PARé, AMBROISE

(b. Laval, Mayenne, France, 1510 [?]; d. Paris, France, 22 December 1590)

surgery.

Pare was the son of an artisan. He served an apprenticeship to a barber-surgeon in the provinces (probably at Angers or Vitre), then went to Paris, where he became house surgical student at the Hotel-Dieu, a post that provided him a valuable opportunity to study anatomy by dissection. About 1536 Pare became a master barber-surgeon and entered military service under Marechal Montejan; he accompanied the army on an expedition to Italy, where he spent two years. He returned to Paris in 1539, but intermittently participated in military campaigns throughout most of the next three decades. In 1552 Henry II appointed him one of his chirurgiens ordinaries; he became premier chirurgien to Charles IX in 1562 and served Henry III in the same capacity. He had a flourishing practice at court and in Paris, and, as a military surgeon, treated the wounded of both sides during the Wars of Religion. (Although often reported to have been a Huguenot, Pare remained a Roman Catholic throughout his life.)

Military practice afforded Pare experience in treating a wide variety of injuries. In particular, he revolutionized the treatment of gunshot wounds, which had been considered to be poisonous and were routinely cauterized with boiling oil. At the siege of Turin in 1536, Pare (according to his own account, published almost half a century later) ran out of hot oil and instead used a“digestive”dressing composed of egg yolk, oil of roses, and turpentine. The following day, he noted that the soldiers who had had their wounds dressed in this improvised manner were recovering better than the soldiers treated by the conventional method; they were free from pain, and their wounds were neither inflamed nor swollen. Pare then experimented with a number of different dressings (including some containing aqua vitae, which would, together with turpentine, have acted as a topical antiseptic) and concluded that gunshot wounds were not in themselves poisonous, and did not require cautery. He reported his discovery in his first treatise, La methode de traicter les playes faites par les arquebuses et aultres bastons a feu, published in 1545. This treatise, written in the vernacular because Pare knew no Latin, brought him immediate fame.

Pare also rejected cautery as a method of achieving hemostasis and advocated the ligature of blood vessels to control hemorrhage during amputations. He devised a new instrument for this purpose–the“crow’s beak,” a sort of hemostat that he used to grasp was also innovative, and he revived the ancient technique of podalic version for difficult deliveries. (Pare’s method was widely used after his own time; one of his chief disciples, Jacques Guillemeau, was primarily an obstetricians extended throughout the seventeenth century.)

Pare’s motto was“Je le pensai, Dieu le guarist”–“I dressed him, God cured him.” Many of the details of his surgery are no longer of scientific interest; despite his innovations, he labored under the humoral theories and superstitions common to sixteenthcentury surgery and was ignorantf of such considerations as circulation of the blood and asepsis. Nonetheless, he saved many patients who would be the despair of a modern surgeon, and he came to represent the ideal practitioner, both for his technical competence and for his humanitarian concern for his patients. He had a vague, reasoned anticipation of some form of transmissible infection and a crude appreciation of public health measures. Although his knowledge of pathology was at best rudimentary, he advocated and practiced (and left records of) autopsy investigations of fatal illnesses.

Pare’s theories and writings were often in opposition to those of the university authorities. He desired to spread anatomical knowledge among his fellow barber-surgeons, and to this end performed dissections and wrote a number of works on anatomy. His use of the vernacular and the advent of the printing press assured his books a wide distribution, although they were published, for the most part, only after legal conflicts with the members of the Paris Faculty of Medicine, who wished to suppress them. Pare was, however, widely supported by his noble clientele, and their support brought him the acceptance of professional associations that were usually closed to all except university graduates. (He was, for example, invited to join the guild of academic surgeons of Paris in the College de Saint-Come, despite his lack of Latin –although the physicians and the Faculty of Medicine always scorned and snubbed him.)

Pare’s personal life was marked by honesty, piety, and concern for the poor and defenseless. His last recorded act is his having, at the age of eighty, stopped a religious procession in the streets of Paris so that he might plead with its leader, the archbishop of Lyons, to come to terms with Henry of Navarre (later Henry IV), who was then besieging the city. Pare hoped thus to alleviate the lot of the starving Parisians, and whether or not his unprecedented act exerted any influence, the siege was lifted about a week later. He died shortly thereafter, in the house in which he had lived throughout most of his active career. He was buried in his parish church, St. Andre-des-Artes (destroyed in 1807, in which year Pare’s bones were transferred to the catacombs). Twice married, Pare had nine children, of whom three daughters survived him.

Pare left a powerfully reactivated surgical tradition at his death. His many publications, which were translated into both Latin and modern languages, circulated throughout Europe, and had considerable influence during his life and well into the following century. But in France itself surgeons were again under the Hippocratic yoke within two generations, and the art of surgery had reverted to about the level at which Pare had found it. Part of the blame for this must be attached to the reactionary character of French academic medicine, and to the prevailing moral and religious antipathy toward the scientific principle; the reforms for which Pare struggled did not come until both the College de Saint-Come and the once powerful and privileged Faculty of Medicine were abolished in the French Revolution.

BIBLIOGRAPHY

Pare’s writings have been collated and described in Janet Doe, A Bibliography of the Works of Ambroise Pare; Premier Chirurgien et Conseiller du Roy (Chicago, 1937). His best books are in J. F. Malgaigne, Oeuvres completes d’Ambroise Pare, 3 vols. (Paris, 1840). Accounts of Pare’s life and works are available in W. B. Hamby, The Case Reports and Autopsy Records of Ambroise Pare (Springfield, Ill., 1960), Surgery and Ambroise Pare (Norman, Okla., 1965), trans. and ed. from J.F. Malgaigne, op cit., and Ambroise Pare; Surgeon of the Renaissance (St. Louis, Mo., 1967). See also G. Keynes, ed., The Apologie and Treatise of Ambroise Pare, Containing the Voyages Made Into Divers Places With Many of His Writings Upon Surgery 9Chicago, 1952); F. P. Packard, ed., The Life and Times of Ambroise Pare (New York, 1926); and Stephen Paget, Ambroise Pare and His Times: 1510–1590 (New York-London, 1897).

Wallace B. Hamby