Ambroise Paré, the famous 16th century French barber surgeon, was not content to stop at removing a soldier’s shattered arm or leg.
He teamed up with “Little Lorrain,” a well-known Parisian locksmith, to provide functional prostheses for his patients.
Paré’s title may sound strange today. But in his day, “barber surgeons,” not physicians, commonly performed operations. When they were not using their razors to shave customers, they wielded their blades to remove arms and legs. Thus, barber surgeons often went to war with armies and trimmed beards and limbs from soldiers who needed their special services.
More realistic prosthesis
Paré died in 1590 at age 80 years, having served as royal surgeon to Henry II, Francis II, Charles IX and Henry III. He “earned his position by practicing medicine on the battlefield, attempting to save, or at least treat, wounded soldiers,” wrote Philippe Hernigou, MD, PhD, chief of Orthopaedic Surgery at the Henri Mondor Hospital, University of Paris-East, in a 2013 article in International Orthopaedics.
Paré was stunned to find some soldiers committed suicide rather than endure horrible wounds or live without arms or legs. So the surgeon turned to inventing moveable mechanical limbs.
Paré wanted his prostheses to be like real arms and legs.
“He was an accomplished anatomist, and so when he designed limbs, he attempted to make them work the way biological limbs worked,” Hernigou wrote.
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Paré devised artificial legs with mechanical knees that could be locked when the amputee stood, and flexed when the amputee walked. He sketched an arm with a pulley that replicated the action of muscles.
But the surgeon’s most celebrated invention was a mechanical hand “operated by multiple catches and springs, which simulated the joints of a biological hand,” Hernigou wrote. He honored his partner by naming the device Le Petit Lorrain.
The mechanical hand was part of a metal arm a French soldier wore into battle in 1551. Paré claimed the contraption “worked so well that he was able to grip and release the reins of his horse,” according to Hernigou.
The soldier evidently was François de la Noue, a Huguenot (Protestant) fighter who lost his left arm at the 1570 siege of Fontenay during the French Wars of Religion between Catholics and Protestants.
“Having at first refused amputation — his arm was shattered by the shot of an arquebuse [early musket] — preferring to die, rather than be incapacitated for fighting, he was at length persuaded by friends to submit himself to the surgeon’s hands,” according to Vol. 1 of the International Encyclopaedia of Surgery, A Systematic Treatise of on the Theory and Practice of Surgery [sic], published in 1881.
As stated in the book, “The Queen of Navarre herself held his arm during the operation. An iron arm supplied the place of the missing member, and gave its bearer the sobriquet of ‘Bras de Fer [Iron Arm];’ the artificial limb served to hold his horse’s bridle, and enabled the gallant captain to engage in fresh battles with renewed ardor.”
Accounts of the Little Lorrain describe a device that featured moving internal parts that functioned like bones, muscles and tendons. A button opened the hand; springs closed it and kept it shut.
Innovative design
Many people consider Paré “the father of modern amputation surgery and prosthetic design,” as stated in a 2007 article for the Amputee Coalition.
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According to the article, Paré “introduced modern amputation procedures to the medical community.” The surgeon “also invented an above-knee device that was a kneeling peg leg and foot prosthesis that had a fixed position, adjustable harness, knee lock control and other engineering features that are used in today’s devices.”
Paré’s “work showed the first true understanding of how a prosthesis should function,” according to the article.
Paré and Lorrain teamed up to craft artificial arms of “iron, boiled leather or glued paper” and artificial legs of wood,” according to the 1881 encyclopedia account. Their lower limbs for “poor men” were “in all essential particulars the same as the ‘box-leg,’ which we still often see at the present day.”
But Lorrain also was credited with making the first attempt to replace the wooden leg. His prosthesis, for above-the-knee amputees, “consisted of a tin shell for the thigh stump and a tin boot, furnished with an ankle articulation, and joined to the thigh piece by a knee articulation,” according to a 1902 scientific publication. “An iron rod extended from the thigh covering in the inside down to the boot, and imparted firmness to the whole structure.”
The wearer could flex the knee via a strap fastened to the hip.
“This apparatus was rather heavy and cumbersome and attended with the objection that the end of the thigh stump had to carry the weight of the body, and the stump cicatrix had to endure a constant pressure,” according to the encyclopedia account.
- Reference:
- Ashhurst J, et al. The International Encyclopaedia of Surgery; A Systematic Treatise on the Theory and Practice of Surgery. Vol I. 1881. Available at https://archive.org/details/internationalenc01ashh. Accessed Feb. 23, 2016.
- Hernigou P. Intl Orthop. 2013;doi:10.1007/s00264-013-1884-7.
- Norton KM. A brief history of prosthetics. InMotion. 2007. Available at www.amputee-coalition.org/inmotion/nov_dec_07/history_prosthetics.html. Accessed Feb. 23, 2016.
- Scientific American: Supplement. Vol. 53. 1902. Available at https://books.google.com/books/about/Scientific_American.html?id=yWw3AQAAMAAJ. Accessed Feb. 23, 2016.
