Apr 032019

Today is the birthday (1778) of Pierre-Fidèle Bretonneau, a French physician who was a pioneer in many ways.  He was born in Saint-Georges-sur-Cher, in the Loir-et-Cher département. His father was a surgeon. He studied with his uncle, the vicar at Chenonceaux (Indre-et-Loire) department along with the children of the Chenonceau château. Madame Dupin, the grandmother of George Sand, financed his medical studies in Paris. He married a protégé of Madame Dupin and settled in Renaudière in Chenonceaux (the Renaudière is currently a restaurant and hotel). He had a laboratory at his disposal and occupied himself with gardening in his spare time.

Bretonneau was the mayor of Chenonceaux from 1803 to 1807. He spent 15 years in Chenonceaux gaining experience, wrote his thesis in medicine in 1815, and then became medical director at the hospital in Tours; which currently bears his name. He continued his study of disease and founded the medical school at Tours. He believed in “morbid seeds” (i.e. bacteria and viruses) that spread specific diseases from person to person. It is one of the great oddities of medicine that bacteria were first observed by Antonie van Leeuwenhoek in 1676, using a single-lens microscope of his own design. He then published his observations in a series of letters to the Royal Society of London. They were just at the limit of what his simple lenses could make out and, in one of the most striking hiatuses in the history of science, no one else would see them again for well over a century. Bretonneau hypothesized that disease was caused by bacteria in 1855, however, a microscope was not available to him and he was unable to confirm his hypothesis. He also discovered that the same illness could manifest itself differently in different patients. He identified typhoid fever and named diphtheria, (from Greek diphthera “leather” describing the appearance of a pseudomembrane in the throat), and distinguished between scarlet fever and diphtheria in 1826.

Probably Bretonnuau’s greatest claim to fame is that he performed the first successful tracheotomy in 1825. The procedure is now routine, of course, and can be lifesaving, as in cases of diphtheria.

Bretonneau died in 1862 in Paris. He is buried in Saint-Cyr-sur-Loire, near Tours.

Tours is well known for its lamb which can be served with a local sauce or made into a stew depending on the cut.  The simplest method is to cut noisettes from a rack of lamb, sear them in a hot skillet, and then roast them for about 6 minutes in a 200°C oven. Do not overcook them; lamb should be a little pink. Meanwhile make a sauce of lamb stock infused with thyme and rosemary and a dash of cider vinegar. Reduce and finish with a knob of butter.

Tours lamb stew is more complicated although the idea is not so very different (just more complex). Cut 1 kilo of lamb shoulder into strips, and brown in olive oil in a skillet over medium-high heat. Add 100 grams of thinly sliced onions and your choice of finely chopped vegetables (peppers, leeks, carrots, celery and fennel). Continue to cook until the vegetables soften. Dust with flour. Add a tablespoonful of tomato puree, one cup of dry Vouvray wine, 100 grams of chopped tomatoes, and cover with lamb stock.  Add a bouquet garni of orange zest, rosemary, bay leaf, thyme, cloves, coriander seeds, peppercorns and garlic. Season to taste with salt. Simmer, covered, for 1½ hours.