class,—we obtain the best of evidence that Paré was not influenced by the wealth, rank or social position of his patients. Upon both classes he bestowed freely the fruits of his knowledge, experience and skill.
The first mention, in medical literature, of a fracture through the neck of the femur close to the joint, is to be found in Chapter 21, Book XIII., of Paré's treatise (page 753, Vol. II., of Malgaigne's edition). Furthermore, the first published account of a case of diaphragmatic hernia is that given by Paré. (Von Gurlt.)
In 1538, during a visit to Turin in the capacity of surgeon to the Mareschal de Montjean, Paré was asked by the latter to take charge of one of his pages who had been wounded by a stone which struck him on the right side of the head, causing a fracture of the parietal bone, with escape of a portion of the brain substance from the external wound. The subsequent history of this case is given by Paré in the following words:—
As soon as I fully realized the true nature of the injury and had
examined the mass of tissue (about the size of a small nut) which
had been expelled from the wound, I predicted that the patient
would probably not recover. A young surgeon who happened to
come into the room at this moment, examined the mass of tissue
which had escaped from the wound and at once pronounced it to
be fat. I assured him that, if he would wait until I had finished
dressing the patient's wound, I would prove to him that the mass
was in reality cerebral tissue and not fat. . . . If this substance,
I said, is fat, it will float on the water; but, if it is brain
tissue, it will sink at once to the bottom of the dish. And, again,
if it is fat it will promptly melt on exposure to heat, whereas brain
substance will simply become desiccated. These tests were applied
and it was shown that the tissue consisted, as I had declared, of
brain substance.
Notwithstanding the apparently serious damage which had been inflicted upon his brain the page made a good recovery, but remained permanently deaf in the right ear.
Among Paré's numerous reports of cases there is one
which possesses, as I believe, sufficient interest—as well
from the viewpoint of the pathologist as from that of the
