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Jean-Baptiste Bouillaud

Born  1796
Died  1881

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French internist, born September 16, 1796, Bragette near Angoulème; died October 29, 1881. Paris.

Biography of Jean-Baptiste Bouillaud

Jean-Baptiste Bouillaud, one of the last of the great bloodletters, was a shrewd observer and responsible for a number of discoveries, among them the localisation of the speech centre in the middle of the left cerebral hemisphere, an observation first reported in 1825 in his early treatise on brain diseases.

Bouillaud spent his student time under the guidance of his uncle Jean Bouillaud - chirurgien-major in the army. Following the completion of his studies Bouillaud received his doctorate in Paris in 1823 and subsequently distinguished himself by publishing a treatise on diseases of the heart, with René-Joseph-Hyacinthe Bertin (1757-1828). In 1831 he was appointed to the chair of clinical medicine at the Charité through concours, and soon enjoyed the reputation of an outstanding clinician. However, an enthusiastic follower of François Joseph Victor Broussais (1772-1838), his therapy of bloodletting was heavily criticised.

Bouillaud's works concerned different fields of medicine; he published on hermaphroditism, on cholera, encephalitis, diseases of the heart, cancer, and various forms of fever. His main achievement, however, was in the field of rheumatism. Acute rheumatoid endocarditis is still commonly termed Bouillaud's disease in medical dictionaries in the French language. He recognised the cartilaginous and synovial lesions of this disease and was the first to describe them.

Following his 1842-1846 term as deputy for angoulême - in which he usually voted with the leftists, he, as a member of the Conseil supérieur of the university, was elected dean of the faculty of medicine, in stead of Mathéo-José-Bonaventure Orfila (1787-1853). Because of conflicts with the administration, however, he resigned this position. In 1868 he became a member of the Académie des sciences. His mind remained lucid until the very last, only weeks before his death he participated in discussions at the academy of medicine. By 1861, Bouillaud was Doyen of the Faculty, Membre de I'Institut, and head of La Charité.

In his work on diseases of the heart, Traité clinique des maladies du coeur, Bouillaud was close on trail of the damages caused by rheumatoid arthritis. Other investigators had previously noted the relationship between rheumatism and heart disease, but Bouillaud was the first to demonstrate a "law of coincidence" which statistically confirmed the correlation. Also in this work is the first description of Bouillaud's disease (rheumatic endocarditis). His discoveries were confirmed by the findings of Karl Albert Ludwig Aschoff (1866-1942) and Geipel in 1904 through the discovery of the rheumatoid nodules of the heart muscle named after them.

Bouillaud may be considered the link between Franz Joseph Gall (1758-1828) and Pierre Paul Broca (1824-1880) Bouillaud received part of his clinical training from Gall, and he was a founding member of the Société Phrénologique which was organized in Paris three years after Gall died. In his publication of 1825 he argued on the basis of clinical evidence that loss of speech corresponds to a lesion of the anterior lobes of the brain, and that his findings confirmed Gall's opinion on the seat of the organ of articulate language. This question was the topic of fierce debates for decades, continued, by among many others, his pupil and son-in-law Ernst Aubertin (1825-1865).

Bibliography

  • Essai sur le diagnostic des anévrismes de l'aorte etc. Doctoral thesis, Paris, 1823.
  • Observations sur l'état des veines dans les infiltrations des membres.
    Journal de physiologie experimentale et pathologique, Paris, 1823, 3: 89-93.
    Description of venous obstruction and dropsy.
  • Traité des maladies du coeur et des gros vaisseux, redigé par J. Bouillaud.
    Paris, 1824.
    Bouillaud was the editor of this work by Rene-Hyacinthe Bertin (1757-1828).
  • Traité clinique et physiologique de l'encéphalite, ou inflammation du cerveau.
    Paris 1825.
    Includes some pathological and clinical studies on loss of articulate speech associated with lesions of anterior lobes, and gives reasons for the localization of this function in the brain.
  • Recherches cliniques propres à démontrer que la perte de la parole correspond à la lésion des lobules antérieures du cerveau.
    Archives générales de médecine, Paris, 1825, 8: 25-45.
    Classic account of aphasia. Bouillaud was the first to suggest that injuries of the frontal lobe were a cause of aphasia.
  • Recherches expérimentales tendant à prouver que le cervelet préside aux actes de la station det de la progression, et non à l'instinct de la propagation.
    Archives générales de médecine, Paris, 1827, 15: 64-91, 225-247.
    Bouillaud identified the anterior lobes as the speech centre. refuting Gall, he showed that the brain controls equilibration, station and progression.
  • Essai sur la philosophie médicale et sur les généralités de la clinique médicale etc. Concours-thesis for professorship. Paris 1831; 2nd edition, 1836; Bruxelles, 1836.
  • Traité clinique du rheumatisme articulaire. Paris, 1832.
  • Traité théorique, pratique et staistique du choléra-morbus de Paris. 1832.
  • Exposition raisonnée d'un cas de nouvelle et singulière variété d'hermaphrodisme, observée chez l'homme. 1833.
  • Traité clinique des maladies du coeur. 2 vols. Paris, J. B. Baillière, 1835; 2nd edition, 1841; German translation by Alf. Ferd. Becker, Leipzig, 1836-1837.
    Bouillaud's disease is described on page 238, volume 2. Although not first to note the cardiac manifestations of acute rheumatism, Bouillaud was the first to demonstrate the frequency and importance of heart disease co-incident with acute articular rheumatism. This work includes the first description of a case of mitral disease with articular rheumatism.
  • Nouvelles recherches sur le rhumatisme articulaire aîgu en général et spécialement sur la loi de coincidence de la péricardite et l'endocardite avec cette maladie.
    Paris, 1836; English translation by James Kitchen, Philadelphia, 1837.
    German by Ferdinand Leopold Kersten (1804-(1853), Magdeburg, 1837.
  • Clinique médicale de l’hôpital de la Charité, etc. 3 volumes, 1837.
    German translation by Gust. Krupp, Cassel and Leipzig, 1838; 2nd edition, Quedlinburg, 1846.
  • De l'introduction de l'air dans les veines. 1838.
  • Sur le siége de sens dans le langage articulé. 1839-1848.
  • Traité clinique du rhumatisme articulaire. Paris, J. Baillière, 1840.
    Same title as his work of 1832. Extension of his work on the coincidence of heart disease and acute rheumatism. He regarded fever as the effect of endocarditis.
  • Traité de nosographie médicale. 5 volumes, 1846.
  • Leçons cliniques sur les maladies du coeur et des gros vaisseaux. 1853.
  • Du diagnostic et de la curabilité du cancer. 1854.
  • De l’influence des doctrines et des systèmes pathologiques de la thérapeutique. 1859.
  • Discours sur le vitalisme et l’organisme. 1860.
  • De la congestion cérébrale apoplectiforme dans ses rapports avec l’épilepsie. 1861.
  • Discussion sur l'organologie phrénologique en général et sur la localisation de la faculté du langage articulé en particulier. 1865.

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