On this occasion, we are going to talk about a very important man in orthopedics. Nicolas Andry de Boisregard. Doctor of Medicine, adjunct professor and Dean of the Faculty of Medicine in Paris. It was Andry who coined the term “Orthopedics”, which etymologically comes from two Greek words. Orthos, meaning straight or upright, and Pedia, meaning “education or training”. Pedia = education or training With this concept, he referred to the ability to correct or avoid skeletal deformities in children. He describes this in his book “Orthopedics, or the art of preventing and correcting deformities of the body in children”, published in 1741.
In one of the engravings in the book, Andry uses the image of a young crooked tree that grows guided by ropes tied to a post, which try to correct the deformity. This image has become an icon of the specialty of Pediatric Orthopedics, the central theme of this video. Nicolas Andry was the first to link exercise and the locomotor system in a scientific way. In a thesis written in 1723, he comments that moderate exercise is the best method to maintain health. Curiously, Andry also earned the nickname of “doctor worm” for being recognized as the father of Parasitology. For our story, we have to go back to 1658 in Lyon - France, where he began to study theology, and abandoned it to begin medicine at the Faculty of Reims, where he studied surgery. Although he was ambitious and very energetic, Andry had a rather turbulent life, constantly in conflict with his classmates.
He graduated and became a professor at the school of France, and in 1724 dean of the faculty.
In 1700 he published his first book “The Generation of Worms in the Human Body. The Different Kinds and Types of This Disease and the Ways of Preventing and Curing It”. This work earned him the title of “father of parasitology”, although his explanation of worm pathology was often fanciful. However, at the end of his life he wrote the work that would give him his current notoriety: which by its translation is called “Orthopaedics or the Art of Preventing and Correcting Bodily Deformities in Children”. This book was first published in Paris in 1741 in two volumes. It was an immediate success and was soon published abroad: as in Brussels, then in London in English and finally in Berlin. The original term orthopaedics , had no relation to surgery. What is more, Andry was an anti-surgeon who obtained the abolition of the privileges of surgeons in 1724, placing them under the authority of the Faculty of Medicine. The word Orthopaedics was conceived as a preventive activity or home remedy, with the intention of improving children's deformities in 1741. It is important to realize that this treatise is not written for doctors or surgeons. It is a kind of homage to the grace and beauty of children. Andry wrote thus: “one must not neglect the body and let it become deformed, this would be against the intention of the Creator; this is the basic principle of orthopaedics” and then “this book is addressed exclusively to fathers and mothers and to all people who raise children and who must try to prevent and correct any deformed part of the child's body.”
If one looks only at the principle of prevention, then these words have a real meaning today. The work is divided into four books. The first one reminds us of the superficial artistic anatomy of the whole body, with a curious and interesting chapter on external proportions. Books 2 and 3 deal with one of the most important parts of this specialty, more precisely that of pediatric orthopaedics in its modern meaning. Book 2 describes useful methods for preventing and correcting postural deformities of the trunk and spine. Book 3 covers limb deformities: Andry distinguishes between inequalities that are congenital or acquired and pseudo shortening of the limbs due to dislocation, in which case, he recommends “prompt intervention by the surgeon.” And finally, in the fourth book, he covers deformities of the head and face in considerable detail.
Today's orthopedics does not deal with these types of deformities. However, many other specialists will enjoy this section, such as maxillofacial surgeons, dental orthopedists, and cosmetic surgeons. The word orthopedics sparked, as it did in its day, some controversy, although it must be acknowledged that it is the word that is used today throughout the world to refer to orthopedics for adults and children.
The meaning of this word is interesting, as the sense has been narrowed and then broadened. To begin with, we saw that this word referred to children, with the connotation of prevention, and then a century later, in the 1840s, there was a rapid increase in surgical procedures and it was now accepted that it was bone and joint surgery that had come to the fore.
This is why Nicolas Andry was important in first relating exercise to the locomotor system, the term orthopaedics and the emblem that we know today.
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