(Peter Joseph), surgeon in chief to the Hospital of Humanity, formerly the Hotel-Dieu at Paris, was born on the 6th of February 1744 at Magney Vernois, a village in the neighbourhood of Lure, in the department of Haute Saone (formerly the province of Franche Comté). His father and mother were in that situation of life which is removed from want, and yet does not dispense with labour; he himself was the youngest child of a numerous family.
At Lure, under the direction of a private instructor, he was taught the first rudiments of the Latin tongue; his parents afterwards confided him to the care of the Jesuits, then almost exclusively entrusted with the education of youth in the public schools. This celebrated society, prompt in discovering, as expert at developing, and adroit in appropriating talents, soon distinguished Default, the young student from the crowd; and he, in his turn, was not displeased with the life he led in one of their seminaries.
On the completion of his studies, his father, who had destined him for the church, intimated a wish that he should apply himself to theology; but his genius had taken a different direction, and he was averse to the profession of an ecclesiastic: in short, young Default declared that he was determined to betake himself to the study of the healing art; and, after a long and ineffectual resistance on the part of his family, he was sent to Belfort, in order to serve an apprenticeship, as it was then termed, in the military hospital of that place. He accordingly spent three years there, during which he acquired some knowledge of anatomy, attended to the dressing of the patients, and endeavoured to supply, by his own observations, what was wanting in his instruction.
In the midst of these professional labours, his mind frequently rambled towards another science but little connected with surgery: this was mathematics, the elements of which he had acquired among the Jesuits. His progress in this favourite study was rapid; but he fell into one of the many errors so common among the physicians of that day: this consisted in a false application of the rules of geometry to the laws of the animal economy.
He not only perused with avidity the treatise of Bonelli De Motu Animalium, but actually translated the whole of it, and even added a commentary, still more abundant in calculation than that of the celebrated professor of Naples.
His success in a branch of physiology so much cultivated at that time, attracted the attention of one of his superiors, a zealous partisan of the doctrine of the mechanicians, who wished to attach him to his person; but his desire of fame required a more extensive theatre, and his love of study made him solicitous of better means of instruction. Paris presented both these advantages, and he accordingly repaired thither in 1764, at the age of nineteen, in search of them.
Surgery at that period flourished in the capital under the auspices of a Lafayette, a Morand, an Andosillet, and a Louis. The sight of such great masters excited the genius of those who aspired to emulate them: young Default deemed himself worthy of equalling men whom other students were content with only admiring. Animated by this sentiment, he entirely resigned himself to his ardour; anatomy became the special object of his labours, and his dispositions were not confined to the human body, for he investigated, by means of his knife, a prodigious number of animals of all kinds: at first, from a difficulty of procuring human subjects, and afterwards on account of the advantages which he experienced from this general method. In order to become intimately acquainted with our own organization, it is necessary to compare it with whatever has a resemblance to it in other bodies.
He accordingly spent the greater part of the day in the amphitheatre. The hours stolen from his favourite labours were employed in attending the hospitals; he was the first at the bed of the patient where an operation was to be performed, and was sure to be present at the dressings, on purpose to examine the result. The infirmities infirmities of mankind, sterile in respect to the vulgar, served him as the best treatise for curing them; and the great surgeons of all nations have formed their mode of practice by contemplating the same book.
But he reckoned too much on a robust and vigorous temperament; for, after two years close and assiduous application, he fell into a cachectical habit of body, which had nearly proved mortal, and which confined him for almost twelve months to his bed; but at length, owing partly to the vigour of his youth, and partly to the attention of his young friend Chopart, his inseparable companion in his operations, who attended him also during his last illness, and only survived him a few days, he was so fortunate as to recover.
Restored to life, he forgot that an excess of attention had conducted him to the very gates of death; a new career opened to his view, and required new efforts on his part. In the winter of 1766 he commenced a course of anatomy, and soon reckoned 300 pupils, most of them older than himself, who were attracted by the clearness of his demonstrations, the methodical arrangement of his descriptions, and, above all, by his indefatigable zeal in the science of instruction.
His success inspired the privileged professors, whose schools became deserted, with jealousy and revenge; they employed the authority of the corporation against him, and would have nipped his efforts in the bud, had it not been for the protection of Louis and Lamartine, who were zealous of protecting a youth of talents, whose sole reproach was, that he had not wealth enough to purchase certain franchises. After all, had it not been for the permission he obtained of borrowing the name of a celebrated physician, he must have actually desisted from his lectures.
Default's reputation now began to be buzzed about, and a multitude of patients claimed his assistance; but he constantly refused to practise until he should be placed at the head of some great establishment.
At length, at the repeated solicitations of his friends, he presented himself as a candidate to the corporation of surgeons; and they, much to their honour, admitted him in 1776, on condition of paying the usual fees when convenient. The following is the title of his thesis: "De calculo vesicae urinariae, eoque extrabendo, praedictae sectionis, ope instrumenti Haufenfiani emendati."
His public lectures were accompanied with as much celebrity as his private ones. Brilliant discoveries were not the object of his anatomical labours, which were always connected with the art of healing: he was, however, the first man in France who taught surgical anatomy.
After becoming first a simple member, and then a counsellor, of the perpetual committee of the academy of surgery, he was appointed chief surgeon to the hospital of the college, and consulting surgeon to that of St Sulpice: neither of these added any thing to his fortune, but they gave him a clear insight into practice, and enabled him to judge of cases by the inductions arising from his own experience.
In 1779 he invented the bandage now in use for fractures; by means of which, the fragments being kept in a state of perpetual contact, become consolidated, without the least appearance of deformity, an almost inevitable consequence of the former mode.
On his appointment to the place of surgeon major to the hospital de la Charité, in 1782, he introduced a new method of treatment in oblique fractures of the thigh-bone; and he also healed, by means of a methodical compression, those various ulcers whose cure had hitherto been attended with great difficulty. In addition to this, he substituted new bandages in fractures of the humerus and clavicle, and adopted a new mode of treating the hare-lip, superior to that used by Louis. He never resorted to amputation but in extreme cases, when there was a certainty that dissolution would have followed a neglect of the operation.
When a premature death carried off Ferrand, chief surgeon of the Hotel-Dieu in Paris, Default was considered as the most proper person to succeed him; and, on the demise of Moreau, the whole charge of the hospital devolved on him. After three years of solicitations and disputes, he at length in 1788 proceeded in his long-projected scheme of establishing a clinical school; and a spacious amphitheatre was accordingly erected for that purpose. Scarcely had his first (a) course commenced, when the number of pupils who flocked around him was really astonishing. Foreigners repaired from all parts, and several of the neighbouring states sent students to Paris, expressly for the purpose of assiting at his demonstrations. More than 600 auditors constantly attended, in order to learn a new system, consisting of a simple mode of treatment, disengaged from ancient prejudices, and a complex incoherent practice.
A few of his improvements are here specified:
1. The method of ligature employed by the ancients in the cure of umbilical hernias of children, having been generally omitted in the practice of the moderns, he again introduced and perfected this mode, and demonstrated, by his success, its superiority over compressive bandages.
2. He was one of the first men in France to extract the loose cartilages (cartilages flottants) in joints.
3. He employed a new treatment, that of a methodical compression, in respect to schizotomies of the rectum; in order to which he introduced a candle or bougie, the size of which he gradually augmented.
4. He simplified, and rendered more commodious, the reduction of luxations of the humerus.
5. Fatal experience having pointed out the danger of employing the trepan in wounds of the head, he substituted another method of treatment (l'usage de l'émisique) now adopted by many practitioners.
(a) The business of the day was conducted in the following routine: 1. A public consultation concerning the indigent out-patients. 2. The young practitioners belonging to the hospital read a detailed account of all the interesting cases of such patients as were to be discharged that day. 3. The operations; each of these was preceded by a dissertation on the state of the patient, who was then carried to the amphitheatre, where Default, attended by his assistants, performed the operation in presence of all the pupils. 4. Argumentative details, by the professor, either on the dangerous maladies existing in the hospital, or on the situation of the patients on whom operations had been performed during the preceding day. 5. The division of subjects. And, 6. A lecture on some particular branch of pathology. He made several very useful improvements on chirurgical instruments; such as those employed in the cases of polyps in the womb and nostrils (la pince à galte et des porte-mains pour la ligature des polypes, &c.) for cutting through obstructions in the different cavities (le kystome); and for the fistula in ano. In cases of incision he introduced the use of the instrument (le gorgette) invented by Marchetti, well known among foreigners, but almost totally neglected in France before this period.
He at the same time retrenched the use of a great number of superfluous ones, and banished all practices attended with greater pain than utility. Avoiding every thing that was complex, he proved that the art of healing, in imitation of nature, ought to be simple in its means, and fruitful in its resources.
In 1791 he published his Journal de Chirurgie, which was edited by his pupils, and destined to describe the most interesting occurrences in his school, and also extracts from his lectures, which were then dedicated to the investigation of the maladies incident to the urinary passages. The treatment of these diseases, hitherto the reproach of practitioners, had been much improved by the affluence of the artist Bernard. The elastic probes (les fondes élastiques), on their first appearance, fixed the attention of all professional men; but none knew better than Default how to appreciate their advantages. By means of them, he introduced a novel mode of cure in contractions of the urethra, which saved a great number of lives every year in the Hotel-Dieu. But he did not confine their use to the diseases of the urethra alone, for he employed them to remove the divers obstructions that impede deglutition or respiration.
In the midst of such a multiplicity of labours, and although he was obliged to attend 450 sick twice a day, Default nevertheless employed more than four hours of his time in visiting private patients.
Few surgeons ever enjoyed such an exclusive share of public confidence; few ever possessed similar means of enriching themselves; and yet he neglected for a long time to take advantage of this. Had he been less ardent for glory, he would have been more favoured by fortune; but he sacrificed all interested views to the noble ambition of advancing his art. His clinical and anatomical courses were gratuitously opened by him to the world after the year 1790; and while the public schools languished in the midst of troubles, inseparable perhaps from a mighty revolution, he was forming the greater part of those surgeons employed at this present moment in the numerous armies of the republic. Considered under this point of view alone, the services which he rendered to humanity are incalculable: too happy if persecution had not been his sole reward!
While out of mere attachment to the public weal, he added to his various functions that of a member of the council of health, conferred on him in 1792 by the minister Servan, he was denounced in the popular societies as an egotist, an indifferent, &c., and became one of the first victims of that proscription which, under Robespierre, extended to nearly every man of talents.
Chauvet accused him to the sections as having neglected the brave men wounded on the 10th of August, while they themselves were lavishing their blessings at the Hotel-Dieu on their favour. Twice was he brought to the bar of a commune; dourous of discovering a pretext for persecution, the clamours of the people were unremittingly excited against him. He was at length carried away from his amphitheatre, while in the very act of haranguing his pupils; and, in consequence of a mandat d'arrêt from the revolutionary committee, conducted by a body of armed men to the Luxembourg. From this horrid prison few ever departed but to meet their fate; luckily, however, his name was not yet entered on that bloody list, in which those of Maleherbes and Lavoisier were inserted. On the contrary, at the end of three days he was liberated, and instantly resumed all his functions.
On the establishment of L'Ecole de Santé, Default was appointed clinical professor; and for external maladies he soon after obtained from the government the conversion of the Évêché into an hospital for surgical operations.
In the midst of these plans, the troubles that occurred in the month of May unfortunately affected his mind, and made him dread lest the days of proscription should return. It was in vain that his friends attempted to soothe his sufferings; for on the night of the 29th of May, a malignant fever made its appearance, and a nearly continual delirium ensued until his death, which occurred on the 1st of June 1795, on which day he breathed his last, in the arms of his pupils, at the age of 51.
The populace were persuaded that he was poisoned. This ridiculous opinion originated in consequence of the epoch of his death, which preceded but a short time that of the son of Louis XVI., whom he had visited during his illness in the prison of the Temple. It is pretended that he fell a victim to his constant refusal to yield to the criminal views entertained against the life of that child.
Default was of a middling stature. He was well proportioned, and possessed an open countenance. His temperament, naturally robust, had been fortified by his early education, and was never fagged by an excess of pleasures, for to them his heart was always indifferent. His ruling passion was the love of glory; his favourite pursuit, the practice and advancement of his art. He was warm, nay sometimes violent; and his scholars were not always inclined to praise the sweetness of his temper. On the other hand, his mind was noble, elevated, and great, even to excess.
The French republic, eager to pay homage to his memory, has presented his widow with a pension of 2000 livres per annum. A son, Alexis Mathias Default, was the sole fruit of his marriage; and he has left but one work behind him, in which the name of his friend Choart is joined with his own. It is entitled Traité des Maladies Chirurgicales et des Opérations qui leur conviennent, 2 vols 8vo.