RELATIONS OF MEDICINE AND SURGERY 203 



lifted far above some of his great Italian contemporaries, such as 

 Maggi, Carpi, or Botallo, yet taken all around the founder of mod- 

 ern surgery surely surpasses all the physicians of his time as an 

 independent, original, and inventive genius, and as a gentle, mas- 

 terly, and true man. Yet I am often surprised to see, even to-day, 

 the invention of ligature of arteries attributed to Pare", whose sur- 

 prise, if our journals have an astral shape, must be greater still, 

 seeing that he himself refers the ligature to Galen. The attribu- 

 tion is of course a legend. Malgaigne discreetly claims no more for 

 Pare than the application of the ligature from wound-surgery to 

 amputations; but in my opinion even this claim goes beyond the 

 truth of history. Celsus speaks of the ligature as an ordinary 

 method in wounds; from Oribasius we learn that Archigenes of 

 Apamea even tied vessels in amputation, after fixing a tight band 

 at the root of the limb. It seems probable that, unless performed 

 with modern nicety, secondary hemorrhage must have been fre- 

 quent; indeed in 1773, Petit deliberately discarded the ligature, 

 as Franco and Fabricius had done before him. Military surgeons 

 considered even Pare's "ligature en masse" too delicate a method 

 for the battle-field. It is a more intelligent service to this great 

 man to point out that the ligature and other operative details were 

 no singular devices, but orderly steps in a large reform of method 

 in amputation, a reform made imperative by the ravages of fire- 

 arms, ravages which could not be covered up with Galenisms. 



It is the privilege of the historian to make light of time and space; 

 and it is not easy to leave Pare and his times without some reflec- 

 tion upon the great German surgeons, Brunschwig, Gersdorff. and 

 Wiirtz, who, like him, were concerned with the effects of firearms. 

 In Italy in the sixteenth century surgery was somewhat on the 

 wane, but in Germany Wiirtz, in the freshness and originality of 

 his mind and in his freedom from scholastic convention, reminds 

 us of Pare. 



Paracelsus (born 1491) was a surgeon and no inconsiderable 

 one. Had this extraordinary man been endowed with a little pa- 

 tience he would have been a leader in wound-surgery, though, like 

 Wiirtz, he was not an operator. He pointed out not only the abuse 

 of the suture by the surgeons of the day, but also that suppura- 

 tion is bad healing, for, if left to herself, nature heals wounds by 

 a natural balm, a phrase which Pare adopted. In his Grosse Wun- 

 darznei he says he began at the surgical because it is the most cer- 

 tain part of medicine, and time after time he rebukes those who 

 withdraw medicine from surgery. Brunschwig was indeed the first 

 surgeon to write upon the surgery of gunshot wounds with any 

 fullness or precision. He held, however, as Vigo after him, that a 

 gunshot wound was a poisoned wound; and, to eliminate the poison 



