The Academy had six prizes to award this year, that is, in order of their foundation, : The Prize of the Academy, The Prize Portal, The Prize Civrieux, The Prize Barbier and the Prize Orfila.”
“The Prize of the Academy. – The question posed by the Academy to the competitors was the following:
To determine, relying on clinical information : 1st what is the natural course of the various types of pneumonia taking into account the differing physiological states of the patients; 2nd what is the relative value of expectant treatment in these diseases.
Is it necessary to point out that ‘expectant treatment’ is not simply inaction since, in that case, it would no longer be medicine?
The task that the Academy imposed on the candidates was, said the commission’s rapporteur, principally to study whether, by a careful examination of the various types of pneumonia and by a valid comparison of the treatments used, it might be possible to conclude which pneumonias were intrinsically benign and did not require energetic medication; in sum, the Academy asked them to determine the features by which they could be recognised. This was the real aim of the studies proposed by the Academy.
The Academy particularly picked out the memoir marked by the somewhat sceptical epigraph Nil admirari, whose author is M. doctor Louis Duclout, physician at Sainte-Marie-aux-Mines (Haut Rhin). The author of this work first presents a very careful account of 66 observations on pneumonia in children, adults and the elderly, [all] treated by the so-called expectant method, and compares these to 81 observations on pneumonias treated more actively, either by bloodletting or by a ‘mixed’ method of bleeding, emetics and vesication. The author’s results are grouped in the form of statistical tables, in which the figures on comparative mortality serve, in a sense, as conclusions.
These conclusions favour the expectant method, to which the author also attributes the advantage of reducing the duration of the disease and to make convalescence less unpleasant and more rapid.
Are the observations analysed by the author sufficient in number to give these conclusions the status of proof?
The Commission would have preferred that, by using statistical tables published abroad and in France, and examining their validity with that critical ability which he has demonstrated, he could have brought to the solution of the problem to be resolved a more impressive number of observations. At the end of his work the author states, in a general manner, that no medication is excluded in pneumonia but he does not indicate what indications there are to guide the clinician.”
“The memoir labelled number 3, carrying as epigraph that phrase of Hippocrates ‘Medicus naturae minister et interpres’, is the work of M. doctor Émile Molland, physician in Paris. This memoir includes a remarkable study of the pneumonia of youth; perhaps nowhere else can one find documents so numerous and complete. This work is based on a total of 126 observations on children collected between 1856 and 1859 : 72 were treated by the expectant method and 54 by more or less active intervention. In this considerable number of pneumonias the author reports only a single death, a remarkable result which gives new support to an established observation. In respect of deciding what effect the various methods of treatment had on the progress of childhood pneumonia, the author’s conclusions are : 1st, that bleeding is useless in mild pneumonia,; 2nd that it prolongs the convalescence of pneumonias of moderate severity; 3rd and finally, that bleeding, emetics or expectant treatment do not result in more rapid resolution of some than of other severe cases of pneumonia.
In respect of adult pneumonia and that of old age, the author has much less to offer and scarcely does more than repeat known observations.
The Academy, having taken account of the number of his observations and the points elucidated by Dr Émile Molland awards him a prize of 400 francs.”
Translation by IML Donaldson
The editors are grateful to:
Iain Donaldson for providing the English translation of this record.
The Wellcome Trust for making available the portrait of Pierre Augustin Béclard (1785-1825).