Joseph François MALGAIGNE1806–1865

persons to “the fullest physical, mental, voca- tional, social, and economic usefulness of which they are capable.” Through his efforts funds were raised and a board of directors selected, which established the Rehabilitation Institute of Chicago. As founder and first president of the Institute, his dream of a complete rehabilitation centre in the mid-west was realized when North- western University accepted the Institute as a part of the University and took over management of this unique facility.

For 50 years of service to medicine Dr.

Magnuson received many honors. He was pre- sented with three honorary degrees, a DSc from Duke University and the LLD degrees from Baylor University and Western Reserve University.

He was honorary member of the British Orthopedic Association; a Fellow of the American College of Surgeons, serving as secre- tary of the Board of Regents; a member of the American Association for the Surgery of Trauma, serving as president in 1949; and a founding member of the American Board of Surgery and the Clinical Orthopedic Society. He also was a Diplomat of the American Board of Orthopedic Surgery and a member of the American Academy of Orthopedic Surgeons, the American Orthope- dic Association, the American Surgical Associa- tion, the Southern Surgical Association, the Western Surgical Association, the Association of Industrial Surgeons, the International Society of Orthopedics and Traumatology, the International Society of Surgery, the Chicago Surgical Society, the Chicago Orthopedic Society, the Chicago Medical Society, the Illinois State Medical Society, the American Medical Association, the Institute of Medicine of Chicago, and Sigma Xi.

He was a member of the Metropolitan Club, Washington, DC, the Century Association, the Brook of New York and Racquet Clubs.

In his presidential address, “Some Wise Men in American Surgery,” delivered to the 88th annual meeting of the American Surgical Association, April 17–19, 1968, Dr. William P. Longmire, Jr., paid tribute to Dr. Paul B. Magnuson’s contribu- tions to American medicine. In the closing para- graph of his address, Dr. Longmire stated: “Let us be ever mindful of the contributions of certain wise men of American surgery, such as Halsted, Bevan, Archibald, the Mayos, and Magnuson, for each has introduced a unique concept to enhance the delivery of our professional care.”

On November 5, 1968, Paul Budd Magnuson, MD died at George Washington University Hos-

pital, Washington, DC, of a cerebral vascular accident at the age of 84.

217

Who’s Who in Orthopedics

Joseph François MALGAIGNE

1806–1865

Securité–Simplicité–Celerité

Some surgeons are remembered as great techni- cians, others, as great teachers. Medical folklore is full of tales of surgeons remembered because of, or in spite of, their eccentricities. It is an unusual surgeon, however, whose name lives on because of his literary genius as an author and editor. Joseph François Malgaigne

was such a man. An experienced surgeon, he was actively engaged in the practice of his profession through- out his life. A scholar, he searched out original sources for their meaning without relying upon translators and compilers. A gifted teacher, he was accustomed to marshalling minutiae into concise and logical patterns. Blessed with these talents, he used them efficiently, with the result that the sur- gical literature of his time was enriched.

The Traité des Fractures et des Luxations

appeared in 1847 as a comprehensive two-volume

work with a sumptuous supplementary atlas of

plates. The first, and smaller volume, deals with

fractures

and the second, larger volume, deals

with dislocations. It is the finest and most com-

plete work on fractures to be published up to that

time, far exceeding Astley Cooper’s Treatise on

Dislocations and Fractures of the Joints both in scope and execution.

Little escaped his observing eye or his inquir- ing mind. He describes a patient with an ischaemic contracture of the forearm due to a dressing too tightly applied, 34 years before Volkmann. He was led to investigate the gas pro- duced during gas gangrene infection; managed to collect a quantity; found that it burned with a blue flame; and identified it as carburetted hydrogen.

He was imaginative in his approach to technical problems such as maintaining the fragments of a displaced transverse fracture of the patella in apposition. For this, he devised an apparatus with which two sets of hooks could be inserted subcu- taneously into the fragments and, drawn together by a threaded screw, approximate the fragments, i.e. Malgaigne’s hooks.

Joseph François Malgaigne was born February 14, 1806, at Charmes, in the valley the Moselle, where his father, an old army surgeon, was the local health officer. At what to us may seem the tender age of 15, he was sent to Nancy to begin his medical education. At 19, he was qualified as an officer de santé, or health officer. Hoping to continue his education, Malgaigne left for Paris without the support of his family and almost com- pletely without funds. His early years in Paris were marred by hardship, and occasionally by real privation.

In the fall of 1830 the Poles revolted from their Russian masters and appealed to the new French government for help. Malgaigne organized a vol- unteer hospital unit consisting of nine surgeons and other personnel, and led it in action in support of the Polish army. He distinguished himself under fire during several engagements.

In 1840 he founded the Journal de Chirurgie, and in 1847 became chief editor of the Revue medico-chirurgical de Paris. It is as an editor that Malgaigne exerted his greatest influence upon his contemporaries. He was a staunch advocate of the statistical approach to the study of medical prob- lems, and encouraged animal experimentation.

Young men and new ideas always gained a hearing on the pages of his journals.

The medical journals of Paris at this time were a far cry from the staid journals of today. Con- troversy and invective, “yellow journalism,” was commonplace. Such an exchange, between the former associates, Guérin and Malgaigne, led to a famous law suit in 1843 when Guérin sued for defamation of character. The basic point at issue was an important one. Can the results of clinical

investigations and laboratory experiments that demonstrate the ineffectiveness of methods of treatment strongly advocated by various individ- uals be published with impunity? In the uproar created by the suit among the physicians, Malgaigne had the greatest support as an advo- cate of freedom of inquiry and freedom to publish opinions based on investigations. After a long public trial in which Malgaigne gave an impas- sioned speech in his own defence, the case against him was dismissed.

In his role as a medical editor, Malgaigne kept in close touch with new developments throughout the world. He not only read about them, he acted.

On January 12, 1847, at a meeting of the Acade- mie de Medicine, less than 3 months after Morton’s success in Boston, Malgaigne announced that he had “etherized” three patients with great success; one patient, incompletely, and one, without effect. Velpeau had heard of ether inhalation anesthesia, but had not yet tried it.

Malgaigne had administered the ether intranasally with an apparatus of his own design. Not only was he the first to use ether anesthesia in France, but he was also largely responsible for its rapid adop- tion throughout the country.

In 1835 Malgaigne joined the Faculty of Med- icine and became a surgeon of the central bureau of hospitals, serving in turn at Bicêtre, Saint- Louis and la Charité. He lectured on, and later published a book on surgical anatomy. In 1850 he succeeded to the chair of Professor of Operative Surgery, a position he held until his death in 1865.

He is a mild man, quite stiff in figure and movements, but possessing good manners, and an intelligent expres- sive countenance. He operates well and is a thorough master of surgery. His ‘courage camarade’ so fre- quently addressed to patients on whom he is operating, being pronounced in a military tone, and with a slight but pleasant accent, produces a very agreeable impres- sion on those to whom it is addressed, and encourages them to bear with greater patience the suffering to which they are necessarily subjected.

Malgaigne’s reputation today rests chiefly upon two of his books: Traité des Fractures et des Luxations, and Oeuvres Completes d’Ambroise Paré revues et collationnées sur toutes les édi- tions aver les variantes. Having already discussed his great work on fractures and dislocations, a brief comment on the other is in order.

Malgaigne’s edition of the complete works of Ambroise Paré was an attempt to produce, as Littré had done for the works of Hippocrates, a 218

Who’s Who in Orthopedics

Who’s Who in Orthopedics definitive edition. In this he succeeded admirably.

It was a task of great complexity, for Paré had had a long life as a writer (1545–1590) and during this time had not only discussed a tremendous variety of subjects, but had modified and changed his opinions and doctrines continually. The entire body of Paré’s writing is arranged and ordered with great skill. It is possible to follow the devel- opment of Paré’s ideas on any subject to their final form. A complete subject index multiplies the value of the collection.

A considerable portion of the first volume is devoted to an introduction, which consists of a history of surgery in western Europe from the sixth to the sixteenth century, ending with a bio- graphy of Paré and a discussion of his work. This introduction is one of the finest short accounts of the history of surgery extant. It is unfortunate that it was not published separately, as it stands in the shadow of the immensity of Paré’s achievement, and for this reason has not received the attention that is its due. It has recently become available in English translation.

John Shaw Billings, American surgeon and his- torian, epitomizes the career of Malgaigne:

Malgaigne was the greatest surgical historian and critic the world has yet seen, a brilliant speaker and writer, whose native genius, joined to incessant labour, brought about a new mode of judging of the merits of surgical procedures—the mode of statistical compari- son joined to experiment. He was not a great operator, and although he made some improvement in the art, such as his hooks for the treatment of fractures of the patella, his suggestion of suprathyroid, laryngotomy, etc., these are of small importance as compared with his work of exploding errors, exposing fallacies in rea- soning, and bringing to bear upon the work of the present day the light of the experience of the past, of which his treatise on fractures and dislocations affords many excellent examples.

References

1. Hamby WB (1965) Surgery and Ambroise Paré by J.F. Malgaigne. Norman, Oklahoma Press

2. Malgaigne JF (1859) A Treatise on Fractures. Trans- lated from the French with Notes and Additions by John H. Packard. Philadelphia, J.B. Lippincott and Company, p 523

3. Pettier LF (1958) Joseph François Malgaigne and Malgaigne’s Fracture. Surgery 44:777

4. Stewart FC (1843) The Hospitals and Surgeons of Paris. New York, Langley, and Philadelphia,Carey and Hart, p 360

219

John L. MARSHALL

1936–1980

John L. Marshall died in a light-plane crash on February 19, 1980. He had just left the Atlanta, Georgia, meeting of the American Academy of Orthopedic Surgeons and was en route to Lake Placid, New York, for the Winter Olympics as consultant to the US ski team. Although an accomplished pilot, he was a passenger in the plane. He was 43 years old and at the height of a remarkably distinguished and productive career.

Dr. Marshall was Director of Sports Medicine

at the Hospital for Special Surgery in New York

City, having founded the Sports Medicine Clinic

there in 1971. At the time of his death he had

become a world-renowned figure in orthopedics

and sports medicine. His patients included many

famous professional athletes as well as innumer-

able New York City public-school athletes who

crowded his weekly clinic. At the Hospital for

Special Surgery he was an attending surgeon in

the Department of Orthopedics and Director of

the Laboratory of Comparative Orthopedics and

Experimental Surgery. He also held appointments

in the Departments of Anatomy and Surgery at

Cornell University Medical College. As such, he

was intimately involved in undergraduate and

graduate medical teaching and research. He was

an active Fellow in the American Academy of

Orthopedic Surgeons and the American College

of Surgeons and was a member of numerous

other professional organizations, including the

American Orthopedic Society for Sports Medi-

cine, the American College of Sports Medicine,