antiseptic, in the form of tablets or enemas. It is also used to treat typhoid fever. Its prolonged use can cause irritation of the mucosae . . . It is also applied as an antihelmintic . . . Externally, it is used as an aqueous solution or salve in dermatology to treat acne and eczema."
    • (1955) Traité de Pharmacie Chimique, 4th Ed. , vol.2 , pp. 958-960
    • Lebeau, P.1


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