. : Mr the Baron, why did you embrace the surgical career?

: I was able at Paris in 1789 to enter to the college of the Functioning street of the Holy-Genevieve mountain. The Revolution made close the gates of the college four years after, in 1793 whereas I had almost finished my humanities. I was sixteen years old and it was necessary me to choose a profession. I had chosen soldiering and had decided to engage me in a regiment of volunteers. I however needed the assent of my parents and I was turned over from there to foot to Limoges where they were installed. My parents me to embrace a liberal profession to continue the family tradition. My father was avocado and my large father had been surgeon with Pierre-Buffières, a small village located at four miles of Limoges. My father decided that I would be surgeon.

 

. : Which were your first Masters?

: I started to study the anatomy with at the hospital of Charity and the chemicals with and Bubble-Lagrange. At eighteen years I passed a contest to be a at the School of Health. I followed the teaching of in then I passed in the service of which especially charged me with the autopsies. It is which recommended to me near the famous instructor of physiology, , of which I was the collaborator, I think, most effective. Some reports which we published together attest some.

 

. : Under which material conditions were you at your beginnings?

: Very difficult conditions. I occupied a small room poorly furnished in a fifth stage. My family did not have great resources and I have to manage all alone. It sometimes happened to me to eat only one day out of two and to work with the bed for lack of carbon to heat me. But God who I was proud. One day in my mansard I have the inspection of Saint-Simon who sought among the young doctors of the followers to his doctrines. Struck by the embarrassment in the middle of which I was, it has pretends to forget while leaving a roller 200 francs on the extinct stove. I realized some and I promptly joined it in the street to return his alms to him. It was very amazed by it!

 

. : Let us take again the exchange rate of your career…

: The place of chief of anatomical work was released in 1801 and my candidature was adopted unanimously. I could kind give it all the measurement of my value in the curricular area and continue a whole series of research tasks. I could organize the practical teaching of the anatomy and give him an unequalled glare. It was initially necessary to organize a regular recruitment of corpse. The shortage of subject had arrived from there at such a point, that one could have feared that anatomical teaching is not tiny room to essays on skeletons. Then it was necessary to make reign the discipline in the amphitheaters of dissection. All these efforts enabled me to clear the ignored field of anatomo-pathology. I could join together a collection of almost 1000 pathological parts and to open at the School practices a famous exchange rate of pathologic anatomy.

 

. : You followed the example of regretted and supplemented its work: “Discussed pathologic anatomy”?

: Admittedly, was interested in this vast domain but at his place imagination too often took the place of the observation. I think that there is poetry in all that left the feather of . Me, I am implemented to thorough studies and firmly supported. I determine the proportion of the injured parts, the precise nature of the lesions, their character, their relationship with the appearance of the individual, the frequency and the nature of the lesions observed according to the various seasons of the year, the age and the sex. At 30 years I was famous.

 

. : Why you are you separated from Theophilus ?

: was my pupil and it was useful to me with respect and zeal during a certain time. In addition it is with him and that I founded in 1803 Anatomical Society. took an increasingly large interest with anatomical search to which I had initiated it and which it carried out under my authority. It published much in the Newspaper of medicine and I still remember his item on “the synovial purse under-deltoïdienne” which it claimed to have discovered. Then it started to express a singular need for independence and with the contempt of any propriety and elementary respect that one owes with his Master it decided to write its own Treaty of pathologic anatomy and to open its own public exchange rate! Nonglad to betray my confidence, it started to develop foolish theories on the classification of the lesions likely to attack all the systems.

 

. : When were you appointed surgeon of the Hospital?

: I passed a contest in 1802 to be a surgeon as a second of the Hospital. The proofs were particularly difficult and I recognize readily that in the circumstance the support of was invaluable for me. I thus worked at which was surgeon-chief and of assistant surgeon. A few years after its bond gave up what allowed me to become surgeon-assistant of the Hospital.

 

. : Since you have just appointed , will you allow us, to light our readers, to reconsider the circumstances which surrounded the rupture of your banns with Miss ?

: You do not miss a base! However with the last years, I carry out that it persists of the whiffs of all calumnies of which I was the purpose on this subject and which the moment perhaps came for me to expose the truth. My Master saw in me his future son-in-law and his/her Adelaïde oldest daughter intended to me. I was strongly encouraged to make him the court and it quickly appeared to us that we did not have a slope one for the other. But the father had stopped the marriage for on January 25th, 1810 without taking account of my reserves. In order not to disappoint the affection that it carried me and not to force Adelaïde with a marriage also little wished by it, I asked for the hand of his junior, . But wanted nothing to know and gave me consultings on the manner of acquiring wedding rings. I can believe only the fact of having obtained from the Emperor that it affixes his signature on the marriage contract can explain such a blindness. The date day before which it persisted in maintaining as that of the marriage it sends me a note where it is astonished not to see me with the premarital dinner and I answer him at once that Adelaïde did not like me and that she had affirmed me a few days before that she did not want to be given in marriage to only obey the wishes of her parents. I renewed my proposal to marry . maintained the ceremony to which no gentleman could have agreed and not seeing me coming howled with treason. Do those which today discuss me with any matter of go-getter without scruple, measure at which point this decision was painful for me and how much it was likely to compromise my career?

 

. : Let us return there. Was your accession with the pulpit of surgery the purpose of stormy debates, why?

: It was a contest where the main candidates were Roux, , and . The proof of the thesis provided for the handing-over of the proofs at the latest on January 26th, 1812. However at this date the jury by an exceptional favor granted a time of a few days to me. The reason in is simple: an accident of workshops had made delay the impression of my manuscript and my editor provided to the jury a certificate proving that this delay was not my fact. My adversaries violently protested and I had to undergo public torts. But the proofs finally began again. My thesis on the lithotomy was regarded as a model of surgical anatomy. Then there be half an hour an oral lesson, after 24 hours of preparation, where I discussed amputations. Then it the proof of operation on corpse and finally on February 8th ago take place the last proof, a new half an hour oral lesson during which Roux discussed simple fractures of the femur, of the primitive luxation of the iléo-femoral hinge, of the fracture of the leg close the hinge of the foot and myself of the luxation of the elbow joint. The jury was carried out by with which my reports had been tightened on several occasions and which could not be suspect of partiality. He would have told in my connection “Here, as judge, I must forget the wrongs of Mr. towards me: according to my conviction it deserves our votes.”

 

. : You here surgeon-assistant of the Hospital and equipped with an important pulpit for Faculty…

: Indeed, but I do not have very a three years good memory which preceded the dismissal by in 1815. had a very conventional approach of the surgery and held for suspect the least innovation. Each time I tried to make profit from the advances in knowledge a patient, he was opposed to my consultings and in the long term the patient suffered from it. Nevertheless he was the surgeon chief and I owed him obedience. Moreover it had supported me for my accession under instructor and I did not wish to overpower his old days. The situation was nevertheless very uncomfortable because in front of all the students it made completely erroneous clinical analyzes which it concluded by aberrant diagnoses. I would have left it well with its are delirious of interpretation if its conclusions did not imply therapeutic choices that most of the time I was charged to carry out. Thus on several occasions I have to contradict it in public so much the danger which it made run to the patient was large and so much the tort made with art was obvious. Despite everything I endeavoured not to tighten our reports too much and after a fashion to fold me with the respect of the hierarchy while waiting for his nearest retreat.

 

. : And then?

: At this point in time it put heading to take his son close to him to ensure the survival of surgeon-chief to him. His/her son was former surgeon of the Imperial Guard and had undergone in Russia a rather long captivity. His/her father exhumed Faculty a regulation fallen since strong a long time in the lapse of memory to make appoint it aid of private clinic to the Hospital. Admittedly the father was not these surgeons with whom a #52AFA5 old age leaves the spirit present and the sure hand, but he had at least legitimacy, whereas did not have the first of the long list of qualities necessary to aspire to the post. It was too much and I decided not to cover my silence more the deplorable practices of my superior. And as he was wary more and more of me, it was led to carry out itself its decisions and the results were catastrophic.

 

. : Can you give us an example?

: Here is one. A Russian soldier had received a blow of fork at the upper part of the thigh and forwarded a considerable infiltration below the inguinal ligament. operates: a flood of blood spouts out because the femoral artery was open. which helped it and with which I had learned how to compress the arteries everywhere, support on the primitive and the hemorrhage stop. , which believed to deal with prepares to bind it, makes two incisions above the inguinal ligament and passes its pointer. It understands in the binding the abdominal wall, strongly tightens and with double knot. It then makes cease compression in spite of the protests of . An enormous flood of blood shows that the artery remained apart from the binding; Disturbed , piles up in the wound on , pushing it until in the abdomen. The patient died a few hours afterwards. The autopsy showed that the binding passed an inch in front of the vessel.

 

 

 

: At the end of long series of deplorable operations, Faculty then the Council of the hospitals ended up being moved and a morning whereas it came to make its inspection as with accustomed, learned that it was nothing any more. There were several candidatures for the post and by vote of the Council of the hospitals the command of the choice was the following: , Dubois, , and . had already refused once the Hospital, moreover it had been surgeon of the Emperor. Dubois had been confined the Empress and was also sullied with Bonapartism. I was thus appointed chirugien-chief of the Hospital on September 9th, 1815 by closure of the Minister of Justice, home secretary. This place for which I had worked for twenty years, it was not any more with the capacity of anybody to remove it to me.

 

. : In order to inform our readers on the charge which falls to you, can you detail us one of your days?

: I arrive in my service at 7 a.m. the summer and 8 hours the winter. A announces my arrival and my male nurses help me to remove me of my mantle, my cap and to cover my large #FFFFFF dashboard to me. My pupils await me in the room Holy-Agnes where I am accustomed to beginning the inspection. My first aid is to make the appeal of the interns and of external and I tolerate any delay nor no not justified absence. In the event of failure, the culprit is irrevocably striped board. There are an intern by room and in charge particularly of the autopsies. The interns are completely responsible for the gestures of external and must report some. Surrounded by my medical team to which gasket a good number of French and foreign doctors, I begin the inspection. Initially the rooms Saint-Agnes and Midsummer's Day then the rooms Saint-Bernard and Saint-Paul. I cannot materially stop with all the beds but I particularly examine the newcomers and the new ones operated by doing myself the bandages. I make a point of specifying in order to make conceal persistent rumors: there is no more for a long time of the beds to “several” with the Hospital. Each patient with his bed, closed by #FFFFFF curtains and I require that it reign greatest cleanliness. The #FFFFFF #F8FFFF is, in the processing, the largest element of success.

 

. : The safety of your diagnosis is notorious…

: I attach an extreme importance to the interrogation which it is necessary to know however to lead because the sick race is eminently lying. The finished interrogation, I practice an examination meticulous person. I carry diagnosis only when the logic and the rigor of my deductions authorize it to me. It was able to me to be mistaken, but I believe to be myself misled less than the others. During the inspection I must practice with the bed some interventions urgent and simple such as the incision of abscess, the opening of whitlow, or dents. The finished inspection I move towards the amphitheater of the exchange rate located on the fronting of the Notre Dame Square and which is filled of a crowd of students and fellow-members. It is there that I make practically the every day my lesson clinical.

 

. : Your clinical teaching eclipses all the others…

: It is true that I have, through work, asset of knowledge and experience of very first command. However knowledge is not enough to collect an audience. Silence should first of all be obtained. For me the unequalled means, is, to express me at the beginning of a low voting right which obliges the assistance with absolute silence. It is only then that I raise the voting right in order to make well understand my arguments. It is necessary that the talk is clear and methodical in order to captivate the attention of the pupils, and it is unceasingly necessary to be repeated in order to be likely to be understood well once. Over all, to keep until the end the presence of the audience and to manage to nourish them of its knowledge, one needs measurement, one needs this quality which my fellow-members always prompt with the eloquence miss so much: economy of the speech.

 

. : After the exchange rate?

: Then comes the hour from the operations. The decision to practice an surgical operation is a major decision and it should be taken only when it is inescapable. It is two things which never should be compromised: days of the patient and the art which one professes. It is advisable to be surrounded by all the measurements of hygiene and to require a cleanliness meticulous person. I take care before acting so that there is no epidemic in progress. I take care that the patient has a maximum of confidence in his surgeon and in the decision which it took. There are two kinds of interventions; those which relate to healthy parts and must be of an extreme anatomical precision because no unforeseen accident should not emerge; and those not regulated which are much more numerous. When the patient enters the amphitheater, I explain to the assistance this in question, which I intend to make and which is its forecast. One should not give only one blow of bistoury without justifying it and reporting some. Even sometimes it is necessary to be compelled to take inconvenient and inelegant positions in order to make it possible to the pupils to better see. It is also necessary to be addressed to the patient permanently to encourage it to endure its proof.

 

. : Your cold blood is legendary…

: Do not believe that it is about contempt of human blood or the indifference for the pain and its noisy evidences. To separate itself of an impassive serenity in the course of intervention is to increase the fear of the patient considerably and to decrease the chances to solve the complications. My true pupils will reveal you that in many circumstances it sometimes happened to me to stop my share in spite of the sarcastic remarks that did not fail to cause.

 

. : After the interventions, did you finish some with the morning?

: Not! The intern charged with the opening of the bodies comes to show me the anatomic specimens of the morning. I make a point of knowing the reasons for dead patients in order to improve certain operational methods and I in addition did not give up publishing my Treaty of pathological anatomy. Then I have still to make the free consultation where all the unhappy ones are admitted.

 

. : Can't you leave this ungrateful task to the one of your collaborators?

: Dear Sir, among all my hours, those which I devote to the service of poor me are most expensive. Nothing could distract me from time that I intend for the needy one. I had quite hard beginnings and of this time I have the memory of good people whose simple generosity of aid stirs up me still today the core. I would like to see one of these rich person who complains that I take to him too expensive when it should be operated, only in Paris, without under nor mesh, a friend, credit, and forced to work of his five fingers to live.

Northern fronting and input of the Hospital on the place of the square of Notre-Dame

. : Then?

: The finished morning, I regain my residence with foot. I live place of the Louvre and while going along the quays, I the bread roll which the administration liberally gives since from ancient times to the surgeon-chiefs. My afternoon is sometimes busy by my specific consultations sometimes by Faculty or the learned societies.

 

. : Mr the Baron, will you grant the favor to us to once again refer to your intervention at the time of the assassination of the Duke of ?

: I had reported myself the details of this tragic night in a deposition made with the room of the Pars. The press had printed without authorization my relationship with negligences and serious omissions and it was necessary that I make corrections there. I think that a new clarification too will not be. In the evening from February 13rd to 14th 1820, while leaving the Opera, the Duke of was stabbed under the right breast by a fanatic of the name of . He had courage and the force to tear off itself the weapon of the wound but a flood of blood spouts out then and the duke fell in syncope. One in vain sought the honorary surgeons and of foundation for the service of the theater which were accustomed to attending the spectacle. Mr , medical student arrived the first. Helped by the Duke of Orleans, he stripped the Prince and proposed a bleeding. It was prepared to make it when Doctor arrived. Struck by violent dyspnea, it removed the clot which blocked the opening of the wound and increases the aforementioned at its lower part slightly: it ran out a little #07645A blood them. Convinced of the existence of blood intrathoracic and to try to decrease the consequences by them, it practiced a first bleeding of a few grams. At this time Doctor arrives who, in his turn, bleeds the casualty with the other arm and hardly more blood obtains. A third bleeding is then tried, this time at the foot, without more result than the preceding ones. But one wants absolutely to have blood and one sends to seek suction cups to implement them to the wound. While waiting, and in spite of the protests of the Prince who fears that the weapon of the crime was not poisoned, Doctor sucks the opening of the wound. After all these maneuvres, the duke appears to a little better breathe; the pulse which was very weak, is noted, the figure slightly, breathing and the word becomes easier. At this point in time I arrive.

. : Finally!

: I am in the presence of the Duchess of , the Duchess of Angouleme, the Duke and the Duchess of Orleans, of the Duke of Bourbon, ministers and many courtiers. The Duke of tightened me the hand while telling me: “Mr I suffer cruelly”. Slept on the right side, it was very pale, the deteriorated features, short breathing, cover of cold sweats, its flooded bed of blood. With the examination, the left side remained sound whereas on the right existed a silence and a considerable . From which did the hemorrhage come? As there had been neither , nor subcutaneous emphysema, I supposed the intact lung. But the symptoms became increasingly worrying. With the doctors present, we withdrew ourselves one moment. Nobody was in favor to close the wound. To await the effects of medication adopted? The results were hardly encouraging, since the evil had progressed. I decided to try to put a term at , causes symptoms observed and to evacuate it if that were possible. I proposed to go directly towards what bled, in order to give to time, nature, with art, the means of opposing to the evil a more effective resistance. The operation was hazardous also one required of Mr his authorization. “I entrust my son to your talent” answered it. I then made an incision with the skin and my directed finger following the way of the wound arrived by it to the opening that the dagger had made with the muscles. I noted an opening in all space , and a rather strong notch at the edge of the two coasts so much the dagger had been dived with force. The existence of blood intrathoracic was confirmed but I could not know the origin of it. After the debridement, the blood left in enough large amount and breathing became easier. These maneuvres had been very painful and the Prince had tried on several occasions to draw aside us.

. : Was it necessary to push more before the browsing?

: Sirs Baron, Red-headed and Dubois had just arrived and we made a new consultation. By mutual agreement we decided that one could base no reasonable hope on the continuation of help of this kind. The state of weakness of the casualty made also reject other medications such as; revulsive, suction cups, bleedings, leeches. There was no question of transporting the Duke to the Elys3ee palace. One decided that the Prince would remain in the place where it was, whom one would support the flow of blood by the slope of the body on the right side, that one would observe with attention the symptoms of the evil in the intention to relieve, if that were possible, and to act more effectively, if the functioning of the disease had suddenly required a more active intervention of Article a bulletin were written in this direction and were given to the Chairman of the Council of Ministers which gave it to the King. There did not remain any hope of hello. From hour in hour the new bulletins confirmed this forecast. I did not leave his bedside and tightened the hand to him. A little before expiring it tells me “Mr , I is well touched of your attentions and of your care but they did not can prolong my existence: my wound is mortal, it entered to the core.”

 

. : What showed the autopsy of the Prince?

: I made with Roux the autopsy. We noted that the walls of the chest were crossed between the fifth and the sixth right coast. The lung which by the negotiable instrument of a rather common variety had only two lobes, was crossed to its former party. These two lesions did not have any influence on the production of the accidents, but the pericardium and the right atrium of the core were open: the latter was crossed right through and the instrument, which to enter with also a great depth had had to make bend the walls of the chest, had stopped in the nerve center of the diaphragm, without entirely crossing it. Two liters of blood in the right side of the chest.

 

. : Nothing could thus have saved the Duke of !

: And yet criticisms of my fellow-members were not lacking to me. On all sides one reproached me for having shown of indecision, inexperience, lack of cold blood, to have dared to probe a penetrating wound of the thorax what would have made run an additional risk of hemorrhage and could destroy salutary adherences. Fifteen days were hardly past that read at the Society of Faculty an already old report on the need for closing the wounds of chest. The year according to, with the meeting of re-entry of the Academy of Medicine, made an allusion wounding to the torture inflicted to the unhappy Prince. In 1823 the section of surgery proposed a price of thousand francs for the question of the penetrating wounds of chest and, the contest not having succeeded, insisted for the hold of the question. The intention to discredit to me was obvious. Later, to the public meeting of the section, in January 1825, still reconsidered this subject. Finally in August 1828, the Academy decreed a #D1FFFF medal with Doctor , who for the question: ” Which is the preferable method in the processing of the penetrating wounds of chest” advised non-intervention, at most the joining of the external wound.

. : You supported all these attacks without answering it?

: Let us not excavate in this mud heap! The facts are sufficiently clear. To thank me for the care given to his nephew, Louis granted me by letters patent of April 17th, 1821 the bond of hereditary Baron. And with the advent of Charles X, I was appointed first surgeon of the King.

 

. : Can you report us the way in which you lived the great days of July?

: The Wednesday the 28th, the shooting begins on almost all the extent of north bank of the Seine of the Seine, i.e. since the arsenal and the barracks of , to the Louvre. The street Saint-Anthony, the place of Strike and all the streets adjacent, the place of , the Innocent market, the street Saint-Honore and especially the Palais Royal, resound of continual discharges. Some blows of gun are made understand and with many corpses strew the thick piece.

 

. : How much casualties did you receive this day?

: Hundred ten wounded was brought and to midnight seventeen had succumbed to too serious wounds not to be completely above the resources of Article the majority as of these unhappy ones had been struck in the place of Strike or on that of . Almost all had received, almost with bearing end, of the shots fired by the royal guard, the battleships, the gendarmes of elite and the lancers. Some offered enormous wounds produced by or portions of grapeshot. The casualties brought on stretchers by their brothers in arms, arrived on the Notre-Dame square, escorted by a crowd of friends, parents and especially the curious ones who made irruption until in the rooms and caused there an extremely harmful tumult with the patients. I due to take measures to put an end to this situation. As much of very serious operations were to be made at once, I had thought that it would be more suitable to practice them in a provisional room, in order to avoid with the others wounded the spectacle of these new pains, as well as the cries which they tore off with the patients. But the bad provision of the room and especially the multitude of the patients, did not make it possible to carry out this project and one was constrained to operate in each room as the case required it. I made the majority of the operations: debridement of the wounds, extraction of balls, bandages of fractures and amputations of the members. I entrusted to sure hands the responsibility of the first aircraft.

 

. : Did you separate the casualties?

: As of this day, soldiers of any weapon were brought to the Hospital and placed shovel-mixes with the citizens. I thought that it was important not to assign a specific room to them. It was resulted from it some embarrassments in the service and besides, by bringing them closer to those against which they had swapped their blows, I hoped to put an end to any species of animosity, if it them still remained about it. The continuation proved how much one had been right, and a few days had been hardly passed that they fraternized all together.

 

. : The night of the Wednesday to Thursday will remain engraved a long time in the memory of Parisian…

: Two hundred and four wounded entered to the Hospital the day of the 29 and in this same day a score of them expired without art being able to cure the serious lesions of which they were reached. The activity of the service had redoubled as the circumstances became more pressing; emulously hastened to fulfill the functions of external pupil, all went with command and the administration assisted of all its efforts the zeal of the surgeons. Among the received casualties this day with the Hospital, a good number was directed on the hospital of the Pity which, by its position and its extent, could more easily provide them a assured asylum. One sent to it especially those which could go easily and without disadvantage for their wounds. An about sixty were in this case and wanted well, after being bandaged, to yield their place to those for which it was much more necessary. A much greater number still left the house to go on their premises.

 

. : He was addressed to your hospital a reproach of overall dimension…

: The need for devoting the rooms to the casualties promptly made evacuate by the administration all the patients whom they contained. The Thursday the 29th, three hundred and sixty two patients had been evacuated on and . The previous day the population of the hospital rose with nine hundred and fifty two individuals; the evacuation of the following day was not completely compensated by the receptions of Thursday; also the evening of this day we had only one seven payroll hundred sick. The following days the exits exceeded the inputs constantly. Never the rooms of wounded were not full. It is a thing much more important to examine in the hospitals, it is the food regime, whose poor quality constantly was the purpose of the complaints of all the doctors and surgeons. It is undoubtedly suitable that the most severe economy governs all, but a hospital cannot be discussed like a barracks. The bread, the wine and the meat are passable, we are appropriate about it; but the thin food, consistent out of vegetables, pea, lenses, beans and potatoes, generally is not edible, even for healthy people; with stronger reason will be they harmful with the patients and too often it arrives of the serious accidents in consequence of their employment in convalescents whose digestive forces cannot work out this coarse food. I made an intervention near the Board of directors and soon the patients whose state allowed it accepted fresh fish and vegetables, light meats, chicken, calf; one gave them good wine and under the influence of this more substantial regime one saw faster convalescences.

 

. : Can you detail us some one of the lesions produced with the members by ball or any other projectile?

: We had one case of fracture of the clavicle, still it was produced by a blow of stick of rifle, when the casualty precipitated on Switzerland to disarm it. The fractures of the scapula were much more common. The majority of the large penetrating wounds of the chest were accompanied by lesions of this bone. Its position, its form and its uses make its fracture not very dangerous and do not require any average private individual of processing. That is rigorously true only for its punt party; because if the fracture took place in the portion which forms the stub of the shoulder, then that becomes more serious. If, indeed, a ball crosses the shoulder joint and breaks bone surfaces, the experiment proves that the entire member must be removed; what constitutes one of most serious operations the than the surgeon can practice. I practiced it at two individuals who both today are completely cured. A third, at which her place was also indicated and which did not want to be forwarded to it, tested during five weeks a crowd of accidents which twenty times compromised its existence. He finally resigned himself when all the chances of hello seemed to him lost and the operation was made not to give up the last which remained. The unhappy one succumbed at the end of eight days, victim of an obstinacy which no prayer had been able to overcome. The fractures of the arm are much less serious unless the disorder of the soft parties is not carried very far. The bone being located at little depth, one can extract with facility all the detached by the ball and then bandage so as to bring the cure. If the bones of before arm, the wrist or the hand are reached by a ball which break them in glares, dilacerate the soft parties, open the arteries, it is necessary to cut down above it badly and to remember that these parties are endowed with an exquisite sensitivity, that the inflammation which develops to with it infallibly is often accompanied by corruption and which in the greatest number of the cases, death is the result of the attempts made to preserve a member too often useless. An unhappy workman , father of several infants, had the wrist right crushed by a , with the capture of Tileries: the amputation was proposed to him like single means of hello. “Which will nourish my children? told he, my hand only the fact food. “And after one moment of hesitation he added: “Cross: perhaps the fatherland will come to their help”. He is well cured today.

 

. : And with the lower extremity?

: When a ball carries part of the thigh, breaks the bones and thus operates a beginning of amputation, it is necessary that the surgeon completes what is started and it then carries out one of the most appalling mutilations than one can see. The thigh amputated in the hinge, leaves after it a wound of an immense extent; enormous vessels are cut, of large divided nerves and however there exist several alive evidence of the effectiveness of this frightening means. The fracture of the bone of the thigh by a ball always has much seriousness because the femur is of a very compact structure; its extreme hardness resists well the cause which tends to break it, but if this cause is endowed with a great power, then it breaks in glares and this multitude of fragments opposes a regular consolidation. It still results from it that the inflammatory accidents take an excessive intensity, that the suppuration becomes abundant and of bad nature, that the general health of the individual worsens and that death is almost assured in such a case. It is seen that the amputation is the only way prevent annoying continuations, also must one have recourse in this circumstance often there. When the ball crossed the knee, opened the hinge and deteriorated bone surfaces, the amputation is of rigor. All times that one exempted oneself some for more or less plausible reasons, it following proven how much one had been mistaken. In vain one quotes the example of one of the most honourable men of our time which cures perfectly after having refused to let itself cut the thigh for a wound of this kind; the miracles can be used as a basis for no judgment and besides it would have initially to be proven that the ball had entered in the hinge.

. : If it is an established fact in military surgery, it is the incurability of the wounds of the knee by firearm…

: Indeed and one must in such a case hasten to put the patient at the shelter of the accidents fatal of which he is threatened. When a ball fractures the bones of the leg, the danger varies according to the point which occupies the patient and according to the extent of the disorders. At the upper part of the tibia, this bone has an important volume, it is spongy and a ball can extremely well cross it without producing of fracture. In 1814, a French soldier wounded under the walls of Paris was accepted with the Hospital. By examining the upper part of the leg, I found fragments of fabric inserted in the bone of this party; strong tractions brought to the outside a kind of purse containing a ball entirely wrapped by part of the gaiter of the patient. I preserved the part. With the average party of the tibia, under the negotiable instrument of a ball, the bone is generally fractured in glares like the femur. Then the are numerous and one must remove them carefully in order to shorten the continuations of the disease, which are all the more long as the work entrusted to the forces of nature is more important. A type-setter of printing works, had the leg broken by a ball, Wednesday morning in the place of Strike. Endowed with a very irritable constitution, one have much sorrow to make itself main of the nervous symptoms which appeared in the first times and one had to abstain from practicing the amputation as the case required it. Later it occurred of the accidents singularly exaggerated by the burning imagination of the patient; some accesses of fever carried it on August 31st. It is seen that in this enumeration of wounds, much are likely to involve the loss of the subject if one does not decide to remove the sick party.

 

. : But this average violent one, if it is salutary, is not free from disadvantage?

: It is true. The amputation produces a simple wound removed from the annoying share of the foreign body, of an easy access, consequently always forwarded to an on-line operation; but one should not forget only one wound of such a great dimension, inflicted to some extent with a quite bearing individual and who did not have time to be accustomed to it, involves in all the economy of the serious disorders. Thus a dangerous disease is discussed by a dangerous means in itself, but which offers to the wounded one and with the expert more chances of success.

 

. : Did these remarkable events as all those which announced the long career of your hospital, at least disarm the detractor of this worthy building?

: The experiment of all times proved that it is especially in the center of the big cities that the catastrophes arrive which the most imperiously claim help of art, and the last events of which we have just been pilot provide, in favor of a central hospital, an irresistible argument. And indeed, which disadvantages weren't resulted from transport to long distances from a crowd from casualties whom the vicinity of the battle field made it possible to help almost immediately? So already we, how much hadn't we have such an amount of demise to regret had of it more in the middle of circumstances much more unfavourable? But so certain architect declared the enemy personal of the Hospital it is that there remains attached to this establishment an antique prevention. Too much a long time one saw there piled up in immense , a crowd the unhappy one which was not long in succumbing, victims of a command of things that the respect for old habits let remain until in the last years of the eighteenth century. Today the Hospital of Paris does not offer any more any trace of these cruel institutions and can be flattered through all Europe to be the temple of surgical art. But the history indeed showed us that there was no temple, if large it was, which is not threatened of destruction.

. : He thinks that you lead the hard life to your pupils…

: However I refuse places daily. The rigor with which some could feel discussed is the best proof of the interest than I carry to their formation. One can nothing forward without authority and it is while being useful with humility, diligence and perspicacity their Master and their patients whom my pupils can gradually hope for to acquire the premises of my Article.

 

. : which was your surgeon in second left for the hospital…

: It is what it had of to better do. He was an endowed pupil, but he wasted his time with the Hospital.

 

. : You would have told him to his capture of post: “You were designated to replace me when I go away and when I am sick. I warn you that I never go away and that I am never sick”!

: Isn't this the truth?

 

. : Your pupil complains that you would have tried to prevent it from obtaining the place of surgeon chief of the hospital of Pity…

: with a and aggressive character which naturally pushes it to cover torts all the instructors of the Medical school. Its attacks are of such a coarseness that I refuse to comment on them. The inanity of all these attacks on my alleged tyranny appears clearly in front of reality: I entrusted the responsibility for part of my service to MISTERS and which justify each day confidence that I grant to them.

 

. : Mr the Baron, see no offense there, but what do you answer those which say you that you are the first of the surgeons and the last of the men?

: I think that they have with half reason!

Images of Paris of the Middle Ages at our days with the pleasant authorization of editions - Paris

 

. : In which circumstances you were appointed surgeon-chief of the Hospital?