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

(if it could even be described as such a thing) came from
hands-on experience. He was familiar with basic anatomy and the
theories of more advanced surgical techniques, such as amputation,
but had not had the opportunity to put his knowledge into practice.
He was going to have to learn fast.
    Although the technology of war had advanced considerably over
the last few centuries, battlefield surgery had changed very little.
Surgeons had few options at their disposal. Any substantial wounds
or compound fractures of a leg or arm usually meant the limb had to
be removed. If a bullet entered a soldier's abdomen, surgeons might
attempt to remove it with their fingers, or try to drain the wound of
blood (and later pus as infection developed), but could do little else.
For any seriously wounded soldier, the odds of survival were poor.
However, surgery might give them a chance of life.
    Every day Paré would saw off limbs. To stop the bleeding he
used a hot cauterizing iron. As the leg or arm was removed, he
placed the iron against the flesh – searing the muscle, blood vessels
and skin together. Bullet wounds received the same treatment.
With larger wounds, boiling oil was applied instead. Poured into
the hole left by the bullet, the oil would burn everything it touched,
destroying tissue but defeating blood flow. There was a belief at the
time that gunpowder was poisonous, so cauterizing with an iron or
pouring in hot oil had the secondary effect of destroying any
poison. Or so the theory went. When bullets had failed to kill the
soldiers, the shock of having boiling oil poured into their wounds
often finished the job.
    Cauterizing was not only brutal, it was also ineffective. By the
time the surgeons had amputated a limb, a tremendous amount of
blood had already been lost. Many soldiers bled to death before the
arteries could be sealed shut. Even if they didn't die immediately,
they would often lose so much blood that their chances of recovery
became even slimmer. *
    * Paré also had to deal with increasing numbers of casualties suffering severe burns. Lines of gunpowder would be laid by the enemy to create explosive walls of flame, cannons could misfire, and there were regular accidents with powder flasks and kegs. The salves available for burnt skin caused horrible blistering, and wounds often became infected as a result. Paré developed new treatments for burns and revised traditional ones. In one instance he used the juice of onions mixed with salt, which he applied to the wound with a cloth. He reported it as being a remarkable treatment.
    Paré started desperately looking for better and more humanitarian
ways of treating battle wounds. His priority was to work out a
more effective method of stemming the flow of blood. What little
spare time he had was devoted to studying anatomy texts. When the
guns went silent, he spent the evenings drawing diagrams and
making reams of notes. His aim was to seal the arteries themselves –
rather than the entire wound – block them off to prevent the worst
of the blood loss.
    His solutions were simple. His first invention he called a 'crow's
beak'. The beak consisted of a set of curved forceps that could be
clamped across the artery to block the flow of blood. Although
other, smaller blood vessels would still be open, this device stopped
the worst of the bleeding and bought him time during operations.
    Next Paré devised a way of tying off blood vessels during
amputations. This was not a completely new idea, but there is no
evidence that it had been tried in practice before. Once the artery
was clamped off using the crow's beak, he would tie off the vessel
downstream of the forceps using silk thread. This 'ligature' would
permanently block the artery. Starved of blood, the portion below
the ligature would eventually die and drop off.
    Paré published his first book, Treatise on Gunshot Wounds , in
1545. In it he detailed his experiences in combat and the lessons he
had learnt. His practice of