Where does that come from? A regular column that examines the history and origins of a particular medical topic.

There is nothing that brings a doctor down to earth more than being a patient. Normally, in the course of their working day a doctor is on his or her home territory, fully dressed, in control and frequently looking down on a partially disrobed patient who is probably feeling disadvantaged and vulnerable as bits of anatomy not usually seen in polite company are exposed.

At the beginning of April it was my turn to play the subordinate role in this medical scenario. If my situation had come about with something ho-hum like having a heart valve replacement I would not have mentioned it, but in fact I was about to fall under the knife of a plastic surgeon, no less, and I tell you about it, mainly because the man who lent his name to the condition for which I was being treated has a fascinating history.

My operation was for a long-standing disfigurement on my right and dominant hand known as Dupuytren's contracture. This is a deformity of the ring and little finger, which causes them to curl down toward the palm. This contracture is caused by an overgrowth of fibrous tissue in the palm. More common in males, it is almost always an inherited condition and indeed both my father and grandfather had it before me.

The contracture had been progressing at a glacial pace over about 25 years. It did not trouble me in the slightest and nobody seemed to notice it. Its main use to me was to frighten my younger grandchildren and appall my older ones. Eventually, the pointed comments from my immediate family wore me down and led me to the operating table where, wearing a flimsy gown and feeling appropriately vulnerable, I looked up first at the surgeon who appeared as cool and collected as his TV counterparts, and then the anaesthetist who, incredibly, had been in the same primary school class as my elder son. The last thing I can recall before passing into oblivion was Dr Dupuytren's odd story.

Baron Guillaume Dupuytren (1777-1835) was an illustrious French surgeon who in 1802, at the age of 25, started work in the great Parisian hospital, the Hôtel-Dieu. He continued to do so for the next 33 years, rising to become professor of clinical surgery in 1812.

Born of humble parents in a village near Limoges in central France, he must have been a very attractive child for at the age of four he was kidnapped by a rich lady overwhelmed by his beauty. He was rescued, but when he was a cavalry officer fell victim to his charms and offered to take the boy to Paris for his education. It is almost beyond belief that his parents, however impoverished, could accept such a scary offer, but they did and young Guillaume blossomed in the city, becoming a well educated man about town. He wanted to follow a military career like his mentor, but was persuaded to take up medicine and went on to become a top surgeon, teacher and inventor of a number of surgical instruments and operative techniques.

Though his lectures were very popular and he pursued his work with an almost religious fervour, he had an unattractive and eccentric personality - often cynical, insulting and intolerant towards his students and staff. Moreover, he was forever gnawing the nails of his left thumb and index finger, which was perhaps not surprising in view of his childhood experiences.

Dupuytren started at six in the morning dressed in his hallmark get up of dirty apron, threadbare coat, green cloth cap and carpet slippers. There were no surgical gloves, theatre gowns and masks then, nor, of course, anaesthetics. Though brilliant at his job and often called the ‘Napoleon of surgery', it was said he was a man whom many admired, few loved and none understood. Regarded as ‘first among surgeons, last among men', his advice to students was ‘read little, see much, do much'.

Not surprisingly, his long-suffering wife eventually left him, after which he became even more misanthropic. Despite his rudeness, his matchless operative expertise made his practice large and lucrative.

In 1833 he suffered a stroke while walking to work and had to give up operating. In 1835 aged 57 he developed pneumonia and died while his doctors were debating whether or not to drain the resulting empyema (accumulation of pus between the lungs and the ribs). Legend has it his last words to them were, ‘It's better to die of the disease than the operation'.

The Hôtel-Dieu is still situated in the square in front of Notre Dame Cathedral. Though founded in 651 AD, the current building now dates from the 19th century. If you are ever nearby, go inside the huge entrance hall and see the display of various medical instruments used there over the centuries.

Dupuytren was the first to fully and accurately describe the condition which now bears his name. His moment of enlightenment came in 1832 after carrying out a post mortem on a coachman who had the deformity. The surgeon attributed it to the driver holding his whip too tightly. I could have told him he was wrong: I have never driven a coach and horses in my life.

The actual cause is unknown, though in over 80 percent of cases there is a family history due to a dominant gene which can be traced back to Scandanavia and probably spread by the Vikings during their raping and pillaging. Repeated small trauma in a subject with such a family history has been mooted as a cause. I certainly am not a pick and shovel man and I do not think that pecking away at a keyboard could be regarded as repeated trauma, so I do not fit in there either. I am probably the outcome of some north of England rapine 1200 years ago.

However, you can be reassured that after the 90-minute operation, my fingers now line up as straight as the Brigade of Guards: my plastic surgeon is to be congratulated.

In passing, it is nice to know that I shared the condition not only with my father and grandfather, but also, it seems, with Ronald Reagan and Margaret Thatcher.

ACSM #41