Armand Trousseau

Armand Trousseau (1801-1867)

Armand Trousseau (1801 – 1867) was a French Physician.

19th century French physician best-known for performing the first thoracocentesis; popularising tracheotomy in the treatment of croup, and his extensive studies involving yellow fever and laryngeal phthisis.

A leader of the French therapeutic renaissance, Trousseau was instrumental in creating new modes of treatment of croup, emphysema, pleurisy, goitre, and malaria.

Eponymously affiliated with a sign, a spot and a syndrome…


Biography

  • Born 14 October 1801 Tours, France
  • 1825 – MD
  • 1828 – Assigned to investigate epidemics in Southern France.
  • 1830 – Physician of the hospitals
  • 1832 – Publich health physician, Central Bureau
  • 1838 – Prize from the French Academy of Medicine for his classic essay Traité pratique de la phthisie laryngée
  • 1839 – Physician to St. Antoine Hospital
  • 1850 – Chair of Clinical Medicine, Hotel-Dieu
  • 1856 – Member of the Academy of Medicine
  • Died 27 June 1867

We do not know the mode of action of almost all remedies. Why therefore fear to confess our ignorance? In truth, it seems that the words “I do not know” stick in every physicians throat.

Observe the practice of many physicians; do not implicitly believe the mere assertion of your master; be something better than servile learner; go forth yourselves to see and compare

Trousseau 1859: 744-745

Medical Eponyms

Trousseau sign

Carpopedal spasm and paraesthesia produced by pressure upon nerves and vessels of the upper arm sufficient to arrest. A physical sign of hypocalcaemic tetany

In the upper limbs, the thumb is forcibly and violently adducted; the fingers are pressed closely together, and semi-flexed over the thumb in consequence of the flexion of the metacarpo-phalangeal articulation; and the palm of the hand being made hollow by the approximation of its outer and inner margins, the hand assumes a conical shape, or better the shape which the accoucheur gives to it when introducing in into the vagina…

In the lower limbs, the toes are bent down towards the sole and press against one another while the big toe turns in under them, and the sole becomes hollowed out in the same manner as the hand. The dorsum of the foot is strongly arched, and the hell pulled up by the contracted muscles at the back of the leg.”

Trousseau 1861: 375-377


Trousseau syndrome

[Archaic term] Venous thrombosis (thrombophlebitis) of the upper and lower extremities associated with visceral cancer. Often as the first presenting sign of visceral malignancy classically pancreatic cancer, but other tumours particularly adenocarcinomas, are associated. In 1861 Trousseau stated that if the diagnosis of a suspected carcinoma of an internal organ could not be verified, the sudden and spontaneous appearance of thrombophlebitis in a large vein afforded necessary proof for diagnosis. [See Ultrasound Case 097]

So great, in my opinion, is the semiotic value of phlegmasia in the cancerous cachexia, that I regard this phlegmasia as a sign of the cancerous diathesis as certain as sanguinolent effusion into the serous cavities. In the cachexiae, as I have told you, there exists a special crasis of the blood, which irrespective of inflammation, favours intravenous coagulation


Trousseau spots

[aka *tache cerebrale, meningitic streaks]

The sign is elicited by firmly stroking the skin with a fingernail, tongue depressor, or a similar object. There may be a brief period of blanching, followed within 15–30 seconds by the appearance of a line of erythema that spreads laterally beyond the original area of stimulus. The width of the red line is related to the pressure of the stroke. The red line may be flanked by thin pale areas and may be evident for several minutes.

When I very gently made on her abdomen with my nail cross markings, longitudinally and transversely, in less than half a minute the portion of skin which I had touched was suffused with a very bright red tint, which was diffused at first, but grew by degrees fainter. Leaving along the track where the nail bed passed, lines of a deeper red colour, which persisted for a pretty long time. This is what I mean by cerebral macula.

If after exposing the patient, his skin be gently rubbed with a hard body, such as a pencil, or simply with the nail, the part touched rapidly becomes of a bright red colour, which persists for a more or less prolonged period, eight, ten, or fifteen minutes.

Trousseau Fièvre cérébrale. 1861: 310

Major Publications


Point of Interest

Trousseau is believed to have died from the very syndrome which bears his name. In 1867 he noticed phlegmasia in his own left hand and reportedly told his student “ I am lost; the phlebitis that has just appeared tonight leaves me no doubt about the nature of my illness ”. He died from gastric cancer just months later.

The originator of the term “Trousseau Syndrome” is unknown, but Trousseau’s 1861 Lectures on Clinical Medicine has often been regarded as the first published work linking thrombosis and malignancy.


References

Observe the practice of many physicians; do not implicitly believe the mere assertion of your master; be something better than servile learner; go forth yourselves to see and compare


eponymictionary CTA

eponym

the person behind the name

Physician in training. German translator and lover of medical history.

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