Lessico
Jean-Baptiste Bouillaud
Nato a
Bragette, presso Angoulême, Francia, ii 16 settembre 1796
Morto a Parigi il 28 ottobre 1881
Medico
Bouillaud venne incoraggiato a intraprendere la carriera medica da suo zio, un chirurgo militare. I suoi studi medici parigini furono interrotti dagli obblighi del servizio militare, cui adempì durante le ultime fasi delle guerre napoleoniche (si arruolò volontario e combatté a Waterloo). Ripresi gli studi, subì l’influenza di Guillaume Dupuytren (1777-1835), F.J.V Broussais (1772-1838), J.N. Corvisart (1755-1821) e François Magendie (1783-1855).
Dalle diverse prospettive e dai diversi interessi di questo gruppo di studiosi, Bouillaud estrapolò le idee che gli si confacevano: quelle sul localismo in patologia chirurgica, quelle sulle malattie cardiache, quelle di fisiologia sperimentale e quelle riguardanti il valore terapeutico del salasso.
Bouillaud si laureò in medicina nel 1823. Quindi divenne interno presso l’Hôpital Cochin, sotto René-Joseph-Hyacinthe Bertin (1757-1828) con il quale collaborò nella stesura del Traité des maladies du coeur et des gros vaisseaux (1824). Una nuova edizione di questo testo, completamente rivista da Bouillaud, e pubblicata nel 1835 a suo nome, è certamente opera ben più notevole dell’originale. A quel tempo egli aveva già assunto (1830) l’incarico di professore di medicina clinica alla Facoltà di Parigi, ed era ben noto per i suoi scritti sull’infiammazione cerebrale (1825), sulle febbri (1826) e sul colera (1832). Inizialmente negò il carattere contagioso del colera, ma in seguito cambiò idea. Egli attribuì i propri “successi” nel trattamento di questa malattia a salassi locali, combinati alla cauterizzazione della colonna vertebrale.
Come molti docenti di medicina francesi del suo periodo, Bouillaud pubblicò sintetizzate le sue lezioni universitarie: Clinique médicale de l’Hôpital de la Charité (1837). Egli elaborò la propria dottrina nei cinque volumi del Traité de nosographie medicale (1846). Tenne in gran considerazione il ragionamento e la speculazione, mettendo in discredito il sensualismo estremo: “Un idiota”, scrisse, “può avere cinque sensi perfettamente sviluppati”.
Bouillaud viene ricordato soprattutto per il contributo alla cardiologia e alla neurologia. Egli fu un buon stetoscopista e descrisse un gran numero di rumori e soffi, insieme al ritmo di galoppo dello scompenso cardiaco congestizio. La sua esposizione delle scoperte cliniche e patologiche intorno all'endocardite divenne classica. Tale affezione è indicata talvolta come La malattia di Bouillaud anche se altri prima di questi avevano richiamato l’attenzione su di essa. Egli notò le connessioni tra endocarditi e poliartriti. Nella seconda edizione del suo trattato sulla malattia cardiaca incluse numerosi e precisi dati intorno al peso e alle prestazioni cardiache.
L'‘interesse di Bouillaud per la neurologia e la localizzazione cerebrale era stimolato dal suo coinvolgimento negli studi di frenologia, tuttavia non fu un acritico seguace di F.J. Gall (1758-1828). Compì una serie di esperimenti sul cervelletto e per primo suggerì l’ipotesi che i lobi anteriori del cervello costituissero il centro della parola.
Non si può dire che Bouillaud invecchiò con grazia. Si oppose a lungo alle idee di Pasteur (1822-1895), guardò con sospetto le ferrovie e le altre diavolerie della nuova era e continuò a cantare le lodi del salasso — sostanzioso e frequente — per le più svaniate affezioni. Fu presidente, inoltre, del primo Congresso internazionale di medicina, tenutosi a Parigi nel 1867.
William
F. Bynum - Weilcome Institute
Liber Amicorum
Franco Maria Ricci – Milano - 1985
Jean-Baptiste Bouillaud (16 septembre 1796, Angoulême - 29 octobre 1881, Paris) est un médecin français. Grand clinicien, Bouillaud identifia le rhumatisme articulaire aigu en lien avec les troubles cardiaques et fut le premier à localiser le centre du langage dans les lobes frontaux du cerveau.
Formé par son oncle, Jean Bouillaud, chirurgien-major de l'armée, Bouillaud participa avant même d'avoir achevé ses études, aux campagnes napoléoniennes de 1815, ce n'est qu'à la suite de la défaite de Waterloo qu'il achèvera ses activités universitaires avec son doctorat de médecine en 1823, à Paris. Son intense activité médicale se matérialise dans la publication d'un Traité des maladies du cœur et des gros vaisseaux, avec René-Joseph-Hyacinthe Bertin, en 1824, puis un an plus tard, un Traité clinique et physiologique de l'encéphalite, ou inflammation du cerveau dans lequel il expose sa thèse concernant les localisations frontales du centre du langage. Cela lui vaut de devenir à 30 ans, membre de l’Académie royale de médecine. Ses travaux seront poursuivis par son gendre Ernest Auburtin qui en les exposant à la Société d'anthropologie, en 1861, les fera découvrir à Paul Broca.
En 1831, il obtient un poste de professeur de médecine clinique à l'Hôpital de la Charité de Paris. Paru en 1840, son Traité clinique du rhumatisme articulaire et de la loi de coïncidence des inflammations du cœur avec cette maladie établit définitivement sa réputation de grand clinicien. En 1848, il est honoré doyen de la faculté de médecine de Paris, à la suite Matteo-José-Bonaventure Orfila mais des dissensions avec son prédécesseur le feront quitter ce poste.
Le 1er juin 1868, il est élu membre de l'Académie des sciences (section de médecine et chirurgie), institution qu'il fréquentera jusqu'à ses tout derniers jours. Libéral et républicain, il fut aussi député de Charente entre 1842 et 1846.
Les recherches de Bouillaud s'étendent à de nombreux domaines médicaux: depuis l'étude des troubles cardiaques aux rhumatismes des pathologies du système nerveux (lésions cérébrales, encéphalites) aux fièvres, en passant par le choléra ou encore, l'hermaphrodisme.
En cardiologie, il fit le premier l'observation de la co-occurrence des troubles cardiaques associés au rhumatisme articulaire aigu (Maladie de Bouillaud). Il donnera les premières explications mécaniques de l'origine du son produit par les battements cardiaques dont il décrit certaines arythmies. Il découvre aussi certaines propriétés pharmacologiques de la drogue issue de la digitale, qu'il baptise l' « opium du cœur ».
Dans le domaine de la neurologie, inspiré par la phrénologie de Franz Joseph Gall, il énonce le principe de la double dissociation, un raisonnement qui sera l'un des piliers théorique de la neuropsychologie des XIXe et XXe siècles. Voici le raisonnement de Bouillaud: Si le langage est bien localisé dans les lobes frontaux du cerveau, alors deux conclusions peuvent être tirées, d'une part en cas d'atteinte des lobes frontaux, le langage doit être aussi affecté, d'autre part, si les lésions touchent d'autres zones du cerveau alors le langage doit être épargné. En analysant, les données rapportés par un confrère neurologue, Claude-François Lallemand, Bouillaud obtient une confirmation expérimentale de cette théorie. C'est à la suite des travaux de Bouillaud que Paul Broca étudiera la question et donnera une localisation plus précise du centre du langage au pied de la troisième circonvolution frontale ascendante, une région depuis nommée aire de Broca. Les autres découvertes de Bouillaud sur le langage ne sont pas moins importantes: il est le premier à démontrer que la perte de langage, l'aphasie, existe sous deux formes qui résultent soit d'une incapacité à comprendre, mémoriser et générer des mots soit d'une incapacité motrice à les produire. Ces deux formes seront ultérieurement désignées sous les noms: aphasie de Wernicke et aphasie de Broca.
Malgré ces découvertes fondamentales, outre la théorie phrénologique désormais invalidée (contrairement à la localisation qu'il fit lui-même des aires du langage), on peut citer parmi ses fourvoiements un usage inconditionnel des saignées en cas de fièvre, la défense obstinée de la médecine anti-phlogistique et une grande réticence vis-à-vis des travaux de Louis Pasteur.
Jean-Baptiste Bouillaud (September 16, 1796 - October 29, 1881) was a French physician who was born near the town of Angoulême. He received his medical doctorate in 1823 and afterwards was a professor at the Charité in Paris.
Bouillaud performed research of many medical diseases and conditions, including cancer, cholera, heart disease and encephalitis, to name a few. He is remembered for providing a correlation between rheumatism and heart disease, and French medical dictionaries still refer to acute rheumatoid endocarditis as Bouillaud's disease. He describes this condition in his treatise Traité clinique des maladies du coeur. Bouillaud was also an early practitioner of the drug digitalis for treatment of heart ailments. He referred to digitalis as the "opium of the heart".
In 1825 Bouillaud published Traité clinique et physiologique de l'encéphalite, ou inflammation du cerveau in which he includes one of the earliest studies regarding localization of brain functions. He maintained that loss of articulate speech was associated with lesions of the anterior lobes. Also, along with cardiologist Pierre Potain (1825-1901) he performed studies regarding "heart sounds" and the differentiation between normal and abnormal heart rhythms. Bouillaud was an ardent follower of François-Joseph-Victor Broussais (1772-1838) concerning the dubious practice of bloodletting.
Puerto Rican independence leader, surgeon and Légion d'honneur laureate, Ramón Emeterio Betances, was one of his prominent students.
Jean-Baptiste Bouillaud
French internist, born September 16, 1796, Bragette near Angoulême; died October 29, 1881. Paris.
Associated eponyms: Bouillaud's disease, A systemic inflammatory disease, characterised by acute attacks of fever spaced by remissions, the presence of acute joint disorder, endocarditis and pericarditis.
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).
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