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This work is in German Swiss, and is difficult reading for one not familiar with the dialect. Its importance in the history of our subject lies in its vigorous plea that the healing power of nature should be allowed free play. It is the first modern work that lays adequate stress on this overwhelmingly important medical principle.

In the year 1543 appeared a second work which had a revolutionary effect on surgery. It was the 'De humani corporis fabrica' of André Vesale of Brussels, published in his twenty-ninth year. This work immediately placed anatomy in the position of a science, and raised its author to a place among that small list of really great medical writers whose work is for all time. From this date onward all good surgical work became primarily conditioned by the exact knowledge of the structure of the human frame inaugurated by Vesale.

The great anatomist was followed by the great surgeon; and the work of Ambroise Paré (1510-1590) (Fig. 3) stands, along with the researches of André Vesale and the suggestions of Paracelsus, as the groundwork of modern surgery. Paré has been the subject of a fine monograph by his countryman, Malgaigne; and the account given of him by Mr Stephen Paget presents to the English reader a picture of a lovable, loyal, and tenderhearted man, whose beneficent earthly course of eighty years was crowded with adventure and incident. Throughout his lifetime France was rent by disastrous wars of religion; and Paré, while belonging fully to neither party, retained the love and affection of both. It has been said that Paré was the only Huguenot in Paris who survived the awful night of St Bartholomew, but this begs the question of his religion, a question that never has and probably never will be decided. For the truth is that he was neither fully Catholic nor fully Huguenot, but a devout and simple-hearted lover of God and man, who went his way and did his work according to such light as was given him, avoiding, so far as was possible in those evil days, all the hatreds and envies that the name of religion inspired.

Paré was surgeon successively to four kings of France -Henri II, François II, Charles IX and Henri III. His attachment to the court and persons of his sovereigns did not prevent his serving on a multitude of battle-fields,

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(From an engraving by Horbeck in the British Museum.)

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where his skill and gentleness ever earned him the affection of the wounded and the sick. Thus, when in 1552 Metz was hard beset by the Germans, he succeeded in penetrating into the beleaguered city; and his arrival was equivalent to its relief. The Duke of Guise, who was in command, fell on his neck and wept for very joy; while officers and men, crowding round him, declared that they no longer feared wounds or death. New life was inspired into the defence; and the French held out for fifteen months longer, until the besieging army was compelled to withdraw. Paré was not a learned man, unless one who spends a life in the industrious accumulation of knowledge can be called learned; but it must be admitted that in an age of fantastic pedantry his ignorance was probably a gain rather than a loss. I desire not,' he wrote, 'to arrogate to myself that I have read Galen either in Greek or in Latin; for it did not please God to be so gracious to my youth that it should be instructed either in the one tongue or in the other.' Nevertheless he made his influence deeply felt on both the art and the status of the surgeon.

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The pernicious doctrine of the poisonous character of all gunshot wounds, popularised by John of Vigo, had become almost universally accepted in Paré's time, and was not at first rejected by him, though the sufferings of the wounded under treatment with boiling oil and pitch and cautery always smote upon his tender heart. In 1537, in his first military campaign, he was converted to the use of milder methods; and he opposed the older practice in his first book, 'The method of treatment of wounds made by arquebusses and other firearms, and of those made by arrows, darts and the like, also the burns made by gunpowder,' published at Paris in 1545 at the suggestion of the anatomist Jacques Dubois (Jacobus Sylvius). But the story of how he reached his conclusions is best told in his 'Journeys in Divers Places,' published as a part of his 'Opera Omnia' in 1585, when he was seventy-five years of age. The passage is probably the most familiar in the whole of his voluminous works.

During the war between the Emperor Charles V and King Francis I, the French laid siege to the Château de Villane in Piedmont, about thirty miles from Turin.

'The soldiers within the castle (writes Paré), seeing our men come on them with great fury, did all they could to defend themselves, and killed and wounded many of our soldiers with pikes, arquebusses and stones, whereby the surgeons had all their work cut out for them. Now I was at this time a fresh-water soldier. I had not yet seen wounds made by gunshot at the first dressing. It is true I had read in John de Vigo... that wounds made by firearms partake of venenosity by reason of the powder; and for their cure he bids you cauterise them with oil of elders scalding hot, mixed with a little treacle. And to make no mistake, before I would use the said oil, knowing this was to bring great pain to the patient, I asked first before I applied it, what the other surgeons did for the first dressing; which was to put the said oil, boiling well, into the wounds, with tents and setons; wherefore I took courage to do as they did. At last my oil ran short, and I was forced instead thereof to apply a digestive made of the yolks of eggs, oil of roses and turpentine. In the night I could not sleep in quiet, fearing some default in not cauterising, that I should find the wounded to whom I had not used the said oil dead from the poison of their wounds ; which made me rise very early to visit them, where beyond expectation I found that those to whom I had applied my digestive medicament had but little pain, and their wounds without inflammation or swelling, having rested fairly well that night; the others, to whom the boiling oil was used, I found feverish, with great pain and swelling about the edges of their wounds. Then I resolved never more to burn thus cruelly poor men with gunshot wounds. . . . See how I learned to treat gunshot wounds; not by books' (Paget, pp. 33, 34).

In the same passage Paré tells us that he was not the pioneer in this more merciful treatment:

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'While I was at Turin, I found a surgeon famed above all others for his treatment of gunshot wounds; into whose favour I found means to insinuate myself, to have the recipe of his balm. . . . And he made me pay my court to him for two years. In the end, thanks to my gifts and presents, he gave it to me; which was to boil, in oil of lilies, young whelps just born, and earthworms prepared with Venetian turpentine. Then I was joyful, and my heart made glad, that I had understood his remedy, which was like that which I had obtained by chance' (Ibid. p. 35).

The other great reform introduced by him into military surgery was the ligature of vessels for the control of

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