Auguste Nélaton
Auguste Nélaton (1807-1873) was a French physician and surgeon.
Nélaton was a great teacher and operator at the Hôpital St. Louis in Paris. Widely respected by his contemporaries such as Malgaigne and Desault, he was known for his surgical dexterity, and served as personal surgeon to Napoléon III.
Along with Wilhelm Roser eponymously affiliated with the Roser-Nélaton line
Biography
- Born June 17, 1807, Paris
- Raised by his mother from a young age, as his father was lost at war during the french army’s campaign in Russia (circa 1813)
- 1828 Attended the Faculté de Paris as a medical student
- 1831 Appointed as intern at the Hôtel-Dieu in Paris
- 1835 Appointed as intern under Guillaume Dupuytren, who died suddenly in February of the same year
- 1839 Professorship at the hôpital Saint-Louis
- 1851 – MD, Thèse: De l’influence de la position dans les maladies chirurgicales
- 1863 Member of the Academy of Medicine (France)
- 1868 Received the title of Grand Officer in the Légion d’Honneur
- Died September 21, 1873
Original
English
l’entrée d’Auguste faisait sensation. A première vue, on se sentait attiré par je ne sais quel charme, mélangé d’une sorte de respect, vers ce jeune homme au doux et ferme maintien, au regard à la fois si modeste et si assuré
Auguste’s entrance made sensation. At first glance, one felt attracted by a certain charm, mixed with a sort of respect for this young man, with his gentle yet firm affect, with a look at once so modest, yet so assured
Medical Eponyms
Nélaton’s line (Roser-Nélaton line)
Original
English
“Si l’on examine à l’état normal les rapports exacts du grand trochanter avec les diverses saillies osseuses que l’on trouve sur le bassin, on reconnaît que , si le fémur est fléchi à angle droit avec une légère adduction, le sommet du grand trochanter répond à une ligne qui partirait de l’épine iliaque antéro-supérieure pour se rendre à la partie la plus saillante de la tubérosité sciatique, et que cette ligne divise en même temps la cavité cotyloïde en deux parties égales.”
Nélaton A. Luxations de l’articulation coxo-femorale. In: Elémens de pathologie chirurgicale, 1844; 2(XXXIII): 441-442
If one examines, in its normal state, the exact relations of the greater trochanter to the different bony prominences which are found on the pelvis, one recognizes that, if the femur is flexed at a right angle with a light adduction, the summit of the greater trochanter corresponds to a line traced from the anterior superior iliac spine to the ischial tuberosity, and that this line also divides the acetabulum into two equal parts.
Nélaton A. Luxations de l’articulation coxo-femorale. In: Elémens de pathologie chirurgicale, 1844; 2(XXXIII): 441-442
Original
English
“Die diagnose der Luxation erschien uns inden meisten Fällen dieser Art sehr leicht: bei normaler Lage befinden sich die Spina ilii, der Trochanter und der Tuber ischii nahezu in Einer Linie, ist Luxation da, so steht der Trochanter auffallend höher und weiter nach hinten als die Linie, welche man sich von der Spina zum Tuber gezogen denkt.”
Roser W. Hacker, Erfahrungen und Abhandlungen im Gebiete der Chirurgie. Archiv für physiologische Heilkunde, 1846; 5: 142
The diagnosis of luxation presented itself in most cases quite clearly: in a normal situation, the iliac spine, the trochanter and the ischial tuberosity lie nearly on the same line; if there is a luxation, the trochanter lies noticeably higher and more posterior to the line, which one may imagine traced from the spine to the tuberosity”
Roser W. Hacker, Erfahrungen und Abhandlungen im Gebiete der Chirurgie. Archiv für physiologische Heilkunde, 1846; 5: 142
Nélaton tumor (Dupuytren-Nélaton disease)
First published a detailed manuscript on bony cysts, a phenomenon first described by his senior physician, Baron Guillaume Dupuytren (1777-1835) in 1832
Original
English
J’ai présenté à la societé de chirurgie, dans l’année 1844, un fort bel exemple de ces kystes multiloculaires contenant de la sérosité sanuinolente. La tumeur, qui occupait le fémur gauche, était étendue depuis la base du grand trochanter jusqu’à deux centimètres des condyles fémoraux, et elle résultait de l’agglomération d’une multitude de kystes dont la plupart auraient pu contenir une noix.
I presented, at the surgical society in the year 1844, a very nice example of these multilocular cysts containing serosanguinous fluid. The tumor, which occupied the left femur, extended from the base of the greater trochanter to two centimeters from the femoral condyles, and it was a result of the agglomeration of a multitude of cysts, most of which were large enough to hold a nut.
- Dupuytren G. Des kystes qui se dévelop dans l’épaisser des os, et de leurs différentes espéces. In: Leçons orales de clinique chirurgicale faites à l’Hôtel-Dieu de Paris. 1832;(2):129-148.
- Nélaton A. Des kystes des os. Élements de pathologie chriurgicale. 1844; 2(XXVII): 46-52
Nélaton Probe (1862)
Porcelain-tipped probe for locating bullets
1862 and Garibaldi
The Italian general Giuseppe Garibaldi (1807-1882), was shot while trying to take control over the city of Rome at a time when Italy had just undergone unification to create a single kingdom. Rome did not accept the unification so Garibaldi, with a band of volunteers, took on the Royal Army of Italy at the Battle of Aspromonte on August 29, 1862. The battle lasted less than ten minutes with only 15 casualties however, Garibaldi was shot three times, and imprisoned along with the rest of his volunteers.
Garibaldi was provided full respect and medical treatment whilst imprisoned. Two of the three shots were to his hip and were treated with ease. The third shot was to his right medial malleolus and caused significant pain. Despite multiple medical reviews including by the revered Dr. Richard Partridge, professor at King’s college, no cause of the pain could be found, and all physicians deemed the bullet had passed through and was no longer lodged.
After five weeks, the Italian physicians sent for Nélaton. He attended Garibaldi on October 28 and deemed the bullet to still be present and that amputation of the foot not necessary. Garibaldi’s sick room became an international conference with the Italian doctors, the Frenchman Nélaton, the Englishman Partridge, and a Russian physician all prodding and poking the General.
Nélaton returned to France to design a probe to prove the presence of a bullet in the wound. He placed an unglazed porcelain tip on the end of a normal medical probe. When the porcelain touched bone the probe remained unaffected. When it rubbed against the lead of a bullet however, the tip would become marked.
The Italian physicians Rosseau and Zanneti used the probe to confirm that the bullet was still in Garibaldi’s ankle and they successfully removed it on November 22, 1862.
Ball extracted from the wound of Garibaldi as assured by your diagnosis guaranteed by the result of your probing. Honneur à vous Torrelli
Telegram to Nélaton on November 23, 1862
1865 – Abraham Lincoln assassination
On the night of April 14, 1865, Lincoln was taken to the Petersen House across the street from Ford’s after being shot. He was attended to by several doctors including the Surgeon General Joseph Barnes and the first responder, Dr. Charles Leale. At first, they introduced regular, silver probes into Lincoln’s wound and, like in Garibaldi’s case, they were unsure if the solid mass they encountered was the bullet or a piece of Lincoln’s skull. Dr. Leale recounts:
About 2 a.m. the Hospital Steward who had been sent for a Nelatons probe, arrived and examination was made by the Surgeon General, who introduced it to a distance of about 2 ½ inches, when it came in contact with a foreign substance, which laid across the track of the ball.
This being easily passed the probe was introduced several inches further, when it again touched a hard substance, which was at first supposed to be the ball, but as the bulb of the probe on its withdrawal did not indicate the mark of lead, it was generally thought to be another piece of loose bone.
The probe was introduced a second time and the ball was supposed to be distinctively felt by the Surgeon General, Surgeon Crane and Dr. Stone
Charles A. Leale, MD
The Nélaton probe proved to be efficient and started to be mass produced and shipped globally. They became an essential instrument for the military surgeon and continued to be used into the 1900’s before they were replaced by the advent of less intrusive devices such as the X-ray.
Other eponyms
- Nélaton ulce [trophic plantar ulcer, malum perforans pedis] 1852
- Nélaton catheter – tubular rubber bladder catheter
Major Publications
- Nélaton A. De l’influence de la position dans les maladies chirurgicales. Thèse 1851
- Nélaton A. Elémens de pathologie chirurgicale. 1844 [Tome II 1847] [Tome IV 1848] [Tome VI 1876] [English translation Clinical lectures on surgery, 1855] [Roser-Nélaton line]
- Nélaton A. Affection singulière des os du pied. Gazette des hôpitaux civils et militaires, 1852; IV: 13 [Nélaton ulcer]
References
Biography
- Guyon F. Eloge de Nélaton prononcé le 19 janvier 1876
- Béclard, J. Praise of Auguste Nelaton (1817-1887), Mémoires de l’Académie de médecine. 1879; 32: XXI-XL
- Bibliography. Nélaton, Auguste 1807-1873. WorldCat Identities
Eponymous terms
- Dupuytren G. Des kystes qui se dévelop dans l’épaisser des os, et de leurs différentes espéces. Leçons orales de clinique chirurgicale faites à l’Hôtel-Dieu de Paris. 1839;(2):129-148. [Dupuytren-Nélaton disease]
- Warren JC. The Nélaton Probe. The Boston Medical and Surgical Journal, 1919; 181(8), 235–236.
- Bolton J. Nelaton’s Method of Detecting the Position of the Ball in Gun-Shot Wounds, with Illustrative Cases-i. Gun-Shot Wound of the Thigh; Ball Lodged in the Condyle of the Femur; Detected by Nelaton’s Probe and Canula Forceps; Successful Removal;-ii. Letter to the Editor from Surgeon A. Y. P. Garnett, on the Use of Nelaton’s Probe. Confed State Med Surg J. 1864 Feb;1(2):21-23. [Nélaton probe]
- Dobson J. A surgical problem of the last century: Garibaldi’s bullet and Nélaton’s probe. Ann R Coll Surg Engl. 1953; 13(4): 266-269. [Nélaton probe]
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Eponym
the person behind the name
Dr Conor O'Reilly, MB BCh BAO BComm, University College Dublin / Dublin City University, Ireland. In Australia working in Emergency Medicine with an interest in Sports medicine
