History of Medicine

BONES and WORMS

A WRITER ON PARSITES INVENTS  “ORTHOPEDICS”

     It is ironic that the term “orthopedics” denotes a surgical specialty, considering that the inventor of that word, Nicolas Andry, was a fervid enemy of surgeons. Andry was born in Lyon in 1658. He studied for the priesthood, left that path to teach humanities, then decided rather late on medicine and studied at the University

Nicolas Andry de Boisregard (courtesy Wellcome Library and
Wikipedia)

of Reims and the University of Paris, obtaining his degree at age 39. His thesis was “The relationship in the management of diseases between the happiness of the doctor and the obedience of the patient”, a subject not unusual at the time (and relevant today!). He rose to become a professor at the College de France and finally, in 1724, dean of the faculty.

     He wrote two important books. The first appeared at the start of his career, at age 42: An Account of the Breeding of Worms in the Human Body, a book that earned him the name “father of parasitology”. Though it is an early work on parasites, with several illustrations (some of them fanciful), its real importance lies in Andry’s strong stand against spontaneous generation. Belief in spontaneous generation of intestinal worms went back to Hippocrates and continued through Galen and Avicenna. But Leeuwenhoek’s

Tapeworm, from "An Account of Breeding..."
(from Haiti Trust)

microscope and Redi’s experiments with flies in the late 1600s shed doubt on that notion. Andry never experimented; he simply stated, “Worms breed in the bodies of men and other animals, by means of a seed that enters there, in which those worms are enclosed. For all animals are bred of a seed which contains them…” (Grove). He describes a patient with fever, chest pain, and coughing blood who, after a purgative, expelled a long tapeworm, complete with head. Andry was the first to illustrate the tapeworm head (see illustration), though they had been described previously.

     At the other end of his career, at age 82, he published Orthopaedia or the Art of Correcting and Preventing Deformities in Children (English translation). This book earned him the title “father of orthopedics”, and though that is a little off the mark, the  author introduced the word “orthopedics” by saying “As to the title, I have formed it of two Greek words, viz. orthos, which signifies straight, free from deformity, and paidos, a child. Out of these two words I have compounded that of Orthopaedia.” The word persisted and infiltrated many languages.

     The book was actually a manual for the use of parents to treat or prevent, in their children, deformities of the skeleton and in part 2, those of the head. Various massages and braces are recommended for crooked spines and limbs, and exercises, proper posture, etc., for prevention of deformities. The section on the head covers skin problems, smallpox, deafness, nasal deformities, and the like. Overall, measures are conservative.

     One remedy is of particular interest. If a child is becoming bow-legged (usually from rickets at that time) Andry advises placing an iron plate on the

Straightening the tree trunk, in Orthopaedia
(from Hathi Trust)

inner side of the leg and binding it with a linen bandage, tighter each day "as is used for making straight the crooked trunk of a young tree” (see  illustration). The famous tree image has been adopted by orthopedic associations around the world. The logo of the American Board of Orthopedic Surgery is one example:

Logo, Amer Board of Orthopedic
Surgery

An interesting variation was created by the Arizona Orthopedic Society - a curved cactus:

Logo, Arizona Orthopedic Society

     Andry was described by colleagues as irascible, scornful, jealous, and superb. As a critic for the Journal des Savants he carried on a prolonged campaign against barber surgeons, abolishing surgical positions at the school and requiring that surgeons operate with a medical doctor present. Ironically,

Jean-Louis Petit (from Wikipedia)

he unjustly targeted Jean-Louis Petit, a famous surgeon who invented the screw tourniquet, was the first to drain the mastoid bone, and wrote a highly regarded work on bone surgery, the first comprehensive orthopedic surgery text.

    

Sources consulted:

    Grove, D I. A History of Human Helminthology. 1990.

   “Eulogy of Jean-Louis Petit”. Chirurgie 126: 475-81, 2001

   “A History of the Ecological Sciences, Part 30”. Bull Ecol Soc

       America, Oct 2008, pp 407-433.

   “Nicolas Andry de Bois-Regard, the Inventor of the Word

       Orthopedics and the Father of Parasitology”. J Child Orthop

       4: 349-55, 2010.

   Kirkup, J R. “Nicolas Andry and 250 years of Orthopaedy”. J

        Bone Joint Surg (Br) 1991. 73-B: 361-2.

   Andry, N. De la Generation des Vers dans le Corps de

       l”Homme. 1700.

   Andry, N. Orthopaedia: or the Art of Correcting and Preventing

      Deformities in Children. 1741 (Eng trans 1743).

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