Any Friend of Stephen’s is a Friend of Mine: Guillaume Dupuytren

Throughout the course of our beloved series, a few allusions are made to Stephen’s past studying medicine in Paris. He “dissected with Dupuytren”, apparently, but what on earth does that mean? Was he a mentor of Stephen’s? As it turns out, our dear Maturin and Dupuytren would more accurately be described as contemporaries. Dupuytren had a long and successful career as well as much fame and fortune, which places Stephen in very illustrious company!

Best remembered for the development of a surgical technique to correct a tissue defect later named after him, Dupuytren conquered early poverty to become a royal surgeon and one of his country’s most famous and wealthy people.

Dupuytren was born in Pierre-Buffière, a suburb of the city of Limoges, and endured abject conditions during his early years. However, despite his background and a protracted struggle with tuberculosis, his superior intellect earned him a scholarship at the Collège de la Marche. In 1795, when he was just 18 years old, Dupuytren outperformed many others in a competitive examination for the position of anatomy professor at Paris’s new School of Medicine. His career received a major boost when he accepted an appointment in1803 as assistant chief surgeon at the prestigious Hôtel Dieu, where he would remain for three decades, becoming professor of operative surgery there in 1811 and chief surgeon in 1815. In the meantime, in 1810 he invented an early type of stomach tube. In addition, he worked as professor of clinical surgery at the School of Medicine beginning in 1815. He was a popular lecturer, and many of his lectures were featured in the prominent medical publications of the period.

When King Louis XVIII ascended to the throne in 1814, he not only made Dupuytren a baron, but also appointed the physician as his royal surgeon. By this time, Dupuytren had made a name for himself as a brilliant anatomist, having performed the first successful removal of a lower jaw and ligation of the subclavian artery in 1812. Subsequently, he discovered an effective way to treat aneurysms using compression, invented the cutting forceps (enterotome), and developed a surgical treatment for wry neck, in which muscles of the neck contract spasmodically or continually, producing a crooked neck.

As Dupuytren continued his work under King Louis, he persisted in his intense investigation of new surgical tools and techniques. In 1824, Charles X became king, and he also appointed Dupuytren as his royal surgeon. Much of the physician’s most famous work occurred during this period, including his creation of the first good description of the pathology of congenital hip dislocation and a new classifying system for burns and development of a surgical treatment for cervical cancer and invention of an artificial anus.

In 1831, Dupuytren evolved a surgical technique to fix a debilitating proble mnow known as Dupuytren’s contracture. The ailment afflicts perhaps 2-3% of the global population and its etiology is unknown, although it has been associated with liver disease. Dupuytren’s contracture involves fibrosis of deep tissues in the palm (and, rarely, the feet). These fibers contract, which causes little or no pain, but results in the permanent retraction of one or more fingers (most often the ring and little fingers) toward the palm. Dupuytren’s technique for resolving the deformity centered on the removal of the tissue causing the contracture.

Despite his reputation for having a quick temper and a somewhat sour disposition, by the last years of his life Dupuytren had one of the largest and most lucrative surgical practices in history. He was devoted to his profession and to those who practiced surgery, even donating part of his $1.5 million fortune to start a home for physicians who had fallen on hard times. He also sent aid to King Charles, who by then was in exile, and willed some of his estate to organizations performing medical research. Dupuytren died of tuberculosis in Paris in 1835.

Courtesy of FAQs.org.
Image: Guillaume Dupuytren operating on a cataract, artist unknown. Courtesy of Wellcome Images.

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