Ambroise Paré (1510-1590) and His Contribution to the Treatment of Scoliosis (original) (raw)
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Erciyes Medical Journal, 2022
A Historical Perspective of the Management of Scoliosis Efforts to treat spinal deformity have a long and fascinating history. The ancient Greek physicians Hippocrates and Galen are credited with early descriptions of the condition, management, and the term scoliosis, though even earlier references are seen in Hindu epics. The first known treatment techniques used axial traction and pressure. Subsequent cast correction required fixation of the pelvis and flattening of lumbar lordosis. Bracing superseded traction as the primary means to treat spinal deformities in the 1900s. The first spinal fusion surgery was performed in the 20 th century. Scoliosis treatment was greatly improved with the recognition of the 3-dimensional nature of scoliosis and its symptoms. Advances in nonsurgical treatment alternatives included the Milwaukee brace and the subsequent development of underarm plastic braces, such as the Boston brace, the Wilmington brace, and the Chêneau brace. Today, treatment options include bracing, and scoliosis-specific exercises selected according to the curve type and severity, in addition to surgery.
Ambroise Paré (1510–1590): on the diagnosis and treatment of shoulder dislocations
International Orthopaedics, 2017
Aim of study This article aims to summarize the treatment methods for shoulder dislocations supported by Ambroise Paré, and his clinical and academic contribution to this subject. Introduction Ambroise Paré (1510-1590) was one of the most prominent surgeons of his time, and one of the most significant innovators of the Renaissance in the fields of military operation, bandages, wound healing, bloodletting, close blood vessels techniques and cesarean section. For many, he is considered Bthe Father of Modern Surgery^. Methods In our search we went through the literature in Pubmed and Google Scholar as well as the works of Hippocrates and Galen and several other ancient and medieval authors. Results His work on shoulder injuries and dislocations is outstanding. In this work, he uses the classifications of Hippocrates (460-377 BC) and Galen (130-201 BC). He also uses the reduction techniques, ointments, bandages, cooling creams and treatment options described by the ancient medical authors. Discussion Paré is heavily based on the work of previous authors on shoulder dislocations. He uses the work of Hippocrates and Galen as well as the additions made in the Cannon of Medicne of Avicenna. Conclusion Ambroise Paré in his excellent work on shoulder dislocations uses the classifications of Hippocrates and Galen and the reduction techniques, cooling ointments, bandages and post-reduction management options as previously described by Hippocrates himself.
Ambroise Paré (1510 to 1590): A Surgeon Centuries Ahead of His Time
The American Surgeon, 2014
In their extensive writings, Hippocrates and Celsus counseled physicians to be knowledgeable in both the medical and surgical management of patient recovery.1 However, their words fell by the wayside because cutting of the body was forbidden by the Roman Catholic Church. Furthermore, the contemporaneous Arabic medical teachings emphasized tradition and authority over observation and personal experience. This created an ever-growing rift between the schools of surgical and pharmacologic medicine with both groups denying their involvement in the other domain. Surgeons had been plagued by postoperative complications including infection, malnutrition, and muscular wasting for centuries. Surgeons were forced to re-examine how diet and exercise affected outcomes before the advent of microbiology and advances in pharmacology. All of this changed when Ambroise Paré, a 16th century surgeon, revolutionized the medical world with his astute observations of postoperative diet and exercise.
Ambroise Paré (1510-1590) and His Innovative Work on the Treatment of War Injuries
Surgical Innovation, 2017
The purpose of this study is to summarize the innovations of Ambroise Paré (1510-1590) on the treatment of war wounds and improving amputation technique through ligature in arteries and veins. Ambroise Paré debunked the widely accepted idea that gun powder was poisonous for wounds. He also minimized the use of cautery of wounds by his dressing methods and the application of ligature during amputations. All these innovative rationales revolutionized the practice of war surgery during the Renaissance and paved the way for the introduction of modern surgery. Nevertheless, although his wound dressing innovations became widely accepted, the same did not happen with ligature and amputation; those techniques could become widely applicable if one could somehow control bleeding until the blood vessels had been tied. This became possible much later in the 18th century when Jean Louis Petit invented the first useful and efficient tourniquet.
A contemporary approach to surgical treatment of scolioses
Scoliosis belongs to the most frequent deformations of human axial skeleton. In about 20% of cases, the pathology constituting the original cause of scoliosis is recognized. As regards the remaining cases, the diagnosis of scoliosis idiopathica is made by way of elimination. For many years, surgery has been the standard procedure in the treatment of large scolioses, where preservative treatment proves ineffective. The aim of the work is to present contemporary opinions and controversies concerning the indications for surgical treatment of scoliosis, the choice of surgical access, modern possibilities and evolution of surgical methods employed for correction and stabilization of scoliosis. Therapeutic decisions taken after scoliosis has been diagnosed are based on clinical and radiological assessment of a number of factors having a documented influence on the risk of progression of the curvature. General indications for surgical treatment of scoliosis include progressing scoliosis of Cobb's angle over 40-45° in skeletally immature children, considerable deformations of Cobb's angle over 50° in adolescents, irrespectively of their skeletal age, scoliosis-related pain complaints unresponsive to preservative treatment, thoracic lordosis coexisting with progressive scoliosis, and cosmetic deformations. In scolioses of known etiology, the decision of surgical treatment is influenced not only by the factors of progression risk, common to idiopathic scolioses and related to growth potential and extent of the deformation, but also by additional factors, specific to the original pathology underlying the scoliosis, e.g. the type, number, and location of congenital defects in the spinal area in congenital (osteopathic) scoliosis, the dynamics and type of neurological disorders in neuropathic scoliosis. The origin of the modern spinal surgery was a combination of the concept of spinal fusion and inner stabilization and correction of the scoliosis with spinal implants. In consideration of the patient's age, morphology of the scoliosis, as well as the operator's experience and preferences, a choice is made between spondylodesis and anterior or posterior stabilization, or a combination of the two. Among the contemporary surgical methods, two different approaches can be distinguished with respect to the patient's age: correction and stabilization of scoliosis with an application of implants and spinal fusion, and stabilization and correction of scoliosis, utilizing the remaining growth potential for curbing the progression and directing further spinal growth until final spondylodesis is applied. In spite of enormous progress in spinal surgery that has been made over the last hundred years, the main objective of surgical treatment of scoliosis has remained the same: an optimal and permanent correction of the deformation with the least possible complications. The evolution of surgical techniques of correction and stabilization of scoliosis from Harrington instruments to segmental instrumentation with pedicle screws is an indication of the progress from single-plane to multi-plane correction of scoliotic deformations.
HISTÓRIA History AMBROISE PARÉ - THE "FATHER OF SURGERY
2006
1 CSc, DDS, Department of History of Medicine Semmelweis University of Budapest Hungary. e-mail: forjud@net.sote.hu He was born in French, at Bourg-Hersent, near Laval, in 1517. Paré had a long life till 1590. In his family the profession of barber-surgeon profession was very popular: his brother and his bother-in-law were barber-surgeon. In his very early life started to learn this craft and for a long time he cured patients. He became the best French surgeon, the “father of Surgery, the Court Surgeon to Four Kings of France”, in the sixteenth century. Paré became barber-surgeon at the HôtelDieu, Paris, surgeon in the army of Francis I (153638), re-enlisted on the reopening of hostilities (1542-44) and in 1545 began the study of anatomy at Paris, under François-Jacques Dubois (Sylvius). He was appointed field-surgeon and (1552) became surgeon to King Henry II, in 1554 member of the Collège de St-Cosme, exempt from taxation, and in 1563 f irst surgeon and chamberlain to King Charles...
Ambroise Paré: «The father of modern surgery» Ambroaz Pare: «Otac moderne hirurgije
The thorough study of historical researches that reflect the radical appearance, the gradual formation, but also the multidimensional contribution of medical achievements, as if of their talented inspir-ers deterministically lead to the unhindered expression of irrefutable truths. Multifarious personality, tireless scholar, versed in the diachronic humanistic ideals French Ambroaz Paré was able to confront seemingly insurmountable obstacles: his bad social status, the large financial diiculties, and additionally the unbearable everyday life on the battlefields of the endless conflicts which neither limited his fiery spirit nor put out his unparalleled desire for substantial solidarity and selfless love for all human beings. On the contrary, these parameters forged a magnanimous physiognomy that is reasonably admired for its scientific foundation, the unique inventiveness and the rich authorial activity. Furthermore, the modest doctor barber impressed the mankind by his rare moral mosaic and the unpretentious faith in God. Based on the mentioned facts Pare obtained the universal acceptance of the medical community that awarded him with the superb title of " father of modern surgery ". However all generations constantly pore over his enlightened thoughts and receive valuable material related to surgery, obstetrics, forensic science and pharmacology.
ANATOMY AND SURGERY FROM ANTIQUITY TO THE RENAISSANCE
The study of anatomy reached the 14th century bridled with all the same assumptions and techniques indicated by the classical world and continued to follow the traces linked to the philosophical knowledge of the human body, rather than speculative requirements. The dissections carried out on dead bodies therefore only served to support what had already been written by the classical authors. Mondino’s Anatomy does just this, though it appears to be ready to accept first-hand knowledge. Its nonlinear path did not depend so much on the aversion of the Church, which so hindered and restricted its path, as on as the relationship between society and the corpse. The quest for observation and experimentation that began to stir the minds of many doctors, students and artists in as early as the 14th century, clashed with the general reluctance and horror of handling a body. An ancestral, anthropological problem of life and death that curbed this form of practice and forced ‘researchers’ (whether doctors or artists) to hide away and carry out secret dissections in the crypts of churches or in private houses. The dead bodies to be dissected were chosen mainly from among people who had been executed, and the limited numbers of the yearly dissections, the fact that they were carried out mainly during Carnival or Lent, because of their innate moral and religious significance, are elements that confirm that anatomy was considered a reprehensible act that could only be done under certain ethical and moral conditions or with certain personalities and facilities. The Vesalian revolution revolved around these strongly rooted assumptions. Accordingly, the anatomist was not only ‘bound’ to verify, by directly empirical observation, the cognitive tools that, until then, were in his possession, but also to promote practical teaching exercises. This not only introduced a specialisation in this subject, but also a better handling and familiarity with the body and was to lead to the scientific advances of the following century.
A Review of the History of Spine Surgery in Greece until the Middle of the 20th Century
Spine Surgery began its evolution in the beginning of the 19th century in order to reach nowadays the point of being considered an important subspecialty of Neurosurgery and Orthopaedics. The purpose of this historical review is the search and evaluation of the progress in spine surgery until the middle of the 20th century. This review concerns the inauguration and evolution of this field in Greece. Special references are made to the first achievements of this field, to the pioneers physicians and surgeons (general surgeons, orthopaedic surgeons and neurosurgeons) who inaugurated this subspecialty and to clinical and scientific work of that era. Eventually, the progress of medicine and technology who led to the first achievements of this subspecialty are shown and also the difficulties (both social and scientific) that the pioneers of this field faced are demonstrated. In Greece, with small exceptions, the new techniques emerged with a certain delay.
Historical overview of spinal deformities in ancient Greece
2009
Little is known about the history of spinal deformities in ancient Greece. The present study summarizes what we know today for diagnosis and management of spinal deformities in ancient Greece, mainly from the medical treatises of Hippocrates and Galen. Hippocrates, through accurate observation and logical reasoning was led to accurate conclusions firstly for the structure of the spine and secondly for its diseases. He introduced the terms kyphosis and scoliosis and wrote in depth about diagnosis and treatment of kyphosis and less about scoliosis. The innovation of the board, the application of axial traction and even the principle of trans-abdominal correction for correction of spinal deformities have their origin in Hippocrates. Galen, who lived nearly five centuries later impressively described scoliosis, lordosis and kyphosis, provided aetiologic implications and used the same principles with Hippocrates for their management, while his studies influenced medical practice on spinal deformities for more than 1500 years.