Avi Ohry
Tel Aviv, Israel

Frantz Glénard (1848–1920) was a French physician whose work on visceroptosis (a prolapse or sinking of the abdominal viscera below their natural position) in 1885 was once considered of fundamental importance to our knowledge of abnormal anatomical states of the abdominal organs.¹ He wrote on a variety of subjects, based on his theory that abdominal ptosis was a nutritional disease characterized by atrophy and prolapse of the intestine.^2,3 A correspondent of the Academy of Medicine and officer of the Légion d’honneur, he served as a military physician during the French-Prussian War and was taken captive. In the POW camp, he noted that victims of typhoid fever benefited from cold bath immersion.⁴ His Glénard’s girdle test consisted of the examiner placing his arms around the patient, so that his hands meet in front of the patient’s abdomen; he squeezes, raising the viscera, and then allows them to fall suddenly; Glénard’s theory suggested that if the patient felt relieved by the raising pressure and experienced distress on the release, the condition was probably one of splanchnoptosis.

The “Brand’s Cold Bath Method” was named after Ernst Brand (1827–1897), a German physician who developed a cold-water treatment for patients with typhoid fever in the mid-19th century. Brand believed that the high fever of typhoid was itself a major cause of death and that carefully controlled cold-water immersion would improve survival.⁵

Another forgotten theory was that of Stiller’s gastroptosis, due to “universal asthenia” and characterized by weakness and laxity of the viscera. Berthold Stiller was a surgeon-gynecologist (later internist) who studied in Budapest and Vienna, worked in Budapest, was nominated as “court consultant,” and died in 1922.⁶ He proposed a “constitutional theory of visceral ptosis.” Gastroptosis and other forms of visceroptosis were not primarily diseases of the stomach itself, but rather reflected a congenital “universal asthenia, including “neurasthenia” (fatigue, nervousness, functional digestive complaints). One physical sign he emphasized was the “Stiller rib” (a mobile or “floating” tenth rib), which he believed was evidence of generalized connective tissue laxity and therefore supported his theory of constitutional splanchnoptosis. 

References

1. “Frantz Glénard (1848-1920).” Bibliothèque nationale de France. https://data.bnf.fr/en/ark:/12148/cb10500179k
2. Ramsay FW. “Fixation of Liver and Both Kidneys in a Case of Glenard’s Disease.” Br Med J 1897;1(1897):1152-3.
3. Thorek P. “Glénard’s disease (generalized visceroptosis): The importance of some of its complications.” Am J Surg, 1947;73(5):597-601.
4. Glénard MF. “The Treatment of Enteric Fever by Cold Baths.” Glasgow Med J 1874;6(3):370-396.
5. “Ernst Brand.” Wikipedia. https://en.wikipedia.org/wiki/Ernst_Brand
6. Kenez J. “Bertalan Stiller (1837-1922) et la doctrine de la maladie constitutionnelle.” Rev Hist Med Heb 1983 Oct;36(3):39-41.