|Portrait of Dominique-Jean Larrey|
Anne-Louis Girodet de Roussy-Trioson
The Louvre, Paris
I can hardly believe my own memory when I recall the old practitioners and professors who were still going round the hospitals when I mingled with the train of students that attended the morning visits…. The short, square, substantial man with iron-gray hair, ruddy face, and white apron is Baron Larrey, Napoleon’s favorite surgeon, the most honest man he ever saw,—it is reputed that he called him. To go round the Hotel des Invalides with Larrey was to live over the campaigns of Napoleon, to look on the sun of Austerlitz, to hear the cannons of Marengo, to struggle through the icy waters of the Berezina, to shiver in the snows of the Russian retreat, and to gaze through the battle smoke upon the last charge of the red lancers on the redder field of Waterloo. Larrey was still strong and sturdy as I saw him, and few portraits remain printed in livelier colors on the tablet of my memory.
—Oliver Wendell Holmes
Posterity remembers Dominique-Jean Larrey, a great French army-surgeon whose name is inscribed on the Arc de Triomphe in Paris, for his skill and dedication, his courage and generosity, and his innovations in military medicine. Son of the French Revolution, he took part in the storming of the Bastille and became a soldier in the army of the Rhine. He then served under Napoleon in the Italian campaign and subsequently accompanied him his surgeon-in chief in all his battles and campaigns, from Italy and Egypt to Germany, to Moscow, and eventually to Waterloo.
It was there in 1815, on the battlefield of Waterloo, that the Duke of Wellington noticed him operating on wounded soldiers while the bullets were whirling by, and ordered his soldiers not to shoot in that direction, saluting him as a man of courage from an age now gone by. Later he was knocked unconscious and left for dead, taken prisoner by the Prussians and ordered to be shot; but his life was saved when one of his former students recognized him and took him to General Blücher, who invited him to his table and then sent him back safely to France.
Larrey’s courage and dedication have become legendary. In Italy he rallied sword in hand the demoralized fleeing soldiers who were running away from Austrians. In battle he often exposed himself to treat and rescue a wounded soldier, even operating on the battlefield himself. During the expedition to Egypt he fearlessly plunged into the Mediterranean to save a colleague general who had fallen overboard. At the final retreat from Russia at the Berezina he repeatedly crossed the river carrying medical supplies and was almost caught in the stampede on the bridge, but saved by the soldiers who passed him over their heads to rescue the general who had saved so many of them.
There are also many examples of his humane behavior and generosity, how he treated the enemy wounded as well as his own, advocating humane treatment of prisoners of war, being just in administering justice and discipline, and standing up for his soldiers even to his superiors, to Napoleon and Charles X. It is reported that in Egypt he treated not only an injured enemy soldier but also his monkey, who would came back every week to be bandaged and would run to hug him.
During the revolutionary wars of 1792, while serving with the Army of the Rhine, Larrey instituted the system of flying ambulances to remove wounded soldiers from the battlefield so they could receive early treatment. At first these flying ambulances consisted of simple carts drawn by one horse, but during Napoleon’s Italian campaign they were expanded to be staffed by doctors, several soldiers and officers, a drummer, and also bandages and other medical supplies. With this system soldiers could often be brought to the rear lines in as little as fifteen minutes, and most were operated within twenty-four hours. Larrey also instituted a triage system in which those most in need and likely to be saved were selectively treated first. Soldiers from both sides received treatment in a humanitarian system that years later was expanded into the modern Red Cross. To prevent the onset of infection and gangrene, Larrey became an advocate of early amputating hopelessly injured limbs, and at Borodino is said to have carried out 200 operations in one day.
During his long career he made other important contributions to medicine. He reported on the infectiousness of trachoma, the natural history of tetanus and trench foot, of yellow fever (hepatitis?) and cold injury, effective control of hemorrhage, packing chest wounds, aspirating hemopericardium, and draining empyemas and hemothorax. He was the first to use maggots to clean infected wounds, perform amputations at the hip or shoulder joint, and ligate the femoral artery below the inguinal ligament. He received many honors, the Legion d’honeur and a baronetcy from Napoleon, and appointment to the Academy of Medicine in 1820. He was greatly admired and honored by Napoleon, who in his memoirs of Saint Helena described him as the most virtuous man he had ever met.
GEORGE DUNEA, MD, Editor-in-Chief