Ambroise Paré1510–1590

Phantom limbs

At the onset of the 16th century, much more was known about the peripheral nerves than the brain. This is evident in the diagram of the nerves given by Paré: the structure of the brain is crudely represented. It was still the belief that the animal spirit flowed through the hollow nerves from the senses to the ventricles in the brain. Paré was surgeon to a succession of French kings and followed them in their military campaigns. The battlefield injuries he treated led extended his knowledge about the efficacies of a variety of surgical procedures. One condition Paré frequently encountered was amputation and he made great strides in its surgical treatment; he applied ligatures to the large vessels in the limbs to staunch the bleeding following amputation and he applied tourniquets above the site of severance. These were described in his book La Méthode de Traicter les Playes Faictes tant par Hacquebutes que par Fleches published in 1551. A consequence of this was encountering patients who reported sensations in their missing limbs and Paré initiated medical interest in the intriguing phenomenon of phantom limbs. The reports were clearly a surprise to him: “Verily it is a thing wondrous strange and prodigious, and which will scarce be credited, unlesse by such as have seen with their eyes, and heard with their ears the Patients who have many months after the cutting away of the Leg, grievously complained that they yet felt exceeding great pain of that leg so cut off.” Evidence of loss of limbs, through disease, accident, warfare, or ritual has been commented upon since records began. With this legacy, it is remarkable that reports of phantom limbs entered so late into medical records. Perhaps this was because few of those who had limbs amputated survived to describe their experiences. Accordingly, it is appropriate to present two portraits of him in one of his diagrams with missing limbs. It is from a 1649 translation of his works into English: The Workes of that Famous Chirurgion Ambrose Parey. Oddly enough, the legs are complete in the French original Les Œuvres de M. Ambroise Paré!