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Who first described Dupuytren's Contracture?
Thickening and contracture of the palmar fascia of the hand resulting in the eventual flexure of the 4th and 5th fingers. There is an association with alcoholic cirrhosis and manual work, but in most instances the etiology is uncertain.
By: Ailesbury Media
Baron G. Dupuytren (1777-1835) French Surgeon
G. Dupuytren was born in Pierre-Buffiere, France in 1777, the same year that Joseph Preistley told the world how he could produce oxygen by heating mercuric oxide. This was also the year that France went to war with Great Britain and aided the American colonists in their struggle to form an independent nation, the United States. When he was still only twelve years old, his family sent him to school in Paris on the advice of a local army officer. The year was 1789, and the revolutionary war in the Americas had left France in severe financial crisis. This is turn led to huge crowds gathering in the streets of Paris chanting for social reform. One of these groups stormed the royal fortress, the Bastille and begun the French Revolution. A series of elected legislatures then took control of the French Government and executed King Louis XV1 and his wife, Marie Antoinette. Dupuytren's family were keen that for him not to join the French army and under great physical duress his father decided that he should become a surgeon. His family were impoverished and the young man had to get a job in the autopsy department at his medical school to help pay his tuition . When he was only 24, he was elevated to the position as Chef de Travaux Anatomiques and later he wrote an illustrated anatomy book based on his years of working in the autopsy room. He also became an eminent lecturer in pathology and Lannaec and Bayle were among his students. It is said that Lannaec could not stand Dupuytren and considered him to be financially ambitious and opportunistic. By now it was now 1801, and Napoleon was in control of France, having won a great victory against the Austrians and succeeded in signing a peace treaty with the war-weary British.
Dupuytren was appointed to the Hotel Dieu in 1802, and was elected to the Chair of Operative Surgery in 1812 ,the same year that Napoleon's troops were facing the first horrors of a Russian winter. He became Surgeon in Chief at the Hotel Dieu two years later and although considered to be a fine surgeon, remained unpopular with his other colleagues. He is said to have seen over forty patients a day outside of his hospital work and accumulated enough wealth to make him a millionaire. In that year also, the allies pursued Napoleon to Fontainebleau in Paris, where they forced to abdicate the Imperial throne to Louis XV111. This returned exile later made Dupuytren a Baron for services rendered to his family. The Bourbon family continued their reign with the succession of Charles X to the throne in 1824. Dupuytren was then appointed first surgeon to the family. Charles X was the younger brother of Louis XV111, and had originally escaped the Revolution by fleeing to Britain in 1789. He was forced to return there in 1830 after a failed attempt to restore the power of the French monarchy. It is known that despite his famed meanness, Dupuytren offered Charles X one million francs after his dethronement. This money was respectfully declined. He continued to work at the Hotel Dieu and is still recognised as the first surgeon to successfully remove a lower jaw. he is also remembered as the first surgeon to recognise Dupuytren's contracture and devise the operation to correct it. He invented surgical instruments which were found useful and modified by other surgeons such as Abraham Colles, Mikulicz and Sir Astley Cooper. In the fall of 1833, Dupuytren developed a stroke during one of his lectures but decided to continue despite his residual paralysis. From that period onward he remained invalided, and died little more than a year later. The year was 1835, and across the other end of the world, a Tasmanian sheep farmer, John Batman was more concerned about purchasing some land near the Yarra river from the local aborigines. The village that grew up around the settlement became the city of Melbourne.
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Dr. Patrick Treacy is Medical Director of Ailesbury Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors. He is a Medical Advisor to the website Consulting Rooms. He wrote a Medical History series in 1999 for the Irish Medical TImes