J. L. PETIT, OF PARIS, AND HIS CONTEMPORARIES IN SURGERY—SABATIER, CHOPART, DESAULT AND DUPUYTREN

In the history of surgery in France there is a conspicuous absence of distinguished names from the list of men who succeeded Ambroise ParÉ, until we reach that of J. L. Petit, a surgeon whose career shows him to have been worthy of all the praise and esteem which the French have lavishly bestowed upon him.

Jean-Louis Petit was born at Paris in 1674, and already at the early age of twelve manifested a strong inclination to adopt a surgical career. By the time he had reached his sixteenth year he had become so expert as a dissector that he was entrusted with the duties of a demonstrator of anatomy, a position which he filled to the entire satisfaction of both the students and the superior authorities of the medical school. Two years later,—that is, in 1692,—he entered the military service and was given the position of Army Surgeon. He was present at the siege of Namur, and served through all the succeeding campaigns up to the year 1697, at which time he was placed in charge of the Military Hospital at Tournay. In 1700 he retired from the army and returned to Paris, where he engaged in private practice and at the same time gave instruction in anatomy and surgery. From this time forward his reputation as a skilful surgeon rose rapidly until he was universally acknowledged to be the leading surgeon of the capital, a fact which was confirmed by his election to the position of Director of the Royal Academy of Surgery.

It was said of him by a very competent critic (A. Richet) that Petit was one of the boldest and most skilful surgeons of his day. He possessed a profound knowledge of the anatomy of almost every region of the body, and at the same time was remarkably skilful in the handling of his bistouri. He also seemed to possess, on the spur of the moment, an intuitive knowledge of what he should do in any situation of affairs that might suddenly develop in the course of an operation. The reflections which he made as he progressed in the work with which he happened to be busied, were most original, and led somebody to say of him, on a certain occasion: “He must have invented surgery.” On reading his treatise on surgical maladies one is struck with the originality of his remarks, with the profoundness of his thinking, and with the closeness and accuracy of his observations. His writings make most attractive reading for the surgeon.

In order that my readers may judge for themselves how cleverly and how wisely Petit dealt with some of the surgical problems which presented themselves for solution in the course of his private practice I will give here, in the form of very brief translations, three instances which seem to me to possess to-day a peculiar interest in that they reveal the important fact that a correct diagnosis may occasionally be made without the aid of some of the complicated and expensive machinery which not a few of our modern surgeons think indispensable to the ascertainment of the truth. I should perhaps modify this last remark by stating that the extraordinary cleverness and practical wisdom exhibited by J. L. Petit are gifts not often bestowed by Nature upon physicians, and that therefore the X-ray and other modern inventions which compensate for the infrequency of such gifts, are to be considered in the light of very important blessings conferred upon suffering humanity.

(1) “The man, whose case history I am about to relate, said that the symptoms from which he had suffered, during the preceding twelve months, were the following: a frequent but dry cough, with loss of appetite; almost constant thirst; difficulty in obtaining sleep; night-sweats, more marked in the region of the head and neck than elsewhere; and irregular chills and fever. The physicians whom he had consulted were led to believe that he was affected with consumption, and they treated him in accordance with this belief, but so far without success.—On examination I found that two of his teeth were carious, and I advised their extraction. A rapid restoration of the patient’s health followed in less than a fortnight.”

(2) “The late Princess of CondÉ had interested herself greatly in a young girl whom she had taken into her service. Upon her return to Paris she took the girl with her, in the hope that the physicians of that city would be able to cure her of the hemicrania (‘Migraine’) from which the girl had frequently suffered during the preceding five years. Bloodletting was the remedy adopted at that period for nearly every malady, and these Paris physicians let her have a full taste of this remedy, prescribing in rather rapid succession twenty such bleedings, the arm, the foot and the region of the throat being the localities selected for this operation. Medical students were thought to be quite sufficiently competent for the management of the arm and foot bloodlettings, but it was I who was obliged to officiate when it became necessary to carry out the bleeding from the neck. As this was the first occasion on which I saw the patient I asked her a number of questions in order to learn the more important facts concerning her malady; and then, failing to discover any that seemed to me to justify the numerous bleedings to which she had been subjected, I examined her mouth, not as a casual matter, but because she had told me about having experienced a sense of heaviness and numbness in her lower jaw. Observing some irregularity in the arrangement of her teeth I counted them, and discovered that there were eighteen instead of the sixteen which are usually present; and it also seemed to me that the second molar tooth on each side was crowding the others. After stating these facts to the Princess, and obtaining her approval of the step which I proposed to carry out, I had the two molars extracted; whereupon, to the great astonishment of her ladyship and all of us, the girl found herself, at the end of twenty-four hours, entirely cured of a malady which had often, during the preceding five or six years, been so distressing that she could not perform her regular duties.” (Copied from Petit’s “TraitÉ des Maladies Chirurgicales,” etc.)

(3) In another part of the same volume Petit reports in detail the history of a case of middle-ear inflammation in which, after the lapse of a few weeks, there developed symptoms that pointed very strongly to the presence of a subdural collection of pus behind and above the inflamed middle-ear. Whereupon, at a consultation that was held between the physicians in attendance upon this patient, Petit urged the desirability of trephining the skull in order to give vent to the contents of this assumed abscess. Such a proposition, however, was promptly voted down by the other consultants. (The events here described, it should be remembered, occurred somewhere between 1750 and 1774.) Two or three weeks later, the patient’s pain having become in the meantime more severe, the timid consultants at last withdrew their opposition, and Petit performed the trephining with success. Much foul-smelling pus was evacuated, and after the lapse of a few weeks the patient was pronounced cured.

It would be easy to furnish here, from the printed record already mentioned, additional instances showing the courage, wisdom and skill exhibited by J. L. Petit in his practice of the art of surgery. But the instances already cited amply suffice, as it appears to me, to show the admirable character of the man and his right to be considered the worthy successor of Ambroise ParÉ.

Petit’s death occurred in 1760.

Petit made comparatively few contributions to medical literature, and of these the shorter ones will be found in the “Journal des Savants,” the “Recueil des MÉmoires de l’AcadÉmie des Sciences,” and the “MÉmoires de l’AcadÉmie Royale de Chirurgie.” His great work, which was published in three volumes at Paris in 1774 (also a later edition in 1790), bears the title: “TraitÉ des Maladies Chirurgicales et des OpÉrations qui leur Conviennent.”

Raphael-Bienvenu Sabatier was born at Paris on October 11, 1732. His father, Pierre Sabatier, was one of the earliest members of the AcadÉmie Royale de Chirurgie, and it was therefore quite natural that Raphael chose medicine for his profession. There was nothing remarkable about his early career. He worked hard at his studies of anatomy and cultivated at the same time experimental physiology. At the age of twenty-four he succeeded Balleul as Professor of Anatomy at the Royal College of Surgery. In 1773 he was made a member of the AcadÉmie des Sciences, and a few years later, when the war broke out, he was ordered to report, as a consulting surgeon, at the headquarters of the Army of the North, at Mons. But, his strength not permitting him to perform the duties of this new position for any length of time, he was soon allowed to return to his private practice. Toward the end of his life Napoleon appointed him one of his consulting surgeons, and at about the same period of time the decoration of the Legion of Honor was conferred on him. When the École de SantÉ was established he accepted the Chair of Operative Surgery. His death occurred on July 19, 1811.

Sabatier was highly esteemed by his professional brethren. Unlike Desault he brought forward no new inventions or methods of treatment, but he constantly sought how he might introduce some little improvement in existing well-established methods. He was not of an enthusiastic temperament and rarely did anything to call forth opposition on the part of his associates. As a consequence he led a most peaceful life.

Sabatier’s contributions to medical literature were fairly numerous, and among them the following deserve to receive particular mention:—

“TraitÉ d’Anatomie,” 3 vols., Paris, 1764.

“De la MÉdecine OpÉratoire,” 3 vols., Paris, 1796; a second edition appeared in 1810; and a third (in 4 vols.) in 1821–1824.

FranÇois Chopart was born at Paris in 1743. During his youth he received a thorough preliminary training. From the very beginning of his medical course he showed a decided preference for surgery. Then, for a certain length of time, he served as an interne at HÔtel-Dieu. Afterward he was transferred first to La PitiÉ Hospital and then to BicÊtre, where he devoted his attention mainly to syphilitic affections. In 1767 he divided the prize offered by the AcadÉmie de Chirurgie for the best memoir on the subject of “The Nature and Treatment of Wens.” In 1768 he was given an “Honorable Mention” for his memoir on “Injuries of the Head produced by Contrecoup.” In 1770, after passing with great credit the examinations required, he was given on July 20, 1770, the degree of Master of Surgery; and only one year later he was appointed Professor of Practical Surgery. His pupils were very much attached to him on account of the interest which he manifested in their work and because his teaching was so methodical and was so clearly delivered. On March 13, 1782, he was chosen successor to Bordenave, the Professor of Physiology; and a little later he was elected to the Chair of External Pathology. While on a visit to England he made the acquaintance of John Hunter, and kept up an active correspondence with him during the following years. He was also one of Desault’s intimate friends. Being open-minded and frank he got along pleasantly with all who came in contact with him. He died in 1795 from an attack of cholera morbus.

Among his writings which deserve special mention are the following: “TraitÉ des Maladies Chirurgicales et des OpÉrations qui leur Conviennent,” Paris, 1780, 2 vols.; and “TraitÉ des Maladies des Voies Urinaires,” Paris, 2 vols., 1701, and a later edition in 1821.

Chopart is known to American and English surgeons chiefly through the fact that he devised an amputation of the foot which is commonly known as “Chopart’s amputation.” The procedure is thus briefly described by Dr. Thomas L. Stedman in his Medical Dictionary: “Disarticulation at the metatarsal joint, leaving only the astragalus and calcaneum, with the soft parts of the sole of the foot to cover the stump.”

Pierre-Joseph Desault was born on February 6, 1744, at Magny-Vernois, a small village in the Department of Haute-Saone, on the western slope of the Vosges mountains. At the time of his birth his parents were living upon the income derived from a modest fortune, and they found it very difficult to support their family of seven. As soon as Pierre was old enough to receive regular instruction he was placed under the care of a private teacher at the neighboring village of Lure, the chief centre of that district. In this way he acquired an elementary knowledge of Latin and was fitted, by the time he reached the age of twelve, to enter the fifth form or class at the Jesuits’ college in Lure. His favorite study, as soon became evident, was mathematics, and this branch of knowledge he cultivated with such assiduity and success that already at the age of seventeen he had reached the point where all the elementary treatises to which he had access no longer afforded him any satisfaction. At a somewhat later period of his life, when he could no longer receive help from his parents, this decided preference for mathematics stood him in good stead, enabling him to contribute to his own support by giving lessons in geometry. It also aided him in making useful applications of its principles to the art which he was soon to cultivate with such conspicuous success—viz., surgery. He took special delight at this time in the perusal of Borelli’s celebrated treatise “on the movements of animals,” and even went so far as to write a long commentary on this work. Nothing, however, is now known about the fate of this document, as Desault never published it nor showed at any time a wish to become an author.

Bichat, from whose eulogy of Desault I have derived most of the facts which are reported in the present brief sketch, says that during the years immediately preceding the period which is now under consideration, surgery was cultivated by artisans rather than by artists; and that, in consequence of this situation of affairs, it was very slow in making any advances which were worthy to be characterized as genuine steps of progress. “Genius, when not appreciated, escapes as mere froth; its efforts result in nothing unless glory is the reward. Little by little, as the public learned more and more how great was its need of surgery, this art began to receive a larger share of consideration; and thus, as it became more honorable, it was cultivated to an ever greater degree, and as a result it advanced at a more rapid pace toward perfection. In its different branches, which were all working to accomplish some useful purpose, new discoveries were constantly being made, and thus it came about that from the middle of the eighteenth century onward French surgery rapidly outdistanced the surgery of all the other nations.” (Bichat.)

It was at this period that Desault began his career as a surgeon, and in the course of that career he did at least his full share in the work of supplying the deficiencies that were observed in some of the methods commonly employed at that period, in removing the positive defects that were discovered in others, and in devising entirely new procedures. At the same time Desault did not fail to recognize the importance of making the foundations of his knowledge as solid and firm as possible, and with this idea in mind he spent all the time that he could possibly spare from the clinical lessons which he was then giving, in utilizing the anatomical material available in the dead-house of the hospital. As his rivals stuck closely to the old methods of instruction, and in addition were not endowed with his remarkable gifts of teaching, of drawing all sorts of interesting inferences from the anatomical relations of the part or limb that was under consideration at the moment, Desault rapidly outdistanced all his competitors. He was, so far as I am able to learn from the printed records of this period (1766), the pioneer of this particular type of instruction (anatomical, pathological and clinical) in surgery in the great Paris hospital HÔtel-Dieu. The young men who attended these courses in ever increasing numbers were fascinated by what they heard and saw,—for Desault always taught with the cadaver or the living subject before him,—and it soon became very noticeable that the attendance upon the lectures given by his rivals (i.e., the regular professors) was falling off. Actuated by bitter jealousy these men managed at first to have his permit to teach taken away from him. But Antoine Louis and La MartiniÈre, two of the most influential surgeons of Paris, at that period, interfered and so arranged matters that Desault was able to resume his private courses. In fact, Louis made it clear, by his presence at several of the sessions, that he approved of this teaching and that he proposed to protect Desault against all interference on the part of rivals. Desault’s method of teaching, says Bichat, constituted the first development, in France, of what is now known as surgical anatomy, a very extensive and important department of the art of surgery.

Another striking feature of Desault’s manner of giving instruction is to be found in his invariable practice of demonstrating, whenever it was possible for him to obtain the materials necessary for doing this, the alterations which are produced in a part by disease or by accidental injuries, and also the influence exerted by these lesions upon the neighboring tissues or organs. In these demonstrations he never allowed his mind to wander in the direction of pointing out something akin to a discovery in pathology; he stuck closely to the questions that were under immediate consideration, thus giving preference, over everything else, to what was of chief importance to the students.

By thus conducting his teaching always with an eye single to the best interests of his pupils Desault became, in the course of a very few years, the most celebrated teacher of surgical anatomy in France. His rivals laid stress upon this particular feature of his fame in the hope of thereby belittling, in public estimation, the equally important celebrity, which he was now shortly to attain, of being also a great surgeon. It is in some such words as these which I am using that Bichat, who was his favorite pupil and righthand man during this period of his career, records the efforts made by his jealous rivals to interfere with Desault’s professional success.

In the early stages of his career as a surgeon Desault gave instruction in operative surgery, but in a comparatively short time he advanced beyond this stage and showed that he possessed considerable originality. He invented a very effective method of treating a fractured clavicle by the application, to the shoulder, the elbow and the chest, of a bandage which even to this day is known as “Desault’s bandage.” In planning this bandage its inventor first calculated with great care the forces which play the principal part in causing the displacement of the two segments of the fractured clavicle. This manner of attacking the problem of how best to treat such a fracture was, so Bichat declares, not that which had usually been followed by his predecessors, but it nevertheless proved to be the correct way of finding the right remedy. He believed, for example, that, inasmuch as the external segment or fragment is pulled downward by the weight of the shoulder and forward and inward by the action of the muscles, the right course to pursue must, first, be to furnish proper support to the shoulder, and at the same time to draw the external fragment outward and backward. He realized that by the employment of continuing extension it would be practicable to effect these results. So, placing a cushion over the chest, to serve in some measure as a point or angle of resistance, and resting the arm firmly against it, he was able, by pressing the lower part of the arm closer to the chest, to cause the upper part, together with the fragment attached, to stand out from this part of the trunk. Thus, as it were by a single stroke, he succeeded in obtaining a result which, for a very long period of time, had eluded the best efforts of the surgeon’s art. This was a great triumph for Desault, but its importance was not immediately appreciated. The bandage was successfully used at the SalpÉtriÈre, one of the larger hospitals of Paris, but the full recognition of its value came only after the lapse of many years,—indeed, not until after the death of its inventor. To-day it occupies an important place in the history of surgery.

Of the other improvements in surgical procedures that we owe to Desault I will mention here only one—that of ligating the exposed ends of the larger arteries which had been divided in the course of the amputation of a limb. Ambroise ParÉ, it will be remembered, was the first to introduce this practice in France (early in the seventeenth century), but it failed to meet with general acceptance and was then abandoned for more than a century. At BicÊtre, another of the large hospitals of Paris, the practice of immediately ligating the divided blood-vessels after an amputation was first revived by Desault, and not long afterward Ferrand also introduced the revived method at HÔtel-Dieu. From this time onward it became the standard method of procedure.

In 1788 Desault succeeded Ferrand as Chief Surgeon of HÔtel-Dieu, and from this time forward, for five years, he conducted with great success regular instruction in clinical surgery. Then, toward the end of May, 1793, he was thrown into the prison of the Luxembourg, the charge brought against him being that he had refused to give his professional services to those wounded in the affair of the previous 10th of August. He was retained as a prisoner only three or four days; but from this time to the day of his death (June 1, 1795) he was kept in almost constant fear of being prosecuted, and was consequently prevented in large degree from doing any useful work in surgery.

In his analysis of Desault’s career as a surgeon Bichat calls attention to the fact that the establishment of a clinical school at HÔtel-Dieu was not the only benefit which he conferred upon that hospital. He did much more than this; he improved the arrangement and the ventilation of the different wards, established better methods of distributing the food systematically among the patients, increased their comfort by making rules whereby their wants would be more promptly supplied, etc. All matters of this nature occupied the first place in his thoughts and drove out of his mind, long before he died, all ambition to accumulate a fortune. Despite the stormy conditions which prevailed during the Revolution and which upset completely all the existing arrangements in Paris, he managed to keep up a good part of his clinical courses.

Speaking of Desault’s personal traits of character Bichat says that he was somewhat quick-tempered, but that he promptly got over his bad temper and was then once more gentle and reasonable in his speech.

He had his full share of enemies. In nearly all cases this enmity sprung from jealousy. But what really great man, adds Bichat, ever passed through life without being annoyed by enemies through jealousy? On the other hand, Desault had excellent friends, men who—as he expressed it—were the joy of his life.

Desault was not of a scientific turn of mind; he never wrote articles or took active part in any discussions. Some of the best of the pupils who attended his courses took full notes of his lectures, and these, after Bichat had revised them and edited them, were published under the title of “The Surgical Works of Desault.”

Guillaume Dupuytren was born at Pierre BuffiÈre, France, October 5, 1778. He commenced the study of anatomy and physiology at an unusually early age, and was appointed Prosector at the Paris École de SantÉ before he had reached his eighteenth year. In 1802, very soon after he had received the degree of Doctor of Surgery, he was given the appointment of Attending Surgeon to HÔtel-Dieu. Of this early period of his career very little need be said. He lost none of his enthusiasm for his chosen work and was recognized by all his associates as a surgeon of great promise. From the position of simple attending surgeon at HÔtel-Dieu he rose in 1808 to that of Adjunct Surgeon-in-Chief. Finally, in 1815, after the death of Pelletan, he was made full Surgeon-in-Chief of that great hospital. So far as it was possible for Dupuytren to advance in the endeavor to gain official recognition as a surgeon, he had by this time risen to the highest point that it was practicable for him to reach. Let us now consider some of the other aspects of his career.

After the death of Bichat in 1802 Dupuytren turned his attention from what was supposed to be normal anatomy to pathological anatomy. The change was greatly favored by the fact that, in the course of his regular work as prosector, he was constantly encountering all sorts of pathological conditions, and thus he gradually acquired a strong interest in pathological problems. Pathological anatomy, as newly interpreted, was no longer a mere observing of the abnormal changes which take place in different structures and organs of the body,—the sort of “cold work” which had occupied in large measure the minds of Bartholinus, Mangetus, Bonnet of Geneva, Morgagni of Bologna, and Lieutard, and which involved practically no study of the origin of such changes,—but what might be termed a living pathological anatomy, in which the effort is made to ascertain the beginning, the gradual progress and the termination of the process. Ample material for this sort of study was constantly passing through Dupuytren’s hands, and he made the most of his opportunities. Professor LeClerc, who is my chief authority for the present sketch of Dupuytren, says that by means of this new pathological anatomy much light was thrown upon both diagnosis and symptomatology. At first the courses which Dupuytren gave in the École de SantÉ ran in large degree parallel with those of Bichat, but after the latter’s death Dupuytren had the field almost entirely to himself. He taught anatomy, pathological anatomy, and physiology, and increased the interest in his teaching, on the part of the pupils, by furnishing a variety of facts drawn from his wide experience. His great skill as a dissector enabled him to demonstrate all sorts of fine details—as, for example, not merely a limited portion of a nerve, but nerves throughout their entire course.

After Dupuytren became full Surgeon-in-Chief at HÔtel-Dieu he ceased teaching operative surgery and devoted himself largely to clinical surgery. He adopted the habit of visiting the hospital at an early hour, long before the time appointed for the arrival of the class, and thus he was able to examine the patients leisurely and to give all the necessary instructions to his assistants. By the time the class arrived he was entirely ready to receive them. He was extremely punctual in attending to his hospital duties.

In 1814 Dupuytren took an active part in caring for the wounded soldiers on the field of battle; and again in 1830, during the civic disorders of that period, he had the care, at HÔtel-Dieu, of many cases of wounds from firearms.

A French physician whose identity is concealed under the initials J. L. H. P., has published a very complete pen-portrait of Dupuytren’s most prominent personal and professional characteristics, and Elisha Bartlett, M.D., of Boston, has furnished us with an excellent English translation of this work. From this book I shall take the liberty of quoting here several sections that seem to me to be particularly interesting.

Monsieur Dupuytren is, in my opinion a surgeon of the most exalted merit.... He has a coup d’oeil of most admirable precision, a sure and steady hand, a coolness and self-possession always imperturbable, and that innate instinct or tact so necessary in all the arts. A man is born surgeon or physician, as a man is born poet or painter.... Monsieur Dupuytren is particularly remarkable for his diagnostic foresight.... Arrived at the bedside of the patient, his fine senses are all awake; in a few minutes of question and researches, his examination is finished. One might often believe that he has given to the case only a superficial attention, but his subsequent lecture will prove that he has seen everything and seen it thoroughly.... He describes a pathological alteration, yet hidden in the interior of an organ, as though it were visible, and, when the scalpel has dissected and uncovered it, the truth of his description is verified by all who witness it.... Monsieur Dupuytren is not less skilful in treating surgical diseases than he is in detecting them.... I do not fear that I shall be accused of exaggeration in saying that very few surgeons have given proof of so much surgical genius in the invention of modes of operating or so much expertness in their execution. Monsieur Dupuytren possesses in the highest degree a creative and inventive spirit....

So much for Monsieur Dupuytren as a practitioner; Let us now consider him as an instructor....

Since 1815, the surgical clinic of HÔtel-Dieu has lost none of its ancient reputation. No other clinical course in France can be compared to this, whether for the number of students, the abundance of cases, or, finally, for the genius of the professor. In effect, Monsieur Dupuytren comprehends perfectly in what clinical instruction consists; a thing that ought to be somewhat difficult, seeing how few there are who succeed in it. Lessons of clinical surgery have no resemblance to a course of surgery.... A clinic is altogether a different thing. The professor has need here to speak continually without preparation, because the material of his lesson cannot be regulated by himself, in advance, but is dependent upon chance, which brings him, to-day, a strangulated hernia, to-morrow, a fracture; and, in the same day, four or five different cases....

An excellent practitioner, Monsieur Dupuytren thus really possesses the most essential quality of a clinical professor. But to this first fundamental qualification others ought to be united. The professor ought to have a free command of language and the talent of extemporaneous speaking; he should possess a memory sufficiently good to recall distinctly all the circumstances of diseases, and the peculiarities of the different treatments that he has directed; it is necessary, that, thoroughly understanding the necessity and obligations of his instruction, he should accustom himself to return every day to things which he has a thousand times repeated, unmindful of the fatigue resulting from such repetition; above all, he should remember that he is occupied with inexperienced hearers, to whom it is not sufficient to say things imperfectly; hearers who may easily be dazzled and led astray, but who ought to be instructed, an end that cannot be attained without patience. In respect to all these things, Monsieur Dupuytren is almost irreproachable.... As to myself, instructed by my personal experience, and by the numerous comparisons that I have made, I do not hesitate to believe and to say that the clinic of Monsieur Dupuytren may be offered as a model of this kind of instruction.

In his memoir concerning the medical schools of Paris, John Gross, an English surgeon, says that no lectures at the École de MÉdecine were so numerously attended as were those delivered by Dupuytren on operative medicine. He adds that at the lecture which he attended on the operation for inguinal hernia, there were present about 1200 students, the greatest number that the theatre is capable of containing. “But I must confess that I have seldom learnt less from any good practical lecture than I did from this. I was too far off to distinguish well what I saw, or comprehend what I heard; and I returned home with a feeling of regret, that what is grand should be so far remote from what is most useful.”

Dupuytren’s health began to break down in 1833, and he was obliged to take a trip to Italy. A certain amount of improvement resulted from this journey, but only for a brief period of time. On February 7, 1835, he died, leaving in his will the sum of 200,000 francs to l’École de MÉdecine for the establishment of a chair of pathological anatomy. Before his death, however, he assented to the proposition that the École should assume the responsibility of providing funds sufficient for founding the professorship and thus enable the authorities to utilize the legacy in establishing an anatomical museum, the MusÉe Dupuytren, where all sorts of pathological specimens may be carefully preserved and exposed to view in well-constructed cabinets. (See photograph of this museum in the plate facing page 260.)