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BICHAT

Volume 4 · 2,926 words · 1842 Edition

MARIE FRANÇOIS XAVIER, celebrated as an anatomist and physiologist, was born in France, at a village called Thorette, on the 11th of November 1771. Great attention was paid to his education by his father, who was himself a physician, and who initiated him at an early age in those studies which were to prepare him more particularly for the profession to which he had destined him. He studied first at the college of Nantua, and afterwards at a seminary at Lyons; and was early distinguished for that activity of mind and facility in acquiring knowledge, which are the sure presage of great attainments at a mature age. In mathematics, and the physical sciences more especially dependent on abstract reasoning, for which he showed a remarkable predilection, he made rapid progress. He afterwards became passionately fond of natural history, and devoted all his time to this new study. He had already made considerable advances in this branch of science, as he had before done in natural philosophy and mathematics, when his ardour was suddenly checked by the reflection that he was engaged in pursuits that were boundless in their object, and that were in danger of leading him too far from his future profession, through which alone he aspired to celebrity. Bidding adieu, therefore, with a singular effort of resolution, to his favourite occupations, he applied himself at once with great diligence to the study of anatomy and surgery, under the guidance of Petit, who was chief surgeon to the Hôtel Dieu at Lyons. It is also curious that, some time after he had fully engaged in this course of instruction, he experienced a relapse of his passion for mathematics to such a degree, that, yielding to the fascination, he resumed his early studies, in which, however, he had sufficient discretion to restrict himself within such limits as did not interfere with his medical pursuits. Petit soon discerned the superior talents of his pupil; and, although the latter had scarcely attained the age of twenty, employed him constantly as his assistant in his professional labours. The revolutionary disturbances, which raged with so much fury at Lyons, unfortunately interrupted his progress, in the midst of the flattering prospects which were opening to him; and flying from the horrors of the siege which that devoted city was about to sustain, he took refuge in Paris about the end of the year 1793. He there resumed the course of his professional studies, and became the assiduous attendant upon the lectures of the celebrated Dessault; and in this, as in the former instance, became in no long time the companion and friend of his instructor. His merit was brought to the notice of Dessault by an accidental circumstance. It had been an established custom in the school, that the substance of the lecture of the preceding day should be recapitulated, as an exercise, before the whole class, by one of the pupils selected for this purpose. It happened one day that the pupil on whom this task devolved was absent at the time when he was expected to perform it, and the professor asked if anyone among his auditory would offer himself as a substitute. Bichat boldly came forward to volunteer his services, and acquitted himself to the admiration of all his hearers. The subject he had to explain was the theory and treatment of fractures of the clavicle. The exact analysis which he made of the instructions contained in the lecture, the copiousness and novelty of his illustrations, and the spirit of order and of method which characterized the whole of his exposition, joined to the modesty with which he stated some doubts, as well as some original views which he had taken of the subject, revealed at once the extent and vigour of his genius, and the expectations which might justly be entertained of his future eminence in his profession. Dessault, in particular, was strongly impressed with the superiority he had manifested over all his other pupils; and from that day he became an inmate in his house, and was treated in all respects as an adopted son. The opportunities which fortune thus placed within his reach were eagerly employed; and the favoured pupil showed himself worthy of the protection and confidence which he received. We find him, between the years 1793 and 1795, actively participating in all the labours of Dessault, visiting his patients both at the hospital and in private, accompanying him everywhere as his assistant in his operations, and writing the greater part of his letters in answer to those who consulted him from a distance. His exertions by no means closed with the day; and he passed a great portion of the night in assisting to conduct the experimental researches on the diseases of bones, in which that able surgeon was engaged, and in consulting, previously to each lecture, the works of the ancient authors on the subjects to which they related. Whatever Dessault expressed a desire to have done, and he often required more than an ordinary person would have supposed it possible to perform, was sure to be accomplished within the requisite time by his indefatigable pupil. Notwithstanding these multiplied occupations, Bichat found means to prosecute his own researches in anatomy and physiology, to which he devoted every interval of leisure he could seize. The sudden death of Dessault, who was snatched from the world in the meridian of his fame, was a severe stroke of adversity to Bichat; but the event, though it deeply afflicted, did not discourage him; and though it might interrupt for a time, did not eventually relax, his efforts at advancement. His first care seems to have been to acquit himself of the obligations he owed his benefactor, by contributing to the support of his widow and her son; and by conducting to a close the fourth volume of Dessault's Journal de Chirurgie. To this volume he subjoined a biographical memoir of its author, in which he pays a just tribute to his merit. His next object was to re-unite and digest in one body the different surgical doctrines which Dessault had advanced in fugitive papers, published in various periodical works. Of these he, in 1797, composed a work, in two volumes octavo, entitled Œuvres Chirurgicales de Dessault, ou Tableau de sa Doctrine, et de sa Pratique dans le Traitement des Maladies Externes; a work in which, although he professes only to explain the ideas of another, he develops them with the clearness and copiousness of one who is in perfect possession of the subject which he treats. He was now at liberty to pursue the full bent of his genius, and soon arrived at those comprehensive and masterly views of physiology which, when afterwards developed in his writings, gained him so much applause. Undisturbed by the storms which agitated the political world, he pursued with steadiness the course he had meditated, and directed his more immediate attention to surgery, which it was then his design to practise. We meet with many proofs of his industry and success at this period in the Recueil de la Société Médicale d'Emulation, an association of which Bichat was one of the most zealous and active members. Three memoirs which he communicated were published by the society in 1796; the first describing an improvement in the instrument for trepanning; the second detailing a new process which he devised for the ligature of polypi; and the third, in the distinction to be observed in fractures of the clavicle, between those cases requiring the assistance of art, and those in which its interference would be of no avail. In 1797 we find him undertaking the arduous task of instructing others, which he commenced by a course of anatomical demonstrations. Not expecting any great number of pupils, he had hired a small room for the purpose; but his merit as a teacher soon attracting a crowd of auditors, he was obliged to enlarge his theatre, and was also encouraged to extend the plan of his lectures, and to announce what had never hitherto been attempted by one so young and inexperienced, a course of operative surgery. If the boldness of the enterprise was calculated to excite surprise, his success in the execution of it was still more astonishing. His reputation was now fully established, and he was ever after the favourite teacher with the students who resorted to the capital. In the following year, 1798, he gave, in addition to his course on anatomy and operative surgery, a separate course of physiology. But the exertion of speaking which these numerous courses of lectures, all of which he conducted at the same time, required, was more than his frame could bear; and a dangerous hemoptysis, with which he was seized in the midst of his labours, obliged him to interrupt them for a time, and warned him that there are limits to human strength. But the danger was no sooner passed than the lesson seems to have been disregarded; for we find him plunging into new engagements with the same ardour as before. He had now scope in his physiological lectures for a fuller exposition of his original views in the animal economy, which were no sooner made known to his pupils, than they excited much attention in the medical schools at Paris; and he was induced to publish them in a more authentic form. Sketches of these doctrines were given by him in three papers contained in the Memoirs of the Société Médicale d'Emulation. The first is on the synovial membranes; in which he gives a more clear description of the organ that secretes synovia, a fluid, the origin of which had been a matter of much controversy. The next contains an account of the membranes of the human body in general, which he considers apart from the organs they invest and support, and which they serve to supply with vessels; and regards as performing offices in the economy distinct from those of the organs with which they are so connected. His last memoir relates to the symmetry, which is so remarkable a feature in all those parts of the body that are the instruments of the animal functions, and which establishes so exact a similarity between the limbs and organs of sense on each side of the body; while, on the other hand, no such regularity can be traced in the forms and dispositions of the viscera, which, like the heart, the stomach, liver, and other organs of assimilation, are subservient to the vital functions. He even assumes this difference as the foundation of a marked distinction between these two classes of functions; the one, being common to all organized beings, he designates organic; the other, as exclusively pertaining to animality, he denotes by the name of animal functions. The doctrines contained in these memoirs were afterwards more fully developed in his Traité sur les Membranes, which appeared in 1800, and which immediately drew the attention of the medical world both at home and abroad. Some time previous to this he gave to the public a small work, in which he endeavoured to bring together, in a condensed form, the lessons of Dessault relative to the diseases of the urinary passages: in the notes to this volume we may perceive the germ of many of those views which were peculiar to Bichat.

His next publication was the Recherches Physiologiques sur la Vie et sur la Mort, in 1800, which consists of two distinct dissertations. In the first, he explains, at still greater length than he had previously done, his classification of functions, and is at pains to trace the distinction between the animal and organic functions in all its bearings. In the second, he investigates the connection between life and the actions of the three central organs, the heart, lungs, and brain, on which its continuance so essentially depends. But the work on which he bestowed the most attention, and which contained the fruits of his most profound and original researches, is the Anatomie Générale, which was published in four volumes octavo in 1801. It is founded on his classification of the parts of the body, according to their intimate structure; in order to establish which, he decomposes the animal machine, not merely into the larger pieces of which it is formed, but into the organic elements that constitute them. Of these elementary parts or textures, as he terms them, into which every organ may be ultimately analyzed, he enumerates twenty-one different species. He conceives each of these textures to possess a peculiar modification of vitality, from which it derives those properties that distinguish it from dead matter, and that give rise to all the phenomena of the animal economy, both in a healthy and a diseased state.

Before Bichat had attained the age of eight-and-twenty, he was appointed physician to the Hôtel Dieu, a situation which opened an immense field to his ardent spirit of inquiry. In the investigation of diseases, he pursued the same method of diligent observation and scrupulous ex- periment which had characterized his researches in physiology. He learned their history, not from books, but by studying them at the bedside of his patients, and by accurate dissection of their bodies after death. He engaged in a long series of examinations, with a view to ascertain the exact changes induced in the various organs by diseases, which he conceived, in every instance, primarily to affect some one of their constituent textures, while the rest did not suffer any change, unless by the intervention of some other disease. In the prosecution of these inquiries he had, in less than six months, opened above six hundred bodies. As intimately connected with the practical exercise of the healing art, he was anxious also to determine, with more precision than had hitherto been attempted, the effects of remedies on the body. It must be confessed, that our knowledge of the operation of remedies is, for the most part, extremely vague and conjectural; and it appeared to him an object of great importance to rescue this branch of science from the uncertainty in which a multitude of points relating to it were still involved, by applying to it the same methods of inductive reasoning which in other sciences have been attended with so much success. The basis of the inquiry was to be laid by collecting a sufficient number of facts to admit of their being compared and generalized. A large hospital could alone furnish the means of conducting such an investigation; and Bichat eagerly availed himself of the opportunities which his appointment at the Hôtel Dieu now afforded him, of instituting on these subjects a series of direct experiments on a very extensive scale. He began by giving singly different medicinal substances, and then watching attentively the phenomena that ensued. He then united them in various ways, first joining two together, then three, and so proceeding to more complicated combinations; and observed the particular changes in their mode of operating which resulted from their being thus combined. So wide a range of experiments, it is evident, could not have been conducted without assistance; and he selected forty of his young pupils to aid him in collecting the requisite observations. He had already, in this way, procured a vast store of valuable materials for his course of lectures on the Materia Medica, the completion of which was unfortunately prevented by his untimely death; but a great part of the facts were subsequently published in the inaugural dissertations of his pupils. Latterly, he had also occupied himself with framing a new classification of diseases.

During these arduous vocations, he never lost sight of his anatomical pursuits, and had commenced a new work on the subject, in which the organs were arranged according to his peculiar classification of their functions, under the title of Anatomie Descriptive. He lived only to publish the first two volumes of this work. It was, however, continued on the same plan, and completed in three volumes more, by Messrs Buisson and Roux, who had been his most active assistants, and who appear to have been perfect masters of his ideas on the subject. His death was brought on by a fall from a staircase at the Hôtel Dieu; and although the accident did not at first appear to be serious, it excited so great a degree of fever, that his frame, already exhausted by excessive labour, and enfeebled by constantly respiring the tainted air of the dissecting-room, in which he had latterly passed the greater part of his time, sunk under the attack. He died on the 23rd July 1802, universally regretted by his pupils, and attended to the last by the widow of his benefactor, from whom he had never been separated. Every tribute of respect was paid to his memory; his funeral was attended by above six hundred of his pupils; and by a number of the physicians in Paris. His bust, together with that of Desault, was placed at the Hôtel Dieu by order of the first Biclinium consul, in joint commemoration of the man under whose fostering protection so bright a genius was first brought before the public, and of the pupil who nobly emulated the fame of so great a master. We cannot, indeed, refrain from admiration, when we contemplate all that Bichat has done in his profession in so short a period of time, nor sufficiently lament that a career so auspiciously begun should at the age of thirty have been so suddenly and prematurely terminated.