Ambroise Paré Barber Surgeon Pioneer in Modern Surgical Techniques!

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• published: 30 Mar 2015
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Ambroise Paré (c. 1510 – 20 December 1590) was a French barber surgeon who served in that role for kings Henry II,Francis II, Charles IX and Henry III. He is considered one of the fathers of surgery and modern forensic pathology and a pioneer in surgical techniques and battlefield medicine, especially in the treatment of wounds. He was also an aanatomist and invented several surgical instruments. He was also part of the Parisian Barber Surgeon guild. In his personal notes about the care he delivered to Captain Rat, in the Piémont campaign (1537–1538), Paré wrote: "Je le pansai, Dieu le guérit " (I bandaged him and God healed him). This epitomizes a philosophy that he used throughout his career. (Jean-Pierre Poirier, Ambroise Paré, Paris, 2006, p. 42.) At this time, little could be done for battlefield wounds and injured soldiers were often put out of their misery by comrades if the wound was too severe to be treated. During the 1536 Battle of Milan, Paré encountered two men who had been horribly burned by gunpowder. A soldier came up and asked if anything could be done to help them, to which he shook his head. The soldier then calmly took out his dagger and proceeded to cut their throats. A horrified Paré shouted that he was "a villain", to which he was told "Were I in such a situation, I would only pray to God for someone to do the same for me." Paré was born in 1510 in Bourg-Hersent in north-western France. As a child he watched, and was first apprenticed to, his older brother, a barber-surgeon in Paris. He was also a pupil at Hôtel-Dieu, France's oldest hospital. Paré first experienced being a battle medic at Piedmont, during the campaign of Francis I. When, one day, he was presented with more gunshot wounds than he had oil for, he improvised and used an old Roman technique, using oil of roses, egg white, and turpentine. He worried through the night that the soldiers would die, but to his surprise, he found the next morning that the soldiers treated with oil were in agony, their wounds swollen and some had even died during the night, whereas the men treated the Roman way were well rested, their wounds calm and beginning to heal. He then continued with this approach to sealing wounds, rather than the largely accepted method of cauterizing wounds. His new technique was not perfect, as there was still a chance of infection and the pain was still a problem, but both of these were a much smaller problem than when using boiling oil. Paré was a keen observer and did not allow the beliefs of the day to supersede the evidence at hand. In his autobiographical book, Journeys in Diverse Places, Paré inadvertently practiced the scientific method when he returned the following morning to a battlefield. He compared one group of patients who paid for treatment treated in the traditional manner with boiling elderberry oil and cauterization, and the remainder from a recipe made of egg yolk, oil of roses and turpentine, and left overnight. Paré discovered that the soldiers treated with the boiling oil were in agony, whereas the ones treated with the ointment had recovered because of the antiseptic properties of turpentine. This proved this method's efficacy, and he avoided cauterization thereafter. However, treatments such as this were not widely used until many years later. He published his first book The method of curing wounds caused by arquebus and firearms in 1545. Paré also reintroduced the ligature of arteries (first used by Galen) instead of cauterization during amputation. The usual method of sealing wounds by searing with a red-hot iron often failed to arrest the bleeding and caused patients to die of shock. For the ligature technique he designed the "Bec de Corbin" ("crow's beak"), a predecessor to modern haemostats. Although ligatures often spread infection, it was still an important breakthrough in surgical practice. Paré detailed the technique of using ligatures to prevent hemorrhaging during amputation in his 1564 book Treatise on Surgery. During his work with injured soldiers, Paré documented the pain experienced by amputees which they perceive as sensation in the 'phantom' amputated limb. Paré believed that phantom pains occur in the brain (the consensus of the medical community today) and not in remnants of the limb. In 1567, Ambroise Paré described an experiment to test the properties of bezoar stones. At the time, the stones were commonly believed to be able to cure the effects of any poison, but Paré believed this to be impossible. It happened that a cook at Paré's court was caught stealing fine silver cutlery, and was condemned to be hanged. The cook agreed to be poisoned, on the conditions that he would be given a bezoar straight after the poison and go free in case he survived. The stone did not cure him, and he died in agony seven hours after being poisoned. Thus Paré had proved that bezoars could not cure all poisons.