Ambroise PARÉ1510–1590

Oration in 1877 was a memorable occasion. He spoke with amazing eloquence to an audience that included HRH the Prince of Wales, Gladstone, Dean Stanley, Lord Acton, Huxley and Tyndall.

He paid tribute to John Hunter, who through no external advantage but through the force of his scientific mind, exercised a vast influence on surgery and made of it a profession commanding public respect. Paget was Bradshaw Orator in 1882, and for a time was Vice Chancellor of London University. In 1867 he became Sergeant Surgeon to Her Majesty the Queen. He reached the climax of his career in 1881, when he was president of the International Congress of Medi- cine held in London in that year. Those taking part in the discussions included Pasteur, Virchow, Charcot, Esmarch, Koch, Langenbeck, Volck- mann and Ollier. The inaugural address of Paget was impressive.

His sound knowledge of morbid anatomy and his stress on the scientific basis of surgery made him a link between John Hunter and modern sur- geons. His tact, courtesy, integrity and great elo- quence made an appeal to the social world, where he counted as his friends leading figures of church and state in Victorian England. He was the recip- ient of honorary degrees from many universities, and was an honorary member of several scientific societies at home and abroad. He retired from practice in 1893 and went to live at number 5 Park Square West, Regent’s Park. Here he died on December 30, 1899. He held settled religious convictions all his life; in the last hours of con- sciousness he received Holy Communion from his son the Bishop of Oxford. The first part of the funeral service was in Westminster Abbey, where he had borne the pall for Tennyson and Brown- ing. He was buried in Finchley Cemetery.

Sir James Paget was one of the greatest of English surgeons. By precept and example he exercised an immense influence among surgeons of the Victorian era and he handed on the torch of scientific surgery, which was lit by John Hunter.

References

1. British Journal of Surgery (1914) 2:4

2. Paget, Sir James (1853) Lectures on Surgical Pathology. Two vols. London, Longman

3. Paget, Sir James (1867) Cases that bone-setters cure. British Medical Journal i:1

4. Paget, Sir James (1870) On the production of some of the loose bodies in joints. St. Bartholomew’s Hospital Reports 6:1

5. Paget, Sir James (1870) A case of necrosis of the femur, without external inflammation. Transactions of the Clinical Society of London 3:183

6. Paget, Sir James (1874) On disease of the mammary areola preceding cancer of the mammary gland. St.

Bartholomew’s Hospital Reports 10:87

7. Paget, Sir James (1877) On a form of chronic inflammation of bones (osteitis deformans). Medico Chirurgical Transactions 60:37

8. Paget, Sir James (1901) Memoirs and Letters. Paget S (ed). London, Longman

261

Who’s Who in Orthopedics

Ambroise PARÉ

1510–1590

Ambroise Paré was the greatest surgeon of his century. He was born in Laval in northern France, where, it is thought, his father was valet de chambre and barber to a nobleman. At the time, barbers customarily performed such surgical pro- cedures as blood letting. Paré’s older brother was a barber–surgeon, and his sister had married a barber–surgeon. Poorly educated and knowing neither Latin nor Greek, but nonetheless ambi- tious, Ambroise Paré became a barber–surgeon through apprenticeship; he then served for 3 or 4 years as a “house surgeon” in L’Hôtel Dieu in Paris. His subsequent medical career was spent alternately on the battlefield with the French army during the interminable wars of the period and in practice in Paris during the frequent lulls in fighting.

Because of his intelligence, skills, and person-

ality, Paré rose to become the surgeon to four

Who’s Who in Orthopedics

kings of France. His reputation and political position led to his admission to the College de St. Côme, the elite group of academic surgeons in France. In this manner he formed a bridge between the barber–surgeons, surgeons of the short robe, and the academic surgeons of the long robe. His accomplishments helped to launch the progression of surgery from a hereditary craft to an intellectual yet pragmatic discipline.

Because Paré was an accomplished and prolific writer, a great deal is known about his life, opin- ions, and practice. His books, written in French rather than the Latin of the academicians, enjoyed a wide circulation. His personal and autobio- graphic account, The Apologie and Treatise of Ambroise Paré, Containing the Voyages Made into Divers Places, gives a good description of the circumstances in which he practiced. His impor- tance in the history of surgery has been delineated by Geoffrey Keynes.

Paré’s contribution to surgery is usually sum- marized by mentioning his three important “dis- coveries”—the harmfulness of treating gunshot wounds with boiling oil, the use of the ligature in amputation, and podalic version in obstetrics—

but in reality his contribution was far greater than this. He was, in fact, by virtue of his personality and his independent mind, the emancipator of surgery from the dead hand of dogma. There was no comparable practitioner, during his time, in England or in any other country, and his influence was felt in every part of Europe. He left in his col- lected “Works” a monument to his own skill and humanity, which is unsurpassed in the history of surgery.

Of particular interest is Paré’s description, the first, of intracapsular fractures of the femoral neck and epiphyseal separations of the proximal femoral epiphysis.

Reference

1. Paré A (1951) The Apologie and Treatise of Ambroise Paré (edited with an introduction by Keynes G). London, Falcon Educational Books, pp zx–xxi

262

Clayton PARKHILL

1860–1902

Clayton Parkhill was born in rural Pennsylvania.

He attended the Jefferson Medical College in

Philadelphia and graduated in 1883. After 2 years

of postgraduate training, he opened his surgical

practice in Denver. He taught anatomy at the

University of Denver and became professor of

surgery at the Gross Medical School. Later, he

became professor of surgery and dean of the

medical school at the University of Colorado in

Boulder. An ingenious surgeon, he is remembered

for his early contribution to the development of

external skeletal fixation for the treatment of frac-

tures. His medical career was interrupted by mil-

itary service in the Spanish–American War, which

took him to army camps throughout the south and

to Puerto Rico. Shortly after returning to reopen

his practice in Denver, he became ill. Appendici-

tis was diagnosed, and an operation was pro-

posed. At this critical moment his surgical

judgment failed. He refused the operation and

died shortly afterward of peritonitis.