Paré's Treatise on Gunshot Wounds

Surgeons in the 1530s were taught that a gunshot wound was poisoned by the powder. Jean de Vigo's surgery told them to cauterize it with oil of elderberry mixed with a little treacle, and army surgeons applied the oil to the wound as close to boiling as they could.

Ambroise Paré met the problem on his first campaign, when the French army crossed into northern Italy in 1537 and took the castle of Villaine. He had not yet passed the examination to join the community of barber-surgeons. He copied the other surgeons until his oil ran out, then dressed the remaining wounded with a digestive of egg yolk, oil of roses and turpentine. He slept badly, expecting those men to die of poison. At first light he found them in little pain, their wounds neither swollen nor inflamed, while the men treated with oil were feverish, swollen and in great pain. He resolved never again to burn wounded men so cruelly.

Jacques Dubois, the Paris professor known as Sylvius, heard of his methods and urged him to publish. The book appeared in 1545, signed by Paré as a master barber-surgeon of Paris, and was reprinted in 1552 and 1564. His collected works describe tests of the same kind on burns. He treated a scalded kitchen boy with crushed raw onions on a village woman's advice, and later put onions on one half of a burned guard's face and the usual remedies on the other; the onion side did not blister.

His second change came more slowly. The 1552 edition still relied on the cautery to stop bleeding after amputation. Paré discussed the question with Etienne de la Rivière and François Rasse, two surgeons of Saint Côme, and at the siege of Danvilliers in 1552 he tied off the vessels when he amputated an officer's leg. The officer went home on a wooden leg. In his Dix livres de la chirurgie of 1564 Paré published the method and advised readers to give up the cautery altogether.

Not everyone was persuaded. A surgeon named Comperat blamed the ligature for the death of Paré's brother-in-law, Gaspard Martin, after Paré amputated his leg, and in 1580 Etienne Gourmelen attacked both his wound dressings and his ligatures. Paré answered in his Apology, quoting ancient authors to show that the ligature itself was old and that his contribution was to use it in amputations.