Ambroise Paré

1510-1590

French Surgeon

Ambroise Paré inaugurated modern military surgery and was the greatest military surgeon before Dominique Jean Larrey (1766-1842). He invented or introduced many surgical instruments and popularized the use of trusses, ligatures, artificial limbs, and dental implantations. His Oeuvres were first published in 1575 and had gone into five editions by 1598.

The son of an artisan in Laval, France, Paré served as apprentice to a barber-surgeon then studied surgery at the Hôtel Dieu hospital in Paris. He became a master barber-surgeon in 1536 and joined the army the same year.

In 1536 King François I made war on the Duke of Savoy and besieged Turin, Italy. Paré was a surgeon with the French army. Until this time, the standard surgical procedure for arrow, bullet, and similar puncture wounds was to cauterize them with hot oil. European doctors had used this ancient Arabic technique for over 500 years and no one questioned it. Paré used it too, until the Savoyard defenders of Turin shot so many French soldiers that he ran out of oil. Desperate because he could not cauterize, he wrapped the newer wounds in bandages soaked with egg yolk, rose oil, and turpentine. The next day he was surprised to discover that the bandaged wounds were healing better than the cauterized ones. He never cauterized again.

Paré experimented with various substances to soak the bandages and presented his results in his major work, La méthode de traicter les playes faictes par hacquebutes et aultres bastons à feu, et de celles qui sont faictes par flèches, dardz, et semblables (The method of treating wounds made by harquebuses and other firearms, and those made by arrows, darts, and the like), published in 1545. He was at first disbelieved because he did not know Latin. He wrote in the vernacular at a time when all learned treatises were supposed to be written in Latin. After 1552, when King Henri II appointed him as one of the royal surgeons, such criticism diminished.

While competing in a tournament in 1559, Henri II received a lance wound to the eye. He was attended by Paré, but died eleven days later. Because of this incident, Paré turned his research toward head wounds and published La méthode curative des playes et fractures de la teste humaine (The method of curing wounds and fractures of the human head) in 1561.

In his 1549 Briefve collection de l'administration anatomique (A short collection on governing the body), Paré improved upon podalic version, an obstetrical technique introduced in the second century by the Greek gynecologist Soranus. Podalic version is a means of extraction used in cases of difficult birth. The physician, with the right hand on the abdomen and the left hand inside the uterus, turns the fetus and extracts it by the feet. No further improvements of this technique were made until John Braxton Hicks (1823-1897) did so in the 1860s.

Paré's 1564 Dix livres de la chirurgie (Ten books on surgery) discuss dental and oral surgery, amputations, and several other topics. His 1573 Deux livres de chirurgie (Two books on surgery) contains both scientific and fanciful accounts of birth defects.

Among Paré's innovations were tying (ligating) blood vessels to control bleeding during operations, performing autopsies to determine the cause of death, and using bandages rather than stitches to close wounds so as to minimize scarring. His autopsies led him to think that syphilis might be the cause of some aneurysms. His colleague Jean François Fernel (1497-1558) held the same belief, but the relationship between syphilis and aneurysm was not proved until 1899 by Arnold Heller (1840-1913).

A lifelong devout Catholic, Paré's motto was "I treated him; God cured him."

ERIC V.D. LUFT