- Email: [email protected]
Abecedarium: Who am I? X’…
G Model ANORL-418; No. of Pages 2
ARTICLE IN PRESS European Annals of Otorhinolaryngology, Head and Neck diseases xxx (2015) xxx–xxx
Available online at
ScienceDirect www.sciencedirect.com
Editorial
Abecedarium: Who am I? X’. . . Dear reader, My family goes back to the late 19th century, when the electric fairy first hovered over our cradle. Friedrich Voltolini, who introduced the oxyhydrogen incandescent light, and Thomas Edison, who developed an electricity distribution system for the light bulb he had just designed, had left me precious gifts at birth. I also owe a lot to the man who founded our first university clinic, in Vienna in 1870. It was there and later at almost exactly the same time in Germany and Britain that it all began. Other key dates in my early history in France were 1875, with the first edition of my national journal; 1892, when 15 colleagues founded my national Society; and 1913, with my first university Chair, in the fair city of Bordeaux. From then on, the family never looked back. By 2014, there were 3074 of us (including 679 of female gender), 11 of whom were under 30 and 94 over 70, for a mean age of 53 years [1]. Half of us are “selfemployed”, although the term is not altogether apt, as our fees have long been set by the State, giving us an average pre-tax income of D 91,937, well below the D 100,549 enjoyed by other specialists in France [2]. The time has long since passed when we were comfortable dignitaries making an unchallenged and unanimously admired contribution to society. And how our working conditions have changed! Everything turns around cost saving. Our in-service training now has to be validated by a mandatory assessment, as if we did not already have enough futile paper work to keep us busy! Ah! The days when passing your doctorate were enough to set you up for life. . . You will now have guessed, dear sisters, brothers and other family members, that X’ is each of us: that is to say, a French otolaryngologist. History traces the roots of our family tree back to 3500 BCE: a mortuary engraving testifies to the gratitude of the 5th dynasty pharaoh Sahure for the rhinologic care he had received at the hands of his physician Sekhet’enanch, wishing him long life: “As my nostrils enjoy health, as the gods love me. . .”. Some 2000 years later, in Egypt again, the Smith and Ebers papyruses record our early triumphs. And in India, in the 6th century BCE, Susruta prefigured modern rhinoplasty, in an attempt to repair the damage wreaked by nose amputation, the standard punishment for unfaithful wives. Our growth, however, was stunted by the fire that destroyed part of the great library of Alexandria, with the loss of tens of thousands of writings, and by the Black Death that decimated Europe. Not until the Belle Époque and the turn of the 20th century did otorhinolaryngology make its début in French society. Several factors had come together to make this possible: macroscopic and microscopic anatomy and the fundamentals of head and neck physiology had been sorted out. A Spanish singer, Manuel Garcia, was the first to envisage the device which would enable us to examine our patients properly: a mirror. The Austro-Hungarian
physicians Ludwig Türck and Johann Czermak became the firsts to observe their patients’ vocal folds. They also made use of an innovation eye specialists had recently adopted for ophthalmoscopic examination and which, in the hands of Antonin Von Tröltsch would revolutionize otology: the concave mirror. At first, it was hand-held, but a frontally mounted, monocular then binocular model quickly came to be developed. Not everyone, however, remembers that, before the advent of this excellent mirror, in 1883, the “frontal electric photophore” had been developed in partnership between Paul Hélot, a surgeon from Rouen, and Gustave Pierre Trouvé, who in 1881 had invented the first electric automobile. It was at this point that the circumstances surrounding the death from laryngeal cancer of a German Crown Prince first put our specialty on the forefront of the world stage. In the same period, in France, Jules Emile Moure in Bordeaux and Jean Baratoux in Paris were among the firsts to realize how laryngology, otology and rhinology needed to be combined in a single field, whereas the two main branches of our specialty tended to turn up their noses at rhinology and were developing in tandem, with courses taught outside the hidebound hospital environment [3]. Otologists such as Marie Ernest Gellé, Jules Ladreit de Lacharrière and Maurice Lanois were taking over from such famous “aurists” as Jean-Marc-Gaspard Itard or Prosper Menière [3]. Laryngologists such as Charles Fauvel, Jean Garel, Emile Isambert, Maurice Krishaber and Louis Mandl were the worthy heirs of Armand Trousseau [3]. As usual, French bureaucracy was dragging its heels, and it was only in 1899 that Achille Gouguenheim became the head of the first otorhinolaryngology department, known as the Clinic of larynx, nose and ear diseases, in the Lariboisière hospital in Paris [3]. The fact that ORL was using techniques drawn from ophthalmology inspired the authorities to consolidate our specialty with that of ophthalmology, and it was decades later, in the mid20th century, that the two fields were finally officially separated and our specialty gained its recognized medical independence. A shared, thrilling adventure, crowned by success! Our joint efforts have given rise to a single complex specialty of uncontested value. Let us never forget that our diversity and union were and will continue to be our strength. . . Best regards to each one of you, Sincerely yours, X’ (a French otorhinolaryngologist).
Disclosure of interest The authors declare that they have no conflicts of interest concerning this article.
http://dx.doi.org/10.1016/j.anorl.2015.05.001 1879-7296/© 2015 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Laccourreye O, et al. Abecedarium: Who am I? X’. . .. European Annals of Otorhinolaryngology, Head and Neck diseases (2015), http://dx.doi.org/10.1016/j.anorl.2015.05.001
G Model ANORL-418; No. of Pages 2
ARTICLE IN PRESS Editorial / European Annals of Otorhinolaryngology, Head and Neck diseases xxx (2015) xxx–xxx
2
References
b
[1] http://www.data.drees.sante.gouv.fr/TableViewer/tableView.aspx?ReportId= 815 [2] http://www.carmf.fr/chiffrescles/stats/2014/bnc2012.htm [3] Legent F. La naissance de l’otorhinolaryngologie en France. http://www. biusante.parisdescartes.fr/histmed/medica/orlc.htm
Ollivier Laccourreye a,∗ Alfred Werner b Iain McGill c Christian Martin d a Service d’oto-rhino-laryngologie et de chirurgie cervico-faciale, HEGP, université Paris Descartes Sorbonne Paris Cité, AP–HP, 20-40, rue Leblanc, 75015 Paris, France
18, rue de la Ferme, 92200, Neuilly-sur-Seine, France c Place du Plâtre, 69930 Saint-Laurent-de-Chamousset, France d Service ORL, pavillon B, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France ∗ Corresponding
author. E-mail address: [email protected] (O. Laccourreye)
Please cite this article in press as: Laccourreye O, et al. Abecedarium: Who am I? X’. . .. European Annals of Otorhinolaryngology, Head and Neck diseases (2015), http://dx.doi.org/10.1016/j.anorl.2015.05.001
ARTICLE IN PRESS European Annals of Otorhinolaryngology, Head and Neck diseases xxx (2015) xxx–xxx
Available online at
ScienceDirect www.sciencedirect.com
Editorial
Abecedarium: Who am I? X’. . . Dear reader, My family goes back to the late 19th century, when the electric fairy first hovered over our cradle. Friedrich Voltolini, who introduced the oxyhydrogen incandescent light, and Thomas Edison, who developed an electricity distribution system for the light bulb he had just designed, had left me precious gifts at birth. I also owe a lot to the man who founded our first university clinic, in Vienna in 1870. It was there and later at almost exactly the same time in Germany and Britain that it all began. Other key dates in my early history in France were 1875, with the first edition of my national journal; 1892, when 15 colleagues founded my national Society; and 1913, with my first university Chair, in the fair city of Bordeaux. From then on, the family never looked back. By 2014, there were 3074 of us (including 679 of female gender), 11 of whom were under 30 and 94 over 70, for a mean age of 53 years [1]. Half of us are “selfemployed”, although the term is not altogether apt, as our fees have long been set by the State, giving us an average pre-tax income of D 91,937, well below the D 100,549 enjoyed by other specialists in France [2]. The time has long since passed when we were comfortable dignitaries making an unchallenged and unanimously admired contribution to society. And how our working conditions have changed! Everything turns around cost saving. Our in-service training now has to be validated by a mandatory assessment, as if we did not already have enough futile paper work to keep us busy! Ah! The days when passing your doctorate were enough to set you up for life. . . You will now have guessed, dear sisters, brothers and other family members, that X’ is each of us: that is to say, a French otolaryngologist. History traces the roots of our family tree back to 3500 BCE: a mortuary engraving testifies to the gratitude of the 5th dynasty pharaoh Sahure for the rhinologic care he had received at the hands of his physician Sekhet’enanch, wishing him long life: “As my nostrils enjoy health, as the gods love me. . .”. Some 2000 years later, in Egypt again, the Smith and Ebers papyruses record our early triumphs. And in India, in the 6th century BCE, Susruta prefigured modern rhinoplasty, in an attempt to repair the damage wreaked by nose amputation, the standard punishment for unfaithful wives. Our growth, however, was stunted by the fire that destroyed part of the great library of Alexandria, with the loss of tens of thousands of writings, and by the Black Death that decimated Europe. Not until the Belle Époque and the turn of the 20th century did otorhinolaryngology make its début in French society. Several factors had come together to make this possible: macroscopic and microscopic anatomy and the fundamentals of head and neck physiology had been sorted out. A Spanish singer, Manuel Garcia, was the first to envisage the device which would enable us to examine our patients properly: a mirror. The Austro-Hungarian
physicians Ludwig Türck and Johann Czermak became the firsts to observe their patients’ vocal folds. They also made use of an innovation eye specialists had recently adopted for ophthalmoscopic examination and which, in the hands of Antonin Von Tröltsch would revolutionize otology: the concave mirror. At first, it was hand-held, but a frontally mounted, monocular then binocular model quickly came to be developed. Not everyone, however, remembers that, before the advent of this excellent mirror, in 1883, the “frontal electric photophore” had been developed in partnership between Paul Hélot, a surgeon from Rouen, and Gustave Pierre Trouvé, who in 1881 had invented the first electric automobile. It was at this point that the circumstances surrounding the death from laryngeal cancer of a German Crown Prince first put our specialty on the forefront of the world stage. In the same period, in France, Jules Emile Moure in Bordeaux and Jean Baratoux in Paris were among the firsts to realize how laryngology, otology and rhinology needed to be combined in a single field, whereas the two main branches of our specialty tended to turn up their noses at rhinology and were developing in tandem, with courses taught outside the hidebound hospital environment [3]. Otologists such as Marie Ernest Gellé, Jules Ladreit de Lacharrière and Maurice Lanois were taking over from such famous “aurists” as Jean-Marc-Gaspard Itard or Prosper Menière [3]. Laryngologists such as Charles Fauvel, Jean Garel, Emile Isambert, Maurice Krishaber and Louis Mandl were the worthy heirs of Armand Trousseau [3]. As usual, French bureaucracy was dragging its heels, and it was only in 1899 that Achille Gouguenheim became the head of the first otorhinolaryngology department, known as the Clinic of larynx, nose and ear diseases, in the Lariboisière hospital in Paris [3]. The fact that ORL was using techniques drawn from ophthalmology inspired the authorities to consolidate our specialty with that of ophthalmology, and it was decades later, in the mid20th century, that the two fields were finally officially separated and our specialty gained its recognized medical independence. A shared, thrilling adventure, crowned by success! Our joint efforts have given rise to a single complex specialty of uncontested value. Let us never forget that our diversity and union were and will continue to be our strength. . . Best regards to each one of you, Sincerely yours, X’ (a French otorhinolaryngologist).
Disclosure of interest The authors declare that they have no conflicts of interest concerning this article.
http://dx.doi.org/10.1016/j.anorl.2015.05.001 1879-7296/© 2015 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Laccourreye O, et al. Abecedarium: Who am I? X’. . .. European Annals of Otorhinolaryngology, Head and Neck diseases (2015), http://dx.doi.org/10.1016/j.anorl.2015.05.001
G Model ANORL-418; No. of Pages 2
ARTICLE IN PRESS Editorial / European Annals of Otorhinolaryngology, Head and Neck diseases xxx (2015) xxx–xxx
2
References
b
[1] http://www.data.drees.sante.gouv.fr/TableViewer/tableView.aspx?ReportId= 815 [2] http://www.carmf.fr/chiffrescles/stats/2014/bnc2012.htm [3] Legent F. La naissance de l’otorhinolaryngologie en France. http://www. biusante.parisdescartes.fr/histmed/medica/orlc.htm
Ollivier Laccourreye a,∗ Alfred Werner b Iain McGill c Christian Martin d a Service d’oto-rhino-laryngologie et de chirurgie cervico-faciale, HEGP, université Paris Descartes Sorbonne Paris Cité, AP–HP, 20-40, rue Leblanc, 75015 Paris, France
18, rue de la Ferme, 92200, Neuilly-sur-Seine, France c Place du Plâtre, 69930 Saint-Laurent-de-Chamousset, France d Service ORL, pavillon B, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France ∗ Corresponding
author. E-mail address: [email protected] (O. Laccourreye)
Please cite this article in press as: Laccourreye O, et al. Abecedarium: Who am I? X’. . .. European Annals of Otorhinolaryngology, Head and Neck diseases (2015), http://dx.doi.org/10.1016/j.anorl.2015.05.001