Ambroise Pare: standard bearer for barber-surgery reform

Mildred Wilson
Detroit, MI

 

Portrait of Ambroise Pare

Ambroise Pare, Posthumous, Fantasy Portrait by William Holl. Public Domain

“There are five duties of surgery: to remove what is superfluous, to restore what has been dislocated, to separate what has grown together, to reunite what has been divided, and to redress the defects of nature.”

-Ambroise Pare1

For centuries, barbers throughout Europe assisted monks in bloodletting. In 1163, Pope Alexander III issued a decree which prevented clergymen from shedding blood. It was believed that the practice was incompatible with their role in society.2 Medical doctors agreed because they felt that these procedures were beneath their dignity.3

In fourteenth-century London, barbers formed a guild. The first barber-surgeon on the Registry of the Worshipful Company of Barbers was recorded in 1312. The bleeding barber is the reason modern barbers display red-and-white striped poles: the pole was a stick for the patient to grip; the white stripes were the bandages, the red stripes the blood. The ball on the top was believed to be a deformation of the blood-gathering bowl.4

During the European Renaissance (1450-1699), surgery was a mix of art, science, and myth. Claudius Galenus (Westernized as Galen), a Greek physician in the Roman Empire, had advocated that personal observation was a necessary part of medicine. Often physicians did not follow his advice. However, the strength of his writings led physicians in the Roman, Muslim, and later European empires to take his teaching as dogma.5

Humoral medicine had been the prevailing dogma for thousands of years. This theory held that the body was made up of four humors or liquids. Hermann Glasscheib, a medical historian, called them “the four juices; yellow bile, black bile, white phlegm, and red blood.” Further, he stated, the body had three doors to evacuate novice matter; the skin (sweat), kidneys (urine), and the bowels (feces). A fourth door, bloodletting, was invented by Hippocrates, Galen, and Paracelsus, who believed in the power of relieving the body of blood through various veins.6

The Renaissance became a period for advancing the science of surgery. One of the men who was skeptical about the earlier writings of Galen and challenged what he regarded as folklore and tradition was Ambroise Pare. His dedication to empirical observation and reasoning elevated the position of barber-surgeon. He became one of the most notable surgeons of the European Renaissance and was regarded as a pioneer in battlefield medicine, specifically in the treatment of wounds.7

Ambroise Pare was born in c. 1510 in Bourg-Hersent in the little village close to Laval in Maine. His father was valet-de-chambre and barber to Francois de Laval. He had a sister, Catherine, and two brothers, both named Jehan.8

Pare went to the village school and then was sent to board with M. d’Orsay, a chaplain, so that he might learn Latin. The chaplain spent little time tutoring Pare. Instead, Pare weeded the garden and looked after a mule. He never learned Greek or Latin.9

One of Pare’s brothers was a barber-surgeon. He watched his brother at work and became his brother’s apprentice.10 In 1533, he went to Paris where he trained to become a barber-surgeon at the Hotel-Dieu de Paris where he was taught anatomy and surgery. The hospital had been founded in the seventh century and was the oldest in France.11

The barber-surgeons at Hotel-Dieu de Paris were sometimes called “doctors of the short robe” to distinguish them from the surgeons who were called “doctors of the long robe.” Pare started as a “doctor of the short robe,” but his eminence was honored by the long robe as a result of his experience at the Hotel-Dieu.12

In 1536, Pare was too poor to pay his barber-surgeon examination fee.13 He entered military service during the siege of Turin under his patron, Marechal de Montejan, colonel-general of the French infantry. He treated the wounded of both sides.14

When Pare entered the army, surgeons treated gunshot wounds with boiling oil, since the wounds were considered poisonous. On one occasion, Pare ran out of the oil and decided to try something different. He experimented with a mixture of egg yolk, rose oil, and turpentine. He found that the wounds healed better.15

In 1539, Pare returned to Paris. He passed his exam in 1541 and was accepted into the Company of Barber-Surgeons. A few months later, he married Jeanne Mazelin.16

In 1545, he wrote his first book, The Method of Treating Wounds by Harquebuses and Other Guns. The book was written in French rather than Latin and it became instantly popular.17

One innovation that did not win Pare medical acceptance was his reintroduction of tying large arteries to replace the method of searing vessels with hot irons to check bleeding during amputation.18

Pare understood the phenomenon of phantom limbs, in which an amputee still “feels” pain or other sensations in the limb that has been amputated. At the time, the pain was believed to be in the remaining part of the amputated limb, but this did not fit with the patients’ descriptions of the pain. Pare had studied neurosurgery and suggested that the feeling had to do with what was going on in a patient’s brain, not the residual limb.19

Amputations were a major part of Pare’s work on the battlefield. This led him to investigate prosthetics. He designed prosthetic limbs as well as artificial eyes, using enameled porcelain, silver, and gold.20

Throughout Pare’s thirty-year career, he served four French monarchs; Henry II, Francis II, Charles IX, and Henry III. In 1552, while Pare was serving as one of Henry II’s doctors, the king died in a joust with the Comte Montgomery, which eventually split France in a civil war.21 In 1559, Francis II ascended the throne at age fifteen after the death of his father, Henry II. He died of an ear infection in 1560.22

In 1562, Pare was appointed as Charles IX’s primary doctor. On August 24, 1572, the day of the St. Bartholomew’s Day Massacre, Charles IX saved Pare’s life by hiding him in a clothes closet. Pare lived outwardly as a Catholic, but was of Huguenot descent.23

On November 4, 1573, Pare’s wife, Jeanne, died. On January 18, 1574, Pare married Jacqueline Rousselet.24 In the same year Pare was also appointed Henry III’s primary doctor. He remained with the king until the king’s death in 1589.25

Pare died in his home in Paris of natural causes on December 20, 1590. He was buried in his parish church, St. Andre-des-Artes.26

Despite Pare’s innovations, he labored under the superstitions common to sixteenth-century surgery. However, he saved many patients and came to represent the ideal practitioner both for his technical competence and for his humanitarian concern for his patients. His motto for treating war-wounded men was, “I dressed him, and God healed him.”27 In the U.S. alone, over 1,500 soldiers have become amputees in war since 2001.28 Much like Pare, many of the military medical assistants are not physicians, but often have to make split-second decisions.

Ambroise Pare is generally regarded as the founder of modern surgery, a restorative process that heals the body with minimal suffering.29 Battlefield medicine is still an imperfect science and Pare’s words are worthy of note, “Cure occasionally, relieve often, and console always.”30

 

Endnotes

    1. Drucker, Charles B. Ambroise Pare and the Birth of the Gentle Art of Surgery, accessed January 15, 2020, ncbi.nlm.nih.gov/pmc/articles/pm2605308/Yale J. Biol Med., Dec.2008., pg. 1.
    2. Pang, William, Bloody History of Barber Surgeons, ‘Medical Dialogue Review,’ October 3, 2016,accessed January 15, 2020, mdrnyu.org/fall-2015-bloody-history-of-barber-surgeons .
    3. Norn S., Permin H., Kruse P. R., Kruse E. Ambroise Pare (1510-90) and Features of the History of Surgery, accessed January 15, 2020, ncbi.nlm.nih.gov/pubmed/21560770.
    4. George, Rose. Nine Pints: A Journey Through the Mysterious World of Blood, Granta Publications, London, England, 2018, pg. 34.
    5. Drucker, Charles B., Op. Cit., pg. 2.
    6. George, Rose, Op. Cit., pg. 34.
    7. Drucker, Charles B., Op. Cit., pg. 1.
    8. Paget, Stephen. Ambroise Pare and His Times, G. P. Putnam’s Sons, New York City, New York, 1897, pg. 11.
    9. Ibid., pgs. 12-13.
    10. Ibid., pg. 14.
    11. The Editors of Encyclopaedia Britannica, Ambroise Pare: French Surgeon, January 1, 2020, ‘Encyclopaedia Brittanica,’ http://www.britannica/biography/ambroise-pare.
    12. [Norn S., Permin H., Kruse P. R., Kruse E., Op. Cit., January 15, 2020.
    13. Drucker, Charles B., Op. Cit., pg. 4.
    14. Encyclopedia.com/people/medicine/medicine-biographies/ambroise-pare, accessed January 15, 2020.
    15. Encyclopedia.com/people/medicine/medicine-biographies/ambroise-pare, accessed January 15, 2020..
    16. Ambroise Pare Facts, accessed January 15, 2020, biography.yourdictionary.com/ambroise-pare. Ambroise Pare: Standard Bearer for Barber-Surgery Reform 7
    17. The Editors of Encyclopaedia Britannica, Ambroise Pare: French Surgeon, January 1, 2020, Encyclopaedia Britannica, accessed January 15, 2020, www.britannica/biography/ambroise-pare.
    18. The Editors of Encyclopaedia Britannica, Op. Cit,, January 1, 2020.
    19. Farelly, Elly, Ambroise Pare- 16th Century Surgeon and Father of Military Medicine, February 8, 2019, accessed January 15, 2020, www.warhistoryonline.com/war-articles/ambroise-pare-16th-century.html.
    20. Ibid., February 8, 2019.
    21. Ibid., February 8, 2019.
    22. The Editors of Encyclopaedia Britannica, Op. Cit., January 1, 2020.
    23. Farelly, Elly, Op. Cit., February 8, 2019.
    24. Hernigou, Philippe. Other Aspects of Ambroise Pare’s Life, accessed January 15, 2020, ncbi.nlm.nih.gov/articles/PmC3685679.
    25. The Editors of Encyclopaedia Britannica, Op. Cit., January 1, 2020.
    26. Ibid., January 1, 2020.
    27. Ambroise Pare Facts, https://biography.yourdictionary.com/ambroise-pare.
    28. https:todayinsci.com/P/Pare_Ambroise/PareAmbroise-Quotations.htm., accessed January 15, 2020.
    29. Wood, David, U.S. Wounded in Iraq, Afghnistan Includes More Than 1500 Amputees, November 8, 2012, accessed January 15, 2020, Huffpost.com/entry/Iraq-afghanistan-amputees-n-208991.
    30. Marcucci, L., M.D., Inside Surgery, accessed January 15, 2020, insidesurgery.com/2010/07/cure-occasionally-relieve-console/01.

 


 

MILDRED WILSON has a Masters of Teaching in Visual Arts and a Doctorate in Curriculum Development and Administration. She is a former high school art teacher and an education analyst for the Michigan Legislative Service Bureau. She currently spends her time as a caregiver for her mother who is 101 years old and writing fiction and nonfiction.

 

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