l.o. to understand the importance of ambroise pare 1510 - 1590
TRANSCRIPT
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.