The Evil Eye, Thanatology, and Other Essays

by Roswell Park

While it has been from time immemorial the custom to attach surgeons to various armies, some idea of prevailing notions of antiquity may be gained from the statement that Xenophon had but eight field surgeons with his 10,000 troops. In his army the sick and wounded were cared for in adjoining villages, or, when on the march, were carried in the rear of the troops, being cared for by women from "the baggage." Whether these women were the "vivandieres" of those days I do not quite make out, nevertheless they must have been much the same thing.

In the days of Rome's greatest glory each cohort of 420 men had four surgeons, while each legion of ten cohorts had one legionary physician. In the navy there was also one physician to each trireme; nevertheless the wounded on land or sea received scant attention, although it is interesting to read that each soldier carried with him the most necessary bandages ready for use, an emergency packet supposed to be quite modern.

A few hundred years later, in the Eastern Empire, the Emperor Maurice ordered that throughout every division of from two hundred to four hundred cavalry eight or ten of the strongest men be selected, in order to bring to the rear those who were severely wounded, to supply them with water, and to collect the weapons lying upon the field. These mounted cavalrymen received a small reward for each person rescued. Three hundred years later this arrangement was continued in operation by Leo VI. Wherever it was possible the sick and wounded soldiers were cared for by monks or by sisters, in the numerous hospices and institutions which abounded throughout the East, and although the care was often of the worst the efforts made were in the right direction. Holy oil, laying on of hands, supplication, and the use of holy relics constituted a large part of the treatment in vogue; nevertheless these remedies were not quite so injurious as some of the other and more disgusting ones whose use prevailed in those days.

Without doubt the two army surgeons who during the last 500 years achieved more fame than any of their colleagues were Ambroise Paré, and Baron Larrey. Such commanding figures were they, not only in their professional work, but in the general influence which they wielded alike upon sovereign and common soldier, that they will ever be regarded as among the most memorable characters of common history. Paré died in 1590, Larrey in 1842. Each was passed along from one ruler or commander to his successor, and each was regarded as about the most priceless legacy which could be thus transmitted.

Paré's name has always been most conspicuously mentioned in connection with the history of the introduction of the ligature as a substitute for the cautery iron or boiling oil, previously in use for the checking of hemorrhage, and for his teaching concerning the nature of gun-shot wounds, which had been previously and universally considered as necessarily poisoned wounds; but his new practice and his new views in these respects were but a small part of the general services which he rendered. It is not worth while to try to even epitomize here to-day the history of the ligature; though while its introduction has been widely credited to Paré, you must not forget that it was in use many centuries before his time, and was frequently mentioned by the early writers. What Paré really did was, first, to abolish a barbarous and unscientific method of dealing with hemorrhage, and then to re-introduce or promote the employment of the ligature as a far preferable substitute, more humane, more clean, and more desirable. And so rather than do scant justice by incomplete reference to Paré's actual contributions to knowledge I prefer rather to speak of the other side of this great man's character, and to remind you of some of the many ways by which he secured such marvellous influence over those around him, and made his remarkable personality of the greatest use. As he passed through one campaign after another his reputation became more and more firmly established, and inspired surgeons the world over with the desire to visit him. In almost his every act his sagacity was conspicuously displayed, while, whenever they were called for, his personal courage and absolute lack of fear were equally apparent.

Deprived of the benefits of early and liberal training he probably, on that very account, developed his power of thought, his memory and his analytical powers all the more keenly, inasmuch as these were made to take the place of what he might have learned from books.

The following anecdote will serve to illustrate, for instance, the general esteem in which he was held. In October, 1552, the army of Charles V. was besieging the city of Metz, and Charles himself came to take command. In the beleaguered city were gathered the nobility and the bluest blood of France, while at the head of the defending forces was the Duke of Guise. The imprisoned soldiers and civilians suffered alike from the onslaughts of the enemy, the rigors of a frightful winter, the lack of food, and the presence of disease. The Duke had established two hospitals for the soldiers, which he put in charge of the barber surgeons of the city, and furnished them with money with which to procure supplies, but owing to the wretched incompetence of these same barber surgeons nearly all the wounded perished, and the horrible suspicion arose that the soldiers were being poisoned. The Duke sent word to the King of France that the place could hold out for ten months, but that they needed more medicines. The King then sent for Paré, gave him money, ordered him to take all the medicines and other supplies he deemed necessary, and further aided him by bribing an Italian captain to permit the celebrated surgeon, in some way, to enter the besieged city. Braving all dangers, and being finally successful, Paré entered Metz two months later. He had at this time been with the armies for at least sixteen years, and was known by sight to officers and soldiers alike. On the day after his arrival the Duke of Guise dramatically presented him, on the ramparts, to all his officers, who embraced him, and hailed him with loud acclaim, while by the soldiers he was received with shouts of triumph. "We shall not die," they exclaimed, "even though wounded, for Paré is among us." The effect of this great surgeon's appearance was to give new vigor to the defenders, and to it was due the fact that the city was saved.

In his time Paré met with success such as to-day would be pronounced most extraordinary. He inspired the wounded with utmost confidence, and displayed, always and everywhere, remarkable firmness. Not the least notable feature in his personal history is it that he should have so long retained favor at court with such outspoken independence of character.

Equally reputable among army surgeons of the past, and one of the most commanding figures in history, medical or other, was Baron Larrey. For more than fifty years he was an army surgeon, and for a great part of that period he stood really closer to Napoleon than almost any of the men whom the latter attached to his person by one or another of those traits that made him such a remarkable figure. That one of the greatest murderers and one of the greatest life-savers of all time should have been so closely drawn to each other, constitutes one of the most noteworthy incidents of history. Alike in many respects, so unlike in so many others, it is one of the most creditable features of Napoleon's career that he should have accorded to Larrey that recognition which he early gave and never withdrew. Never was such tribute more signally deserved nor worthily bestowed. Though he passed through twenty-six campaigns, "from Syria to Portugal, and from Moscow to Madrid," and though his wonderful courage never failed him under the most trying surroundings of carnage and conflict, it may still be questioned whether it did not take a higher degree or order of courage to face Napoleon in his tent, or tell him plain truths in the Tuilleries.