Hektoen International

A Journal of Medical Humanities

Pierre Charles Louis of the numerical method

Etching of Pierre Charles Alexandre Louis, a man in glasses

Pierre Charles Alexandre Louis. Early 1800s. From An introduction to the history of medicine: with medical chronology, bibliographic data, and test questions by Fielding Hudson Garrison. London & Philadelphia, W.B. Saunders, 1914. Via Wikimedia. Public domain.

Pierre Charles Alexandre Louis (1787–1872) was a physician and epidemiologist who made significant contributions to medicine. He worked on the transmission of infectious diseases and developed the concept of “therapeutic nihilism” in the treatment of disease.

Louis grew up during the French Revolution, studied medicine in Reims and Paris, and received his medical degree in 1811. After graduation he went to Odessa, Ukraine, where he maintained a successful private practice for four years and received an honorary title from the Tsar in 1816. Returning to Paris in 1820 to work at the Hôpital Charité, he cared for thousands of patients and performed numerous autopsies. He taught at the University of Paris and became Professor of Clinical Medicine in 1827, a position he held until his retirement in 1867.

Louis worked on the transmission of infectious diseases. He conducted extensive research on the spread of cholera and showed it was transmitted by contaminated water. His findings led to the institution of measures to prevent its spread by the construction of clean water systems and the treatment of sewage. He studied tuberculosis and was the first to distinguish typhus from typhoid fever. He systematically collected and analyzed data on the incidence and spread of diseases, and he laid the foundations for modern epidemiology and controlled trials by dividing patients into different groups to evaluate the efficiency of treatment. He also became known for his therapeutic nihilism, arguing that there was no effective treatment for most diseases and that patients would be better served by receiving adequate supportive care. This specifically applied to pneumonia, which in his days was a frequent cause of death and was still widely treated by bloodletting. He divided a group of patients into those who were transfused and those who were not, and showed there was largely no difference in outcome. This approach became known as the numerical method and was the precursor to epidemiology and modern clinical trials. Louis also made some improvement in the ways doctors obtained a history from their patients, and as mentor of the young Oliver Wendell Holmes Sr. during his training in Paris, spread his nihilistic outlook to America.



GEORGE DUNEA, MD, Editor-in-Chief


Winter 2023  |  Sections  |  Physicians of Note

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