Apollinaire Bouchardat

Apollinaire Bouchardat was one of the outstanding diabetologists of the 19th century. His father was away with Napoleon’s army when Apollinaire was born in L’Isle-sur-Serein near Avallon in Burgundy on 23 July 1806. He worked in his uncle’s pharmacy before leaving for Paris at the age of 19 to study pharmacy. To fund his studies, he worked as a teacher and later published a book to prepare students for the Baccalaureat. In 1829 he began his medical studies, and in 1832 wrote his doctoral thesis on cholera. He was nominated as Professor of the Medical Faculty as early 1833, but had to wait thirteen years to be appointed to the chair of Hygiene. From 1834-55 he was chief pharmacist at the Hôtel-Dieu, and he lost no opportunity to criticise the disastrous hygienic conditions of the old hospital, located beside the Seine in front of the new Hôtel-Dieu building. He lived at 8 Rue de Cloître Notre Dame, facing the north entrance of Notre Dame, and when he retired in 1885 he was succeeded by Adrian Proust, father of the writer Marcel Proust. Bouchardat died on 7 April 1886 and is buried in the Père-Lachaise cemetery in Paris.

Bouchardat’s portrait was featured in the the sixth issue of Diabetes in 1952, and an article by Elliot Joslin (1870-1962) (one of our forthcoming Past Masters) honoured his contributions to diabetes care and research. Apollinaire Bouchardat
Apollinaire Bouchardat
Joslin stated that Bouchardat was the first clinician to introduce patient education, including self-monitoring of urine glucose[1]. At a time when 300 ml of blood was required for glucose estimation, Bouchardat wrote that “this daily measurement of glucosuria guides patients like the compass that guides the sailor on unknown oceans” [2]. Bouchardat observed that weight reduction and increased exercise resulted in substantial improvements in metabolic control, and he was the first to introduce a systematic regimen in obese people with diabetes. In contrast, his speculations on the pathogenesis of diabetes now seem obscure, and he attributed hyperglycaemia to pathologically increased absorption of glucose in the stomach [1]. This hypothesis may seem curious to us, but today’s speculations on the pathogenesis of diabetes may sound just as strange in a hundred years.

Bouchardat was among the first to discuss the pancreas as the source of diabetes. He tried pancreatectomy on dogs, but the dogs all died. He tried ligation of the pancreatic duct and observed that the dogs lost weight and developed glucosuria [3], but from today’s perspective his work on physiology and pathogenesis falls far behind his major discovery, which Joslin formulated as “having introduced the personal responsibility of the patient for his own treatment into diabetic therapy” [1]. This was his cardinal contribution.

Less known in the diabetes world is his main publication as a Professor of Hygiene: Traité d’hygiène publique et privée, basée sur l’étiologie [4]. Over 1100 pages long, this book covers all aspects of disease prevention and is written in an accessible style that made it a tremendous success with the public. The book expresses a very human touch and its many amusing stories reveal Bouchardat’s sense of humour and his art de vivre. In the chapter on nutrition, Bouchardat recommends oysters be included in the diabetic diet, but does not forget to add that they should be accompanied by bread, butter and a good glass of Chablis to form a complete meal [4]. Politically, Bouchardat was a democrat, not easy in a time when Napoleon “le petit” was ruling France, and in one public lecture entitled ‘On Poverty’, he demanded more financial support for the working class [5].

Wise men foresee the future. Apollinaire Bouchardat wrote in 1866: “at a time which may not be as distant as we believe, Europe will form one big republic and the only rivalry among the states will consist of the struggle to develop and to perfect agriculture, trade, science, art and literature”. He was not alone in his generation in believing that scientific progress might soon lead to the development of social welfare and a peaceful Europe. Sadly his aspirations were far ahead of their time—but we are fortunate that our own generation now has the unique opportunity to translate his dream of a “big European republic” into reality.

References

  1. ^ Joslin E P (1952) Apollinaire Bouchardat. Diabetes 1: 490-491

  2. ^ Bouchardat A (1883) De la glycosurie ou Diabète sucré son traitement hygiénique, Paris, Libraire Germer Baillière, p.188

  3. ^ Bouchardat A (1883) De la glycosurie ou Diabète sucré son traitement hygiénique, Paris, Libraire Germer Baillière, p. 108

  4. ^ Bouchardat A (1881) Traité d’hygiène publique et privée, basée sur l’étiologie, Paris, Librairie Germer Ballière

  5. ^ Bouchardat A (1865) Entretiens populaires, Évariste Thévenin, Paris, Libraire De L. Hachette, p. 262

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