Saturday, 10 August 2013

Men of Yore: Ambroise Pare

This is another in a series of posts about men from history who have either achieved great things in one form or another by pushing boundaries: either in themselves or in society or science or exploration of some form.  Boundary pushing and growth is what men do, it's their nature: to grow and push outwards.  We, as men, are the frontiers men, the first to discover/uncover new territory, in a metaphysical sense (i.e. including both material and the immaterial) that is later colonised and 'civilised' by the rest of humanity. 

It is also partly intended to show images, be they paintings, statues or photographs of the countenaces of men of yore.  Because, quite frankly, many men wear the countenances of women these days: smiling, smirking, cooing, rolling their eyes, looking smug etc.  It's a sign of the times, and by showing some images of men from the past, I hope to show some modern men why looking surly, frowning and giving hard-ball stares at people is something to do, something to practice.

Ambroise Pare

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 anatomist and invented several surgical instruments.

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 epitomises a philosophy that he used throughout his career. (Jean-Pierre Poirier, Ambroise Paré, Paris, 2006, p. 42.) [1] 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."

Early Career
Paré was born in 1510 in Bourg-Hersent in north-western France. He was first apprenticed to 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 presented with a gunshot wound, he did not use hot oil, as was commonly practiced, but used a simple bandage. He then continued with this approach to wounds, and began using herbs and anti-septic materials instead of cauterizing wounds.

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.[2] 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 introduced the ligature of arteries instead of cauterization during amputation.[3] 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.[4]

Bezoar Stone Experiment
In 1567, Ambroise Paré described an experiment to test the properties of the Bezoar Stone. At the time, the bezoar stone was 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 some 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 the bezoar stone could not cure all poisons.[7]

Paré's writings further include the results of his methodical studies on the effects of violent death on internal organs.[8][9] He also created and wrote, Reports in Court,[10] a procedure on the writing of legal reports in relation to medicine.[11] His writings and instructions are known to be the beginning of modern forensic pathology.[8][9]

Paré contributed both to the practice of surgical amputation and to the design of limb prostheses.[12][13] He also invented some ocular prostheses,[14] making artificial eyes from enameled gold, silver, porcelain and glass.

What is noteworthy about this man is the compassion that he showed to the soldiers whom he treated, which was in total contradistinction to the other doctor-surgeons of the era.  He felt empathy for the person that he was treating, which allowed him to feel their pain, instead of just getting frustrated by the 'wriggling patient on the operating table' like the other doctors probably did.  This empathy included all aspects of the treatment of the patient, a thorough approach you might say.  From pre-operation, to operation, to post-operation; he made sure that the patients lives benefitted by the surgery that he undertook, rather than just walking around as mutilated victims who would've been looked down on by society.  The development of prosthetics shows this empathetic quality.

He also was willing to follow his own intuitions and go 'against the grain' of the medical establishment, despite the hosility that he may well have faced from it (like all dissenters whom go against the 'established views', whatever community they're in).

Check out some of the other entries from the 'Men of Yore' series:


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