Pierre Fidèle Bretonneau Biography (1778-1862)
Bretonneau was the first person to study and describe fully the symptoms of diphtheria, and gave the disease its name. He also believed there was a difference between typhoid fever and typhus, which were often mistaken as the samedisease. In a time before anyone understood that pathogens (germs) cause disease and infection, Bretonneau suspected that these diseases were contagious,believing that diphtheria was transmitted between individuals from drinking glasses. His suspicion was an entire generation earlier than Louis Pasteur's germ theory.
Bretonneau was born in Saint-Georges-sur-Cher in France. His father, Pierre,was a master surgeon and his mother, Elisabeth Lecomte, was from a wealthy, upper-class family. Oddly enough, Bretonneau received virtually no education as a young child and was still unable to read at the age of nine. He was sentto the École de Santé in Paris in 1795 where he attended medical lectures, but left in 1801 after being unfairly failed in an examination. He entered the field of public health, becoming an officer, and his medical skill quickly gained him recognition. He was asked to be chief physician at thehospital of Tours, for which he needed a degree. So he sat for his final exam, wrote his doctoral thesis, and took the position in 1815. He also became director of École de Santé where he lectured to medical students. However, he left both positions in 1838 to devote his time and medical skills to the poor.
Bretonneau gained a reputation as a dedicated and capable physician and therapist whose lectures based on the medical philosophy of Hippocrates (460-377 B.C.) earned him a great deal of respect from his students. Hisclose scrutiny of the symptoms of diphtheria when the epidemic swept throughTours from 1818-1820 led him to discover that a leathery parchment-like membrane (the name diphtheria comes from the Greek word for leather) formed in the throat of the patient, ultimately causing asphyxiation (suffocation). His desire to help prevent death through asphyxiation led him to invent a device called the double cannula (a small tube for insertion into a body cavity) withwhich he performed the first successful tracheotomy in 1825 on a four year old girl. By cutting an opening into the windpipe through her neck, he savingher life. Four previous attempts to save other children had failed, but as aresult of his determination and ultimate success, another physician by the name of Trousseau soon reported performing successful tracheotomies on more than 200 children with diphtheria.
In 1819, Bretonneau also identified typhoid fever as being a different from typhusmthe two originally thought to have been the same disease. Also, becausethese diseases produce lesions, or sores, of the mucous membranes that go through cyclical changes in appearance as the disease progresses, each stage was originally believed to be a different disease when first observed at one ofthe progressive stages. Because of his keen observation skills, Bretonneau understood the cyclic development of the individual disease.
He was also able to prove that the mucous membranes respond differently to different microorganisms (germs), just as the skin shows many different reactions to different diseases, and firmly believed that a single, contagious agentcaused disease to spread from one person to another. In 1829, he described fully the course of the typhoid epidemic at Chenonceaux, giving sound evidencefor the way in which it spread. Regardless of all his observation skills, Bretonneau wrote very few monographs; rather, he felt it most important to passhis findings on to his students, upon whom he made a deep and lasting impression.
Bretonneau gained a reputation as "independent, proud yet modest, and disdainful of honors." He also had many interests beside medicine: he constructed hydraulic hammers, thermometers and barometers, was a first-class botanist (hewrote an essay on grafting plants), studied the habits of bees and ants, andhis private garden in Palluau was famous throughout all of Europe. He was 25years younger than his first wife and, at the age of 78, married a young woman of 18. He was 84 when he died.