Dominique Jean Larrey

Dominique Jean Larrey
1804 portrait of Larrey by Marie-Guillemine Benoist
Born	(1766-07-08)8 July 1766 Beaudéan, Bigorre
Died	25 July 1842(1842-07-25) (aged 76) Lyon, France
Nationality	French
Spouse	Marie-Élisabeth Laville-Leroux
Children	Félix Hippolyte Larrey Isaure Larrey
Scientific career
Fields	Surgeon

Dominique Jean, Baron Larrey (8 July 1766 – 25 July 1842) was a French surgeon and soldier best known for his service in the French Revolutionary and Napoleonic Wars. An important innovator in battlefield medicine and triage, Larrey invented the flying ambulance and is sometimes considered the first modern military surgeon.

Early life and career

Larrey was Born in Beaudéan, and the second of three children to Jean Larrey, a shoemaker, and Philippne Perès. His father died in 1780, When Larrey was only 13 years old. He was then sent to live with His Uncle Alexis, a surgeon in Toulouse.

After an 8-year apprenticeship, he went to Paris to study under Pierre-Joseph Desault, who was chief surgeon at the Hôtel-Dieu de Paris. Larrey then went to Brest, where he was appointed surgeon in the navy and began lecturing. In 1787 he boarded a ship deployed to the defense of Newfoundland, and was, at nearly 21 years-old at the time, the youngest medical officer in the French Royal Navy. While in America, Larrey took an interest in the local environment, writing observations on the local flora, fauna, climate and manners, which were published years later in his Mémoires de chirurgie militaire et campagnes du baron D.J. Larrey.

In 1789, Larrey was back in Paris, where he worked with Jean-Nicolas Corvisart, Xavier Bichat and Raphaël Bienvenu Sabatier in Les Invalides. On 14 July, during the Storming of the Bastille, he improvised an ambulance to treat the wounded.

Revolutionary Wars

Larrey's ambulance volante, used to evacuate casualties from the battlefield

A supporter of the ideas of the Revolution, Larrey joined the French Army of the Rhine in 1792, during the War of the First Coalition. In Mainz he met with Samuel Thomas von Sömmerring. During this time, Larrey initiated the modern method of army surgery, field hospitals and the system of army ambulance corps. After seeing the speed with which the carriages of French horse artillery units maneuvered across the battlefields, Larrey adapted them as "flying ambulances" for rapid transport of the wounded and manned them with trained crews of drivers, corpsmen and litterbearers.

At the Battle of Metz (1793) Larrey successfully demonstrated the value of field ambulances. The quartermaster-general Jacques-Pierre Orillard de Villemanzy ordered prototypes to be built, after which ambulances would be supplied to all the Republic's armies. The politicians heard of this, and ordered a national contest to find the best design, thus delaying their delivery by over two years. Larrey also increased the mobility and improved the organization of field hospitals, effectively creating a forerunner of modern Mobile Army Surgical Hospital units. He established a rule for the triage of war casualties, treating the wounded according to the seriousness of their injuries and urgency of need for medical care, regardless of their rank or nationality. Soldiers of enemy armies, as well as those of the French and their allies, were treated.

In 1794 he was sent to Toulon, where he met for the first time with Napoleon Bonaparte. He married the painter Marie-Élisabeth Laville-Leroux. In Spain he fell ill and was sent back to Paris, where he worked as a professor of anatomy at the Val-de-Grâce Medical School for a short time, in 1796, before being appointed surgeon-in-chief of the Revolutionary armies in Italy.

Larrey departed with the Egyptian campaign in 1798. Following the victory at the Battle of Abukir, he established a medical school for army physicians in Cairo. Many of his patients at the time were affected by ophthalmy, a disease known in Europe since the Crusades, which Larrey studied and wrote about in his memoirs. He improved the transportation of wounded soldiers through the use of dromedaries, with two chests attached to each side of their hump to carry the wounded, instead of horses of difficult movement in the desert. He was wounded during the Siege of Acre. Larrey returned to France in October 1801, despite being offered to return alongside Napoleon.

Napoleonic Wars

Larrey was made a Commander of the Légion d'honneur on 12 May 1807. He joined in the Battle of Aspern-Essling, where he operated on Marshal Jean Lannes and amputated one of his legs in two minutes. He became the favorite of the Emperor, who commented, "If the army ever erects a monument to express its gratitude, it should do so in honor of Larrey", he was ennobled as a Baron on the field of Wagram in 1809. In 1811, Baron Larrey co-led the surgical team that performed a pre-anesthetic mastectomy on Frances Burney in Paris. His detailed account of this operation gives insight into early 19th century doctor-patient relationships, and early surgical methods in the home of the patient. Larrey was involved in the French invasion of Russia.

Larrey amputating the arm and leg of colonel Rebsomen at the Battle of Hanau, in 1813

When Napoleon was sent to Elba, Larrey proposed to join him, but the former Emperor refused. At Waterloo in 1815 his courage under fire was noticed by the Duke of Wellington who ordered his soldiers not to fire in his direction so as to "give the brave man time to gather up the wounded" and saluted "the courage and devotion of an age that is no longer ours". Trying to escape to the French border, Larrey was taken prisoner by the Prussians who wanted to execute him on the spot. Larrey was recognized by one of the German surgeons, who pleaded for his life. Perhaps partly because he had saved the life of Blücher's son when he was wounded near Dresden and taken prisoner by the French, he was pardoned, invited to Blücher's dinner table as a guest and sent back to France with money and proper clothes.

Later career

After the empire, Larrey was given multiple opportunities abroad, including those from the United States, Russia, and Brazil. However, he chose to remain in France. He devoted the remainder of his life to writing , but after the death of Napoleon he started a new medical career in the army as chief-surgeon. In 1826 he visited England, received well by British surgeons. In 1829 he was appointed in the Institut de France. A year later, he was elected as a member of the American Philosophical Society. In 1842 he went to Algiers for a health inspection, together with his son, but contracted pneumonia on his way back, dying in Lyon on 25 July. His body was taken to Paris and buried at the Père-Lachaise Cemetery. His remains were transferred to Les Invalides and re-interred near Napoleon's tomb in December 1992.

Larrey's son, Félix Hippolyte Larrey (1808–1895), also became a military doctor

Larrey's writings are still regarded as valuable sources of surgical and medical knowledge and have been translated into all modern languages. Between 1800 and 1840 at least 28 books or articles were published. His son Hippolyte (born 1808) was surgeon-in-ordinary to the emperor Napoleon III.

Works

• Relation historique et chirurgicale de l’expédition de l’armée d’orient, en Egypte et en Syrie. Demonville, Paris 1803.
• Mémoires de chirurgie militaire, et campagnes. J. Smith, Paris 1812. (digitalized books: Volume1, Volume 2, Volume 3)
  • Richard H. Willmott: Memoirs of military surgery. Cushing, Baltimore 1814. (volumes 1–3, digitalized book)
  • John C. Mercer: Surgical memoirs of the campaigns of Russia, Germany, and France. Carey & Lea, Philadelphia 1832. (volume 4, digitalized Book)

NATO award

The Dominique-Jean Larrey Award is the North Atlantic Alliance's highest medical honour. It is bestowed annually by NATO's senior medical body, the Committee of Chiefs of Military Medical Services in NATO (COMEDS), which is composed of the Surgeons General of NATO and partner nations. It is awarded in recognition of a significant and lasting contribution to NATO multi-nationality and/or interoperability, or to improvements in the provision of health care in NATO missions in the areas of medical support or healthcare development.

Bibliography

His statue in bronze, as sculpted by David d'Angers in 1843, is standing in the courtyard outside the Val-de-Grâce military hospital, where Larrey was a professor in 1796

• Baker D, Cazalaà JB, Carli P (September 2005), "Resuscitation great. Larrey and Percy—a tale of two barons", Resuscitation, 66 (3): 259–62, doi:10.1016/j.resuscitation.2005.03.009, PMID 15990216
• Beasley AW (December 2000), "To study the healing art", The Australian and New Zealand Journal of Surgery, 70 (12): 892–7, doi:10.1046/j.1440-1622.2000.01989.x, PMID 11167578
• Bissi A (October 1989), "[Not Available]", Kos (in Italian) (49): 38–47, PMID 11629939
• Bodemer CW (July 1982), "Baron Dominique Jean Larrey, Napoleon's surgeon", Bulletin of the American College of Surgeons, 67 (7): 18–21, PMID 10315971
• Brewer LA (December 1986), "Baron Dominique Jean Larrey (1766–1842). Father of modern military surgery, innovater, humanist", The Journal of Thoracic and Cardiovascular Surgery, 92 (6): 1096–8, doi:10.1016/S0022-5223(19)35826-X, PMID 3537533
• Haddad FS (September 2004), "Baron Larrey: a role model to be emulated", Journal of the American College of Surgeons, 199 (3): 519, doi:10.1016/j.jamcollsurg.2004.05.266, PMID 15325631
• Burton, June K. (2001), Two "Better Halves" in the Worst of Times – Adrienne Noailles Lafayette (1759–1807) and Fanny Burney d'Arblay (1752–1840) as Medical and Surgical Patients under the First Empire (PDF) (published January 26, 2001), pp. 18–21, archived from the original (PDF) on March 13, 2016, retrieved February 18, 2009
• Csillag I (February 1984), "Ferenc Eckstein and military surgery during the Napoleonic wars (Dominique-Jean Larrey)" [Ferenc Eckstein and military surgery during the Napoleonic wars (Dominique-Jean Larrey)], Orvosi Hetilap (in Hungarian), 125 (8): 467–70, PMID 6366693
• DIBLE JH (April 1959), "D. J. Larrey, A Surgeon of the Revolution, Consulate, and Empire", Medical History, 3 (2): 100–7, doi:10.1017/s0025727300024388, PMC 1034461, PMID 13643144
• DiGioia JM, Rocko JM, Swan KG (May 1983), "Baron Larrey. Modern military surgeon", The American Surgeon, 49 (5): 226–30, PMID 6342487
• Egeblad K (1979), "[Not Available]", Dansk Medicinhistorisk Årbog (in Danish): 1979, 132–59, PMID 11628370
• Egeblad K (1978), "[Not Available]", Dansk Medicinhistorisk Årbog (in Danish): 77–123, PMID 11627862
• Fackler ML (March 1989), "Misinterpretations concerning Larrey's methods of wound treatment", Surgery, Gynecology & Obstetrics, 168 (3): 280–2, PMID 2645668
• Faria MA (September 1990), "Dominique-Jean Larrey: Napoleon's surgeon from Egypt to Waterloo", Journal of the Medical Association of Georgia, 79 (9): 693–5, PMID 2212907
• Feinsod, Moshe (2002), "The amputated leg—a tale of scientific curiosity—1792", Harefuah, vol. 141, no. 2 (published Feb 2002), pp. 210–2, 220, PMID 11905097
• Feinsod, M (1998), "The surgeon and the Emperor—a humanitarian on the battlefield", Harefuah, vol. 135, no. 9 (published Nov 1, 1998), pp. 340–3, 408, PMID 10911440
• Feinsod, M; Aharon-Peretz, J (1994), "Baron Larrey's description of traumatic aphasia", Journal of the History of the Neurosciences, vol. 3, no. 1 (published Jan 1994), pp. 45–52, doi:10.1080/09647049409525587, PMID 11618806
• Ferrarelli, L (1954), "The physicians of the Emperor", Minerva Chirurgica, vol. 9, no. 1 (published Jan 15, 1954), pp. 32–5, PMID 13153977
• Haas, L F (Feb 1994), "Dominique Jean Larrey (1766–1842)", J. Neurol. Neurosurg. Psychiatry, vol. 57, no. 2, p. 133, doi:10.1136/jnnp.57.2.133, ISSN 0022-3050, PMC 1072437, PMID 8126493
• Burris, DG; Welling, DR; Rich, NM (2004), "Dominique Jean Larrey and the principles of humanity in warfare", Journal of the American College of Surgeons, 198 (5): 831–5, doi:10.1016/j.jamcollsurg.2003.12.025, PMID 15110817
• Hakulinen, E (1989), "The French revolution—a revolution even for health care", Läkartidningen, vol. 86, no. 28–29 (published Jul 12, 1989), pp. 2535–7, PMID 2674570
• HALL, D P (1959), "Our surgical heritage; Europe", Am. J. Surg., vol. 98, no. 1 (published Jul 1959), pp. 130–1, PMID 13661525
• Hau, T (1982), "The surgical practice of Dominique Jean Larrey", Surgery, Gynecology & Obstetrics, vol. 154, no. 1 (published Jan 1982), pp. 89–94, PMID 7031942
• Hillemand, P; Gilbrin, E (1978), "Not Available", Histoire des Sciences Médicales, vol. 12, no. 3, pp. 255–7, PMID 11627946
• Jellinek, E H (2002), "An unlikely aphasiologist: D J Larrey (1766–1842)", Journal of the Royal Society of Medicine, vol. 95, no. 7 (published Jul 2002), pp. 368–70, doi:10.1177/014107680209500714, PMC 1279946, PMID 12091516
• Jensen, J E (Jul 1981), "Napoleonic medicine", Maryland State Medical Journal, 30 (7): 66–8, ISSN 0025-4363, PMID 7024659
• Lefebvre, P; Cornet, A; Sicard, A (1990), "Not Available", Histoire des Sciences Médicales, vol. 24, no. 3–4, pp. 259–63, PMID 11638332
• Lefebvre, P; Cornet, A; Sicard, A (1995), "The transfer of Baron Larrey's ashes from the Père Lachaise cemetery to the Invalides (December 14–15, 1992)", Histoire des Sciences Médicales, vol. 29, no. 1, pp. 23–7, PMID 11640449
• Leonov, I T (1992), "D. J. Larrey and N. I. Pirogov (on the 225th anniversary of the birth of D. J. Larrey)", Vestn. Khir. Im. I. I. Grek., vol. 149, no. 7–8, pp. 117–9, PMID 1341349
• Marchioni, Jean (2004), "Larrey, a legendary surgeon, a current work", La Revue du Praticien, vol. 54, no. 3 (published Feb 15, 2004), pp. 342–5, PMID 15134246
• McIntyre, Neil (2002), "The Barons Larrey: Dominique Jean (1766–1842); Hippolyte (1808–1895)", Journal of Medical Biography, vol. 10, no. 3 (published Aug 2002), p. 185, doi:10.1177/096777200201000316, PMID 12114954, S2CID 5558961
• Mirskiĭ, M B (2007), "An outstanding field surgeon (devoted to the 240th anniversary of D. Larrey's birth", Voenno-meditsinskiĭ Zhurnal, vol. 328, no. 1 (published Jan 2007), pp. 75–9, PMID 17436718
• Moore, A R (1978), "Preanesthetic mastectomy: a patient's experience", Surgery, vol. 83, no. 2 (published Feb 1978), pp. 200–5, PMID 341385
• Nau, Jean-Yves (2005), "I, Dominique Jean Larrey, baron and surgeon in chief of the Grand Army", Revue Médicale Suisse, vol. 1, no. 2 (published Jan 12, 2005), p. 186, PMID 15773223
• O'Sullivan, S T; O'Shaughnessy, M; O'Connor, T P (1995), "Baron Larrey and cold injury during the campaigns of Napoleon", Annals of Plastic Surgery, vol. 34, no. 4 (published Apr 1995), pp. 446–9, doi:10.1097/00000637-199504000-00020, PMID 7793796, S2CID 42758258
• Pai-Dhungat, J V; Parikh, Falguni (2006), "Medical philaely (Medical theme on stamps). Dominique J. Larrey (1766–1842). Northern France Ambulance, 1918 stamp, Grenada-1970", The Journal of the Association of Physicians of India, vol. 54 (published Oct 2006), p. 811, PMID 17214278
• Quijano-Pitman, F (1997), "Surgical drainage with rubber tubes and Baron Larrey's mobile ambulances introduced by Dr. Ignacio Gama", Gaceta Médica de México, vol. 133, no. 3, p. 249, PMID 9303873
• Richardson, R G (1977), "Larrey – what manner of man?", Proc. R. Soc. Med., vol. 70, no. 7 (published Jul 1977), pp. 490–4, PMC 1543132, PMID 331340
• Richardson, R G (1974), Larrey: Surgeon to Napoleon's Imperial Guard, John Murray
• Rich, Norman M; Burris, David G; Welling, David R; Rignault, Daniel P (2006), "The Larrey legacy: two hundred years on", Current Surgery, 63 (2): 119–21, doi:10.1016/j.cursur.2005.12.008, PMID 16520113
• Rüttimann, B (1979), "Larrey's amputation technic", Gesnerus, vol. 36, no. 1–2, pp. 140–55, PMID 381112
• Skandalakis, Panagiotis N; Lainas, Panagiotis; Zoras, Odyseas; Skandalakis, John E; Mirilas, P (2006), ""To afford the wounded speedy assistance": Dominique Jean Larrey and Napoleon", World Journal of Surgery, 30 (8) (published Aug 2006): 1392–9, doi:10.1007/s00268-005-0436-8, PMID 16850154, S2CID 42597837
• Soubiran, A (1966), "Larrey. The providence of soldiers (1766–1842)", La Presse Médicale, vol. 74, no. 34, pp. 1785–6, PMID 5328565
• Stembrowicz, W (1995), "Dominique Jean Larrey (1766–1842) the author of the work: On wounds of the pericardial sac and heart", Archiwum Historii I Filozofii Medycyny / Polskii Towarzystwo Historii Medycyny I Farmacji, vol. 58, no. 3, pp. 311–28, PMID 11624807
• James J. Walsh, "Dominique-Jean Larrey", Catholic Encyclopedia
• Wangensteen, S D; Wangensteen, O H (1971), "Successful pre-Listerian antiseptic management of compound fracture: Crowther (1802), Larrey (1824), and Bennion (ca. 1840)", Surgery, vol. 69, no. 6 (published Jun 1971), pp. 811–24, PMID 4931133
• Welling, David R; Burris, David G; Rich, Norman M (2006), "Delayed recognition – Larrey and Les Invalides", J. Am. Coll. Surg., vol. 202, no. 2 (published Feb 2006), pp. 373–6, doi:10.1016/j.jamcollsurg.2005.08.024, PMID 16427565
• Wilson, T (1997), "The ambulance – Larrey's legacy", Scalpel & Tongs : American Journal of Medical Philately, vol. 41, pp. 82–3, PMID 11619525
• Wybieralski, A (1966), "Dominique Jean Larrey (1766–1842) On the 200 anniversary of his birth", Archiwum Historii Medycyny, vol. 29, no. 3, pp. 313–20, PMID 5335562
• Zimmerman, L M (1968), "Humanity and compassion in medicine (Ambroise Paré, Baron Dominique-Jean Larrey)", The Chicago Medical School Quarterly, vol. 27, no. 4, pp. 233–4, PMID 4913343
• "The immediate care of the eyes in Napoleonic France", Anaesthesia, vol. 31, no. 3 (published Apr 1976), p. 439, 1976, doi:10.1111/j.1365-2044.1976.tb12341.x, PMID 776029, S2CID 32079369

External links

• The Revolutionary Flying Ambulance of Napoleon's Surgeon
• In Larrey's shadow: transport of British sick and wounded in the Napoleonic wars.
• Larrey, D. J. Memoirs of Military Surgery and Campaigns of the French Armies, Classics of Surgery Library, 1985, reprint of Joseph Cushing, 1814
• Les mémoires de chirurgie militaire et campagne de D.J. Larrey