surgeons and barbers, and were critical in establishing membership rules
and standards. The craft of barber-surgery would have resembled the
“surgery” of Greek and Roman times, limited to basic trauma stabilization
of broken bones, sword and knife wounds, and the new injuries associated
with gunpowder’s arrival from China.
The battlefields of 14th and 15th century Europe would bear witness to
the new power of gunpowder, and the “blast injuries” seen from guns and
cannons represented much greater trauma than had ever been seen.
Ambroise Paré (1510–1590), himself the son of a barber-surgeon, never
attended formal medical school but would rise to become surgeon to four
French monarchs. Paré, the first great French surgeon, revolutionized the
treatment of war injuries, becoming influential through his writing—in
French and not Latin. Physicians in the early Renaissance found
themselves helpless to treat patients whose gunshot wounds were
dramatically worse than any injuries humankind had ever faced.
Therefore, care was left to barber/surgeons, and in the pre-Newtonian age,
it was difficult to understand that it was the energy imparted by the
gunpowder-propelled shrapnel, and not some “poison” within the
fragments, that imparted such significant injury. Giovanni da Vigo (1450–
1525), surgeon to Pope Julius II, theorized in his publications in 1514 and
1517 that gunshot wounds were “poisoned by the effects of gunpowder,”
and should be cauterized with hot oil to counteract the poison, mimicking
the ancient treatment of gladiatorial battle wounds. As one can imagine,
the searing effects of hot oil might staunch bleeding, falsely leading the
traumatologist to conclude that care has been rendered, when in actuality
the “zone of injury” has perversely been enlarged and further trauma has
been introduced. Unfortunately, Vigo’s writings had influence, leading
battlefield surgeons to obediently pour hot oil on blast injuries.
In his famous 1575 book, Oeuvres, Paré elegantly described his crisis
during the Siege of Turin of 1536. Late one night following a horrific
battle, Paré’s ration of oil had been extinguished. He recorded:
At last I ran out of oil and was constrained to apply a digestive
made of egg yolk, oil of roses and turpentine. That night I
could not sleep easily thinking that by the default in cautery I
would find the wounded to whom I had failed to apply the said
oil dead of poisoning; and this made me get up at first light to