Philibert Joseph Roux (1780–1854)

SURGEONS Philibert Joseph Roux (1780–1854) He´le`ne Perdicoyianni-Paleólogou Summary: Philibert Joseph Roux (1780–1854), a French surgeon, was a student and friend of Marie Xavier François Bichat, the father of modern pathology and histology. He was assigned as a surgeon to the Hoˆpital Beaujon (1806), the Hoˆpital de la Charite´ (1810) and to Hoˆtel-Dieu de Paris (1835), where he succeeded to Guillaume Dupuyrten, a French anatomist, as a Chief Surgeon. Roux is best known for having performed the surgical repair of a cleft palate and for having been the first surgeon to stitch a ruptured female perineum. His contribution to surgery has also included the publication of Quarante anneés de pratique chirurgicale. Roux was awarded the grade of Chevalier of the National Order of the legion of Honor and that of Officer. He also served as a President of the Academy of Sciences. He died of a stroke on 3 March 1854. Philibert Joseph Roux was born on 26 April 1780 at Medical studies Auxerre, a commune in the Bourgogne region in north-central France. His father, Jacques Roux, At the suggestion of his father he continued his a Surgeon-in-Chief first at the Hoˆtel-Dieu1 in Paris and medical studies in Paris. He presented himself at the later at E´ cole Militaire in Auxerre, treated him with Concours d’Entreé to the Val-de-Graˆce7 but failed com- great harshness and severity in response to his idleness prehensively. He then decided to study at the E´ cole de and intemperance. He forced him to enrol in the E´ cole Me´decine. His father allowed him 50 francs per month Militaire, directed by monks of the Order of Saint for his medical education. Since this was insufficient to Benedict,2 with the intention of making him an pay for daily expenses, pursuit of dissections and Engineer of the Bridges and Roads3 but after a short admission to private lectures, he turned to the gaming time he changed his mind and had him attend classes table and lost his entire month’s allowance. in surgery at the Hoˆtel-Dieu. In 1798 he attended the private lectures on anatomy In 1796 Jacques Roux suggested his son enrol in the offered by Marie François Xavier Bichat8 who became a army. The young Philibert was appointed an Officier close and devoted friend. Bichat chose him as instruc- de Sante´, third class, in the army of Sambre et Meuse4 tor for the younger students and his assistant in per- and was sent off to Andernach.5 Later he was moved to forming experiments. Afterwards Roux was appointed the Military Hospital at Aix-la-Chapelle where he was Prosector.9 In 1799 he enrolled in the Lectures on assigned to emergency services. As his pay was only External Pathology and Clinical Medicine offered 200 francs a month, he had to be inventive in order to respectively by Alexis Boyer10 and Antoine Dubois.11 obtain adequate rations. In 1790 the Military Surgeons In collaboration with Matthieu Bichat, a cousin of were accorded rations and hereafter were saved from François Xavier, he wrote the first lecture of Bichat on the danger of dying of famine. This hard life ended General Anatomy and a portion of the Descriptive with the ratification of the Treaty of Campo Formio.6 Anatomy. After the disbanding of the army he returned to his In 1801 he was admitted to the E´ cole Pratique by family. obtaining first prize in recognition of his outstanding achievements and in 1802 delivered a series of lectures on Operative Surgery in which he presented a new classification of surgical diseases. In the same year he He´le`ne Perdicoyianni-Paleólogou is a specialist in Greek and Latin presented himself at the Concours d’Entreé for the philology and linguistics, and holds a PhDs in Classical Greek Assistance-Surgery, second class, at the Hoˆtel-Dieu but Philology and in Latin Linguistics (Sorbonne University). She has also was not selected. The successful candidate was his been the recipient of two post-doctoral research positions in Classical 12 Greek and Early Byzantine Papyrology (Sorbonne University) and rival, Antoine Dupuytren. Epigraphy (Besançon University). Since 1996 when she arrived at When Bichat died on 22 July 1802, Roux succeeded Hellenic College/Holy Cross she has been teaching. She was also him and taught courses in anatomy, physiology and appointed Visiting Scholar in the Departments of Classics and operative medicine, held initially at the Cloister of Linguistics of Harvard, Brown and Stanford Universities, as well as a Saint-Jean de Beauvais and later in an amphitheatre in Guest Visiting Scholar at Harvard Divinity School and Research Associate in the Centre of Studies for Ancient Documents (Oxford Rue Huchette in the heart of Paris. Although he gave University). She studied the History of Greek Medicine with these assignments his primary attention, he did not Professor Jacques Jouanna (Sorbonne University) and Mirko Grmek give up writing. In 1803 he defended his Doctoral (E´ cole des Hautes Etudes, Section IV). Correspondence: He´le`ne Thesis, Coup d’oeil physiologique sur les secretions, and Perdicoyianni-Paleólogou, Research Fellow – Adjunct Professor of ´ Classics, HC/HC, Visiting Scholar, Brown University, 44 Washington published the fifth volume of the Traite d’anatomie Street, suite 403, Brookline, MA 02445, USA (email: hperpal@hotmail. descriptive that Bichat had not completed. His fervent com) interest in surgery was also demonstrated in his Journal of Medical Biography 2011; 19: 157–160. DOI: 10.1258/jmb.2010.010057 158 Journal of Medical Biography Volume 19 November 2011 publishing between 1802 and 1808 classifications and tabular views on surgical topics. The Beaujon Hospital in 1807 In 1807 he was appointed Surgeon, second class, to the Beaujon Hospital.13 In 1809 he reprinted his noso- graphic fragments in Me´langes de Chirurgie. In these he described in detail the three operations he had under- taken at the Beaujon. In 1810 he married the daughter of Alexis Boyer who soon introduced him to La Charite´ Hospital14 as Assistant-Surgeon. He then abandoned his thoughts on physiology and surgical nosography and understood that clinical observations are the basis of pathology. In this context he undertook his Treatise on Operative Medicine15 that would be published in 1813 although he was not able to finish the two planned succeeding volumes. In 1811 Roux presented himself at the concours for the Chair of Raphae¨lBienvenuSabatier.16 Among his competitors were AE Tartra, Guillaume Dupuytren and Jean-Nicolas Marjolin.17 The jury was composed of Philippe-Jean Pelletan,18 Antoine Dubois, Pierre-François Percy19 and Anthelme Richerand.20 On 10 February 1812 Dupuytren was unanimously elected Professor of Operative Medicine: once again, he had triumphed over his old rival. Figure 1 Philibert Joseph Roux London, 1814 soft palate in order to remove a nasopharyngeal polyp. He had left the palate open but realized that suture In 1814 Roux spent a month in London. He was one of should be possible later. The patient declined the the few eminent French physicians during that period second operation. In 1783 Eustathe submitted a detailed who travelled to London and witnessed their British description of a proposed method for repairing the soft colleagues at work. In the book Relation d’un voyage fait palate to the Academy of Surgery in Paris. However, on a` Londres en 181421 he compared the French and 12 August 1784 Dubois declared the operation to be English surgical schools and admitted there was equal unfeasible and rejected the proposal. It was not until development of surgical procedures in the two 1816 that Karl Ferdinand Von Graefe reported to the countries. However, he asserted ‘the rational organiza- Medico-Chirurgical Society of Berlin that he had at last tion of the Paris Faculty of Medicine presented more achieved success in closing fissures of the soft palate, guarantees of adequate training than the London freshening the edges with muriatic acid and a solution schools’.22 of cantharides and then joining them with sutures. In In 1815 Roux (Figure 1) was awarded the grade of 1819 Roux modified Graefe’s operation by closing the Chevalier of the National Order of the Legion of cleft palate with three sutures across the cleft, paring Honor23 and in 1831 that of Officier. In 1817 he deliv- the edges, attaching the sutures and drawing the raw 25 ered a lecture at the Academy of Sciences24 during surfaces together and in 1825 he published the 26 which he made out that he had operated on more than details. 700 patients suffering from cataracts, with an estimated In 1820 he succeeded Percy in the Chair in Surgical success rate of 10%. Pathology and was elected a member of the Division of Surgery at the National Academy of Medicine27 and in 1828 he became President. In 1830 he was promoted to Cleft palate surgery the Chair in Clinical Surgery. In 1832 he became the first surgeon to stitch a ruptured female perineum. In In 1819 he operated successfully on an English student 1834 he succeeded Alexis Boyer at the Academy of suffering from cleft palate. The first cleft closure had Sciences. been made in 1764 by the French dentist Le Monnier, When Dupuytren died in 1835 Roux succeeded him who succeeded in closing a fissure in the palate by as Chief Surgeon at Hoˆtel-Dieu and here he had to face paring the edges and stitching them together. In 1779 devoted followers of Dupuytren and defamatory state- after studying the problems of feeding and speaking ments impugning his professional honour although his caused by a cleft palate, Eustathe, a physician of the surgical skills and expertise soon made his adversaries town Beziers in Languedoc, had occasion to divide the change their minds and, indeed, come to feel a deep H Perdicoyianni-Paleólogou Philibert Joseph Roux (1780–1854) 159 admiration for him.

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