Pierre Charles Alexandre Louis

from Wikipedia, the free encyclopedia
Pierre Charles Alexandre Louis

Pierre Charles Alexandre Louis (born April 14, 1787 in Ay in Champagne , † August 22, 1872 in Paris ) was a French doctor and pathologist . Known for his studies of tuberculosis , typhoid , and pneumonia , his greatest contribution to medicine was the development of the "Numerical Method" as the forerunner of epidemiology and modern clinical study .

Life

Louis was born in Ay in Champagne as the son of a wine merchant. He grew up during the French Revolution . At first he wanted to study law, but then switched to medicine, which he completed in 1813. He studied first in Reims and later in Paris.

Louis married late, the only son died of tuberculosis in 1854 while still a child. Louis retired from medical practice that same year. Charles Sumner , who visited Louis at the Hôtel-Dieu de Paris and watched him teach, describes him as a "great man, with a countenance that seems quite passive." Louis also taught at the Hôpital de la Salpêtrière in Paris. Oliver Wendell Holmes, Sr. was one of his students.

education

After graduating, Louis accompanied the Compte de Saint-Priest, a friend of the family, to Russia and traveled with him for several years before settling in Odessa in 1816 and successfully running a private practice for four years. An outbreak of diphtheria in 1820 made him realize that his medical knowledge was insufficient. He returned to Paris , where he worked in a hospital for seven years, initially without pay. He first went through the "Hôpital de la Charité", then the "Hôpital de la Pitié" and later the "Hôtel-Dieu". There he collected the medical histories of thousands of patients and performed hundreds of autopsies . He published studies on the treatment of tuberculosis (1825) and typhus (1829) and developed the "numerical method" for assessing the effectiveness of treatments.

Numerical method

From 1823 Louis began to publish the results of his research on various diseases. He numerically analyzed the information gathered in his case studies and autopsies.

In the 19th century, the French doctor François-Joseph-Victor Broussais advocated the influential thesis that fever is caused by inflammation of organs and that it can be effectively treated by bloodletting . Louis contradicted in 1828 with the publication of a text on the subject (1834 expanded to a long treatise in the American Journal of Medical Sciences , under the title "An essay on clinical instruction"), which proved the ineffectiveness of bloodletting in the treatment of pneumonia. Louis' view was fiercely contested by doctors of the time. They were unwilling to wait for the results of studies to determine the effectiveness of a treatment and to forego treatments that were proven to be ineffective. Nonetheless, Louis's methods gradually gained acceptance as doctors began to see the benefits of the "numerical method" as it improved the objectivity of views and improved patient outcomes. The "numerical method" used the averages of groups of patients with a particular disease to determine how to treat each individual case. Louis emphasized the importance of patient comparability beyond just diagnosing disease; he tried to consider factors such as age, nutritional status, disease severity, and other ongoing treatments besides bloodletting. Louis also recognized the importance of comparing populations as opposed to individual comparisons. He believed that the differences between individual patients would cancel out in the averages. However, he was not yet familiar with the concept of the random sample and the randomized controlled study . His opponents argued that the individual cases were too different to be averaged into statistically meaningful groups; Louis countered by pointing out that individual cases also share characteristics, and that by claiming that each case is unique, medicine would never advance. Louis was aware that his own studies included too few cases to be conclusive. His successor later stated that once 500 cases were accumulated, certainty could be obtained.

Louis' first study of his new method was blood-letting treatment in a group of 77 patients with a very similar form of pneumonia. He specified the time of onset, duration, and death rates of the disease; and whether the bloodletting was done either early (1-4 days from the onset of the disease) or late (5-9 days) in the course. Based on this, Louis found that those treated early recovered earlier but had a higher death rate. From this he concluded that bloodletting was only effective in the later stages of the disease. The impact of Louis' research on the practice of bloodletting in medicine at the time is difficult to assess, as this practice was already declining when he published his results.

Little is known about Louis' education in mathematics and medicine, or how he developed his "numerical method". At the time of his activity, the mathematician Pierre-Simon Laplace was extremely influential, he had introduced the concept of correlation into science; Louis could have relied on it.

legacy

In other, similar pre- epidemiological studies, Louis compared exposed versus non-exposed patients in order to elucidate the relationship between disease and etiology , for example in emphysema . For his work on the numerical method, Louis was elected permanent chairman of the Society for Medical Observation, which had been founded by his students. Louis is also credited with standardizing the history- taking, beginning with questions about health in general and progressing with specific questions about individual symptoms.

Louis was the mentor of Oliver Wendell Holmes, Sr. during his training in Paris and strongly influenced his skeptical attitude.

Honors

In 1849 he was elected to the American Academy of Arts and Sciences . In 1853 he was elected a member of the German Academy of Sciences Leopoldina .

Web links

Wikiquote: Pierre Charles Alexandre Louis  - Quotes

Individual evidence

  1. ↑ a b c d e f g h i j k Simmons JG: Doctors and Discoveries: Lives That Created Today's Medicine . Houghton Mifflin Harcourt , 2002, ISBN 978-0-618-15276-6 , pp.  75-79 .
  2. ↑ Barbara I. Tshisuaka: Louis, Pierre Charles Alexandre. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 867.
  3. ^ A b c Houghton Mifflin Company: The Houghton Mifflin Dictionary of Biography . Houghton Mifflin Harcourt , 2003, ISBN 978-0-618-25210-7 , p. 954.
  4. ↑ a b Pierce EL : Memoir and letters of Charles Sumner . Sampson Low, Marston, Searle & Rivington, 1878, p.  246 .
  5. ^ Clendening L: Source Book of Medical History . Dover Publications , 1960, ISBN 978-0-486-20621-9 , p.  507 .
  6. ↑ a b c Wolfgang U. Eckart : Pierre Charles Alexandre Louis, in: Wolfgang U. Eckart and Christoph Gradmann (eds.): Ärztelexikon. From antiquity to the present , 3rd edition Springer Heidelberg, 2006, pp. 215–216. Medical glossary 2006 , doi : 10.1007 / 978-3-540-29585-3 .
  7. ↑ a b Olsen J; Du V Florey C: The Development of Modern Epidemiology: Personal Reports From Those Who Were There . Oxford University Press , 2007, ISBN 978-0-19-856954-1 , p.  21 .
  8. ^ A b Faguet GB: The War on Cancer: An Anatomy of Failure, A Blueprint for the Future . Springer Science + Business Media , 2008, ISBN 978-1-4020-8620-5 , p.  102 .
  9. ^ A b Porter TM: The Rise of Statistical Thinking, 1820-1900 . Princeton University Press , 1988, ISBN 978-0-691-02409-7 , pp.  157-8 .
  10. ↑ a b c Morabia, A. "Pierre-Charles-Alexandre Louis and the evaluation of bloodletting". Journal of the Royal Society of Medicine 2006, 99 (3): 158-160. doi : 10.1258 / jrsm.99.3.158 . PMID 16508057 . PMC 1383766 (free full text)
  11. ^ Warner JH: Against the Spirit of System: The French Impulse in Nineteenth-Century American Medicine . JHU Press, 2003, ISBN 978-0-8018-7821-3 , p.  8 .
  12. ^ Dowling WC: Oliver Wendell Holmes in Paris: Medicine, Theology, and the Autocrat of the Breakfast Table . UPNE, 2006, ISBN 978-1-58465-580-0 , pp.  55-82 .
  13. ↑ Member entry of Pierre-Charles-Alexandre Louis at the German Academy of Natural Scientists Leopoldina , accessed on November 14, 2015.
personal data
SURNAME Louis, Pierre Charles Alexandre
ALTERNATIVE NAMES Louis, Pierre-Charles-Alexandre (full name)
BRIEF DESCRIPTION French doctor and pathologist
DATE OF BIRTH April 14, 1787
PLACE OF BIRTH Ay
DATE OF DEATH August 22, 1872
Place of death Paris