Dominique Jean Larrey was a pioneering French military surgeon during the Napoleonic Wars who made important innovations, including developing the first field ambulances to rapidly transport wounded soldiers. He participated in over 60 battles and was renowned for his skill, performing up to 200 amputations in a day. Larrey was respected even by enemy forces and worked to treat all wounded soldiers regardless of which side they fought for. His medical writings covered many conditions and he made advances such as using ice or snow to relieve pain from wounds.

3. Dominique Jean Larrey 1766 –1842
• French surgeon in Napoleon's army
• Greatest military surgeon of all times
• Participated in 25 campaigns and over 60 battles
• Managed all the wounded soldiers (Even Enemy)
• Record of doing 200 amputations in 24 hours

4. Dominique Jean Larrey
• Found time for extensive writing.
• He wrote on rabies, tetanus,
aneurysms, elephantiasis scroti,
urine atrophy, etc.
• First to observe that Trachoma
and conjunctivitis are contagious
• First description of trench foot.
• Method of Packing wounds with
ice and snow for pain relief

5. Innovations of Larrey
• He invented the field ambulance to carry soldiers
• Flying Ambulances for rapid transport
• Alone managed all Medical Care in battlefield
• First to described the therapeutic use of maggots
• He did first amputation at the hip in 1812

6. Dominique Jean Larrey
• Loved by the French soldiers and respected
by the enemies
• Enemy - Duke of Wellington ordered his
soldiers not to fire in his direction
• When Larrey sustained a gunshot wound.
Ironically, he was left wounded
• He was promptly sentenced to death -- until
the Prussian commander happened to pass
by and immediately released him because
Larrey had treated his son.

8. Robert Liston 1794 –1847
Speed Surgeon
• Robert Liston, first Professor
of Clinical Surgery
• Prior to the 19th century,
every wound was a potential
case of gangrene.
• To amputate gangrenous
limb, without anaesthesia.
• Pain management - a swig
of whiskey and a knock on
the head with a hammer

9. Robert Liston: Speed Surgeon
• So, a merciful surgery was
a very fast surgery.
• Required sharp Instruments,
a lightning-quick hand and
careful precision.
• Robert Liston had the first
two - could amputate one leg
in less than three minutes --
skin, bone, muscle, tendon,
through.

10. Surgery in 1800

11. Liston’s 300% Mortality Case
• Amputated the leg in under
21/2 minutes
– Patient died afterwards in the ward
• Amputated in addition the fingers of
his young assistant
– He died afterwards in the ward from
hospital gangrene.
• Slashed through the coat of a
surgical spectator
– Dropped dead from fright

12. Robert Liston: Speed Surgeon
• He also performed the first operation in
Europe under Ether Anaesthesia using
ether, on 21 December 1846
• Soon after he died in 1847

14. Dr. J. Marion Sims 1813 - 1883
• Father of Gynaecology
• South Carolina’s Father Butcher
• Medical experiments with enslaved
women, done without anaesthesia or
antiseptics.
• Many lost their lives.
• First surgery – Punctured a
abdominal mass with Shoemaking
awls. The patient was relieved.

15. Gift to Gynaecology
• First Forceps application
• Sims speculum – Used a spoon
• He fashioned over 71 surgical
instruments
• Sims' sigmoid catheter
• Operated Vesico-vaginal fistula
• First gallbladder surgery,
• Introduction of antiseptic
principles

16. Ethical Controversy
• Repair of vesico-vaginal fistula
• 30 surgeries done on ‘Anarcha’
without anaesthesia to perfect his
technique of silver-wire sutures.
• He operated the upper-class
white women with ether
anaesthesia.