When the French surgeon Ambroise Paré (1510–1590) entered the army in the mid-1500s, gunshot wounds were typically treated with amputation of the affected limb and cautery of the amputation site with boiling oil. Realizing that this method was ineffective and even dangerous, Paré later introduced the technique of surgical ligature—the predecessor of today’s modern surgical technique.

Paré was a surgeon in Paris and served four French monarchs in his lifetime. On one occasion when treating soldiers’ gunshot wounds, he ran out of hot oil and instead dressed some of their wounds with a cloth soaked in egg yolk, rose oil, and turpentine. To his surprise, he noticed that these soldiers recovered more quickly and did not suffer from the infection or fever that affected many of the cauterized soldiers. He determined that the gunshot wounds were not inherently poisonous, as previously believed, but that infection was carried into the body from the outside. He began recommending debridement, the opening and cleansing of the wound, to assist the healing process. To perform amputations without cautery, he revived the use of the tourniquet—tying off extremities with a cord above the amputation site to reduce blood loss and sensation. Even with the use of a tourniquet, however, no fewer than 53 ligatures were required for a proper thigh amputation, and the practice required trained assistance. Each artery had to be separately tied, prolonging the surgery in an unanesthetized patient. Only after the invention of anesthesia could this approach be widely used.

In 1545, Paré described these practices in the book La méthod de traicter les playes faites par les arquebuses et aultres bastons à feu, or The Method of Treating Wounds Made by Harquebuses and Other Guns. In addition to improving the way wounds were treated, Paré helped to popularize the use of crude prosthetic devices like gold eyes, wooden teeth, and artificial limbs. He also made many contributions to the field of obstetrics, first describing the technique of podalic version in childbirth, in which the baby is rotated so that it comes out feet first. Today, he is often referred to as the father of modern surgery.

ADDITIONAL FACTS

  1. After amputating the limbs of wounded French soldiers, Paré noticed that many of them would complain about pain and other sensations in the arms and legs that they had lost. He was the first to describe this puzzling neurological oddity, now called phantom limb syndrome.
  2. Paré’s Method of Treating Wounds became an important text and has been translated into many languages. But it was ridiculed when it was first published because Paré wrote in conversational French rather than Latin, the language of scholars and doctors.
  3. Paré was originally trained as a barber and offered haircuts in addition to surgery. This was a common combination in Europe, where such practitioners were called barber-surgeons. The red-and-white- striped poles still found at many barbershops have their origins in the bloody rags that barber-surgeons once draped across their doorsteps.