L.O. To understand the importance of

Ambroise Pare1510 - 1590

In 1552 I was appointed surgeon to

King Henri II of France. I now had

official royal approval for my work

and continued to write medical

texts. In 1545 I published my first

work upon the Method of Treating

Wounds.

In 1575 my Collected Works was

published and in 1585 The Apology

and Treatise of Ambroise Pare.

This last text was based upon my

own life experience and the

methods of treatment I had adopted

.

I was born in France in 1510. My

father was a Barber Surgeon and I

followed in his footsteps by training

as a Barber Surgeon myself in 1533.

However, in 1534 I became surgeon

to the Hotel-Dieu, the only public

hospital in the whole of France. I left

the Hotel-Dieu in 1537 to become a

military surgeon. It was during this

time that I learnt a lot about

surgery as I had to deal with many

terrible wounds – many caused by

muskets.

In 1552 I was appointed surgeon to

King Henri II of France. I now had

official royal approval for my work

and continued to write medical

texts. In 1545 I published my first

work upon the Method of Treating

Wounds.

In 1575 my Collected Works was

published and in 1585 The Apology

and Treatise of Ambroise Pare.

This last text was based upon my

own life experience and the

methods of treatment I had adopted

.

Gunshot wounds

During The Renaissance muskets were being used more and more during

battles.

Gunshot wounds therefore became an increasing problem for surgeons.

Can you think of any problems associated with gunshot wounds that

surgeons during The Renaissance would have to deal with?

Gunshot wounds

The scale of damage caused by musket balls

entering and exiting the body

(Shattered bone, ripped muscle and tissue, etc)

During The Renaissance muskets were being used more and more during battles.

Gunshot wounds therefore became an increasing problem for surgeons.

Can you think of any problems associated with gunshot wounds that

surgeons during The Renaissance would have to deal with?

Gunshot wounds

Musket balls carrying infection deep inside the

body. Musket balls dragged dirt, material and

lead with them as they entered the body

The scale of damage caused by musket balls

entering and exiting the body

(Shattered bone, ripped muscle and tissue, etc)

During The Renaissance muskets were being used more and more during battles.

Gunshot wounds therefore became an increasing problem for surgeons.

Can you think of any problems associated with gunshot wounds that

surgeons during The Renaissance would have to deal with?

Gunshot wounds

Musket balls carrying infection deep inside the

body. Musket balls dragged dirt, material and

lead with them as they entered the body

The scale of damage caused by musket balls

entering and exiting the body

(Shattered bone, ripped muscle and tissue, etc)

New methods of surgery had to be learnt to deal with the new types of

wounds being encountered

During The Renaissance muskets were being used more and more during battles.

Gunshot wounds therefore became an increasing problem for surgeons.

Can you think of any problems associated with gunshot wounds that

surgeons during The Renaissance would have to deal with?

Patients often died

from bleeding or

shock caused by excessive

pain

Questions:

1) What is the title of this text?

2) What does the top right hand picture show?

3) What does the top left hand picture show?

4) Why do you think that the human skeleton and figure have been placed at the centre of the title page ?

5) Describe some of the operating tools seen on this page

Image courtesy of the U.S. National Library of Medicine

Using hot oil

Pare used the accepted treatment for gunshot wounds used

by surgeons at the time – cauterisation - until he stumbled

across a new method for treating these injuries.

Cauterisation involved burning the wound, either with a red

hot cautery iron, or by pouring boiling hot oil (sometimes

mixed with treacle) into the wound.

Pare knew that this method of treating wounds caused the patient great

pain, but did as the other surgeons did, applying the oil as hot as possible to

burn away any possible infection that had set in. Then, one day he ran out of

oil and was forced to use an alternative.

Egg Yolk Rose Oil TurpentinePare had published his idea for treating gunshot wounds in 1545. The

account of how he made his discovery was not published however until 1585

in The Apology.

I wonder what Pare may have been apologising for?

Pare describes how he ran out of oil and was ‘forced to use an ointment

made from yolks of eggs, oil of roses, and turpentine’. Pare feared that this

mixture may cause the soldiers he was treating more pain as infection set

into the wound. He also feared that he would return to his patients the next

day to find many of them dead. The patients however told Pare the next

morning that the swelling around their wounds had gone down and that they

felt little pain. Those who had been treated before the oil ran out were much

worse off. They were in pain and many were ‘feverish with….swelling about

the edges of their wounds.’

PAIN

INFECTIONBLEEDINGIn order for surgery to be successful the surgeon has to combat

the problems of Pain, Infection and Bleeding. Pare knew this and

through his work tried to tackle and combat the problems

associated with each.

With a lack of anaesthetics before and during The Renaissance, doctors

and surgeons knew that their patients could suffer a great deal from the pain

that they felt when injured or wounded. They were also aware of the dangers

involved in operating upon patients. Without adequate anaesthetics (patients

were often given wine or were knocked out) there was the risk that the

patient would feel a great deal of pain and would be conscious for much of

the during the operation.

Patients were also as likely to die of shock on the operating table as from the

infection that set in the wound after the operation was over.

Anaesthetics – Something, usually a drug, that causes a loss of sensation (such as feeling or pain).

With a lack of antiseptics before and during The Renaissance, doctors and

surgeons knew that their patients could suffer a great deal from the infection

that set into a wound before an operation.

They were also aware of the dangers involved in operating upon patients.

Without adequate antiseptics there was a risk that the surgeon would put

germs into the wound himself, sealing the infection deep within the patient.

Because there was no knowledge of germs, medical instruments were not

always cleaned thoroughly and surgeons themselves often failed to ensure

that their hands were clean of dirt and bacteria. It would be some time – long

after The Renaissance - before doctors wore masks and gowns and sterilised

their equipment.

Antiseptics – Substances that help to prevent infection.

If patients lost a lot of blood, either during an operation or from a particularly bad wound,

they were in great danger of not only losing their strength, but of their body not being

able to function properly. In short, they were in all probability going to die. Surgeons

during this time could not, as we do today, transfuse blood or put it back. Some doctors

had experimented with blood transfusions, trying to replace a human’s lost blood (usually

with an animal’s), but patients rarely lived for long afterwards.

Doctors and surgeons did not know, as we do today, about such important factors that

influence blood transfusions, such as how to store blood and knowledge of blood groups.

Pare, like most surgeons, realised that veins and arteries had to be tied up speedily so

that bleeding could be stopped. Pare therefore used a Crow’s Beak (an instrument that

looks like a set of pliers) to pull out the arteries and silk thread to sew them up.

What type of surgical instruments can you see?

What do you think each instrument was used for?

Tools of the Surgeons trade.

* Knives to open and split flesh

* Forceps to pull the flesh apart and to extract parts of the body

* Saws for cutting through bone

* Hammers for driving in instruments or breaking bone

* A needle and thread for sewing up wounds

Pare maintained that the patient should gather strength before an

amputation by eating ‘meats, yolks of eggs, and bread toasted and dipped in

wine’. A ligature should then be tied above the area where the operation

(cutting) is to take place. The flesh should then be cut with a sharp,

preferably crooked knife down to the bone. You then saw through the bone

with a small saw (one foot and three inches long), then smooth the front of

the bone with a file, or some same instrument.

Pare maintained that you should only cut

away what is necessary – the diseased or

infected area of the body. Pare also advised

that the veins and arteries be allowed to

bleed a little before being tied up as quickly

as possible. Pare used a crows beak (which

looks like a set of crooked pliers) to pull out

the arteries and veins. He then used a

double silk thread to tie them off.

Pare had, before developing this method,

used hot irons to seal the wound and stop the

bleeding. But, as he states in Of

Amputations, which appeared in his

Collected Works, he was troubled by the

‘great and tormenting pain’ that this caused

patients.He left ‘this old and too cruel way of healing and embraced the new

’.

What do you think Pare is doing here?

What can you find around the room to support your theory?

People had mixed herbs and plants to create

ointments and medicines for thousands of years

before The Renaissance. Apothecaries opened shops

and sold these mixtures that were often based upon

remedies that had been handed down over

generations.

Plants that were made into a plaster and applied

for joint pain.

Tinctures (liquid made with alcohol), Poultices

(solids mixed into a paste and applied to wounds

and bruises) and Infusions (boiling water poured

over leaves or flowers) were all used by

apothecaries. Pare himself mixed together Rose Oil,

Turpentine and Egg Yolk into an ointment which he

applied to gunshot wounds, instead of using the

traditional method of cauterising, or burning the

wound with hot oil.