Speaker 1: Happy Saturday. In our episode on Goods of the Iron Hand,
Speaker 1: we talked about the state of surgery in fifteen oh
Speaker 1: four when he was injured in battle and had to
Speaker 1: have his hand amputated. We mentioned that when this happened,
Speaker 1: Ambras Pire's work advancing the field of surgery in Europe
Speaker 1: was still decades away, and in our episode on Mpoise Perree,
Speaker 1: which originally came out on May seventeenth, twenty twenty one,
Speaker 1: we talked about how so many other advances happened hundreds
Speaker 1: of years after Pire's groundbreaking work. Our episode on him
Speaker 1: is Today's Saturday Classic, So enjoy. Welcome to Stuff you
Speaker 1: missed in History Class, a production of iHeartRadio. Hello, and
Speaker 1: welcome to the podcast. I'm Holly Frye and I'm Tracy V. Wilson. Oh,
Speaker 1: it's more medical history. So exciting. I've been doing so
Speaker 1: much over the pandemic and we've just had lots of
Speaker 1: medical things come up. But this time we're going to
Speaker 1: talk about early surgery, and I mean very early surgery.
Speaker 1: We're going to talk about Amboise Parrey, who has been
Speaker 1: called everything from the gentle surgeon to the father of
Speaker 1: modern surgery, and he really really did advance the field
Speaker 1: of medicine significantly during his fifty plus years in practice,
Speaker 1: and just for a level set, so you get a
Speaker 1: sense of how ahead of other things we've talked about
Speaker 1: he is. When we recently talked about Jean Baptiste Denis
Speaker 1: in our two parter about the development of blood transfusions,
Speaker 1: those events took place more than one hundred years after
Speaker 1: what we're talking about today. And when we talked about,
Speaker 1: for example, Scottish surgeon Robert Liston, who was famed for
Speaker 1: his speedy amputations, that was three hundred years after Paree.
Speaker 1: And so first though, to set the stage, we have
Speaker 1: to talk a little bit about barber surgeons and some
Speaker 1: of the other stuff that was going on in Europe
Speaker 1: regarding the trade leading up to the sixteenth century, which
Speaker 1: is when Parrey was doing his work, and then we
Speaker 1: will get into Amboise Parrey's story. Yeah, when you sent me,
Speaker 1: when I asked what you were working on this week
Speaker 1: and you told me, I googled it and saw the
Speaker 1: word surgeon and then saw the year and kind of
Speaker 1: went woe. We've talked about some very early surgical history before,
Speaker 1: but this was one that jumped out at me so yes,
Speaker 1: glad you picked it. Yay. So before we get into
Speaker 1: Pare's story, as Holly just said, we need to have
Speaker 1: a little overview of barber surgeons and where they were
Speaker 1: at when he was working in this field. We have
Speaker 1: mentioned barber surgeons before, I don't think we've really talked
Speaker 1: about the origins of barber surgeons and how exactly we
Speaker 1: got to a point that you would hire the same
Speaker 1: person to shave your face as you would to extract
Speaker 1: a tooth or amputate a limb, so wide range of
Speaker 1: job responsibilities. It seems like such a strange grouping today,
Speaker 1: but for a long time it was totally normal. Yeah,
Speaker 1: and we know that specialists in grooming go all the
Speaker 1: way back to ancient Egypt. But there's this question of like,
Speaker 1: when did the cosmetic occupation take on all of these
Speaker 1: other duties. So the answer to that lies in the
Speaker 1: Hippocratic oath. We won't read the whole thing. It is
Speaker 1: quite long. It includes a lot of language about holding
Speaker 1: your teacher in the same regard as your parents, and
Speaker 1: administering healthy diets and all kinds of other things. But
Speaker 1: the section of it that's germane to today's topic is
Speaker 1: this quote, I will not use the knife, not even
Speaker 1: on sufferers from stone, but will withdraw in favor of
Speaker 1: such men as are engaged in this work. So we
Speaker 1: should note two things here, because you also may have
Speaker 1: heard or read a different version of the Hippocratic Oath. First,
Speaker 1: the oath was originally written in Greek, so obviously there
Speaker 1: are translations. Second, there is a modern version that is
Speaker 1: quite different, and you may have heard that one. That one, though,
Speaker 1: was not written until nineteen sixty four, so long long
Speaker 1: after Envois papail time. It was written by Tuft's university
Speaker 1: academic dean of the School of Medicine, Louis Lasagne. That phrase, though,
Speaker 1: about not using the knife on patients, meant that if
Speaker 1: somebody did need surgery, there has to be a different
Speaker 1: profession who could handle it. Physicians could take care of
Speaker 1: their patients in every way that didn't require surgery, but
Speaker 1: then if things reached a point where a knife was involved,
Speaker 1: then the patient needed to be handed off to someone else,
Speaker 1: so a surgeon, or very often a barber surgeon. So
Speaker 1: from their beginnings which had the religious significance of being
Speaker 1: in charge of things like tonsuring clergy barbers, over time
Speaker 1: adopted additional duties as standard for the barber trade. Needs
Speaker 1: like bleeding or tooth extraction were handled by barbers for
Speaker 1: the simple reason that in eleven sixty three, monks, who
Speaker 1: up to that point had been providing services like bloodletting,
Speaker 1: were then forbidden to do so by a papal decree
Speaker 1: issued by Pope Alexander the Third. So at this point
Speaker 1: Pocrates has said that physicians can't do it, and the
Speaker 1: papal decrea said that none of the monks could do
Speaker 1: anything like this. So additionally, actual trained surgeons were pretty
Speaker 1: thin on the ground. So the role of the barber
Speaker 1: continued to expand to include more and more complex procedures,
Speaker 1: until barber surgeon had emerged as a career. Yeah. Basically, basically,
Speaker 1: somebody in Europe's got to do it, yeah, And that's
Speaker 1: where we landed. In London. The Worshipful Company of Barbers,
Speaker 1: which was founded in the early thirteen hundreds and still exists,
Speaker 1: was a guild for the barber profession, and it supported
Speaker 1: this expanding role. But there were also surgeons who were
Speaker 1: just surgeons. They had made their careers specializing in that field.
Speaker 1: So naturally this led to some tension barber surgeons felt
Speaker 1: that they were filling a really vital need for their clientele,
Speaker 1: and they were, But surgeons felt that barbers were beneath them,
Speaker 1: and they didn't have the same skill level because they
Speaker 1: hadn't learned Latin or gone to university, and that these
Speaker 1: combination shops that handled the tasks of multiple professions should
Speaker 1: really just be relegated to the country, where professionals in
Speaker 1: general were a lot more sparse. But most surgeons were
Speaker 1: employed by royal or high ranking households exclusively, so even
Speaker 1: in the city there was still a lot of need
Speaker 1: for somebody who could do all of this stuff. To
Speaker 1: compound matters, a lot of doctors thought that some of
Speaker 1: the tasks that a barber surgeon could perform, like bloodletting,
Speaker 1: was really beneath them. In a nineteen sixty two paper, RS.
Speaker 1: Roberts wrote quote, despite the pretensions of the physicians, it
Speaker 1: was impossible to keep medicine, surgery and pharmacy as separate activities,
Speaker 1: and a more general form of practice which combined all
Speaker 1: that was necessary did develop in London just as quickly
Speaker 1: as the provinces. There was so much strife in London
Speaker 1: over all of this that Henry the Eighth, surgeon Thomas
Speaker 1: Liinaker used his influence with the king to ask that
Speaker 1: some sort of supervisory guidelines be put in place for surgeons.
Speaker 1: Similar requests for medical regulation came from other scholars who
Speaker 1: had the king's ear, and for just about the entirety
Speaker 1: of Henry the Yighth's reign there was this sort of
Speaker 1: constant effort and struggle to get London on par with
Speaker 1: other cities in terms of medical licensing and education. In
Speaker 1: fifteen forty the Company of Barber Surgeons was formed and
Speaker 1: that combined the two professions, although surgeons and barber surgeons
Speaker 1: were still separate things, but under this larger group medical
Speaker 1: care was regulated. In France, the two had joined under
Speaker 1: one guild eighty years earlier, in thirteen eighty three, during
Speaker 1: the reign of Charles the sixth of France, the king's
Speaker 1: first barber and valet was made head of that guild.
Speaker 1: But then Paris had its own complexities and conflicts in
Speaker 1: the medical field. Barber surgeons were sometimes called doctors of
Speaker 1: the short robe, with doctors of the long rowe being
Speaker 1: used to refer to members of the Confraternity of Sant Kame.
Speaker 1: These were theoretically surgeons, although they often had sort of
Speaker 1: a snooty attitude it seems, about performing surgery themselves. These
Speaker 1: doctors of the long robe had a lot of friction
Speaker 1: with the university trained physicians and with the barber surgeons.
Speaker 1: This made Paris a very contentious place to practice medicine
Speaker 1: at all. It's so all of the posturing that goes
Speaker 1: on in the hierarchy of these medical fields is very
Speaker 1: fascinating to me. There was reform to this very problematic
Speaker 1: system just before Envoise Perier was born. The Faculty de
Speaker 1: Midcent decided on a course of action to try to
Speaker 1: alleviate the tension by making barber surgeon a legitimate licensed title.
Speaker 1: That meant the barber surgeons could attend classes at the
Speaker 1: university and they had to take two exams after completing
Speaker 1: their training in order to be licensed. As part of
Speaker 1: this reformation, the existing surgeons could move up in title
Speaker 1: to doctor's region at the faculty. So this ended up
Speaker 1: consolidating these three factions into two, and it elevated both
Speaker 1: barber surgeons and surgeons. And while this did not by
Speaker 1: any means eliminate all of these problems and posturing, it
Speaker 1: definitely did improve things, and m wois Pai was working
Speaker 1: in the medical field right in the middle of this
Speaker 1: unique and sometimes tense culture. We will talk about his
Speaker 1: life and career in just a moment, but first we
Speaker 1: will pause for a quick sponsor break. Amboise Parre was
Speaker 1: born in fifteen oh nine or fifteen ten in Burgerson
Speaker 1: in western France, and his path in medicine was actually
Speaker 1: set fairly early on. Both he and his brother were
Speaker 1: set on educational tracks to become surgeons by their father,
Speaker 1: who was not in the medical field but did well
Speaker 1: for himself as a master carpenter. One of the key
Speaker 1: pieces of education that a surgeon needed was Latin, and
Speaker 1: a working knowledge of Latin was considered vital for that career,
Speaker 1: but and was never quite mastered it. That was even
Speaker 1: though he had been sent to a boarding school that
Speaker 1: was run by a chaplain who could focus on that language. Yeah,
Speaker 1: and there was a lot of very dedicated educational effort
Speaker 1: to getting him to learn Latin, but that was just
Speaker 1: not happening. When he was in his early twenties, Parey
Speaker 1: traveled to Paris to pursue a position as an apprentice.
Speaker 1: Despite his Latin still lacking he did get an apprenticeship
Speaker 1: with a master barber surgeon, so that at that point
Speaker 1: was the only possible path because that Latin requirement was
Speaker 1: not quite as vital for a barber surgeon. He didn't
Speaker 1: really get a whole lot of time with the surgeon
Speaker 1: part of the job, though. He mostly tidied up in
Speaker 1: the shop by sweeping hair, and he was occasionally allowed
Speaker 1: to give beard trims. This was not, we should say,
Speaker 1: because his mentor was particularly cruel. The shop just had
Speaker 1: to be maintained during business hours, so most apprentices faced
Speaker 1: kind of similarly challenging schedules. There just wasn't really a
Speaker 1: way to attend medical lectures because of this, unless they
Speaker 1: were lectures that were given unusually early in the morning
Speaker 1: or late in the evening, so study of the surgery
Speaker 1: side of the job was usually done via late night reading,
Speaker 1: although there were some procedures like leeching that were taught
Speaker 1: their hands on in the shop. Paray accepted this sometimes
Speaker 1: ruling schedule, and he applied himself to get to his
Speaker 1: goal of being accredited as a barber surgeon. But the
Speaker 1: diploma from the master barber was really just the first step.
Speaker 1: The next phase of his education was pretty similar to
Speaker 1: the way a modern medical doctor goes through a residency
Speaker 1: training period. For Pahy, this meant a surgeon trainee position
Speaker 1: at Houtel du de Paills starting in fifteen thirty two
Speaker 1: as an assign. The Houteldieux may one day be its
Speaker 1: own episode. It is the oldest operating hostelspital in the world,
Speaker 1: it still operates, and it has its roots reaching back
Speaker 1: at least eleven hundred years. But for the purposes of
Speaker 1: Mboise Paris story, the key here is that the Hotel
Speaker 1: Dieux had started as a home for the poor of
Speaker 1: Paris that eventually added medical care for the residence to
Speaker 1: its mission, and it had actually become essentially a teaching
Speaker 1: hospital by Parrei's time. There was also sort of a
Speaker 1: weird setup for surgical training because the hospital was run
Speaker 1: by the Church, and the Church looked upon cutting a
Speaker 1: human body as anathema. This meant that any kind of
Speaker 1: actual surgery that mbois Pire was able to perform had
Speaker 1: to be on deceased patients. The hospital was packed, though
Speaker 1: it was often really overcrowded with patients having to share beds,
Speaker 1: so he had plenty to do over the course of
Speaker 1: four years, he provided care to thousands of residents, including
Speaker 1: through a cholera outbreak, and he studied surgery in books
Speaker 1: and by doing autopsies. But even though he had done
Speaker 1: all this hands on training and work to qualify for
Speaker 1: a surgical license, stories go that this lack of Latin
Speaker 1: continued to hold him back. He was not able to
Speaker 1: obtain a license. But really most accounts indicate that it
Speaker 1: wasn't so much the Latin issue. It was that he
Speaker 1: was too poor to take the required certification exam. Yeah,
Speaker 1: the Latin hold back is like a nice story, but
Speaker 1: it really seems more to have been a financial issue.
Speaker 1: Regardless though, of which of those factors was the one
Speaker 1: holding him back, he ended up on another path, and
Speaker 1: that was one that would enable him to practice medicine
Speaker 1: even if he did not have a license, and that
Speaker 1: was as a member of the French military, Parrey was
Speaker 1: able to get a position as the surgeon attending the
Speaker 1: General Martial de Monjan and the impact this role had
Speaker 1: on the way Parrey practiced medicine and consequently a lot
Speaker 1: of other people kind of reminds me a little bit
Speaker 1: of the episode we did about famed chef Augusta Scoffier,
Speaker 1: because if you heard that one and recall it Ascofier
Speaker 1: had learned to improvise really impressive meals for the true
Speaker 1: that he cooked for with minimal supplies during his time
Speaker 1: in the military, and on bois Perree, in kind of
Speaker 1: a similar move, improvised treatment of wounds when his medical
Speaker 1: supplies ran low. Pahia described a key moment in his
Speaker 1: military career during the fifteen thirty seven Siege of Turin,
Speaker 1: when he ran out of the oil that they normally
Speaker 1: boiled to cauterize amputation and gunshot wounds. So the treatment
Speaker 1: that he had always felt was often really damaging and
Speaker 1: risky to the soldiers. So it is very easy to
Speaker 1: the modern ear to immediately hear that whole boiling oil
Speaker 1: thing and think, WHOA, what were they thinking? They're so foolish.
Speaker 1: Keep in mind, though, this is really still pretty early
Speaker 1: in the use of gunpowder artillery in war. There are
Speaker 1: references to artillery on battlefields as early as the mid
Speaker 1: fourteenth century, but in the years between then and when
Speaker 1: Parey was deployed, the use of such weapons had grown
Speaker 1: pretty slowly, and the Italian Wars, which Parey found himself
Speaker 1: part of As France and Spain battled over control of
Speaker 1: Italian territories, were marked by a significant uptick in the
Speaker 1: amount and variety of firearms used, and there was still
Speaker 1: a commonly held belief that there was poison in gunpowder,
Speaker 1: so the oil was thought to somehow counter that. Parree
Speaker 1: listed the weapons of war in his writing as quote
Speaker 1: all sorts of minds, countermines, pots of fire, trains, fiery arrows, lances, crossbows, barrels,
Speaker 1: balls of fire, and all such fiery engines and inventions.
Speaker 1: They are certainly a most miserable and pernicious kind of
Speaker 1: invention by which we often see a thousand unsuspecting men
Speaker 1: blown up with a mine by the force of gunpowder.
Speaker 1: For these modern inventions are such as easily exceed all
Speaker 1: the best appointed and cruel engines, which can be mentioned
Speaker 1: or thought upon in the shape, cruelty, and appearance of
Speaker 1: their operations. Yeah, as many physicians, he had very strong
Speaker 1: opinions about firearms, but his improvisation in this moment and
Speaker 1: its results changed the way he looked at medicine forever,
Speaker 1: and he wrote about it. This is translated, obviously, at last,
Speaker 1: my oil ran short, and I was forced instead thereof
Speaker 1: to apply a digestive made of the yolks of eggs,
Speaker 1: oil of roses, and turpentine. In the night I could
Speaker 1: not sleep in quiet, fearing some default in not cauterizing
Speaker 1: that I should find the sounded to whom I had
Speaker 1: not used the set oil dead from the poison of
Speaker 1: their wounds, which made me rise very early to visit them.
Speaker 1: Where beyond my expectation, I found that those to whom
Speaker 1: I had applied my digestive medica mint had but little pain,
Speaker 1: and their wounds without inflammation or swelling, having rested fairly
Speaker 1: well that night. The others to whom the boiling oil
Speaker 1: was used I found feverish, with great pain and swelling
Speaker 1: about the edges of their wounds. Then I resolved never
Speaker 1: more to burn thus cruelly poor men with gunshot wounds. Clear,
Speaker 1: this was hugely risky. If these soldiers had died because
Speaker 1: of Pire's experimental treatment, not only would he have felt responsible,
Speaker 1: he also probably would have been kicked out of the military. Additionally,
Speaker 1: it would have also likely ended any hope he had
Speaker 1: of being a barber surgeon beyond the battlefield. So it's
Speaker 1: really no surprise that he couldn't sleep, and this discovery
Speaker 1: that an alternate approach to treating wounds, one that did
Speaker 1: not involve pouring boiling oil on already suffering patients, was successful,
Speaker 1: gave Parey a new degree of confidence. He started to
Speaker 1: extol the virtues of observing patients and treating based on
Speaker 1: assessment of the individual, rather than only going by what
Speaker 1: appeared in books as the prescribed method for a particular
Speaker 1: type of injury. He had also decided from that moment
Speaker 1: that he would only use treatments that he truly believed
Speaker 1: to be useful. So in a way, he was making
Speaker 1: a conscious decision to trust his instincts because he had
Speaker 1: always suspected that scalding oil was not the best idea,
Speaker 1: but now he had experiential proof that another approach created
Speaker 1: a far better outcome. Up to the time that he
Speaker 1: became a military medic, Plaret's knowledge about surgery was like
Speaker 1: most medical professionals of the time, based on the writings
Speaker 1: of Galen. Galen moved medical practice forward in a lot
Speaker 1: of ways. He clarified understanding of anatomy, particularly the circulatory
Speaker 1: system and the workings of respiration, and he also did
Speaker 1: a lot of surgeries. He cared for gladiators and accompanied
Speaker 1: Marcus Aurelius into battle to care for the troops, so
Speaker 1: he had plenty of injuries to treat and to learn from.
Speaker 1: But Galen lived in the first century, so a lot
Speaker 1: of his ideas were outdated by the time Parry was working,
Speaker 1: even though he was still a really key part of
Speaker 1: standard medical education. His writing, for example, was based on
Speaker 1: the idea of bodily humors that Hippocrates had developed. Most
Speaker 1: of the early sixteenth century medical profession still had an
Speaker 1: almost dogmatic devotion to following Galen's writings to the letter,
Speaker 1: even though Galen himself wrote about the importance of personal observation.
Speaker 1: Parray continued to elevate the care of wounded soldiers as
Speaker 1: a field medic insurgeon over the course of several military tours,
Speaker 1: and that dedication paid off, although he was encouraged to
Speaker 1: stay in the military because of his usefulness. In fifteen
Speaker 1: forty one he returned to Paris and he was able
Speaker 1: to take the necessary examinations that he needed, and he
Speaker 1: was given the title of Master barber surgeon. He also
Speaker 1: got married after he went home to Paris, and he
Speaker 1: basically set himself up with a house and a shop
Speaker 1: in what is modern day Place de Michele. Pire went
Speaker 1: back to the military in fifteen forty two when he
Speaker 1: was selected by the Grand Lord of Brittany to be
Speaker 1: his surgeon on campaigns. It was during this phase of
Speaker 1: military touring that Piree developed a new technique for dislodging
Speaker 1: bullets from wounds by having the wounded person placed their
Speaker 1: body in the position they had been in when they
Speaker 1: were shot, so that he could more easily track the
Speaker 1: book its trajectory. It seems like such a cool and
Speaker 1: interesting thing, rather than people digging around in wounds, going
Speaker 1: how exactly were you standing? I see it entered here,
Speaker 1: It probably went here. It seems so obvious and yet
Speaker 1: was not standard at all. And one of the reasons
Speaker 1: that we know about amboise Pari's experiences and his refinement
Speaker 1: of surgical techniques is because he wrote numerous books on
Speaker 1: those subjects. And we're going to talk about the beginning
Speaker 1: of his work as an author after we hear from
Speaker 1: some of the sponsors that keep stuff you missed in
Speaker 1: history class going. After he returned to Paris again and
Speaker 1: on the advice of one of the physicians at the
Speaker 1: Faculty de med Saint Amboise started writing about his work,
Speaker 1: and this is where not having learned Latin actually helped
Speaker 1: make him even more well known. He wrote in French
Speaker 1: that was unusual for medical texts, and as a consequence,
Speaker 1: it made them accessible to a far away, wider audience.
Speaker 1: Whereas the use of Latin in the medical field had
Speaker 1: always been a separator between the well educated and the masses,
Speaker 1: Pire's work disregarded that divide, and to some degree it
Speaker 1: democratized medical knowledge. Barber surgeons were no longer left out
Speaker 1: of the conversation. They were reading the exact same text
Speaker 1: as master surgeons. When it came to Paray's work. The
Speaker 1: use of French for his writing also meant that translations
Speaker 1: of his works went into circulation really quickly. Soon there
Speaker 1: were printings of Parre's writings in English, German and Dutch,
Speaker 1: and they spread quickly throughout all of Europe. And because
Speaker 1: of this, his ideas created a true watershed moment in
Speaker 1: medical history where practitioners started re examining some pretty long
Speaker 1: held truths. His first book was published in fifteen forty
Speaker 1: five and it was titled The Method of Treating Wounds
Speaker 1: made by arquebuses and other firearms, darts and such. Also
Speaker 1: combustion made especially by cannon powder. So just as quick aside,
Speaker 1: an arcbus was a long gun, sort of a precursor
Speaker 1: to the musket. And the preface to that book really
Speaker 1: evidences Parre's religious devotion. It is dedicated quote to young
Speaker 1: surgeons of goodwill, and after a few opening lines about
Speaker 1: how he was asked to share his knowledge of treating wounds,
Speaker 1: it reads quote, not presuming in my present capacity being
Speaker 1: able to teach you, for which more instruction would be necessary,
Speaker 1: but to satisfy your desire in part, and also stimulate
Speaker 1: some higher spirit by writing in this way, so we
Speaker 1: can all give it greater attention. Now I ask you
Speaker 1: humbly to take this little book kindly, which, if I
Speaker 1: know you are agreeable, will cause me to do something
Speaker 1: more such as my small mind can undertake. For such,
Speaker 1: I pray the creator, brothers and friends to happily support
Speaker 1: our work by his grace, always increasing our good affections,
Speaker 1: so that something fruitful and useful can come of it,
Speaker 1: to the support of the infirmity of human life, and
Speaker 1: to the honor of the one in whom are hidden
Speaker 1: all the treasures of science. Who is the eternal God.
Speaker 1: This religious reference is also reflected in a phrase that's
Speaker 1: often associated with pay, which is je la pinsaille du
Speaker 1: de gerrie, which is I bandaged him, God cured him
Speaker 1: parey with a lot of course study in his early years,
Speaker 1: You'll remember he did a lot of book learning combined
Speaker 1: with his situational experience on the battlefield. Wrote about the
Speaker 1: various changes to treatments that he had developed while in
Speaker 1: military service, and this of course included his opinion that
Speaker 1: hot oil led to pain that could be avoided in
Speaker 1: amputation situations, and that the oil could actually damage the
Speaker 1: tissue and slow healing. He continually worked to be objective
Speaker 1: about reconsidering old methods of doing things as compared to
Speaker 1: his new ideas. He never presumed that his way was better,
Speaker 1: and he always offered reasoned explanations in situations where he
Speaker 1: felt that surgeons should perhaps update their practice to include
Speaker 1: new techniques. In all of his writings, they're really pervasive
Speaker 1: aspect of it is that he speaks of compassion and
Speaker 1: kindness and remembering that saving lives is worth the effort.
Speaker 1: This isn't necessarily common in medical texts at this time,
Speaker 1: so it was very unusual, and all of this led
Speaker 1: to his nickname in history as the Gentle Surgeon. In
Speaker 1: fifteen fifty he published his second book, which was Brief
Speaker 1: Collection for the Conduct of Anatomy, and once that was out,
Speaker 1: he started editing and updating his first book for release
Speaker 1: as a second edition. Right after that second edition project,
Speaker 1: he was once again attending to soldiers on the battlefield
Speaker 1: with the medics under Vicon de Rohan and Parey is
Speaker 1: said to have gone to great efforts to save a
Speaker 1: soldier who everyone believed was going to die. They had
Speaker 1: actually already dug a grave for him, and that his
Speaker 1: dedication to saving even the lowest ranking of the troops
Speaker 1: gained him great admiration and loyalty among the men. During
Speaker 1: this deployment, pay started to use ligatures to tie off
Speaker 1: vessels during amputations, abandoning the use of hot iron cauterization.
Speaker 1: When the city of Metz was overwhelmed by the forces
Speaker 1: of Emperor Charles the fifth and Bois Parree was snuck
Speaker 1: past the occupation forces so that he could treat trapped
Speaker 1: soldiers there. Because of this and his extraordinary service throughout
Speaker 1: his military assignments. King Henry the Second of France appointed
Speaker 1: him to be one of the king's surgeons. This honor
Speaker 1: came with some strings, though, because after the battles in Ruren,
Speaker 1: Parray had returned home to his practice in Paris in
Speaker 1: fifteen fifty three, only to have the King order him
Speaker 1: almost immediately to another battlefield in Dain, where the situation
Speaker 1: was quite dire and paree were day and night to
Speaker 1: try to treat the overwhelming number of wounded. Things grew
Speaker 1: even more precarious when Parray was taken prisoner along with
Speaker 1: the rest of the French garrison. He disguised himself at
Speaker 1: this point as a low ranking soldier so that his
Speaker 1: identity would not be revealed. At this point, remember, his
Speaker 1: stuff had started to be translated and spread throughout Europe,
Speaker 1: so people knew who he was, and he knew that
Speaker 1: like that could potentially endanger him or cause his captors
Speaker 1: to ask for a very high ransom. But he did
Speaker 1: continue to treat people medically during this time, and he
Speaker 1: actually managed to secure his freedom by treating an enemy
Speaker 1: officer I believe it was for an ulcer on his leg,
Speaker 1: and he returned to King Henry the Second and gave
Speaker 1: his report before once again at least attempting to return
Speaker 1: to his civilian life. In fifteen fifty four, his career
Speaker 1: took another step forward. He was granted the title of
Speaker 1: Master Surgeon, in part because the surgeons of the city
Speaker 1: knew it would make them look good. He became the
Speaker 1: surgeon attending King Francis the Second. Yeah, this is actually
Speaker 1: pretty pivotal, where somebody who came up as a barber
Speaker 1: surgeon suddenly all of the snowdier levels of the medical
Speaker 1: establishment were like, no, no, no, you're one of us.
Speaker 1: You're famous and stuff. He was sent on two more
Speaker 1: military campaigns, at San Quentin and Durlain, and when Charles
Speaker 1: the ninth became King of France, Parrey was once again
Speaker 1: in that monarch service. As the French Wars of Religion began,
Speaker 1: they dominated Parrey's professional life just as other conflicts had,
Speaker 1: because he was ordered to treat soldiers at the request
Speaker 1: of the crown. Although he was sent away from Paris
Speaker 1: less and less often, likely because at this point he
Speaker 1: was getting a bit older. Pirai continued to write, and
Speaker 1: in fifteen sixty four he released a highly illustrated project
Speaker 1: titled Ten Books of surgery with the magazine of the
Speaker 1: instruments necessary for it. He also developed a specialized clamp
Speaker 1: called a beche de crobat, which is a crow's beak
Speaker 1: and that would help hold a vessel closed to keep
Speaker 1: patients from bleeding out. This was used in cases where
Speaker 1: a wound had severed the vessel and the surgeon could
Speaker 1: quickly stem the bleeding with the clamp to improve survival rates.
Speaker 1: He also invented a number of other clamps with similarly
Speaker 1: charming names. The beche de grue in English as the
Speaker 1: crane's beak and another called a duck's beak that's a
Speaker 1: bech decan. We're both developed for bullet extraction. These were
Speaker 1: long and thin, so they could reach deep into the
Speaker 1: tissue to get to a bullet without having to widen
Speaker 1: the entry wound too much. That was an ongoing problem. Again,
Speaker 1: Parray's focus on preserving the tissue and treating the patient
Speaker 1: as gently as possible is driving his innovation. Gentle handling
Speaker 1: of patients and their tissue was just a really important
Speaker 1: part of Pare's writing and work. It was accepted and
Speaker 1: also expected that patients would have incredible pain during surgery.
Speaker 1: If you recall our episode on Scottish surgeon Robert Liston,
Speaker 1: which was in the eighteen hundreds. You may remember that
Speaker 1: he became famous for his speed at surgical procedures and
Speaker 1: was deemed to be a showboater because of it, but
Speaker 1: his real goal with that was to keep the patient's
Speaker 1: pain as brief as possible. Similarly, and was Parrey several
Speaker 1: centuries before that was also trying to be as brief
Speaker 1: as possible with the scalpel and to be as gentle
Speaker 1: as he possibly could in the hopes of minimizing suffering.
Speaker 1: Long before it was customary, and vois Parrey was encouraging
Speaker 1: the medical profession to embrace the idea of pain management
Speaker 1: for patients as well as more comprehensive follow up care
Speaker 1: on the part of the surgeon. So he, like a
Speaker 1: lot of people, dispensed opium for postop recovery. Although this
Speaker 1: wasn't just like a blanket thing to knock people out.
Speaker 1: He was trying to really like carefully determine how much
Speaker 1: they needed to help them with their pain. And at
Speaker 1: a time when surgeons typically kind of performed a procedure
Speaker 1: and then left any after care to physicians and nurses,
Speaker 1: he believed in remaining part of the recovery team for
Speaker 1: the patient after that surgery was completed. When Charles the
Speaker 1: Ninth died in fifteen seventy four, Pare remained the king's surgeon.
Speaker 1: Under the new regent that was Charles's brother, Henry the Third,
Speaker 1: he was also elevated to the position of Valle de Chambre.
Speaker 1: Pare served Henry the Third until the king's assassination in
Speaker 1: fifteen eighty nine. In fifteen seventy five, Parrei published his
Speaker 1: complete Works of Envoise Parier Councilor and Premier Surgeon of
Speaker 1: the King. This volume gathered together all of his writings
Speaker 1: on surgery and medicine into one and it was edited
Speaker 1: and revised as needed, and it was so popular that
Speaker 1: it had multiple edition runs over the course of the
Speaker 1: following century. In sixteen thirty four it was translated into
Speaker 1: English for publication in London. In fifteen eighty five, his
Speaker 1: last book, Apology and Treatise, was released, and this became
Speaker 1: his most famous work. It was part medical discussion, part autobiography.
Speaker 1: It covered his medical career during the fifty years from
Speaker 1: fifteen thirty five until its publication. At its heart it
Speaker 1: was a drama because it was a response to criticism
Speaker 1: from his contemporary, Etienne Gourmalin, who was dean of the
Speaker 1: Faculty to Medicine. Gourmalin's own writing on surgery had never
Speaker 1: been as popular as Parees, and it definitely led to
Speaker 1: some tension. In fifteen eighty one, Gourmalin wrote a book
Speaker 1: about surgical techniques in which he criticized pai is amputation ligatures. Yeah,
Speaker 1: I think it probably ground his gears a little bit,
Speaker 1: that he was a more of a trained and educated
Speaker 1: surgeon and yet no one was listening to him when
Speaker 1: a barber surgeon had gotten famous written books and everyone
Speaker 1: wanted to read them. Apology and Treatise takes on these
Speaker 1: criticisms of Gourmalin's and outlines the many ways in which
Speaker 1: Parey shifted thinking in the medical community throughout his career. Basically,
Speaker 1: he's establishing his street cred and then he kind of
Speaker 1: addresses the actual criticism, and the whole thing is also
Speaker 1: written with the usual careful analysis and logic that he
Speaker 1: became famous for, including detailed case histories that supported his work.
Speaker 1: And this whole thing was a huge humiliation for Gourmelin.
Speaker 1: Just like Gormala shouldn't have been a jerk. Then he
Speaker 1: allegedly wrote a response to it that was written anonymously,
Speaker 1: and it's kind of this like weak, well, you don't
Speaker 1: know of paper that he I can't remember if it
Speaker 1: was written anonymously or if he had one of his
Speaker 1: students publish it under their name. But Gormalin did not
Speaker 1: really get over it, but he was shamed. That sadly
Speaker 1: brings us to the end of m Bois Parey's life.
Speaker 1: He died at home and bed on December twentieth, fifteen ninety,
Speaker 1: at the age of eighty. Yeah. I literally had this
Speaker 1: moment where I was doing the math on the length
Speaker 1: of his career and I was like, wait, he couldn't
Speaker 1: have been practicing myself fifty years. Yes, yeah, fifty years
Speaker 1: at a time when I wonder how many people even
Speaker 1: had any career for fifty years, particularly one that changed
Speaker 1: the way that people practiced medicine. And he undoubtedly, I mean,
Speaker 1: he saved a lot of lives directly himself, but there's
Speaker 1: no real way to measure how many lives were made
Speaker 1: better or saved because other doctors were like, I think
Speaker 1: he's onto something blas Parrey. Thank you for suggesting being gentle.
Speaker 1: Thanks so much for joining us on this Saturday. Since
Speaker 1: this episode is out of the archive, if you heard
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