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Ambroise Paré and his times, 1510-1590 online

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does not say. There is a tradition that it was a
barber-surgeon of Laval, named Vialot ; or he may
have gone to his brother at Vitre, or to someone at
Angers; and it is possible that he served part at
least of his apprenticeship in Paris. By 1533, he
was at Paris : but the year of his going there is not
known. Long after his death, there was published *
in Paris a skit on the treatment of these apprentices
by their masters : it throws back some light over
these lean years of Park's life: —

" The cock has scarce done crowing, when the appren-
tice must rise to sweep and throw open the shop, lest he
lose the least payment that the tricks of the trade may
bring him — some early beard to be shaved. From this
time on to two o'clock, there are fifty customers ; he
must comb the wigs, hang about the parlour or the stair-
case selling his stock, put folks' hair in curl papers, cut
it, or singe it. Toward evening, if the young man wishes
to improve his mind, he will take a book ; but the dul-

* Le chirurgien mSdecin, 011 Lettre au sujet des chirurgiens qui
exercent la m^dectJie. Paris, 1726. Quoted by Malgaigne.



Boyhood and Early Life 15



ness and weariness of learning, which come of his not
being used to it, soon bring him a sound sleep, with
interruptions from the doorbell, warning him some rustic
wants his hair cut. Never did anyone ask so much of a
servant, never in The Islands did a white man seek so
greedily to get profit out of a black one, as a master
barber-surgeon tries to make gain out of the bread and
water he gives his apprentices. If it is not their after-
noon out, he will not let them leave the shop, not even
to go to Lecture, for fear of losing the worth of some
beard which perhaps will not come after all. That is
why the professors, out of kindness, give their Lectures
to these unhappy young men at four o'clock in the morn-
ing."

These lectures, given in Paris and other University
tou'ns to the apprentices of the surgeons and barber-
surgeons, were not such as to stand the test of being
delivered at four in the morning. There is a good
account of them in Malgaigne. They were of course
given by physicians, or by University professors, not
by surgeons ; " probably the lecturer limited himself
to expounding those portions of Guy de Chauliac
which treated of wounds, tumours, and ulcers, adding
a few general remarks on fractures and dislocations."
The honour of the University forbade the professor
to speak French, and the apprentices did not under-
stand Latin. At Montpellier, a compromise was
made: the professor read out his authority in Latin,
and then commented on him in a mixed eloquence



1 6 Ambroise Pare






half Latin, half French, We have the lectures given
at Lyon by Jehan Falcon in 1520, and published by
his widow in 1559. He begins with a careful study
of the title of the book he is reading to his audience ;
observing that the word title is derived either from
the Latin tueri, because it protects the author's
work, or from the Greek Titan, which means the
sun, and as the sun throws light on the world, so the
title throws light on the book. Then, warming to
his subject, he goes on to consider (i) To what part
of philosophy does surgery belong? (2) What is
the order of this book in regard to other books on
surgery ? (3) What is the subject chiefly treated in
this book? (4) How many causes has this book?

" I find it has four causes : efficient, formal, final, and
material. The efficient cause is twofold ; universal, and
particular. The universal cause is God, who is the cause
of all things in this world. The particular cause is the
doctor Guido (Guy de Chauliac), who was a very excel-
lent man in medicine and in surgery, as he teaches you
by his book. The material cause of this book is the
human body, potent alike for health and for sickness,
determined to manual operations, with which difference
it is the subject of this book. And here we take
material cause for matter, wherewith science is con-
cerned."

These lectures of Jehan Falcon extend over 610
pages quarto ; we can only hope that Ambroise



Boyhood and Early Life 17



served his apprenticeship in some small country-
town, far from physicians and professors.

He was at Paris in 1533, twenty-three years old,
and the plague was raging there. The Paris of those
days, growing under the hand of Francois I., was a
walled city of some 1 50,000 inhabitants. The Louvre,
the old Hotel de Ville, and the great church of St.
Eustache, were just beginning to be built ; the Hotel
Cluny was about thirty years old ; Notre Dame,
Saint Germain I'Auxerrois, the Sainte Chapelle, the
Hotel Dieu, and the fortress of Le Grand Chatelet,
were the great landmarks of the life of the city.
There was no bridge across the whole width of the
river, only bridges of wood or stone connecting La
Cit6 with either bank of the Seine. The number of
beggars, thieves, cut-throats, and paupers herded in
Paris was frightful ; an estimate of them, made in
Pare's lifetime, puts the criminal classes at 6000 or
7000, the paupers at 8000 or 9000. And he who
would know what the streets were like, and what
sights were to be seen in them, must read the de-
lightful memoirs of L'Estoile.

Three things Pare must obtain : board and lodg-
ing, plenty of practical work, and the diploma of the
Barber-Surgeons. There was given to him, while
yet unqualified, that which all students most desire,
a resident appointment. He was made *' compagnon



1 8 Ambroise Pare

chirurgien" at the Hotel Dieu, holding there the
office of a House Surgeon or Resident Medical
Officer. For three years he lived within the walls of
the Hospital ; in one place in his books he says it was
four years. Sylvius (Dubois) was one of his teach-
ers ; Andreas Vesalius just missed, by a year or two,
the happiness of being his friend.*

The Hotel Dieu was founded by Saint Landry,
Bishop of. Paris, about the year 660, and was en-
larged in the thirteenth century by Saint Louis. It
was served by a brotherhood and sisterhood, vowed
to the work, but not attached to any great monastic
order. In the time of Saint Louis it had thirty
brethren, twenty-five sisters, four priests, and four
clerks in holy orders. The chapter of Notre Dame
had authority over it, and appointed two of their
own number as overseers ; they also chose one of
the brethren to be Master of the Hospital. In
1327, Charles IV. appointed two of the surgeons of
Le Chatelet to visit it. The sisters appear to have
done a good deal of the work ; one of them im-

* Vesalius was born at Brussels, and had been educated at the
University of Brussels before he came to Paris to study medicine.
He was about three years older than Pare ; they both had Sylvius
for their teacher. The story that they were opposed in the wars,
Pare with the King's army, Vesalius with the Emperor, is not proba-
ble. Pare's first sight of war was in 1537, and in that year Vesalius
was already professor of anatomy at Padua. Probably they met
over the death-bed of Henri II., in 1559.



Boyhood and Early Life 19



parted to Ambroise her prescription for an oint-
ment, and they attended some of the patients at
their own homes: but this good custom was stopped
in 1535, at the very time when he was resident at
the Hospital. We know there were students at the
Hotel Dieu in his time, for in 1505 a Commission
of eight citizens of Paris had been appointed to
take charge of the temporal service of the Hospi-
tal, because of the disorder and neglect of the pa-
tients : the reforms ordered by the Commission
were opposed by the brethren and sisters, and in
1537, at or just after the end of Park's term of
office, things came to a crisis and a riot occurred ;
certain students took the side of the sisters, and
were sent to prison for their pains. (Malgaigne.)

It is certain that he got plenty of work out of
the Hospital. He had the charge of patients, the
privilege of making dissections and post-mortem ex-
aminations, the chance of teaching the students.
In one winter he operated on four cases of loss of
the nose from frost-bite ; he saw the terrors of the
plague, the whole practice, — out-patient and in-
patient, — of the Hospital, He loved the work, and
looked back to it with pride. To any present or future
House Surgeon who may read this book, I would
suggest that Par^ seems to have worked well with
everybody in the Hospital, and that his departure



20 Ambroise Pare



■^



from it was followed by a regular riot of the stu-
dents within its walls ; as though he had done good
work under a bad set of rules.

Having left his beloved Hospital, he was not the
man to hang about it unemployed, or to put his
whole life into a barber-surgeon's shop and wait for
work to come. Practice, and plenty of it, he must
have at once, and a livelihood ; practice anywhere,
and at any cost. Here, then, the river of his life
divides into two streams, which flowed side by side
for more than thirty years, before they joined again,
in Paris in 1569, and ran to the sea. He would live
a double life, — with the army In times of war, at
Paris in the intervals of peace. He took a foothold
in Paris, and went off to the wars with Colonel
Montejan. For more than thirty years he stood
the strain of this twofold work ; and toward the
end of that time it was no longer the Emperor
against whom he served, but his own countrymen.

There was in his time no organised army medical
service. The King took with him his own physi-
cians, who were priests. The Seigneurs had their
own physicians, priests or clerks in holy orders, who
also served as chaplains to the army. A host of
barber-surgeons, irregular practitioners, and quacks,
followed the troops with drugs and ointments ;
women skilled to suck and dress wounds went in



Boyhood and Early Life 21



and out of the camp ; the soldiers had their own
rough and ready remedies for gunshot wounds ;
Par6 notes one, which was a drink of gunpowder
stirred in water. When Saint Louis (i 226-1 270)
went on the Crusades he had with him Jehan
Pitard, his chief surgeon, and others to work under
him ; the Seigneurs brought their own physicians
and surgeons, just as they brought their own follow-
ing of soldiers. Toward the end of the thirteenth
century came the invention of gunpowder: with
the use of powder and shot came the belief that
gunshot wounds had a special virulence : and the
treatment with boiling oil was practised by general
consent long after Pare, within forty-eight hours of
his first sight of fighting, had discovered the folly
of it.

He had no recognised position in the army, no
rank in the camp ; he was paid by the job. He
attached himself first to one great man, then to
another, till in 1552 he /was made one of the King's
surgeons-in-ordinary ./YPigray, one of his pupils, who
afterward, on Park's recommendation, was made
surgeon to the King, did the same : there was no
organisation of this branch of the service. It is
true that Francois I., about 1538, sent Park's friend
and fellow-worker, Theodoric de H6ry, to the French
troops in Italy, but this was a special mission.



22 Ambroise Pare



Some attempt to organise a medical service for
his own army was made by Charles the Bold, Duke
of Burgundy, in the time of Louis XI. (1461-1483).
He attached a surgeon to each company of eight
hundred men ; and of course he and his officers had
also their own physicians and surgeons with them : —

" The Duke himself has four surgeons, for his own
person and for those immediately around him ; and cer-
tainly they are not the least occupied of his attendants :
for the Duke is a Prince of such chivalry and martial ex-
ercises, that by wounds of all kinds there are often so
many to be dressed, in his own house or elsewhere, that
fifty surgeons hard at work would have enough to do for
their proper cure. These four surgeons of the Duke
take nothing from the poor, nor from the foreign sol-
diers in the Duke's pay ; they duly attend him with their
drugs and ointments, and have access to his bedchamber
at all hours, just like the physicians. . . . He has
six physicians ; and these, when he is at table, sit behind
the bench, and counsel him with their advice what viands
are most profitable to him."*

When Pare joined the army, he went simply as a
follower of Colonel Montejan, having neither rank,
recognition, nor regular payment. His fees make
up in romance for their irregularity : a cask of wine,
fifty double ducats and a horse, a diamond, a collec-
tion of crowns and half-crowns from the ranks, other

* Ollivier de La Marche ; quoted by Malgaigne, from whom the
above facts are taken.



Boyhood and Early Life 23



" honourable presents and of great value " ; from the
King himself, three hundred crowns, and a promise
he would never let him be in want ; another dia-
mond, this time from the finger of a duchess : and
a soldier once offered a bag of gold to him.

He qualified as a master barber-surgeon in 154I)*
being at that time thirty-one years old. The corpo-
ration of barber-surgeons was a body of some an-
tiquity ; they are mentioned so far back as the year
1301, and new rules were made for them in 1371.
The King's chief barber was their head ; the church
of Saint Sepulchre, in the rue Saint-Denis, was their
centre ; Saint Cosmo and Saint Damien were their
patron saints. In 1572, they prescribed a four years'
course of study to their apprentices ; the examina-
tion-fees were a crown to each examiner ; and to
obtain the title of Master it was necessary to pay a
further fee to the Faculty of Medicine, to undertake
the dissections in the schools, and to take an oath,
renewed every Saint Luke's Day. They were jeal-
ously restricted in the amount of surgery they might
practise ; fighting their way up into the territory of
the surgeons, just as the surgeons were fighting
against the supremacy of the physicians.

There were two examinations, a year apart : and
Ambroise and his friend Th^odoric de H6ry got
♦Trevedy is wrong in giving " about 1536" as the date.



24 Ambroise Par^



through them side by side. Here is the entry of
payment of their fees for the Mastership * :

A Razoribus de novo examinatis :

A duobus rasoribus qui anno praeterito examinati
fuerant, videlicet, ab

\ Ambrosio Parre 72 sols 6 deniers parisis.

I Theodorico de Heri 72 sols 6 deniers parisis.

Or it may be that Par6 and de Hery were exam-
ined a second time because things did not go well
with them on the first occasion.

Time has spared and Malgaigne has given to us
the record of a batch of candidates who passed their
examination about this time. There were fifteen of
them ; we are not told of those who failed to satisfy
the examiners of this Conjoint Board. We shall hear
of Dr. Flesselles again.

" Nous Philippes Flesselles, docteur regent en la Faculte
de medecine, et medecin jure du roy nostre sire audit
Chastelet de Paris, et Jean Maillard, docteur regent en
ladite Faculte, substitut en 1' absence dudit de Flesselles,
et Pascal Bazin, chirurgien jure du roy nostre sire audit
Chastelet, et Sebastien Danisy, prevost desdits chirurgiens
a Paris, et Frangois Bourlon, chirurgiens jures a Paris ;
et ledit Bourlon commis par Guillaume Roger, chirurgien
jure du roy nostre sire audit Chastelet, parceque ledit
Roger estoit detenu au lict malade d' une fi6vre tierce :

* From Le Paulmier's most admirable work Ambroise ParS d'aprls
de Nouveaux Douiments. Paris: Charavay Freres, 1884.



Boyhood and Early Life 25



Certifions qu' en vertu de certaine' ordonnance donnee
en la chambre de la police, dat^e du sixiesme jour
d'aoList, et signee Valet, nous avons precede a 1' audition,
examen, et experience des dessous nommes sur le fait de
la cognition et curation des clouds, bosses, antrax, et
charbons, tant sur les differences d' iceux que sur les
phlebotomies et saignees, diversions qui en tels cas con-
vient et se devoient faire et aussi pour la parfaite curation
d' icelles : et tout veu et considere, les responces des
dessous nommes, tant en Theorique que Pratique, les
disons estre idoines et suffisans pour guerir lesdits clouds,
antrax, bosses, et charbons : le tout certifions estre vray :
tesmoins nos seings manuels icy mis le vingt sixiesme
jour du mois d' aoust 1' an mil cinq cens quarante cinq."

Then follow the names of the successful candidates.

Here, with his admission to the Barber-Surgeons,
ends the first chapter of Ambroise Fare's life. Next
come the Journeys in Diverse Places, written in
Paris, long after the events, and published in 1585,
in the fourth edition of his collected works, when
he was midway between the threescore years and
ten and the fourscore years.

He wrote them in answer to an attack made upon
him in 1580 by Etienne Gourmelen, Dean of the
Faculty of Medicine. This Gourmelen published in
1580 a book on surgery, in which he asserted that
Park's use of the ligature after an amputation was
vastly inferior to the old estabhshed use of the cau-
tery. The book was an idiotic appeal to authority



26 Ambroise Pare



and tradition ; the very thing that Paracelsus would
have loved to burn. But it has an everlasting merit,
inasmuch as it drew from Pare his Apologie et Traicte
conte7ia7it les Voyages faicts en divers Lieiilx : par
A mbroise Pari, de Laval, Conseiller et Premier Chirur-
gien dii Roy.

He begins with a furious rejoinder to his adversary.
Gourmelen had appealed to authority ; Pare takes
him to authority, and shows him that the use of the
ligature is no new thing. Then comes a long list of
cases where he had used it with success after amputa-
tion. Finally, the appeal to experience. The whole
argument runs thus : (i) It is nothing new to stop a
vessel, bleeding in a wound, with the ligature. (2) I
am the first surgeon who has ever used the ligature
to stop the bleeding of the wounds made by ampu-
tations. (3) I have had good results by this method.
(4) ]\Iy discovery was made not by sitting in a chair
and thinking, but by years of hard practical work in
Paris and with the army.

From the whole of his life, he takes that great
part of it which was spent with the army, and leaves
his practice in Paris out of the question. Once
started on the story of the wars, he tells it to the
end, to a time many years later than the great dis-
covery ; not from vanity, but from love of good
stories, and vehement determination to force on



Boyhood and Early Life 27



Gourmelen the unwelcome fact that his hfe, in com-
parison with Park's, has been a failure : theory against
fact, books against patients, talk against work.

" Moreover, you say you will teach me my lesson in
the operations of Surgery : which I think you cannot do :
for I did not learn them in my study, or by hearing for
many years the lectures of Physicians : but I was Resi-
dent three years in the Hospital of Paris, where I was
able to see and learn much of the works of Surgery upon
an infinity of sick folk, with Anatomy on a quantity of
dead bodies : as I have often given good proof in public
at the Schools of Medicine in Paris. And my good luck
has made me see much more than this. For being
called to the service of the Kings of France (four of
whom I have served) I have been in company at Battles,
Skirmishes, Assaults, and Besiegings of Towns and Fort-
resses : as also I have been shut up in Towns with the
Besieged, having charge to dress the Wounded. Also, I
have dwelt many years in this great and famous City of
Paris, where thanks be to God I have always lived in
very good reputation with all men, and have not held
the lowest rank among those of my Estate ; seeing there
has not been found a cure, were it never so great and
difficult, that my hand and judgment have not been re-
quired. Now will you dare to say you will teach me to
perform the works of Surgery, you who have never yet
come out of your study ?• . . . I believe you have
never come out of your study, save to teach Theorick (if
you have been able to do even that). But the operations
of Surgery are learned by the eye, and by the hand.

" Let me say you are like a young lad, of Low Brittany,
who asked leave of his father to come to Paris. When he



28 Ambroise Pare



had come, the Organist of the Church of Our Lady found
him at the Palace gate : who took him to blow the or-
gans, and there he was three years. He sees he can
speak a little French, and goes home to his father, and
tells him he speaks good French, and moreover knows
how to play well on the organs : his father received him
very joyfully, that he was so clever in a short time. He
went to the Organist of their great church there, and
prayed him to let his son play on the organs, so that
he might know whether he were a skilful master as he
said : which the Master Organist granted willingly.
Being entered into the organs, he cast himself with a
great leap at the Bellows : the Master Organist bids him
play, and he himself would blow the Bellows. Then the
young man tells him, / knoiv nothing else but only how to
play 071 the Bellows. You too, ?non petit Maistre, I think
you know nothing else but how to chatter in a Chair •
but as for me, I will play upon the keys, and make the
organs sound.

" See now, inon petit Maistre, my answer to your Calum-
nies : and I pray you, if you have a good mind to the
Publick, to review and correct your Book so soon as you
can, not to keep young Surgeons in error by reading
therein, where you teach them to use hot Irons after the
amputation of Limbs to staunch the Blood, seeing there is
another way not so cruel, and more sure and easy.
Moreover if to-day after some Assault on a City, where
diverse Soldiers have had legs and arms broken and
carried off by Cannon-shots, or Cutlasses or other Instru-
ments of War, if you should use hot Irons to stay the flow
of Blood, you would need a Furnace, and much charcoal
to heat them : and the Soldiers would have you in such
horror for your cruelty, they would kill you like a
Calf. . . ."



Boyhood and Early Life



29



The rest of the answer to Gourmelen is no less
emphatic, showing the wonderful vigour and spirit
of Ambroise Fare's old age. He appeals, once and
forever, from tradition to experience ; he will show
this " petit maistre," this ass, what it really means, to
be a surgeon.

Room then for Pare himself : hear him tell in his
own last words the wonderful romance of his thirty
years' service in the army : surely one of the most
delightful set of stories in the world. I put such
notes as may be useful well out of the way, that
nothing may interrupt him.




II.



''JOURNEYS IN DIVERSE PLACES."

1537-1569-

A Soldier. " We know enough, if we know we are the King's
subjects : if his cause be wrong, our obedience to the King wipes the
crime of it out of us."

King Henry. "Every subject's duty is the King's — but every
subject's soul is his own. Therefore should every soldier in the wars
do as every sick man in his bed — wash every mote out of his con-
science."

Shakespeare, King Henry V.

The Journey to Turin. 1537.

I WILL here shew my readers the towns and places
where I found a way to learn the art of surgery:
for the better instruction of the young surgeon.

And first, in the year 1536, the great King Francis
sent a large army to Turin, to recover the towns and
castles that had been taken by the Marquis du Guast,
Lieutenant-General of the Emperor. M. the Con-
stable, then Grand Master, was Lieutenant-General
of the army, and M. de Montejan was Colonel-Gen-
eral of the infantry, whose surgeon I was at this

30



"Journeys in Diverse Places" 31



time. A great part of the army being come to the
Pass of Suze, we found the enemy occupying it ; and
they had made forts and trenches, so that we had to
fight to dislodge them and drive them out. And
there were many killed and wounded on both sides, —
but the enemy were forced to give way and retreat
into the castle, which was captured, part of it, by
Captain Le Rat, who was posted on a little hill with
some of his soldiers, whence they fired straight on the
enemy. He received an arquebus-shot in his right
ankle, and fell to ground at once, and then said,
" Now they have got the Rat." I dressed him, and
God healed him.

We entered pell-mell into the city, and passed
over the dead bodies, and some not yet dead, hear-
ing them cry under our horses' feet ; and they made
my heart ache to hear them. And truly I repented
I had left Paris to see such a pitiful spectacle. Being
come into the city, I entered into a stable, thinking


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