Blood and Guts by Richard Hollingham Read Free Book Online Page A

the major organs, nerves and muscles in the
human body. The woodcuts show corpses posed in various unlikely
situations, as if they are still alive. A picture revealing human
muscles has the figure posed on a hillside in front of a town. There
is a corpse dangling from a pulley and a skeleton resting against a
tomb as if contemplating the meaning of life (or death).
    The book was widely distributed and read by medical practitioners
across Europe. In it Vesalius corrected more than two hundred
of Galen's mistakes. These ranged from the structure of bones to
the shape of the liver. In the second edition of his book, Vesalius
also ruled out a connection (through Galen's micro-holes) between
the two sides of the heart. However, even though he had worked out
the structure of the heart, he still believed arteries originated in the
heart and agreed with Galen that veins started in the liver. It was
another eighty years before William Harvey concluded that the
blood circulated around the body (see Chapter 2).
    After 1300 years of stagnation, anatomy was finally on a firm
scientific footing. Physicians and surgeons at last knew how the
human body fitted together. Vesalius had broken the first barrier to
the development of modern surgery. However, there were still three
more barriers to go.
BLOOD ON THE BATTLEFIELD
    A field near Turin, Italy, 1537
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    This is what happens when a musket shot hits a human body.
    The bullet punctures the skin. As it does so, it drags fragments
of clothing and gunpowder with it. The shot rips through the flesh,
burning the tissue and splaying slivers of skin outwards. It gouges its
way through the muscle, tearing apart the muscle fibres and severing
tendons, veins and arteries.
    As an artery wall is ruptured, blood starts to spray from the
wound – pulsing at high pressure into the cavity the bullet has
drilled. The bullet slows as it reaches the bone. The bone splinters,
scattering sharp fragments. The two ends of the broken bone smash
outwards through the skin. By now, the bullet has lost momentum
and becomes lodged in the wound, mixing with the congealing
bloody broth of muscle, bone, cloth and skin.
    Injuries from musket bullets were far worse than anything that
had been seen with daggers, swords or arrows. When a blade or
arrow enters the body it inflicts a 'clean' wound and, with any luck,
comes straight out again. But with the invention of the musket, and
the larger guns that went with it, the battlefield was transformed.
The few battlefield surgeons available had to cope with overwhelming
casualties on a daily basis. When the guns opened fire and the
men fell, the smoke mingled with a flume of fine red mist – blood
spraying upwards from the injured and dying men.
    Ambroise Paré had never seen such horror. The twenty-seven-year-old had been appointed as a battlefield surgeon to the French
infantry commander at the siege of Turin. The army had been
sent into northern Italy by the king, François I, in a long-running
dispute over territory with the Holy Roman emperor, Charles V.
By the time Paré arrived, the carnage was already horrific. To
get close to the battlefield he had to ride across the bodies of
dead and fatally wounded soldiers. Picking his way between them
as best he could, he was forced to ignore their dying moans
and pleas for help.
    As Vesalius had noted, in sixteenth-century European medicine
even experienced surgeons held little standing in society. The
people who practised surgery were usually barbers. They had
received no formal medical training and spent most of their time
trimming beards or lopping off the odd wart. They might sometimes
be employed to assist doctors with bloodletting. As for Paré, he was
neither qualified nor registered as a surgeon. He had been working
as a barber-surgeon at the largest hospital in Paris, he had no
academic qualifications and no experience of anything other than
the most basic surgical procedures. Everything he learnt about the
profession