Ambroise Paré, born in 1510 to a working class family in northwestern France, didn’t seem destined to become one of the most influential surgeons in Renaissance medicine. Yet by the time he died at the ripe old age of 80, Paré had revolutionized battlefield wound treatment and served as the royal surgeon for four French kings. During his long career, Paré authored numerous books—all in his native French rather than Latin, the usual language of learned medicine in the 16th century—including Ten Books of Surgery, published in 1564.

Ten Books is a relatively rare volume, in part because the text was later included in Paré’s better-known book, Les Oeuvres (1575). According to Robert Linker and Nathan Womack, Ten Books’ sole English translators, there are only 14 surviving copies. This particular copy is in the collection of the U.S. National Library of Medicine.

Ten Books is a broad-ranging text, covering everything from gangrene to bone fractures, contusions to “hot pisses,” amputation to artificial limb design. There are numerous images in the book, woodcut illustrations that are as eclectic as the text itself. Among the images digitized by the U.S. National Library of Medicine, there are three illustrations of medical devices, which must seem undoubtedly grim to the contemporary viewer; one illustration of Paré’s revolutionary suture technique applied to a noblewoman’s face; and three almost fanciful-looking illustrations of the surgeon’s designs for hand and arm prosthetic limbs. There are smaller images in the book as well, including designs for a leg prosthesis.

Though Paré’s illustrations for prosthetic limbs look rather whimsical, they were in fact useful designs. Some consider him the father of prostheses; the artificial hand illustrated in Ten Books, which Paré called “Le Petit Lorraine,” included a series of springs and locks allowing the prosthesis to move. The design was worn by a French army captain.

An engraving of Pare at work by C. Manigaud after E. J. C. Hamman via Wikimedia // CC BY 4.0

It’s not surprising that Paré’s artificial hand was made for an army captain. Paré developed his ideas during his 30-year service to the French army, where he practiced as barber-surgeon. Throughout the Renaissance, physicians did not practice surgery, but instead were academics committed to study rather than practice. The grisly work of surgery was left to barber-surgeons such as Paré, who were generally from the lower classes and learned their trade through apprenticeship and practical application. Paré likely followed that traditional path, though there is no surviving documentation about where or with whom he studied. (The term barber-surgeon, by the way, derives from the Middle Ages, after a 1215 papal decree effectively barred physicians and clergy from performing surgery. Since barbers were already in possession of knives and scissors, they took over surgical procedures such as amputation while continuing to cut hair.)

Numerous French wars afforded Paré the opportunity to practice and expand his skills as a surgeon, particularly when it came to treating gunshot wounds, a relatively new battlefield injury. When Paré entered the army, it was standard practice to seal wounds with cauterization, usually using boiling oil. But during Paré’s first job, he ran out of cauterization oil and, looking for an alternative method, applied a poultice of egg yolk, turpentine, and oil of roses. He took note when, the following day, the soldiers who had been treated with the poultice were still alive.

He also advocated for ligatures before and after an amputation rather than cauterization, arguing that using ligatures to seal a wound was far less painful for the patient. Paré's concern with the comfort of patients was relatively rare for the era, and in addition to his innovations in surgery, his bedside manner was part of what solidified his reputation. In 1552, Paré was accepted into royal service under Henry II. Two years later, he was admitted to the Royal College of Surgeons. He spent the remainder of his life lecturing, writing books, and caring for the kings of France.

Paré died quietly in 1590. The Parisian diarist Pierre de L’Estoile noted the famed surgeon’s passing in his journal, describing Paré as “a learned man, foremost in his art, who, despite the times, spoke freely for peace and for the public welfare, which made him loved by good men as hated and feared by the wicked.”