The Accidental Discovery of Ambroise Paré
In the sixteenth century, exciting new advances in technology led to horrifying developments in warfare. For the first time, physicians were forced to confront injuries caused by bullets and shrapnel. Not themselves, of course – surgery and the treatment of wounds were beneath the dignity of physicians, who hired surgeons to deal with such butchery.
In the 1500s it was commonly believed that gunshot wounds were poisoned. We now recognize that high-velocity projectiles often carry foreign matter into a wound and contaminate it, leading to infection and possibly gangrene. Several hundred years before the germ theory of disease was widely adopted, however, everyone was completely ignorant of the nature of infection. Since bullet wounds were ‘poisoned’, they of course had to be cauterized with oil. Burning-hot oil.
During the Siege of Turin, 1537, a young barber-surgeon named Ambroise Paré was overwhelmed by a flood of casualties, so much so that he ran out of oil for cauterization. In desperation, he made a mixture of egg yolks, oil of roses, and turpentine, applied this concoction to the patients, dressed them with clean bandages, then left them for the night. Upon returning next morning, he observed that the patients so treated hadn’t succumbed to sepsis as he feared and were doing well, while the cauterized patients were in agony. Curious, he observed the progression of healing and noted that the non-cauterized patients not only were in significantly less pain but actually healed faster than those scaled by hot oil.
Shocked, he realized that his duty was not simply to provide treatment but to minimize or avoid suffering, and that the standard therapy that everyone used was both tortuous and inferior to simpler methods. His findings were not warmly received by physicians and surgeons at the time, and although his work was well-appreciated by both the military and the monarchy it was rejected for decades by the medical establishment.
Paré went on to challenge many of the surgical dogmas of the time, and although he was often ridiculed for his positions, we recognize them today as obvious. He was the first person to refrain from castrating men who needed surgery for hernias, for example – the belief at the time that eunuchs did not develop hernias was a simple superstition. More generally, he did not resort to surgery unless he felt it was absolutely necessary – a major break with the attitudes of his time. Sadly, the modern era has reverted back to the attitudes of Paré’s contemporaries in some ways.
His most famous saying, which despite being reduced to a cliché through overuse remains in frequent use today, is
I dressed the would, but God healed it.
The theism implicit in the saying is outmoded, but in the real world, humility never goes out of style.