Battlefield Medicine and Triage Innovator Dominique Jean Larrey

battlefield medicine and triage innovator Dominique Jean Larrey
Portrait of Dominique Jean Larrey by Anne-Louis Girodet de Roussy-Trioson, in 1804. Courtesy of Wikipedia.

Battlefield medicine and triage innovator Dominique Jean Larrey was at one time forgotten as much as Napoleon was immortalized. Yet, Larrey’s contributions to military medicine and his care and compassion towards wounded soldiers on both sides while he served in Napoleon’s Grande Armée, enabled hundreds of soldiers to survive. It also resulted in him earning the envious title as “the first modern military surgeon.”

Larrey was born on 8 July 1766 in a small village named Beaudéan, in the Pyrenees. He was the son of a shoemaker, orphaned at 13, and raised by his Uncle Alexis Larrey, who was the chief surgeon in Toulouse. His uncle’s occupation set the stage for Larrey’s future as Larrey served a 6-year apprenticeship before going to Paris to study under the chief surgeon at the Hôtel-Dieu de Paris named Pierre-Joseph Desault.

On 1 April 1792 Larrey joined the French army at Strasbourg and it was there that he claimed, he “became sensible of the inconveniences of the French ambulances.” The tradition at the time was that ambulances were “to remain about a league from the army, while the wounded were also obliged to remain on the field of battle until after the combat.” Moreover, when the wounded were taken off the battlefield at the end of the battle, they were done so in unwieldy ambulances.

“Larrey was depressed and mournful at the sight of the privations to which the wounded were exposed.”

Ambulances Volantes developed by Larrey to rapidly transport the wounded from the battlefield to field hospitals. Courtesy of Wikipedia.

Larrey then begin thinking about how he could provide “speedy succor” to the wounded and dying and this resulted in him developing a carriage that was hung on springs and combined “great strength and solidity with lightness.” The lightness then resulted in the carriage’s ability to move rapidly with as much speed as the “flying artillery.” Thus, these vehicles become known as ambulances volantes, or in other words, “flying ambulances,” and a dispatch written by General Beauharnais to the Convention provides the benefits of Larrey’s ambulances:

“I ought not to omit mentioning the names of the Adjutant-General Bailly, Abbatouchi of the Artillery, and the Surgeon-Major Larrey and his comrades with flying ambulances, whose indefatigable care in the healing of the wounded has diminished those afflicting results to humanity which have generally been inseparable from days of victory, and has essentially served the cause of humanity itself in preserving the brave defenders of our country.”

Larrey’s flying ambulances also gave hope to the wounded and they lifted spirits and improved morale. In fact, Larrey’s innovative ideas made him a hero with the troops and can be demonstrated by the following story. When Napoleon’s troops were fleeing Russia in 1812, they approached the Berezina River, and to ensure that Larrey made it safely over the river, the men lifted him overhead and got him across safely before anyone else crossed.

When 28-year-0ld Larrey was in Paris for a short time in 1794, he married 24-year-old Marie-Élisabeth Laville-Leroux. Marie-Élisabeth was a French painter who studied under Jacques-Louis David and whose sister was the French neoclassical, historical and genre painter, Marie-Guillemine Benoist. Soon after his marriage, Larrey was ordered to Toulon in southern France and it was there that he met Napoleon for the first time. Napoleon would come to think so highly of Larrey that he once commented:

“If the army ever erects a monument to express its gratitude, it should do so in honor of Larrey.”

Napoleon. Public Domain.

After meeting Napoleon, Larrey served in the army in Spain, but because he fell ill, he was ordered back to Paris. In Paris, he became a professor at Val-de-Grâce. He was appointed surgeon-in-chief of the Napoleonic armies in Italy in 1797, and went to Egypt a year later. After Napoleon’s defeat at the Siege of Acre in 1799, Larrey was ordered back to Paris. About eight years later, he was appointed Commandeur of the Légion d’honneur on 12 May 1807.

Besides being instrumental in establishing the flying ambulances, here are a few other interesting tidbits about Larrey:

  • On 22 May 1809, on the second day of the Battle of Aspern-Essling, Larrey operated on one of Napoleon’s most daring and talented military men, Marshal Jean Lannes. Lannes had been sitting with his legs crossed on the edge of a ditch when a cannonball was fired. It ricocheted and struck him, where his legs crossed. Lannes was then taken to Larrey who amputated one of his legs in about two minutes.
  • Between 1800 and 1840 Larrey published at least 28 books or articles.
  • Larrey improved the mobility and organization of field hospitals, thereby creating a prototype for the modern Mobile Army Surgical Hospital.
  • Larrey’s attention to the wounded on the battlefield included the enemy, which was something unheard of at the time. Luckily, his compassionate service survived into modern times in the form of the Red Cross.
  • He co-led the surgical team that performed a pre-anesthetic mastectomy on the famous English satirical novelist, diarist and playwright Frances Burney on 30 September 1811. The surgery occurred in Paris and Burney’s detailed account of her operation provides insight into early 19th century doctor-patient relationships and surgical methods performed in a patient’s home.
  • While trying to escape to the French border, Larrey was taken prisoner by the Prussians who wanted to execute him on the spot. However, Larrey was recognized by one of the German surgeons, who pleaded for Larrey’s life because Larrey had saved Blücher’s son when he was wounded near Dresden. Larrey was eventually pardoned, invited to dine with Blücher, and returned to France with money and proper clothes.
  • When Napoleon was sent into exile at Elba, Larrey wanted to go into exile with him, but Napoleon refused.
  • In Napoleon’s will, he stated that “[Larrey is] the most virtuous man I have ever known.”
Dominique Jean Larrey. Courtesy of Wikipedia.

In 1826, Larrey visited England where he was lauded by British surgeons. He was appointed to the Institut de France three years later, and after the July Revolution of 1830, he was recalled to the Council of Health of the French Armies and dispatched to Belgium, where he organized the ambulances of the Belgian army. When he returned to France, he was appointed Surgeon-in-Chief of the Hotel des Invalides. In 1842, he traveled to Algiers with his son, fell ill from exhaustion, and died on his way back to Lyon on 25 July.

Larrey’s remains were taken to Paris, and among those who honored him on 27 July were members of the Academy of Sciences, members of the Medical Society, all the municipal authorities, many military men, and a large concourse of people. His body was embalmed and after his funeral he was buried at Père-Lachaise Cemetery. However, his remains were later transferred to Les Invalides and re-interred near Napoleon’s tomb in December 1992.

References:

  • Baron Larrey, in The Morning Post, 09 August 1842
  • Burney, Fanny, A Mastectomy: Letter to Esther Burney, accessed 21-5-2017
  • Kelley, Katie, Old World and New: Early Medical Care, 1700-1840, 2010
  • Larrey, Dominique Jean Baron, Memoir of Baron Larrey, 1861
  • Larrey, Dominique Jean Baron, Memoirs of Military Surgery, and Campaigns of the French Armies, Volume 1, 1814
  • Universal Pronouncing Dictionary of Biography and Mythology, Volume 2, 1870

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