• Surgery: “an exercise in the use of the intellect.”
• union of mind and body.
• deliberation and decision; process of intellectual synthesis and logic; essential cooperation of hand and mind.
• The “message of gentle care” [Paré].
• War promotes surgical advance. [Kind of a selective pressure].
• increasingly damaging weaponry causes increasingly complicated injury, requiring increasingly sophisticated knowledge of the body.

Two great wars during Paré’s life:

• Italian Wars, 1495-1558
• Wars of Religion, 1562-1598.
• 1572, 8/24: St. Bartholomew’s Day Massacre of Huguenots  [1585, Revocation of the Edict of Nantes]
• Paré probably a Huguenot.

Medieval belief in gunpowder as poison led to treatment by cautery or [secondary cautery] boiling oil.  Paré, 1537, siege of Turin, ran out of oil.  NB: his first campaign, first time seeing fresh wounds.  He turned to gentle mixture of egg yolk, oil of Roses, turpentine.  EPIPHANY.  “instantaneous and complete conversion”

Paré: wrote extensively in vernacular.  frequently printed, wide dissemination.  a canon for centuries.   ‘triumph of a philosophy’

Transformation:  “..only three times in the long history of western medicine has surgical philosophy and practice, ..., undergone a virtual transformation from what had been before.”  Hippocrates, Paré, John Hunter.

Reason and experience conjoined were most important to Paré.  But also being well acquainted with works of predecessors.
 

Three levels of formal French medicine:

• physicians
• surgeons of the long robe [of St. Come]
• barbers -- eventually 1500-1510, legitimized as barber-surgeons, by education and exam, and admission to St. Come.

1545  Method of Treating Wounds  ....   gentle wound treatment
1552  campaign: use of ligature in amputation.
1554  master surgeon, College of St. Come
1564  Ten Books of Surgery
1575  Complete Works  [English translation 1634]
1585  Apologie and Treatise   - most famous work;autobiographical
                  - paradigmatic lucidity

Example of surgical sophistication: treatment of sucking chest wound, 1553 battle of Hedin.  [116]

opium and henbane for sleep; also: simulation of falling rain [white noise]!

Characteristics: objectivity, humanity, simplicity, originality, independence, logical rationality, deep moral sense.-- a little hero worship?

patient centered, not disease centered.

Porter:  on Paré and surgery.

(pp186-190)

“He who wishes to be a surgeon should go to war.”  Hippocrates 1500s: vernacular handbooks popular: Brunschwig 1497, first printed illus surgical instruments; von Gersdorff, 1517;  rec. Cautery.

Paré: the most acclaimed Renaissance surgeon.

“Je le pansay; Dieu le guarit”  I treated him, God cured him.

Ligature in amputation success awaited 1700s invention of first effective tourniquet, by J. L. Petit.
 

Surgery:

• a skilled, often successful, craft: evidence: case books of Joseph Binns (d. 1664).
• Work: mostly routine, most common: venesection.

A few new operations:  e.g. Tagliacozzi 1597, new type rhinoplasty.