FranÇois Joseph Victor Broussais was born in 1772 at Saint-Malo, a seaport on the north coast of France, in the Department of Ille-et-Vilaine (formerly a part of Brittany). His early medical training was obtained at Paris, where he attended for a short time one of the courses of instruction given by Bichat. On reaching the age of forty-two he entered the service of the Military Hospital at Val-de-GrÂce, and not long afterward was chosen Professor of General and Special Pathology and Therapeutics at the University of Paris. The lectures which he delivered on these subjects so fascinated the students and the numerous physicians who attended the course in increasing numbers, that—as Pagel expresses it—a general impression was created, during a period of several successive years, that the whole of French medicine was represented in the person and doctrines of Broussais. The correctness of Pagel’s statement is corroborated by the following extract from “J. L. H. P’s sketches”:—

Monsieur Broussais is unquestionably the most remarkable medical writer of the present age. Splendid works, celebrated lectures, and a great number of proselytes, have in a few years spread far and wide his name and his opinions.... There are, on the other hand, many physicians, who, too old to return now to their studies, and witnessing with no pleasure all these innovations, say that the professor of Val-de-GrÂce is only a sectary, in whom passion holds the place of genius, and hardihood of force.... His brutal attacks on men, whether dead or living,—French or foreigners, surrounded with the esteem and admiration of all,—have found approval only among the personal enemies of the contemporaries whom he criticises, and this too in a generation greedy of novelty, and imposed upon by his rough manners and bold speech.

The extract also shows that not a few French physicians refused to accept the “fascinating” doctrines promulgated by Broussais, and reported by him to be “founded on physiological principles.” As Broussaism played such an important part, during the early years of the nineteenth century, in hindering the advance of the real science of medicine, my readers will pardon me, I am sure, if I devote considerable space in the attempt to elucidate the meaning of Broussaism. These revolutionary ideas regarding “physiological medicine” were first published in book form in 1816. Two later editions followed,—one in 1821 and another in 1829. The text is arranged in the form of propositions or “physiological principles,” of which there are 568. Pagel describes them as “not being related in the remotest degree to modern physiology.” In the following paragraphs I have reproduced (in the form of translations) a few of these “Propositions de MÉdecine” as they are printed in the edition of 1829:—

II.—Heat, from whatever source it may be derived, is the first and most important of all stimuli; and, when it ceases to exert its vitalizing power upon the economy, all other stimuli lose their power to produce any effect upon it.

IV.—If heat is withdrawn for a certain period of time all those phenomena of the economy which are of a conservative, reparative or medicative nature cease all activity; and the same is true when oxygen is withdrawn.

XX.—Assimilation, which is a phenomenon of the very first order, cannot be explained by the assumption that it is due to the action of sensibility and contractility; it should be looked upon only as a manifestation of a creative force,—as an act of vital chemistry.

XLII.—Instinct consists of nervous impulses or stimuli—sometimes associated with consciousness and sometimes not—which originate in one of the viscera, and which call upon the central nerve power to execute such acts as are necessary to the exercise of the functions of that viscus.

XLIV.—Acts which are originated by instinct are most frequently observed in infants, and are witnessed with diminishing frequency as the child’s intelligence becomes more perfect.

XLVII.—As may be said with equal truth of insanity the passions furnish an example of the triumph of the viscera—that is to say, of instinct—over intelligence; and, on the other hand, it is well-known that the passions themselves produce insanity.

LI.—The intellectual faculties may be exercised without any participation of passion, but never without an accompaniment of either pleasure or pain.

LXIV.—An excess of haematosis or sanguification in an organ increases at first the sum total of its vitality, but this increase is subject to limitations. If, for example, the excitation is kept up beyond a certain length of time the continued hyperaemia establishes in that organ a condition which deserves to be called disease.

XCIX.—When irritation causes the blood to accumulate in a part or tissue, and when, further, this accumulation of blood is accompanied by such an exceptional degree of swelling, redness and heat as to threaten the disorganization of the part thus irritated, it is customary to apply to this complex phenomenon the name of “inflammation.”

CXXVII.—Tubercles, cancers, etc., of the brain owe their origin to a chronic inflammation of that organ.

CLXVIII.—I have never seen tubercles of the lungs except in cases where these lesions had developed from an antecedent inflammation; and it does not appear to me that the tubercles which are observed in the lungs of infants at birth, may rightly be considered as having originated independently of inflammation.

CXCV.—All the different varieties of acute and subacute inflammation possess the power to produce cancer.

CCCVII.—He who does not know how to manage properly a case of irritability of the stomach will never be able to treat successfully any other malady. In short, the key to a knowledge of pathology is to be found in an intimate acquaintance with gastritis and gastro-enteritis.

CCCXLII.—Pulmonary phthisis may be prevented by putting an end, by means of antiphlogistic remedies and revulsives, soon after its presence is discovered, to any existing irritation of the respiratory apparatus.

These dozen or more of Broussais’ “Propositions” or fundamental medical doctrines should suffice, it seems to me, to give the reader a correct idea of the kind of physiology and pathology that found favor in France during the third and fourth decades of the nineteenth century, and that too despite the thoroughly sound and admirably logical, but less fascinating, teachings of such authorities as Morgagni, Bichat, Ch. A. P. Louis, Bayle, Corvisart and LaËnnec.

It was toward the end of this same year (1821) that LaËnnec began teaching his new method of auscultating the chest by means of the stethoscope—which had first been made known to the world by Auenbrugger in 1761, but which had been completely ignored until Corvisart published a French translation of Auenbrugger’s book in 1808. As early, however, as in 1819 LaËnnec had published reports of a number of instances in which, by means chiefly of this method of exploration, he had correctly diagnosed the presence of tuberculous and other deposits in the lungs of certain patients. The publication of these reports evidently excited very much the wrath of Broussais, for in the new edition of his book (viz., that of 1821) he criticises LaËnnec’s statements most unjustly and in a manner that reveals how completely his mind was saturated with the belief that what he calls “inflammation” is at the bottom of most of the pathological phenomena encountered in medical practice. Lack of space will not permit me to quote here more than one or two of Broussais’ comments on the conditions reported by LaËnnec:—

The pathological alterations, considered by themselves, are simply curiosities, and are not of the slightest utility to anybody who may feel disposed to study them; because they are all either the products of simple inflammation, or else they owe their origin to some cause which does not fall legitimately in the domain of physiological pathology.

(Copied from pp. 674, 676, 677, and 679 of Vol. II., edition of 1821.)

Further on in the same volume, speaking of melanotic cancers, Broussais says:—

... this is all that it is important for the physician to know; and, as to what Monsieur LaËnnec has written about black cancers, I may say that it is simply the product of his imagination, a gloomy romance, which I found difficulty in reading from the beginning to the end.

It seems proper that I should furnish some information concerning Broussais’ methods of treatment in different diseases. In the last analysis it will be found that in nearly all cases he adopted such remedial measures as tended to allay or arrest inflammatory action. Thus, in beginning pulmonary consumption he prescribed the application of leeches to the infraclavicular region; in jaundice they were to be applied in the hypochondriac region, in pharyngitis and tonsillitis to the side of the neck, in dysentery to the anus, in articular rheumatism to the neighborhood of the affected joint, and, in maladies that were not distinctly localized, the epigastrium was the region to be chosen by preference. When simple irritation was present Broussais prescribed revulsives—such, for example, as blisters, emetics and laxatives. As a rule, however, he gave the preference to direct antiphlogistic measures. He is credited with having had a profound contempt for the vis medicatrix naturae. It was said that his pupils showed a tendency to push his pathologic teachings to an extreme. Desruelles, for instance, was in the habit of treating his syphilitic cases, not with mercury or any other of the specific remedies commonly employed at that period, but with leeches applied locally.

As early as in 1816 Broussais announced that, as a result of his doctrine, “the mortality of Val-de-GrÂce had greatly diminished, to the grand astonishment and admiration of the world.” This assertion not having been noticed, Monsieur Broussais, in 1821, went a step further. He then predicted, in the Preface to his “Examen des Doctrines,” that his doctrine would soon exert an influence on population more marked than that exerted by vaccination. This was pretty strong, but not, however, sufficient; for in 1822, “the Prospectus of Les Annales de la MÉdecine Physiologique declared that, in the hospitals where the physiological doctrine was adopted, the mortality was only one in thirty, while in the others it amounted to one in five.” These results, which caused great astonishment, induced Monsieur Brasquet, a physician, to inspect the records with a view to ascertaining the exact facts. Thus it was discovered that, during the five years from 1815 to 1819, Monsieur Broussais had lost more patients than his contemporaries had lost during the same period; his mean mortality having been one in thirteen. (The results of Monsieur Brasquet’s inquiry were published in the Revue MÉdicale.) “Monsieur Broussais replied in Les Annales de la MÉdecine Physiologique, but his reply was not at all satisfactory. He did not deny the correctness of the figures published in the Revue MÉdicale, but he maintained that they proved nothing against him.” The proof, however, that he had lost one patient in thirteen, and not one in thirty, as he had claimed, remained unshaken.

It was probably this experience that marked the beginning of the downfall of the doctrine known as “Broussaism”; but many years had to elapse before this doctrine vanished entirely from the accepted medical textbooks. August Hirsch, in his “History of the Medical Sciences in Germany” (1893), passes the following judgment upon Broussais’ work: “Under the title of ‘Physiological Medicine’ Broussais presented to the world a system which for narrowness of scope, for arbitrariness and for the perniciousness of the treatment which was deduced from the premisses that grew out of the theory, could be compared only with Rasori’s therapeutic method.”

Broussais died in 1835.