Orthopedic Center, 1823 – 1833

In France, both orthopedic surgery and post-surgery therapy originated in the first half of the 19th century. A pioneer in these fields was Dr. Jacques-Mathieu Delpech in Montpellier who demonstrated that orthopedics and gymnastics were interdependent. In Paris, the principal founders of these types of treatment centers were Jules Guérin, Sauveur-Henri-Victor Bouvier, Vincent Duval and Charles-Gabriel Pravaz, but numerous other doctors and practitioners established such centers in and outside of the capital between 1825 and 1840 (Quin and Monet 371).

In 1823, 4 rue de Chevreuse was transformed into an orthopedic and gymnastic establishment by Charles-Amédée Maisonabe, Professor at the Faculté de Médecine in Paris. Born in Rodez, France on September 17, 1779, the son and grandson of physicians, he completed his medical education at the Faculté de Montpellier in 1804 with a thesis on cataracts (Dumaitre 61). Maisonabe then practiced in the army, in hospitals, taught surgery and medicine, and published essays on the treatment of what were then referred to as "human deformities." His free course in Paris on "Les difformités du corps humain" was attended by hundreds of students and practitioners from France and other countries (Archives générale de médecine 629). 

Maisonabe was particularly interested in elevating orthopedic procedures to the same level of respect as other forms of surgery. He was fascinated by the origins, causes, natures, and consequences of atypical physiologies so he decided to put his theories into practice by founding the Établissement Orthopédique et Gymnastique du Mont-Parnasse, a residential treatment center for a variety of impairments. The Archives générale de médecine praised his center (translated from French):

[...] he created, in one of the healthiest and most agreeable neighborhoods of the capital, a vast and superb establishment where he treats individuals of both sexes whose bodies deviate more or less from their regular state, and several have already had the very best results from the treatment (629).

The property at 4 rue de Chevreuse, with its courtyard and back garden, was an ideal setting for such a residential treatment facility. Maisonabe's center differed from others in France because it mostly focused on deviations of the spine, especially in women. Maisonabe specialized not only in scoliosis, but also in club feet, muscular contractures, defects of the sensory organs, and skin diseases. He treated men, women, and children.

Orthopedic gymnastics

In 1827, Maisonabe expanded his practice to include two other doctors, Amédée Dupau and N. Bellanger, who had enhanced their scientific expertise in England, Germany, and Russia (Revue Médicale 294). They also hired two other associates: a female residential manager and a male teacher who oversaw the young patients' schooling. Additionally, each patient's physician was invited for regular site visits and for meetings with the directors. The center's brochure boasted about state-of-the-art equipment and a practice that not only conducted surgical operations but also helped patients regain strength and mobility in its user-friendly and healthy environment:

A vast and airy site, near the boulevard du Mont-Parnasse, with a tree-lined garden, serves for the promenades of its residents. The house is composed of three buildings destined for housing both sexes separately. Rooms are reserved for those who prefer to be alone, or for the parents who wish to follow the treatment of their child (2, translated from French).

Orthopedic patients recovering from surgery or healing from an injury also benefited from rehabilitation and physical therapy. Different kinds of baths were installed on the property and an orthopedic gym allowed for several types of exercises. It included a trampoline, parallel bars, swings, and a trapeze. Patients could exercise on their own, with assistance and guidance available when needed.

Club-foot instrument, Michel Bruneau model, biusante.parisdescartes.fr

In its brochure, Établissement orthopédique et gymnastique, the clinic also advertised state-of-the-art surgical equipment and other instruments, some of which had been invented by Maisonabe and vetted by independent medical authorities: "The results obtained by the machines recently invented by M. Maisonabe, for the treatment of clubfoot, were presented to the Institute, which was able to observe the promptness of the cure. Everyday experience confirms the superiority of these orthopedic procedures, which are carefully combined with the frictions and medicines necessary to combat various causes of disease" (3, translated from French).

Spinal traction bed invented by Maisonabe (Weiner and Silver 432)

Maisonabe invented a bed that exerted forceful traction directly on the spine. He theorized that a patient had to remain in traction for extended periods to counteract a lifetime of spinal deviation. The Archives générale de médecine described the bed's operation (translated from French):

As for its mechanism, instead of elasticity, gravity is what drives it: a set of weights are situated under the strapped bottom of the bed, which pull the head and pelvis in the opposite direction; a crank positioned outside the bed can modulate this system of weights, and a dial allows one to calculate the desired degree of extension; patients can also suspend the play of the machine in order to make themselves temporarily comfortable, for blowing their nose, coughing, or satisfying other needs (285).

The Établissement orthopédique et gymnastique brochure claimed that this invention had been evaluated by "The Royal Academy of Medicine [which had] established in its report that Doctor Maisonabe's Extension Bed is as simple as it is efficient in its effects" (3, translated from French).

Treatment at Maisonabe's orthopedic center was extremely expensive; it thus catered to a primarily wealthy clientele:

Map of orthopedic establishments in Paris, 1818-1860 (Quin & Monet 373)

In Paris, the establishments are located in the beautiful districts of the French capital, where the average value ​​of rentals per inhabitant are the highest […]. Several reasons [...] explain this geography: firstly, the proximity of a clientele likely to have recourse to the services of these specialized health centers – mainly middle-class clients; but also better air quality […] or even the availability of large spaces to establish gardens, gymnasiums [...], facilities and equipment essential to the smooth operation of these establishments (translated from the French, Quin & Monet 373-374).


In an 1831 bulletin describing the clinic's objectives, Maisonabe listed the costs that patients would incur depending on the severity of their ailment(s), the type of lodging they requested, the number of teachers they needed, and the length of their stay (determined ahead of time by the directors). If patients were required to extend their treatment, the price would be halved – proof, said Maisonabe, of the care they devoted to the healing process. For a full year, the center charged 2000 francs for medical treatment and room and board, and 1500 francs for gymnastics as well as room and board (36). The clinic also sold the mechanical bed with all of its accessories for 520 francs for outpatients. Since the average annual income for French workers in 1831 was 300-400 francs, Maisonabe's bed and treatment at his clinic were only accessible to the rich (Quin & Monet 375).

Cover of Maisonabe's Journal, 1825

One year after founding his orthopedic center, Maisonabe launched a quarterly journal which he edited and sold from 1825 –1829. In the ten illustrated issues that were published, he documented his clinical observations and described the instruments that were used to correct various physiological anomalies. The journal was criticized by his contemporaries, one of whom published an anonymous pamphlet in 1827 accusing Maisonabe of "ignorance and bad faith disregarding the work of his predecessors” (translated from French, cited in Izac 455). The author of the pamphlet continued his attack: 

We are surprised to see a doctor publish a collection intended only for a very small branch of surgery, when there are ten or twelve medical journals in Paris whose editors often lack interesting materials: also, this collection has had little success and it is so rare that you don't even find it in bookstores, which led a hoaxster to claim that Mr. Maisonabe was the only editor and the only subscriber to his journal (translated from the French, cited in Izac 455).

In 1828, Maisonabe and his partners established another treatment center in the neighborhood of Conflans at Charenton-le-Pont, a suburb of Paris (Dumaitre 61). This period marks a decline in Maisonabe's professional reputation. His traction bed was publicly criticized, especially by G. Jalade-Lafond and Claude La Chaise, who had invented their own orthopedic instruments. They claimed that Maisonabe's bed caused "ulceration of the chin, the jaw and paralysis of the lower limbs" (cited in Weiner 432).

Controversies around Maisonabe's methods continued to mount. He was accused of malpractice by Baron Dupuytren, who was the head surgeon at the Hôtel-Dieu hospital, a professor of surgery at the Faculté de médecine de Paris, the premier surgeon of the king, and a member of the Institut et de l'Académie de médecine (Dumaitre 61). Maisonabe was put on trial and censured in 1829 by the "Conseil de l'université". After this ordeal, he is said to have uttered: "I will not survive this injustice" (translated from French, cited in Dumaitre 66). In spite of the drama and scandal, he continued to publish his medical theories and his center at 4 rue de Chevreuse remained active until 1833.

C. A. Maisonabe, Orthopedie, 1834, reprinted by BnF/Hachette

Maisonabe left France in 1837 and traveled to Moldova (formerly Moldavia), entrusting his Charenton center to a notary (Izac 457). In Moldova, he became the headmaster of a boarding school, but clashed with local doctors and was criticized for being too liberal (Izac 456). He returned to Paris in January 1838, only to discover that his center had lost its clientèle and the property had to be sold. In 1843, Maisonabe taught a course at l'Athénée de médecine de Paris on "Errors and Disappointments in Medicine and Surgery" (Izac 457).

Charles-Amédée Maisonabe died in Paris on August 31, 1851. According to Izac: "His last years were clouded by the accidental death of his son, the [...] lawyer, at the age of 44. Apart from a few short stays in his hometown, with his family, he remained in Paris where his life ended, terribly lonely [...]. He was just shy of 72 years old" (translated from French, 458).


What had begun as a ground-breaking medical venture became fraught with suspicion and accusations of charlatanry, bad judgment, and self-interested policies. And, indeed, many of Maisonabe's instruments and experiments seem to have caused more harm than healing. In retrospect, however, one might surmise that the medical establishment, represented by certain reigning practitioners, harbored a kind of envy or fear of being upstaged by the radical ideas promoted by innovative doctors such as Maisonabe. Nearly 150 years later, in her article on the quarrels between Dupuytren and Maisonabe, Dumaitre clearly indicates that evidence was manipulated to prevent Maisonabe from receiving a fair trial (68).


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