VIII. MEDICINE IN THE SIXTEENTH AND SEVENTEENTH CENTURIES

Of the half-dozen surgeons who were prominent in the sixteenth century, Ambroise Pare (1517-1590), called the father of French surgery, is perhaps the most widely known. He rose from the position of a common barber to that of surgeon to three French monarchs, Henry II., Francis II., and Charles IX. Some of his mottoes are still first principles of the medical man. Among others are: "He who becomes a surgeon for the sake of money, and not for the sake of knowledge, will accomplish nothing"; and "A tried remedy is better than a newly invented." On his statue is his modest estimate of his work in caring for the wounded, "Je le pansay, Dieu le guarit"—I dressed him, God cured him.

It was in this dressing of wounds on the battlefield that he accidentally discovered how useless and harmful was the terribly painful treatment of applying boiling oil to gunshot wounds as advocated by John of Vigo. It happened that after a certain battle, where there was an unusually large number of casualties, Pare found, to his horror, that no more boiling oil was available for the surgeons, and that he should be obliged to dress the wounded by other simpler methods. To his amazement the results proved entirely satisfactory, and from that day he discarded the hot-oil treatment.

As Pare did not understand Latin he wrote his treatises in French, thus inaugurating a custom in France that was begun by Paracelsus in Germany half a century before. He reintroduced the use of the ligature in controlling hemorrhage, introduced the "figure of eight" suture in the operation for hare-lip, improved many of the medico-legal doctrines, and advanced the practice of surgery generally. He is credited with having successfully performed the operation for strangulated hernia, but he probably borrowed it from Peter Franco (1505-1570), who published an account of this operation in 1556. As this operation is considered by some the most important operation in surgery, its discoverer is entitled to more than passing notice, although he was despised and ignored by the surgeons of his time.

Franco was an illiterate travelling lithotomist—a class of itinerant physicians who were very generally frowned down by the regular practitioners of medicine. But Franco possessed such skill as an operator, and appears to have been so earnest in the pursuit of what he considered a legitimate calling, that he finally overcame the popular prejudice and became one of the salaried surgeons of the republic of Bern. He was the first surgeon to perform the suprapubic lithotomy operation—the removal of stone through the abdomen instead of through the perineum. His works, while written in an illiterate style, give the clearest descriptions of any of the early modern writers.

As the fame of Franco rests upon his operation for prolonging human life, so the fame of his Italian contemporary, Gaspar Tagliacozzi (1545-1599), rests upon his operation for increasing human comfort and happiness by restoring amputated noses. At the time in which he lived amputation of the nose was very common, partly from disease, but also because a certain pope had fixed the amputation of that member as the penalty for larceny. Tagliacozzi probably borrowed his operation from the East; but he was the first Western surgeon to perform it and describe it. So great was the fame of his operations that patients flocked to him from all over Europe, and each "went away with as many noses as he liked." Naturally, the man who directed his efforts to restoring structures that bad been removed by order of the Church was regarded in the light of a heretic by many theologians; and though he succeeded in cheating the stake or dungeon, and died a natural death, his body was finally cast out of the church in which it had been buried.

In the sixteenth century Germany produced a surgeon, Fabricius Hildanes (1560-1639), whose work compares favorably with that of Pare, and whose name would undoubtedly have been much better known had not the circumstances of the time in which he lived tended to obscure his merits. The blind followers of Paracelsus could see nothing outside the pale of their master's teachings, and the disastrous Thirty Years' War tended to obscure and retard all scientific advances in Germany. Unlike many of his fellow-surgeons, Hildanes was well versed in Latin and Greek; and, contrary to the teachings of Paracelsus, he laid particular stress upon the necessity of the surgeon having a thorough knowledge of anatomy. He had a helpmate in his wife, who was also something of a surgeon, and she is credited with having first made use of the magnet in removing particles of metal from the eye. Hildanes tells of a certain man who had been injured by a small piece of steel in the cornea, which resisted all his efforts to remove it. After observing Hildanes' fruitless efforts for a time, it suddenly occurred to his wife to attempt to make the extraction with a piece of loadstone. While the physician held open the two lids, his wife attempted to withdraw the steel with the magnet held close to the cornea, and after several efforts she was successful—which Hildanes enumerates as one of the advantages of being a married man.

Hildanes was particularly happy in his inventions of surgical instruments, many of which were designed for locating and removing the various missiles recently introduced in warfare.