Renaissance Surgeons and the Challenges of Gunshot Wounds

1. Image courtesy of the U.S. National Library of Medicine Looking at: Renaissance Surgery andPare’s Work In a little more detail. From The Fabric of the Human Body Renaissance Anatomy and Surgery Timeline

2. Please ‘click’ on one of the following buttons Battlefield Wounds Pain, Infection and Bleeding Examples of Pare’s ‘other’ work Evidence Exercise, Recap and Revision

3. During The Renaissance muskets were being used more and more during battles. Gunshot wounds therefore became an increasing problem for surgeons.Can you think of any problems associated with gunshot wounds that surgeons during The Renaissance would have to deal with? Gunshot wounds 1 1. 2 2. 3. 3

4. During The Renaissance muskets were being used more and more during battles. Gunshot wounds therefore became an increasing problem for surgeons.Can you think of any problems associated with gunshot wounds that surgeons during The Renaissance would have to deal with? Gunshot wounds 1 The scale of damage caused by musket balls entering and exiting the body (Shattered bone, ripped muscle and tissue, etc) 1. 2 2. 3. 3

5. During The Renaissance muskets were being used more and more during battles. Gunshot wounds therefore became an increasing problem for surgeons.Can you think of any problems associated with gunshot wounds that surgeons during The Renaissance would have to deal with? Gunshot wounds 1 The scale of damage caused by musket balls entering and exiting the body (Shattered bone, ripped muscle and tissue, etc) 1. 2 2. 3. 3 Musket balls carrying infection deep inside the body. Musket balls dragged dirt, material and lead with them as they entered the body

6. During The Renaissance muskets were being used more and more during battles. Gunshot wounds therefore became an increasing problem for surgeons.Can you think of any problems associated with gunshot wounds that surgeons during The Renaissance would have to deal with? Gunshot wounds 1 The scale of damage caused by musket balls entering and exiting the body (Shattered bone, ripped muscle and tissue, etc) 1. 2 2. 3. 3 Musket balls carrying infection deep inside the body. Musket balls dragged dirt, material and lead with them as they entered the body New methods of surgery had to be learnt to deal with the new types of wounds being encountered

7. Pare used the accepted treatment for gunshot wounds used by surgeons at the time – cauterisation - until he stumbled across a new method for treating these injuries. Cauterisation involved burning the wound, either with a red hot cautery iron, or by pouring boiling hot oil (sometimes mixed with treacle) into the wound. Pare knew that this method of treating wounds caused the patient great pain, but did as the other surgeons did, applying the oil as hot as possible to burn away any possible infection that had set in. Then, one day he ran out of oil and was forced to use an alternative. Click here to find out what that alternative was Cauterisation Using hot oil

8. Turpentine Egg Yolk Rose Oil Turpentine Pare had published his idea for treating gunshot wounds in 1545. The account of how he made his discovery was not published however until 1585 in The Apology. I wonder what Pare may have been apologising for? Pare describes how he ran out of oil and was ‘forced to use an ointment made from yolks of eggs, oil of roses, and turpentine’. Pare feared that this mixture may cause the soldiers he was treating more pain as infection set into the wound. He also feared that he would return to his patients the next day to find many of them dead. The patients however told Pare the next morning that the swelling around their wounds had gone down and that they felt little pain. Those who had been treated before the oil ran out were much worse off. They were in pain and many were ‘feverish with….swelling about the edges of their wounds.’

9. Click on each image for more information In order for surgery to be successful the surgeon has to combat the problems of Pain, Infection and Bleeding. Pare knew this and through his work tried to tackle and combat the problems associated with each.

10. ___ With a lack of anaesthetics before and during The Renaissance, doctors and surgeons knew that their patients could suffer a great deal from the pain that they felt when injured or wounded. They were also aware of the dangers involved in operating upon patients. Without adequate anaesthetics (patients were often given wine or were knocked out) there was the risk that the patient would feel a great deal of pain and would be conscious for much of the during the operation. Patients were also as likely to die of shock on the operating table as from the infection that set in the wound after the operation was over. Anaesthetics – Something, usually a drug, that causes a loss of sensation (such as feeling or pain).

11. ________ With a lack of antiseptics before and during The Renaissance, doctors and surgeons knew that their patients could suffer a great deal from the infection that set into a wound before an operation. They were also aware of the dangers involved in operating upon patients. Without adequate antiseptics there was a risk that the surgeon would put germs into the wound himself, sealing the infection deep within the patient. Because there was no knowledge of germs, medical instruments were not always cleaned thoroughly and surgeons themselves often failed to ensure that their hands were clean of dirt and bacteria. It would be some time – long after The Renaissance - before doctors wore masks and gowns and sterilised their equipment. Antiseptics – Substances that help to prevent infection.

12. _______ If patients lost a lot of blood, either during an operation or from a particularly bad wound, they were in great danger of not only losing their strength, but of their body not being able to function properly. In short, they were in all probability going to die. Surgeons during this time could not, as we do today, transfuse blood or put it back. Some doctors had experimented with blood transfusions, trying to replace a human’s lost blood (usually with an animal’s), but patients rarely lived for long afterwards. Doctors and surgeons did not know, as we do today, about such important factors that influence blood transfusions, such as how to store blood and knowledge of blood groups.Pare, like most surgeons, realised that veins and arteries had to be tied up speedily so that bleeding could be stopped. Pare therefore used a Crow’s Beak (an instrument that looks like a set of pliers) to pull out the arteries and silk thread to sew them up.

13. What are these objects and how do you think they work? Images courtesy of the U.S. National Library of Medicine This image courtesy of the Clendening History of Medicine Library, University of Kansas Medical Centre

14. Prosthetic limbs like these were made (or designed) by Pare in the sixteenth century. Pare would have worked with armourers to make and develop these replacement limbs. Hands like the one above were operated by a series of catches and springs. Such a hand was designed for a French Army Captain who went on to use it in battle.Pare also invented leg prosthesis.

15. Image courtesy of the U.S. National Library of Medicine You could use the Whiteboard Pen and Highlighter here Questions

16. Image courtesy of the U.S. National Library of Medicine • Questions: • Note down the objects that have been placed within this picture. Next Question Questions

17. Image courtesy of the U.S. National Library of Medicine • Questions: • Note down the objects that have been placed within this picture. Next Question 2) Explain the significance of each of these objects in relation to the work of Ambroise Pare. Saw Gun Books Trephined Skull Drill Jars on the shelf

18. Background Studies D.O.B. D.O.D The Apology Publications Pare Main Ideas - Importance Click here to print out a version of this screen