Jean Alfred Fournier
Jean–Alfred Fournier (1832-1914) was a French dermatologist.
Fournier was a French venereologist and dermatologist, remembered for his contributions to the understanding of syphilis and its cutaneous manifestations. Fournier established himself as an authority on syphilitic disease through his clinical expertise and publications. He defined concepts such as “parasyphilitic” conditions and syphilitic origins of tabes dorsalis and general paresis.
Trained under Philippe Ricord (1800–1889) at the Hôpital du Midi, Fournier dedicated his professional life to advancing syphilology. He became the first Professor of Syphilology and Cutaneous Diseases at the University of Paris and was instrumental in founding the French Society of Dermatology and Syphilography. Fournier described Fournier’s gangrene, the fulminant necrotising infection of the perineum in 1883
Fournier was a public health advocate, campaigning for venereal disease prevention and patient education. Through works such as Prophylaxie de la syphilis, he sought to mitigate the social and familial devastation of untreated syphilis.
Biography
- Born May 12, 1832 in Paris.
- 1852 – Commenced medical studies in Paris.
- 1855 – Appointed Intern of the Paris hospitals; assigned to Hôpital du Midi under Philippe Ricord (1800–1889).
- 1857 – Co-edited Leçons sur le chancre, Ricord’s lectures on chancre.
- 1860 – Received doctorate of medicine, University of Paris; thesis on syphilitic contagion.
- 1863 – Appointed médecin des hôpitaux and agrégé; began teaching syphilology.
- 1863–1868 – Deputy to Professor Augustin Grisolle (1811–1869) at the Hôtel-Dieu de Paris.
- 1868 – Appointed Chef de service at Hôpital Lourcine.
- 1876 – Advanced to Chef de service at Hôpital Saint-Louis; commenced free public lectures on syphilology.
- 1879 – Elected to the Académie de Médecine.
- 1880 – Appointed first Professor of Syphilology and Cutaneous Diseases, University of Paris.
- 1883 – First lecture describing Fournier’s gangrene (gangrène foudroyante de la verge).
- 1886 – Published La syphilis héréditaire tardive, pioneering work on late hereditary syphilis.
- 1889 – Founded the French Society of Dermatology and Syphilography.
- 1893–1894 – Defined affections parasyphilitiques and championed the syphilitic origin of general paresis.
- 1901 – Founded the Société française de prophylaxie sanitaire et morale.
- 1902 – Retired from Hôpital Saint-Louis.
- Died December 25, 1914 in Neuilly-sur-Seine at age 82.
Medical Eponyms
Fournier gangrene (1883)
Gangrene foudroyante de la verge (“lightning gangrene of the penis”) was first described by Fournier as an acute onset of idiopathic, fulminating gangrene of the genitalia in young, otherwise healthy males.
Fournier stressed that hallmarks of the gangrene were both the fulminant course and the unidentified source. However contemporary cases can generally be attributed to local trauma or infection from genitourinary, anorectal, perineal or genital skin sources. No identifiable cause is only found in 8-10% of cases
Key co-morbidities have been identified since the original description as idiopathic. Diabetes mellitus is by far the most common (20-70% cases), followed by chronic alcoholism, malignancy and other immunosuppressed states.
What begins as a localised cellulitis related to the site of entry of the culprit bacteria (polymicrobial, often including Klebsiella, Proteus, Streptococcus and Escherichia Coli), Fournier’s gangrene rapidly progresses to become a deep necrotising fasciitis.
In 1883 – Fournier provided the first clinical descriptions of idiopathic, rapidly progressive necrotizing perineal gangrene in 5 male patients characterised by the absence of any predetermined cause, of sudden onset, with rapid progression, and excessive morbidity
Original
English
En tout cas, dès à présent, ce que je puis affirmer, au nom de la clinique, c’est qu’à coup sûr il existe une gangrène de la verge différente des autres gangrenes du même organe, et différente à divers titres
- Par l’absence de cause actuellement déterminable ;
- Par des symptômes très particuliers, dont les principaux sont : un début soudain et fulminant ; une propagation étonnamment rapide ; une propagation toujours considérable ; la coexistence fréquente de purpura ; et, en bref, une gravité excessive.
C’est à ce type de gangrène qu’il n’est pas exagéré de donner le nom de gangrène fulminante, et c’est à sa description que je me propose de consacrer une prochaine réunion.
In any case and for the present, I want to state in the name of our Clinic, that there exists a different gangrene of the penis from the other types involving the same organ, and different in these respects:
1. By the absence of any predetermined cause.
2. By special symptoms of which the principal ones follow: A gangrenous and sudden beginning; astonishingly rapid extension; always considerable extension; the frequent coexistence of purple discolouration; and finally an excessive morbidity.
It is this type of gangrene which, it is no exaggeration to say, should be given the name, fulminant, and it is this description which I propose to dedicate in our next discussion.
Other eopnyms
Fournier sign (1891) – scars on the mouth following the healing of lesions in congenital syphilis.
Fournier tibia (1891) Fusiform thickening and anterior bowing of the tibia in congenital syphilis.
Reactive arthritis (1868)
Major Publications
- Fournier JA. Recherches sur la contagion du chancre. 1857
- Fournier JA. De la contagion syphilitique. 1860
- Fournier JA. Thèse: De l’uremie. 1863
- Fournier A. Le rhumatisme blenorrhagique. Annales de dermatologie et de syphiligraphie (Paris). 1868;1(1):120, 161, 289, 319. [Reactive arthritis]
- Fournier JA. Nouveau carême de pénitence et purgatoire d’expiation, à l’usage des malades affectés du mal française ou mal vénérien. 1871
- Fournier JA. On the treatment of syphilis. 1872
- Fournier JA. Leçons sur la syphilis : étudiée plus particulièrement chez la femme. 1873
- Fournier JA. De l’ataxie locomotrice d’origine syphilitique. 1875
- Fournier JA. Clinical lecture on syphilitic gummata. 1875
- Fournier JA. De la syphilis cérébrale In: La syphilis du cerveau. 1879 [Transient Global Amnesia]
- Fournier JA. Syphilis et mariage [Syphilis and marriage]. 1880
- Fournier JA. Gangrene foudroyante de la verge. Semaine médicale. 1883; 2: 345-347 [Translated: Dis Colon Rectum. 1988;31(12):984-988.] [Fournier gangrene]
- Fournier JA. Etude clinique de la gangrene foudroyante de la verge. Semaine médicale. 1884; 4: 69.
- Fournier JA. Traité de la syphilis. 1898
- Fournier JA. Tabès d’origine hérédo-syphilitique probable: fracture spontanée. 1886.
- Fournier JA. L’hérédité syphilitique: leçons cliniques. 1891 [Fournier sign] [Fournier tibia]
References
Biography
- Darier J. Alfred Fournier: 1832-1914. 1915
- Besson BB. Alfred Fournier, his life and works. Arch Derm Syph 1924; 10: 297-303,
- Toodayan N. Jean Alfred Fournier (1832-1914): His contributions to dermatology. Our Dermatol Online; 2015.4-32
- Waugh MA. Alfred Fournier, 1832-1914. His influence on venereology. Br J Vener Dis. 1974 Jun; 50(3): 232–236.
Eponymous terms
- Di Serafino M. A clinical case of Fournier’s gangrene: imaging ultrasound. J Ultrasound. 2014 Dec; 17(4): 303–306.
- Morpurgo E, Galandiuk S. Fournier’s gangrene. Surg Clin North Am. 2002 Dec;82(6):1213-24.
- Levenson RB, Singh AK, Novelline RA. Fournier gangrene: role of imaging. Radiographics. 2008 Mar-Apr;28(2):519-28.
Eponym
the person behind the name
BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |