238 ANNUAL REPORT SMITHSONIAN INSTITUTION, 1918. 



As the healing art slowly developed, a few better educated men 

 came to occupy the higher medico-military positions, but in general 

 there was no organized medical service in armies till about the six- 

 teenth century, and even then conditions were most primitive. Most 

 of the common soldiers with serious wounds were left to die where 

 they fell. If ill or permanently disabled, they were dismissed with 

 a little money to enable them to reach their home. As illustrative 

 of the practices of the times, it is related that Ambroise Pare, the 

 foremost military surgeon of the period about 1550, saw three des- 

 perately wounded soldiers placed with their backs against a wall. 

 An old campaigner inquired, " Can those men get well ? " to which 

 Pare replied " No." Thereupon the old soldier went over to them 

 and cut all their throats, as the chronicle puts it, "sw 7 eetly and with- 

 out malice." When Pare upbraided him the old campaigner said 

 he prayed God if he w 7 ere in sickness and pain that some one would 

 do the same for him, that he might not linger in his misery. 



The ancient treatment of military wounds was most primitive. 

 For many ages injuries inflicted by swords, lances, arrows, and mace 

 chiefly claimed attention. Arrow wounds w T ere often regarded as 

 poisoned, so treatment by boiling oil w 7 as considered by many as most 

 appropriate, and may have had some favorable influence by combat- 

 ing infection. Oil and wine were a favorite remedy for wounds. 

 Arrowheads lodged in the body were drawn out with various crude 

 instruments. Often they were pushed through and removed by in- 

 cision from the opposite side. In other instances, where less acces- 

 sible, they were treated by drawing plasters. Rabbits 1 hair, mill 

 dust, and moss from skulls found in graveyards were used as styp- 

 tics. Two of the greatest teachers warned surgeons not to under- 

 take an operation, if the life of the patient was in jeopardy, until 

 he had received the last sacrament — a very cheering preoperative 

 procedure. As most of the ancient surgery was practiced by men 

 without education, the literature on the subject is very scanty and 

 unreliable. Clumsy instruments for extraction of arrows were used 

 for centuries without improvement, and ignorance and superstition 

 clogged the wheels of progress. 



The introduction of gunpowder, beginning in the middle of the 

 thirteenth century, gradually effected a complete revolution in mil- 

 itary strategy and opened up new fields for the military surgeon. 

 The replacing of longbows and crossbows by firearms progressed 

 very slowly, and improvement in the efficiency of these weapons was 

 equally backward. In the unsatisfactory state of surgery in the 

 medieval period, the introduction of firearms brought new dangers 

 and increased the sufferings of the wounded. Fractures of the long 

 bones, previously rare in warfare, became common, together with 

 extensive lacerations of the soft parts. Probes and fenestrated 



