Poirier J, Derouesné C
Centre Hospitalo-Universitaire Pitié-Salpêtrière, Paris.
Rev Neurol (Paris). 2000 Jul;156(6-7):607-15.
In the beginning of the 19th century, many studies were devoted to the diseases of the nervous system in France, long before the work of Charcot. The researches of Léon Rostan on the cerebral softening (1819, 1823) were based on the anatomoclinic method developed by the School of Paris whose most famous representatives were Corvisart and Laennec for the study of heart and lung diseases. The researches of Rostan were performed in the Salpêtrière hospital which was, at this time, an hospice for old women. Rostan was appointed Inspector of the Health service in the Salpêtrière hospital in 1812 then Head of a department in 1818. He was 28 year old when he published his book "Researches on the cerebral softening" in 1819. Rostan was the first to describe the spontaneous cerebral softening as a special anatomoclinic entity distinct from encephalitis and apoplexy. He compared this entity to the senile gangrene and stated that it was related to the ossification of cerebral arteries. He described the pathologic features of the brain softening and also its clinical symptomatology in opposition to that of apoplexy. The concept of brain softening according to Rostan was harshly fought by the followers of the Broussais's physiological medicine (from Lallemand, 1830 to Calmeil, 1859) who claimed that all brain softenings were due to the inflammation process and thus should be described as encephalitis. In opposite, the ideas of Rostan were accepted and developed by others such as Carswell in England (1835), Abercrombie in Scotland (1836) and Andral in France (1827, 1840). These authors agreed that some type of cerebral softening was related to a disease of the arterial system. Nevertheless, the modern concept of brain softening was not definitively accepted before the description of the thromboembolic mechanisms by Virchow in Germany (1856) with the help of the microscope, and the anatomoclinic studies of Proust, Laborde and Prevost and Cottard in France (1866). The book of Rostan was dedicated to the "Conseil Général des Hospices" which was created in 1801 to unify the administration of the hospitals in Paris and became the "Administration Générale de l'Assistance Publique à Paris" in 1849. One hundred and fifty years after its publication, the work of Léon Rostan was outstanding by its modernity of the form as well as the substance.
在19世纪初，早在夏科开展研究之前，法国就有许多关于神经系统疾病的研究。莱昂·罗斯坦对脑软化的研究（1819年、1823年）是基于巴黎学派发展起来的解剖临床方法，该学派最著名的代表人物是研究心肺疾病的科尔维萨尔和拉埃内克。罗斯坦的研究是在萨尔佩特里埃医院进行的，当时这家医院是一家老年妇女收容所。1812年，罗斯坦被任命为萨尔佩特里埃医院的卫生服务检查员，1818年成为一个科室的主任。1819年，他28岁时出版了《脑软化研究》一书。罗斯坦是第一个将自发性脑软化描述为一种与脑炎和中风不同的特殊解剖临床实体的人。他将这种实体与老年性坏疽相比较，并指出它与脑动脉的骨化有关。他描述了脑软化的病理特征及其与中风相对的临床症状。罗斯坦提出的脑软化概念遭到了布鲁塞斯生理医学追随者（从拉勒芒德，1830年到卡尔梅伊，1859年）的激烈反对，他们声称所有的脑软化都是由炎症过程引起的，因此应该被描述为脑炎。相反，罗斯坦的观点被其他人接受并发展，比如英国的卡斯韦尔（1835年）、苏格兰的阿伯克龙比（1836年）以及法国的安德拉尔（1827年、1840年）。这些作者一致认为，某种类型的脑软化与动脉系统疾病有关。然而，在德国的维尔肖（1856年）借助显微镜描述了血栓栓塞机制，以及法国的普鲁斯特、拉博德、普雷沃斯特和科塔尔进行了解剖临床研究（1866年）之后，脑软化的现代概念才被最终接受。罗斯坦的这本书献给了“医院总理事会”，该理事会于1801年成立，旨在统一巴黎各医院的管理，并于1849年成为“巴黎公共援助总管理局”。在其出版一百五十年后，莱昂·罗斯坦的著作在形式和内容上的现代性都十分突出。
