Paul Louis Duroziez (1826 – 1897) was a French general practitioner.
He had a particular interest in diseases of the heart, and published numerous pioneering works in the area. His work ‘Traité clinique des maladies du coeur’ (1891) was acclaimed, and awarded the Montyon Prize from the French Academy of Sciences and the Itard Prize from the Académie Nationale de Médecine.
Duroziez’s clinical descriptions of aortic incompetence and mitral stenosis resulted in the eponymous terms Duroziez sign (1861) and Duroziez disease (1877), respectively.
- Born 8 January 1826, Paris
- 1852 – Awarded the Corvisart Prize for his discussion on the properties and action of digitalis as a medical student
- 1853 – Graduated M.D. from the Faculté de Médecine, Paris, with his thesis on the cases he encountered during his studies, titled ‘Clinique de la Charite, Service de M. le Professeur Bouillard, Semestre d’Hiver 1850-1851‘
- 1856-58 – Appointed Chef de Clinique (chief of clinic) at l’Hospital de la Charité under Dr Jean-Baptiste Bouillaud (1796-1881), and was colleagues with Jean-Martin Charcot (1825-1893)
- 1870 – Served as an ambulance physician and surgeon major for the French army in the Franco-Prussian War
- 1882 – President of the Société de Médecine, Paris
- 1895 – Chevalier of the Légion d’honneur
- Died 16 January 1897, Paris
...le médecin voit des malades et non des maladies […the physician sees patients, and not diseases]Duroziez, 1891
Duroziez Sign (1861)
Duroziez described a ‘double intermittent murmur’ as a sign of aortic insufficiency. It is a systolic and diastolic two-phase murmur (anterograde-retrograde) that can be heard over the brachial or femoral artery in severe aortic regurgitation.
The murmur is produced when firm pressure from the bell of the stethoscope is applied to the artery then altering the pressure proximally and distally. The diastolic component often becomes louder with pressure applied distal to the stethoscope. Duroziez sign is an unreliable indicator of severity of aortic regurgitation.
The intermittent crural murmur always accompanies aortic insufficiency, and betrays it in difficult and complicated cases. It is the pathognomonic sign of this condition. Since this has never been said before by any author, I shall proceed to demonstrate the fact…When the crural artery is compressed, the hand perceives a shock or trembling, and there is audible a sound which might be represented by the word toe or a peculiar murmuring sound, the intermittent simple murmur. … If after having compressed the artery for some time one slowly lessens the compression, and if one is dealing with an anemic subject, a striking murmur is heard…This is the continuous double murmur.
But there is another murmur called the intermittent double murmur which is met in certain cases, to which we shall now give special study …There are two methods of producing this double murmur, that is, with the stethoscope and with the hand. One presses gradually with the instrument until the artery is obliterated, and with a certain degree of pressure the double murmur appears … or one may simply place die instrument over the artery without pressure, then alternately apply pressure proximal and distal to the instrument. Proximal pressure produces the first murmur, and distal pressure produces the second murmur. This, however, can only be done when the second murmur is produced with unusual ease.”-Translation of Duroziez’s original work (from Medical eponym: Duroziez’s Sign. N Engl J Med. 1940; 223:556)
- Duroziez disease (first presented in 1861-1862; later published in 1877) – Congenital mitral stenosis. Duroziez described the clinical features of mitral stenosis, the aetiological difference between rheumatic and congenital, and the increased risk in females across numerous cases he had been following up. In addition, other features included the early age in development; tendency for embolism with secondary neurological complications; absence of global cardiomegaly with dilatation of the left atrium; and a relatively favorable prognosis.
- Duroziez Rhythm (1862)
Some claim the Duroziez murmur also may occur in normal individuals who have increased flow because of fever, anemia, or peripheral vasodilatation. However, the sound produced in these conditions does not have the characteristic to-fro sound of the Duroziez; instead, they resemble the continuous murmur of an arteriovenous fistula.
- Duroziez PL. Clinique de la Charité, service de M. le professeur Bouillaud : semestre d’hiver, 1850-1851. Thèse pour le doctorat en médecine présentée et soutenue le 21 juillet 1853
- Duroziez PL. Du double souffle intermittent crural, comme signe de l’insuffisance aortique. Archives générales de médecine. 1861;17: 417-443, 588-605. [Duroziez Sign]
- Duroziez PL. Essai sur les maladies du coeur. Du rhythme pathognomonique du rétrécissement mitral. Archives générales de médecine. 1862;20:383-401 [Duroziez Rhythm]
- Duroziez PL. Du rétrécissement mitral pur. Archives générales de médecine. 1877; 30: 32-54, 184-197. [Duroziez disease]
- Duroziez PL. Traite clinique des maladies du coeur. Paris: Steinheil. 1891
- Willius FA, Keys TE. The Double Intermittent Murmur over the Femoral Artieries as a Sign of Aortic Insufficiency. Cardiac Classics. Mosby. 1941:493–496
- Berry D. History of cardiology: Paul Louis Duroziez, MD. Circulation. 2006;28;114(22):f188
- Puigbó JJ. La fragua de la Medicina Clínica y de la Cardiología. CDCH UCV. 2002; 513-17.
- Beauvais, G. de. Éloge de Paul Louis Duroziez. Paris: A Davy. 1898.
- Babu AN, Kymes SM, Carpenter Fryer SM. Eponyms and the diagnosis of aortic regurgitation: what says the evidence? Ann Intern Med. 2003 May 6;138(9):736-42. [PMID 12729428]
- Sapira J.D. Quincke, de Musset, Duroziez, and Hill: some aortic regurgitations. Southern Medical Journal. 1981; 74(4): 459–467
- Luisada AA. On the pathogenesis of the signs of Traube and Duroziez in aortic insufficiency. American Heart Journal 1943; 26(6): 721-736.
- Blumgart HL, Erstene AC. Two mechanisms in the production of Duroziez’s sign: their diagnostic significance and a clinical test for differentiating between them. JAMA. 1933; 100(2): 173–177.
- Rowe G.G, Afonso S, Castillo C.A, McKenna D.H. The mechanism of the production of Duroziez’s murmur. N Engl J Med. 1965; 272: 1207–1210.
- Folts J.D, Young W.P, Rowe G.G. A study of Duroziez’s murmur of aortic insufficiency in man utilizing an electromagnetic flowmeter. Circulation. 1968; 38: 426–431.
- MacAlpin RN, Kattus AA. Brachial-artery bruits in aortic-valve disease and hypertrophic subaortic stenosis. N Engl J Med. 1965;273:1012–1018.
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