The Hand of Sabazios: Evidence of Dupuytren's Disease in Antiquity and the Origin of the Hand of Benediction.

Dupuytren's disease gained its eponym from the surgeon Baron Guillaume Dupuytren (1777-1835). However, the terms "Cline's contracture" and "Cooper's contracture," named after the two surgeons who proposed the treatment for the palmar contractures prior to Dupuytren, have also been used to describe the disease. In addition to the eponyms attributed to these three surgeons, a number of other appellations with interesting provenance exist for Dupuytren's disease including the "Curse of the MacCrimmons," "Celtic hand," "Viking's disease," and the "Hand of Benediction." These terms all have interesting provenance; however, contention exists with regard to the appropriateness of their coinage. Of these terms, the "Hand of Benediction" is based upon the oldest history, supposedly thought to be a result of an early Pope afflicted with Dupuytren's disease. This report suggests that Dupuytren's disease was recorded in history prior Christianity, the Vikings, as well as Dupuytren, Cline, and Cooper. Nearly 100 votive "Hand of Sabazios" artifacts from Antiquity appear to document Dupuytren's disease via sculpture. The report posits that Dupuytren's disease may have been represented by the "Hand of Sabazios," subsequently inspiring the "Hand of Benediction" and "Hand of God" that has permeated Christian art and culture for thousands of years.

Guillaume Dupuytren: his life and surgical contributions.

Guillaume Dupuytren (1777-1835) was one of the most influential surgeons of the past. He described and popularized many conditions, including Dupuytren disease, which continues to carry his name. This article reviews Guillaume Dupuytren's life and his contributions in surgery.

Baron Guillaume Dupuytren: Dupuytren's contracture.

Dupuytren's contracture of the hand is an extremely common deformity in middle aged and elderly men but it is rarely encountered in women. It usually involves the fifth and fourth fingers, less commonly the other two fingers, and never the thumb. There is a flexion deformity between the head of the metacarpal and the adjacent proximal phalanx and at the proximal interphalangeal joint. However, the distal interphalangeal joint is not affected. Indeed, in a severe case, the distal phalanx may actually be extended as it becomes progressively pressed into the palm of the hand. It is often bilateral and may affect the sole of the foot--although I have only had one old gentleman where his foot lesion troubled him enough for him to request surgical cure.

Arthur Rainsford Mowlem (1902-1986), plastic surgeon.

Arthur Rainsford Mowlem, the junior of the 'big four' plastic surgeons, with Harold Delf Gillies, Thomas Pomfret Kilner and Archibald Hector McIndoe, came to prominence managing casualties of the Second World War. Rainsford Mowlem's ancestor was John Mowlem, the creator of the construction firm. Rainsford worked his passage to the United Kingdom from New Zealand in 1927 and did not return to New Zealand but retired at the age of 60 to enjoy 23 more years in Spain. He was the driving force between 1934 and 1939 at the Plastic Surgery Unit at St James's Hospital, Balham, and instigated the North London Plastic Surgery Unit at Hill End, St Albans, from 1939 to 1953 and subsequently developed the Unit after moving to Mount Vernon Hospital, Northwood, Middlesex. After successfully hosting the International Meeting of Plastic Surgeons in London in 1959, he received recognition and honours in America but soon afterwards he surprised colleagues by retiring in 1962. Despite his significant contributions, he did not receive national honours but his life outside surgery was active including Trusteeship of the Mowlem Estate at Swanage in Dorset for 40 years.

[Dupuytren's disease ­ the story of an eponym]. / Maladie de Dupuytren, histoire d'un e´ponyme.

December 5, 1831, baron Guillaume Dupuytren presents at the surgical clinics of the Hotel-Dieu of Paris a report upon "an entirely new subject, with a new theory and a new method of treatment for a disease generally regarded as incurable". The patient presented had a permanent contraction of the ring finger and adjacent fingers of both hands, which appeared spontaneously without any injury or previous illness. Dupuytren explains he had the opportunity to dissect the hand of a man who died after having had a contraction of the fingers for many years. He defines the cause of the contraction to be the palmar fascia. He describes the operative treatment: aponeurotomy by a transverse incision. "Probably many surgeons (Cline 1808, Astley Cooper 1822) were aware of the palmar aponeurosis producing this condition before Dupuytren's lecture". "Thoroughness of his demonstration, the brilliance of the presentation and the supremacy of his surgical authority combined to link permanently the name of Dupuytren with this hand deformity" (J. Hueston).

Astley Cooper: his life and surgical contributions.

Sir Astley Paston Cooper (1768-1841) was a successful and influential British surgeon during the early decades of the 19th century. He was a dedicated anatomist, an accomplished researcher, an inspiring teacher, and a skillful surgeon. Cooper published about the cause and treatment of Dupuytren's disease 10 years before Dupuytren. His contributions were widespread and substantially advanced the understanding and treatment of breast disease, vascular aneurysms, and abdominal wall hernias, along with orthopedic, otologic, and hand surgery. His contributions to surgical science have endured and are being used today.

G. Dupuytren's contracture: an inaccurate denomination.

The question of priority in describing 'Dupuytren's disease' as a result of permanent retraction of the palmar aponeurosis has been debated for a long time. This article tries to identify the pioneers who were involved in the research of the origin of permanent contracture of fingers and palm of the hand, and to find out to whom the priority of this affection should be attributed. Selected passages of several authors, as well as of Dupuytren's writings (mainly in italics and translated into English) are used to try and find the truth concerning the primary description of the disease.

[Dupuytren's disease]. / La malattia di Dupuytren.

Dupuytren's disease is a contracture of the hand derived from the retractile fibrosis of the palmar aponeurosis, that leads to a progressive deformity in flexion of fingers. It has been named from the French surgeon Guillaume Dupuytren (1777-1835), that described it in 1831. In this note it is sketched a short biography of Dupuytren and the main clinical features of the disease are described, underlining some particular aspects of therapy.

Report on the surgical clinic at the Hotel-Dieu. 1831.

Concerning finger contracture as a result of a condition affecting the palmar fascia. A description of the illness. A surgical operation that is suitable for it.

Dupuytren's disease secondary to acute injury, infection or operation distal to the elbow in the ipsilateral upper limb--a historical review.

The aggregated total of 385 cases of Dupuytren's disease arising after acute or specific injury, operation or infection of the forearm, wrist or hand between 1614 and 2003 are documented, including a personal series of 52 cases. The history of this relationship is recorded and the medico legal implications of the association are discussed.

Two cases of joint disease in post-medieval church cemetery of St. Ilija.

Evidence of disease was analyzed from the skeletal remains of 11 individuals dating to the post-Medieval period from church cemetery of St. Ilija in Serbia. Two individuals showed pathological condition affecting joints. It was supposed that first individual had been suffering from Legg-Calvé-Perthes disease. It seems that this condition remained untreated, with extensive bone remodeling, and that the deformity of femoral head and acetabulum caused secondary degenerative joint disease at a relatively early age of this individual. Second case was related to the bony akylosis of the hand finger, probably caused by Dupuytren's disease. In addition, we discussed development of differential diagnosis in both pathological conditions.

Dupuytren's disease or Cooper's contracture?: Kenneth Fitzpatrick Russell Memorial Lecture.

In his position as curator of the Cowlishaw collection of historical medical books in the Library of the College, Kenneth Russell prepared the definitive catalogue of the collection. This catalogue is comprehensive and for almost all entries there is an annotation that demonstrates his meticulous attention to detail and the love of the book collection that he managed to secure for the College. It is from this catalogue that I have chosen two books in particular that bring together two great surgeons of the turn of the 19th century. Although he was a pupil of the great John Hunter, the young Astley Cooper possessed good manners and a gift of oratory of which the Scot, his teacher, was devoid. After his apprenticeship with Henry Cline senior, Cooper came to share the podium with Cline at Guy's and St Thomas' hospitals and the two dominated surgical teaching in London for some 22 years, until Cline's retirement in 1811. It was the latter who was first to recognize the true nature of the condition now known as Dupuytren's disease. Later, in 1822, Cooper wrote a detailed description of the contracture of the palmar aponeurosis and recommended fasciotomy as being curative. His book A Treatise on Dislocations and Fractures of the Joints, which contains this description of Dupuytren's contracture, is held in the Cowlishaw Collection. On the other side of the English Channel, M. le Baron Dupuytren repeatedly misquoted Cooper and stated that Cooper believed that the disease was incurable. In his famous lecture given to the staff of the Hôtel Dieu in Paris on 5th December 1931, he admitted to having seen 30 or 40 cases over 20 years of practice. It seems likely that he was not aware of the true cause of the condition before 1831 when he treated his first case. This lecture, along with others, are recorded in his Leçons Orales de Clinique Chirurgicale, a copy of which is also to be found in the Cowlishaw Collection.