The birth of the clinicopathological method in France: the rise of morbid anatomy in France during the first half of the nineteenth century

Abstract

Morbid anatomy underwent extraordinary development in Paris during the last years of the eighteenth and the first half of the nineteenth century, for both philosophical and political reasons. The protagonists of this progress were primarily clinicians whose purpose was to link symptoms with pathological lesions and to elaborate a pertinent nosology. Pierre-Joseph Desault and Jean-Nicolas Corvisart were the forerunners, along with Xavier Bichat, a genius who died before he was able to realize his full potential. Guillaume Dupuytren, a renowned surgeon, founded an Anatomical Society with enthusiastic students; while Gaspard-Laurent Bayle and René-Theophile Laennec studied tuberculosis and developed the principles of clinicopathological correlations. Laennec's invention of the stethoscope in 1816 constituted a dramatic improvement of the possibilities of clinical examination and effectively established the clinicopathological method. A chair of morbid anatomy was created in 1835 for J. Cruveilhier, while a museum of morbid anatomy was established thanks to a 200,000 francs donation on behalf of G. Dupuytren. The French practitioners, however, did not believe that the microscope would play a major part in further medical progress, and after the revolution of 1848, the so-called School of Paris declined.