Martel, Thierry de

Born in 1875 in Maxeville near Nancy . My father was a career officer, descended from an aristocratic family in Normandy . Mother was a famous writer and journalist, published under the pseudonym Gip (GYP). Her publications were characterized by hatred of the republican system of France, democracy and anti-Semitism . Among her relatives were the Countess and Marquis de Mirabeau . Before entering the Faculty of Medicine, de Martel graduated from the Polytechnic School and was about to become an engineer . After graduating from the medical faculty, he initially worked under the guidance of the famous neurologist Joseph Babinsky . On the advice of Babinsky, de Martel studied the technique of brain operations with Victor Gorsley . For almost a whole year, he crossed the English Channel every week: leaving Paris on Monday evening, de Martel appeared in London on Tuesday morning, assisted Gorsley in a neurological hospital at Queens Square, and on Wednesday returned to Paris.

During the First World War he worked as a military doctor. For his services he was awarded the Legion of Honor .

Initially, he worked at the Salpetriere Hospital , where he conducted his first neurosurgical operations in his friend’s obstetrics and gynecology clinic ^[1] . Subsequently, he operated at the clinic of the hospital in Neuilly near Paris.

On the day German troops entered Paris on June 14, 1940, he gave himself a lethal injection of strychnine .

The technical education of de Martel allowed him to improve surgical instruments. He invented hemostatic clips, a self-retaining brain retractor, and a surgical chair. His main invention was an automatic electric trepan. Ordinary trepans often fell into the cranial cavity, damaging the brain and causing postoperative complications. Trepan de Martel was designed for fast trepanation without complications. As soon as the cutter reached the internal bone plate, it automatically stopped and did not damage the dura mater .

The experience gained in the clinic of Victor Gorsley allowed de Martel to start one of the first neurosurgical operations in France. According to statistics from his work in 1913, during the 18-month department in Salpetriere (Paris), 30 surgical interventions were performed on the brain and spinal cord - 11 decompressive trepanations , 3 cases of removal of brain tumors , etc. Of the 29 operated, 9 died.

After World War I published in 1918 the book Les blessures du crane et du cerveau: formes cliniques, traitement medico-chirurgical (Skull and brain injuries: clinical forms, medical and surgical treatment "), in which he summarized his experience (about 5 thousands of cases of traumatic brain injury .) An English publication soon appeared, emphasizing that in the field we should not rush into operations for head injury that must be performed in special hospitals.

In 1913, de Martel met with Cushing at the Neurological Congress in London . After World War I, de Martel crossed the Atlantic Ocean five times to visit his clinic. Together with Denecker, in 1924 he published a French translation of Cushing’s book, Tumors of the Auditory Nerve . As de Martel wrote:

I find Cushing's observations remarkable because of their simplicity and precise localization. It seemed to me that this book would be greeted with enthusiasm. I was wrong. French neurologists, who carefully developed neurological semiotics, felt that the American neurosurgeon did not examine their patients in sufficient detail, and that his observations were incomplete. From a neurological point of view, this may be so, but from a surgical point of view, this is a delusion. A neurosurgeon is not a neurologist or surgeon. This is a surgeon of the nervous system (...). The neurosurgeon appreciates neurology only if it is useful. Neurological symptoms that make it possible to localize the process are few, and only they are used by neurosurgeons during examinations, which are always very simple and seem neurological sketchy.

During a regular visit to Cushing in 1927, Martel persuaded his student and neurologist friend Clovis Vincent to go with him, which subsequently caused their quarrel.

In addition to electrotrepan, local anesthesia and the patient’s sitting position during brain operations (in order to reduce blood loss) are de Martel's most famous achievements in the field of neurosurgery. For the first time in France, he crossed the sensory branch of the trigeminal nerve with trigeminal neuralgia .

• The surgeon is evaluated not only by the operations that he performed, but also by those from which he was able to abstain ^[2] .

• Thierry de Martel named the boulevard in Paris ^[3] .

B. L. Likhterman Neurosurgery: the establishment of clinical discipline. Moscow. 2007 p.176-179 ISBN 978-5-94982-033-9 .