The Development of Surgical Investigation

Abstract

The discipline of surgery has been fortunate in having had a number of investigators who have made significant basic scientific contributions with practical clinical application. The great medical historian, Garrison, considered Ambroise Paré, John Hunter, and Joseph Lister, to be the three greatest surgeons of all time (Fig. 3.1). Paré reintroduced and popularized the ancient use of the ligature to control hemorrhage and placed it on a firm basis. He also introduced the concept of the controlled experiment, when treating two soldiers with similar wounds lying side by side in a tent near the battlefield. The first soldier’s wound was managed by the standard method of cauterization with boiling oil. The second was managed by debridement, cleansing, and the application of a clean dressing. Paré wrote that he spent a restless night, worrying that the second patient would do very poorly since his treatment defied the standard therapy of that time. The following morning, however, he found the second patient to be essentially without systemic symptoms, whereas the other had high fever, tachycardia, and disorientation. When he was congratulated on the outcome of this new approach, Paré very humbly replied: “Je le pansay, Dieu le guarit” (I treated him, God cured him”), a quotation subsequently inscribed on his statue.