Clin. Cardiol. 19, 760-761 (1996)
Profiles in Cardiology
This section edited by J. Willis Hurst, M.D., W Bruce Fye, M.D., M.A.
Marie-Franqois-Xavier Bichat
W.BRUCEFYE,M.D.,
M.A.
Department of Cardiology, Marshfield Clinic, Marshfield,Wisconsin, USA
Marie-Franfois-XavierBichat (Fig. 1) made important observationson the physiology of sudden death. He was born on
November 14, 1771, in the village of Thoirette-en-Bas, near
Lyons, France.’s2He played a major role in establishingParis
as the world’s center for medical education and research in
the early nineteenth ~ e n t u r y Bichat’s
, ~ . ~ father, Jean-Baptiste,
was a graduate of the medical school at Montpelier and practiced in Poncin. After completing his preliminary education
in Nantua and Lyon in 1791,Xavier began medical training at
the HGtel Dieu in Lyon where he worked under MarcAntoine Petit, a famous surgeon.
Bichat enteredthe medical profession at a time when medicine, like all aspects of French culture, was undergoing dramatic reorganization as a result of the Revolution.s After
France declared war on Austria in 1792, Bichat served in the
military hospitals of Lyon and Bourg. He moved to Paris in
1794 where he studied at the Grand HGpital de 1’HumanitC
(H6tel Dieu) under the distinguished surgeon Pierre-Joseph
Desault. Recognizing Bichat’s abilities and his potential,
Desault got the young man an appointment as a chirurgienexteme at the hospital and invited him to live with his family.
After Desault died in 1795, Bichat edited his mentor’s writings with the help of Jean Nicholas Corvisart.
By the end of the century,Bichat was busy teaching private
courses in anatomy, physiology, and surgery, and caring for
patients at the Grand HGpital. A pioneer of vivisection in
France, he adapted surgical techniques he had learned during
the Revolution for his animal experiments.He also used vivi-
Address for reprints:
W. Bruce Fye, M.D., M.A.
Department of Cardiology
Marshfield Clinic
1000 North Oak Avenue
Marshfield, WI 54449-5777, USA
Received: May 6, 1996
Accepted: May 6, 1996
section in his physiology courses.6 As a founder of the SociCtC MCdicale d’Emulation, Bichat (together with Corvisart,
Pierre Jean Georges Cabanis, Guillaume Dupuytren, and
Philippe Pinel) was recognized as a leader in French medical
science.7* This group contributed to the development of
hospital-based teaching, the centerpiece of the Paris clinical
school during the fxst half of the nineteenth century.
Bichat was a leading proponent of vitalism, a doctrinethat
rejected the notion that the principles of physics and chemistry could be applied to organic life and physiologic functions. He believed that animal organisms were imbued with
certain “vital properties” that could not be reduced to simple
laws of physics and chemistry. The roots of Bichat’s vitalism
can be traced to a group of influential eighteenth century
Montpelier physicians, especially Franfois Boissier de
Sauvages (1706-1767).
By 1798Bichat was working on several books that reflected his deep interest in anatomy and physiology and his enthusiasm for vitalism. Bichat’s first book, Traite‘desmembranes
en gknne‘ral et de diverses membranes en particulier, published in 1799, included his doctrine of tissue pathology. He
argued that pathology must be viewed not in terms of whole
organs but in terms of the membranes or tissues that make up
the organs.
Bichat proposed that just as elementary matter could unite
to make more complex compounds in chemistry, the tissues
combined to form various organs. He distinguished 2 1 different tissues according to their gross appearance, texture, and
unique properties such as extensibilityand contractdity.He argued that these tissues were the fundamental components of
all organs and bodily structures. During the mid-nineteenth
century,European medical scientists such as Rudolf Virchow
used the microscope to refine and extend Bichat’sapproachto
create histology and cellularpathology?
Bichat’s second book, Recherches physiologiques sur la
vie et la mort, published in 1800,reveals his passion for physiologic research. In addition to undertaking an extensive series of vivisectionsin an attempt to confirm his theories of the
physiology of life and death, he performed experiments on
decapitatedhumans immediately following execution by the
guillotine.The first part of this important book is a theoretical
W. Bruce Fye: Marie-FranGois-Xavier Bichat
76 1
descriptive, was completed posthumously by a cousin and a
former pupil. This five-volume work consisted of a detailed
exposition of the various systems of the body.
Bichat became ill late in 1801 and died of tuberculosis on
July 22,1802. Despite his short life-he was just 30 when he
died-Bichat had taught many students and had published
several books. He had a profound influenceon clinical teaching and medical practice in Europe and America. Johns Hop
luns internist William Sidney Thayer declared in 1902 that
Bichat’s greatest contribution was the “introduction into
anatomy and physiology of methods of accurate, systematic
observation and experiment, methods similar to those which
distinguished the later clinical schools of Laennec, Louis, and
the physiologic studies of Claude Bemard.”Io
FIG.I Marie-FranGois-Xavier Bichat, 1771-1802. From the collection of W. Bruce Fye, M.D.
discussion of the differences between animal and organic life.
In the second part, Bichat describes a series of observations
and experiments he undertook to study the relationships of
the brain, heart, and lungs in violent or sudden death. He recognized the critical importance of all three componentsof the
body and emphasized the functional independence of the
brain and heart.
Anatomie ge‘ne‘raleapplique‘&la physiologie eta la me‘decine, published in 1801, incorporated Bichat’s vitalist ideas
in a systematic discussion of anatomy. In this four-volume
work, he extended his description of the tissues in health and
disease. In 1801, while teaching a course in pathologic anatomy at the HGtel-Dieu in Paris, Bichat performed more than
600 autopsies. In addition to his many anatomic observations
and physiologic experiments, he contributed to the founding
of experimental pharmacology by studyingthe effects of various drugs on animals. Bichat’s final book, Traite‘d’anatomie
References
1. Haigh E: Xavier Bichat and the medical theory of the eighteenth
century. Med Hist (suppl4), 1984
2. Canguilhem G: Marie-FranGois-XavierBichat. In Dictiunaty of’
Scienrz$c Biography (Ed. Gillespie CC), p. 122-123. New York
Charles Scribner’s Sons, 1973
3. Ackerknecht EH: Medicine at the Paris Hospital, 1794-1848.
Baltimore: Johns Hopkins Press, 1967
4. Foucault M: The Birfh of’ the Clinic: An Archueolugy ofMedicul
Perception. New York: Pantheon Books, 1973
5 . Vess DM: Medical Revolution in France 1789-1796. Gainesville:
University Presses of Florida, 1975
6. Rupke NA, ed.:flvisection in Historical Perspective. London: Wellcome Institute, 1987
7. Lesch JE: Science and Medicine in France: The Emergence of
Experimental Physiology, 1790-1855. Cambridge: Harvard University Press, 1984
8. Maulitz RC: Morbid Appearances: The Anatomy of Pathology in
the Early Nineteenth Century. Cambridge: Cambridge University
Press, 1987
9. Long ER: A History of Pathology. 2nd ed. New York: Dover Publications, Inc., 1965
10. Thayer WS: Bichat. Bull Johns Hopkins Hasp 1903;14:197-201