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Speaker 1: Welcome to Stuff You Missed in History Class, a production

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Speaker 1: of I Heart Radio. Hello, and welcome to the podcast.

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Speaker 1: I'm Holly Fry and I'm Tracy V. Wilson. So obviously

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Speaker 1: still in the midst of pandemic, one of the things

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Speaker 1: that has been in the news a lot and certainly

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Speaker 1: weighing heavily on my mind is all of the work

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Speaker 1: that's being done by emergency and hospital medical workers. And

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Speaker 1: so that kind of like was what I was going

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Speaker 1: to look into for this week's show. Like, I started

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Speaker 1: researching to do kind of a brief history of emergency medicine,

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Speaker 1: which is still in the works, but I got a

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Speaker 1: little sidetracked because there is so much that I found

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Speaker 1: myself like struggling to get a cohesive and organized thing

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Speaker 1: going on. But in the midst of doing all of that,

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Speaker 1: I stumbled across and I'm sorry because it's another French topic,

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Speaker 1: Um Dominique Genrere, who is a really really interesting historical

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Speaker 1: figure that I had not known anything about. I'm kicking

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Speaker 1: myself for reasons. I will reveal at the end that

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Speaker 1: I didn't know about this before we were in France.

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Speaker 1: Um but he created something called the flying ambulance it's

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Speaker 1: not literally airborne um. But his work was largely informed

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Speaker 1: first by his medical schooling, but then also by his

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Speaker 1: work with the French army. And so we're going to

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Speaker 1: talk about him today and how he developed an ambulance

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Speaker 1: system that even today, the systems he set up in

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Speaker 1: an adapted form are still essentially used and a lot

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Speaker 1: of his medical developments that he created are still used

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Speaker 1: even outside of you know, like a combat zone type

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Speaker 1: medic situation. So we're going to jump in on Baron

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Speaker 1: Dominique Jean. Dominique Jean was born in Boudion, France, near

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Speaker 1: the r Nis on July seventeen sixty six. He had

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Speaker 1: an older brother, Charles Francois Hilaire. The family was really

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Speaker 1: not wealthy. Dominic John's early education was given to him

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Speaker 1: by the local priest Abbe Grasse until his father died,

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Speaker 1: and then at that point Dominique Jehan was sent to

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Speaker 1: Lose to study medicine with an uncle, Dr Alexis Lay.

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Speaker 1: There's some discrepancy and exactly when that happened, based on

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Speaker 1: which biography you're looking at. There are some sources that

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Speaker 1: placed the move to to Lose when he was eleven

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Speaker 1: others when he was thirteen. Regardless, in this path of study,

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Speaker 1: Dominique Jehan was following not only in his uncle's footsteps,

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Speaker 1: but also when those of his older brother who had

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Speaker 1: become a surgeon. Yeah, there's a lot of discrepancy and

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Speaker 1: dates when you start really looking at biographies of him.

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Speaker 1: There is a biography that I looked at a lot,

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Speaker 1: written in the eighteen sixties that the date they give

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Speaker 1: for his birth is impossible. Um Like he would have

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Speaker 1: been like eleven doing some of his most important stuff

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Speaker 1: like there are are It's a little bit tricky to

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Speaker 1: tease out exact dates on some of his his um

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Speaker 1: key points until he really gets in the military, when

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Speaker 1: records were really carefully taken. Um Uggle Alexey, who was

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Speaker 1: the surgeon major at Hospital of grav and an associate

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Speaker 1: at the Royal Academy of Surgery in Paris, was very

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Speaker 1: aware that not only was he giving his nephew a

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Speaker 1: medical education, but that he was also stepping into the

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Speaker 1: role of surrogate father. And he actually told Domini Jean

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Speaker 1: when he first arrived that he would be his adopted son.

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Speaker 1: After a number of years with his uncle, when he

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Speaker 1: was twenty one, Larrey moved to Paris. There he became

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Speaker 1: an assistant surgeon in the French Navy, and soon he

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Speaker 1: was departing from the port at Breast aboard a sloop

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Speaker 1: called La Vigelant. His work with the navy was pretty fraught.

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Speaker 1: He was nearly shipwrecked almost immediately. The seven months that

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Speaker 1: he served aboard this ship gave him really strong opinions

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Speaker 1: about the importance of high Jean and also taught him

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Speaker 1: a great deal about the treatment of injuries and ailments

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Speaker 1: and really tight quarters. By seventeen eighty nine, the young

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Speaker 1: doctor was back in Paris, and that was just as

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Speaker 1: the violence of the French Revolution was really creating an

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Speaker 1: increased need for them for some emergency medical care. He

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Speaker 1: also became a student of Pierre Joseph Bissault during this time,

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Speaker 1: who was heading up the teams that were treating injuries

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Speaker 1: from the riots and the fighting at the Hotel Dieu

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Speaker 1: and Hotel des Valid. Dessault was the first professor of

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Speaker 1: clinical surgery in France, and he was both beloved and renowned,

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Speaker 1: So Larrey was basically getting on the job cutting edge

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Speaker 1: education in medicine under his tutelage. In the early seventeen nineties,

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Speaker 1: Dominique John joined France's Army of the Rhyme and reported

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Speaker 1: for duty at Strasbourg on April one of seventeen ninety two.

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Speaker 1: And this is where he made the impact for which

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Speaker 1: he's probably best known today. But to talk about that

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Speaker 1: with a bit of context, wanting to back up just

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Speaker 1: a little bit all the way through ancient history. So

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Speaker 1: the concept of an ambulance, and by that we mean

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Speaker 1: a vehicle that could rapidly transport injured or sick people

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Speaker 1: to treatment, is nothing new. That word ambulance is also

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Speaker 1: used in some of Laray's writing uh later on to

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Speaker 1: suggest like an itinerant hospital. And one of the primary

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Speaker 1: drivers to the development of a system of carrying the

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Speaker 1: wounded throughout history has been war, one of the earliest

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Speaker 1: instances we know of when conflict led to moves forward

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Speaker 1: in emergency care with thanks to Alexander the Great's father,

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Speaker 1: Philip the Second of Masodon during the fourth century b

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Speaker 1: c e. He made the decision that his deployed troops

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Speaker 1: would have medical personnel who traveled with them to treat

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Speaker 1: injuries and illnesses as they occurred during campaigns. Jumping forward

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Speaker 1: from there to the sixth century, Mauritius, Emperor of Byzantine,

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Speaker 1: similarly ensured that his fighting troops were accompanied by medical assistance.

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Speaker 1: In the case of Muritius, his army set up tents

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Speaker 1: that were adjacent to the field of battle were designed

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Speaker 1: for emergency care. Especially designated horsemen stood by with saddles

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Speaker 1: that had been designed to carry the injured to caregivers

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Speaker 1: waiting in those tents. Centuries later, a similar system was

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Speaker 1: employed during the Crusades. The wagons were used at that

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Speaker 1: point in time instead of single horsemen. In the fifteenth century,

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Speaker 1: the idea of dedicated wagon teams for carrying those injured

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Speaker 1: and military battles caught on throughout Europe. Queen Isabella of

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Speaker 1: Spain is the first we know of who created a

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Speaker 1: fleet of wagons that had been designed and constructed just

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Speaker 1: for this task. But soon a lot of other nations

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Speaker 1: had incorporated similar vehicles into their militaries, and the idea

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Speaker 1: of medical personnel traveling with military troops had become a

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Speaker 1: lot more common. But a more formalized plan for ambulances

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Speaker 1: in the field was developed by Domini Genrere in seventeen two. Laray,

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Speaker 1: at this point was a surgeon traveling when Napoleon's army,

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Speaker 1: and he saw firsthand not only how brutal attle could be,

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Speaker 1: but that often wounded soldiers were left suffering for hours,

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Speaker 1: sometimes as long as a full twenty four hour day

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Speaker 1: or longer, before they could be moved by available personnel.

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Speaker 1: While those other militaries that we have been talking about

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Speaker 1: over time had adopted the idea that they should have

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Speaker 1: medical personnel standing by and even vehicles to transport the wounded,

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Speaker 1: none of those protocols were designed to ever be used

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Speaker 1: on an active battlefield. Those features would swoop in once

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Speaker 1: the fighting was over, and so that meant that not

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Speaker 1: only were those injured soldiers going without treatment as they

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Speaker 1: lay on the battlefield, they also weren't getting any food

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Speaker 1: or water. Laray wrote about the problems and obstacles of

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Speaker 1: caring for the battle wounded and their grave consequences, and

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Speaker 1: his notes quote, I now first discovered the inconveniences to

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Speaker 1: which we were subjected. In moving our ambulances or military hospitals,

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Speaker 1: the military regulations required that they should always be one

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Speaker 1: league distant from the army. The wounded were left on

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Speaker 1: the field until after the engagement and were then collected

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Speaker 1: at a convenient spot to which the ambulances speeded as

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Speaker 1: soon as possible, But the number of wagons interposed between

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Speaker 1: them and the army, and many other difficulties so retarded

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Speaker 1: their progress that they never arrived in less than twenty

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Speaker 1: four or thirty six hours, so that most of the

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Speaker 1: wounded died for want of assistance. Yeah, a league, by

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Speaker 1: the way, which he references, is almost three point five

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Speaker 1: miles and more than five point five kilometers, so these

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Speaker 1: makeshift hospitals were set up quite far away from the

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Speaker 1: actual battle. We should note that while witnessing the misery

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Speaker 1: of battlefield injury spurred Laray to developing a solution, it

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Speaker 1: was certainly not as though he was the first person

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Speaker 1: to realize that militaries could do better in caring for

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Speaker 1: their war wounded. Many nations recognized that there was a

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Speaker 1: huge problem, and that soldiers with treatable injuries were often

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Speaker 1: lost simply because they could not get to life saving

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Speaker 1: treatment in time. The French government had issued a call

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Speaker 1: for some sort of solution to this problem several years

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Speaker 1: before Laray even joined the army. We'll talk about Laray's ambulance.

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Speaker 1: After we first paused for a quick sponsor break. The

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Speaker 1: word ambulance is rooted in the French word amboulan, which

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Speaker 1: means itinerant or traveling, and when Laray designed a vehicle

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Speaker 1: that would allow soldiers to be carried from the field,

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Speaker 1: he called it the ambulance volante, which translates to flying ambulance,

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Speaker 1: the idea that flying meant speedy. Laray's ambulance was a

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Speaker 1: two wheeled carriage similar to those that were used in

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Speaker 1: the French military to transport weaponry. Because he had noticed,

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Speaker 1: while watching active battles just how quickly and nimbly those

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Speaker 1: artillery carts could move. The design of the new medical

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Speaker 1: cart was agile enough to get through tight spaces, though

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Speaker 1: it also included a full covering for the soldiers being transported.

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Speaker 1: There was a matter us inside which sat on a base,

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Speaker 1: and that base, which Laray called a floor, could easily

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Speaker 1: slide in and out of the ambulance enclosure using a

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Speaker 1: system of rollers. When it was tested on the battlefield

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Speaker 1: at Limbourge, it worked exactly as Laray and his superiors

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Speaker 1: had hoped. Larger versions of the flying ambulance were also developed,

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Speaker 1: and various adaptations were eventually made to suit difficult to rains,

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Speaker 1: including switching out the horses that drew them for mules

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Speaker 1: and even camels as the location in the climate warranted.

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Speaker 1: But Laray went far beyond merely developing a vehicle. He

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Speaker 1: actually came up with a comprehensive battlefield medical system. Under

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Speaker 1: Laray's system, surgeons or medics, which he collectively called esquad

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Speaker 1: volante or flying squads, would move onto the field even

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Speaker 1: while active fighting was happening to give initial treatment to

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Speaker 1: soldiers and assess the severity of their wounds. Then the

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Speaker 1: ambulance would cart the injured away from the battle, and

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Speaker 1: the next stop was a tent hospital set up adjacent

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Speaker 1: to the battle field, again kind of borrowing from history

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Speaker 1: there and then if that sol jour needed additional treatment

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Speaker 1: beyond what was available in that itinerant tent hospital, he

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Speaker 1: would be taken to a more standard, permanent hospital. A

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Speaker 1: key element in this is that as Laray developed the system,

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Speaker 1: he became the first to establish a triage hierarchy the

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Speaker 1: way that we would see it today. Triage is French

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Speaker 1: for sorting. Under Larrey's guidelines, men with the most life

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Speaker 1: threatening injuries were prioritized, with lower levels of danger sorted

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Speaker 1: into priority under that it seems obvious, but prior to

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Speaker 1: lay battlefield wounded were treated in order of rank, and

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Speaker 1: then enemy prisoners were always last. Lara saw all the

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Speaker 1: patients as equals, with their treatment determined by medical need

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Speaker 1: rather than any class distinction. Each division of this carefully

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Speaker 1: executed system was managed by a chief surgeon, and there

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Speaker 1: were normally sixty four men in any medical unit, which

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Speaker 1: included surgeons, orderly and nurses. And those personnel were traveling

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Speaker 1: aboard sixteen carriages from position to position, and bringing with

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Speaker 1: them twelve ambulance wagons and four wagons to carry supplies.

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Speaker 1: The division was managed in a hierarchy in the following manner,

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Speaker 1: as described by lay quote. One surgeon major of the

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Speaker 1: first class, commanding with two surgeons mates of the second class,

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Speaker 1: twelve junior mates of the third class, two of them

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Speaker 1: serving as apothecaries. A lieutenant steward of division of ambulance,

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Speaker 1: a sub lieutenant inspector of police acting as understeward, a

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Speaker 1: quartermaster general of the first class of ambulance, two deputies

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Speaker 1: of the third class of ambulance, a bearer of surgical

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Speaker 1: instruments with a trumpet, twelve soldiers on horseback as overseers

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Speaker 1: to take care of the wounded, among them a ferrier,

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Speaker 1: a saddler, and a bootmaker, and a commissioned sergeant major

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Speaker 1: of the first class, two commissioned officers of the second

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Speaker 1: class to precede the ambulance, three corporals retained for the

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Speaker 1: performance of various errands, a lad with a drum carrying

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Speaker 1: surgical dressings, and twenty five foot soldiers as overseers to

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Speaker 1: take care of the wounded. Beat further made detailed descriptions

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Speaker 1: of the orders that Kirk should travel in, what particular

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Speaker 1: supplies each person in each position should require and carry,

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Speaker 1: and even specifications regarding their uniforms. And all of these

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Speaker 1: notes and provisions and details about how this should be

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Speaker 1: carried out were carefully made so that each person could

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Speaker 1: do their job to the best of their ability. General

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Speaker 1: Alexandra de Bouharne made sure to mention the work of

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Speaker 1: Laray and his reports to his superiors, saying quote, I

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Speaker 1: ought not to omit the surgeon Major Larrey and his

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Speaker 1: comrades with flying ambulances, whose indefatigable care in the healing

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Speaker 1: of the wounded has diminished those afflicting results to humanity,

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Speaker 1: which have generally been inseparable from days of victory and

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Speaker 1: has essentially served the cause of humanity itself in preserving

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Speaker 1: the brave defenders of our country. Uh. Yeah, it's really interesting.

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Speaker 1: There's a lot of talk. I don't go into a

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Speaker 1: lot of detail in it in this outline, but there

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Speaker 1: was a lot of talk at the time of how

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Speaker 1: much just having Laray working on these problems setting up

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Speaker 1: this system not only saved people's lives, but also it

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Speaker 1: was just a morale boost, Like soldiers felt better knowing

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Speaker 1: there was a codified system in place to take care

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Speaker 1: of them, and so they were better at their jobs.

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Speaker 1: And Lari we should mention, was not the only person

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Speaker 1: that was working on creating vehicles that could go onto

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Speaker 1: battlefields to help soldiers in need of medical attention. We

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Speaker 1: said earlier that there had been a call for the

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Speaker 1: development of a solution to this problem in the form

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Speaker 1: of a battlefield transport for wounded men on the part

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Speaker 1: of the French government, and there had even been a

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Speaker 1: prize offered if someone could design a prototype that was

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Speaker 1: light enough for ease of movement, solid enough to withstand

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Speaker 1: the terrain of battlefields and the constant travel from engagement

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Speaker 1: to engagement, and also large enough to carry four to

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Speaker 1: six adult men. Twenty nine designs were submitted to the government,

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Speaker 1: but none were approved or awarded the prize. One that

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Speaker 1: was in development at the same time as Laray's was

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Speaker 1: designed by another French surgeon, Baron Pierre Francois Percy. His

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Speaker 1: cart was sort of like an elongated, slightly rounded coffin

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Speaker 1: that was filled with medical supplies and pulled by a

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Speaker 1: team of two horses. The idea was that a surgeon

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Speaker 1: would ride with the troops to the battlefield on the cart,

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Speaker 1: which got the nickname worst Wagon because it reminded people

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Speaker 1: of a sausage. All treatment would happen from this mobile hospital.

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Speaker 1: There was no functionality for Percy's designed to carry a

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Speaker 1: soldier to safety or to a hospital tent. Medical staff

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Speaker 1: would still need decartment around on stretchers. While Percy's idea

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Speaker 1: and others were being vetted and discarded, and the government

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Speaker 1: even attempted its own design, Larrey had already been successfully

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Speaker 1: using his ambulance in real world battles. Napoleon was extremely

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Speaker 1: grateful to Laray for this innovation, which, as I said earlier,

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Speaker 1: saved the lives of many soldiers and sped up recoveries

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Speaker 1: of that men could get back to active duty. The

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Speaker 1: leader said of the surgeon, quote, your work is one

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Speaker 1: of the most happy conceptions of our age. It will

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Speaker 1: suffice for your reputation. Laray became one of Napoleon's favorites,

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Speaker 1: and he was promoted to surgeon in chief of the

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Speaker 1: Army of Corsica, and he got that news while he

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Speaker 1: was returned temporarily to Paris. He was there because he

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Speaker 1: was overseeing construction of more ambulances for more troops, and

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Speaker 1: also getting married to his beloved Charlotte Elizabeth laville Arue.

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Speaker 1: The wedding was barely finished when Laray and his bride

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Speaker 1: left for Toulon, on France's southern coast, where Dominique John

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Speaker 1: had been ordered to report. His wife stayed with family

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Speaker 1: that lived there while her husband reported for duty, and

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Speaker 1: from there Laray traveled extensively as needed in the service

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Speaker 1: of the army. He went to Nice and then Spain

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Speaker 1: and then Italy, establishing units to execute his medical system

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Speaker 1: in each location. While he was stationed in Milan, he

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Speaker 1: also established a school of surgery there. Yeah, I don't

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Speaker 1: list them all. Out here, but basically he was setting

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Speaker 1: up these situations military hospitals, etcetera, all over Europe. As

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Speaker 1: as these various engagements went on, and as he continued

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Speaker 1: to work in active battle zones, Laray also pioneered a

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Speaker 1: new approach to amputations. Because a lot of men had

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Speaker 1: limbs damaged and cannon fire amputations were always an issue

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Speaker 1: during this time in military conflict, Laray developed what came

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Speaker 1: to be known as his twenty four hour principle, meaning

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Speaker 1: that he believed the patient's chance of surviving with a

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Speaker 1: limb that needed amputation dropped if he was not operated

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Speaker 1: on within twenty four hours. Prior to this, there had

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Speaker 1: been a belief that the surgeon should wait for evidence

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Speaker 1: of dead tissue to make sure that the limb was

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Speaker 1: truly lost before amputating. Under Laray's ideology, the amputation would

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Speaker 1: happen as soon as possible after the injury happened. It

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00:17:51,400 --> 00:17:53,919
Speaker 1: was more a matter of really carefully assessing the injury

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Speaker 1: and determining this limb cannot be saved. The idea was

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Speaker 1: that leaving so called devitalized tissue in tact increase the

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00:18:01,520 --> 00:18:05,399
Speaker 1: chance of infection and sepsis. Lari actually noted once in

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Speaker 1: his writings that before these ideas were implemented, you almost

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Speaker 1: never saw amputees, particularly amputees that had lost multiple limbs.

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Speaker 1: But he was like, that's because they rarely survive. Additionally,

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Speaker 1: Laray's early study with his uncle had included hours and

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Speaker 1: hours of dissection lab work, so he had a masterful

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Speaker 1: understanding of anatomy. As a consequence, he was able to

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Speaker 1: develop a new method for performing amputations at the shoulder,

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Speaker 1: which came to be known as Laray amputation. He may

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Speaker 1: recall that when we talked about Robert Liston, he had

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Speaker 1: developed a way of amputating that left extra skin so

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Speaker 1: that the wound could be sutured without the skin being

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Speaker 1: too tight. Laray had a similar idea, but it worked

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Speaker 1: from the opposite angle. He severed the limb above the damage,

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Speaker 1: often close to a joint, leaving enough skin to similarly

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Speaker 1: close the wound with the optimal comfort for the patient.

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Speaker 1: And Larie was also willing and able to perform the

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Speaker 1: very dangerous amputation of the leg at the hip. This

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Speaker 1: is a very controversial operation at the time, and Laray

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Speaker 1: received a lot of criticism from the medical community for

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Speaker 1: doing it, but he was adamant that there were cases

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Speaker 1: when this was the only option, and he wrote, quote,

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Speaker 1: however cruel that operation. Maybe it is an act of

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Speaker 1: humanity in the hands of the surgeon when he can

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Speaker 1: save the life of the injured in danger. And the

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Speaker 1: more the danger is great and pressing, the more the

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Speaker 1: response must be prompt and energetic. Laray made a number

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Speaker 1: of other strides, not just in field medicine, but in

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Speaker 1: medicine in general. He developed a trauma focused method of

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Speaker 1: pericardio synthesis, or removing fluid from around the heart with

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Speaker 1: a needle. He designed a new type of needle for

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Speaker 1: suturing that he used on the battlefield. He developed a

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Speaker 1: way to use a patient's breathing to assist in draining wounds.

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Speaker 1: He also realized that extreme cold could be used as

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Speaker 1: an anesthetic, something that he practiced on the battlefield by

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Speaker 1: packing snow onto injuries. And he pioneered the removed full

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Speaker 1: of bullets from wounds by making a secondary incision rather

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Speaker 1: than digging through the damaged tissue that the bullet had

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Speaker 1: damaged upon entry. We're going to talk about Laray's continuing

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Speaker 1: service to Napoleon and the power of his reputation in

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Speaker 1: just a moment. But first we'll take a break in

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Speaker 1: here from the sponsors that keep stuff you missed in

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Speaker 1: history class going. When Napoleon launched his campaign into Egypt,

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Speaker 1: Laray was part of it, and he had arranged for

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Speaker 1: the most promising surgeons from medical schools in Montpellier and

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Speaker 1: to Lose to be part of the medical staff for

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Speaker 1: the expedition. In total, he had assembled three medical divisions

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Speaker 1: for the journey. The forces departed from Toulon on May

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Speaker 1: nineteen seventy. Three weeks later they were at Malta, which

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Speaker 1: quickly surrendered, and then they continued on to Alexandria. The

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Speaker 1: year that campaigned through Egypt and Syria wrapped up, which

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Speaker 1: is eighteen o one, Laray was promoted again, this time

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Speaker 1: to surgeon general of Napoleon's famed Imperial Guard. His coundra

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Speaker 1: of soldiers who had been with the emperor from the beginning,

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Speaker 1: and we're the most trusted. Laray always served admirably throughout

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Speaker 1: his time as a military surgeon. He was himself even

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Speaker 1: wounded while traveling with the army, and at one point

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Speaker 1: he was almost captured by the enemy. Later there is

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Speaker 1: a capture we'll talk about. But he was undeterred in

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Speaker 1: his mission to improve the medical care of Francis soldiers,

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Speaker 1: and for his bravery and dedication, the Emperor made him

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Speaker 1: a baron on the battlefield at Vagrum in eighteen o nine. Lay,

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Speaker 1: for all of his work, was incredibly well respected not

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Speaker 1: only by the soldiers and leaders of France, but by

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Speaker 1: other armies as well as French troops fled Russia. Special

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Speaker 1: care was made so that Laray, who was with them,

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Speaker 1: could make it to safety. Soldiers are said to have

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Speaker 1: passed him over their heads to ensure that he safely

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Speaker 1: made it across a bridge at the Berezina River. Allegedly,

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Speaker 1: during the Battle of Waterloo, enemy forces were ordered to

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Speaker 1: point their fire away from Laray's ambulance divisions when they

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Speaker 1: were on the field treating the wounded. This is in

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Speaker 1: part because he always felt and shared with his fellow

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Speaker 1: military doctors that all patients, even the enemy wounded, should

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Speaker 1: be treated with care and compassion when it came to

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Speaker 1: their medical needs. I feel like this is kind of

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Speaker 1: a precursor to UH standards about how wartime medical staff

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Speaker 1: should be treated like that became for more formal parts

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Speaker 1: of international standards later on, Yeah, he was really groundbreaking

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Speaker 1: in this regard. Like we mentioned earlier that normally, prior

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Speaker 1: to his work, if you were an enemy combatant that

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Speaker 1: had been captured, even if you were in horrible, life

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Speaker 1: threatening pain, you still got treated last, whereas he was like, no,

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Speaker 1: that's not how we're going to do this. Uh Napoleon's

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Speaker 1: defeat at Waterloo ended with the order of self keep,

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Speaker 1: basically every man for himself, but Domini, Genrerey and the

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Speaker 1: surgeons who served with him felt that this was against

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Speaker 1: their first obligation as medical practitioners, so they stayed to

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Speaker 1: look after the wounded, and as night fell, the doctor scattered,

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Speaker 1: hoping to evade the Prussian army. But Larrey was first

396
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Speaker 1: shot at and then cut with a saber, and he

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00:23:12,040 --> 00:23:14,320
Speaker 1: had passed out and he was left for dead, but

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Speaker 1: then he was captured. When he awoke and he realized

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Speaker 1: he could run, he kind of made his way some

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Speaker 1: distance and was captured. And the story goes that just

401
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Speaker 1: as he was about to be executed, one of the

402
00:23:24,200 --> 00:23:28,080
Speaker 1: Prussian doctors recognized him, having attended a lecture given by

403
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Speaker 1: Larrey and Berlin six years earlier. Having been recognized, he

404
00:23:32,800 --> 00:23:35,720
Speaker 1: was brought to a field Marshal Blucher to determine what

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00:23:35,760 --> 00:23:38,680
Speaker 1: should be done. It turned out that Bluecker's son had

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Speaker 1: been treated as a prisoner of war by Lay, who

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Speaker 1: had saved the young man's life, so in saving an

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00:23:44,000 --> 00:23:46,760
Speaker 1: enemy's life, he ultimately saved his own. Larrey was taken

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Speaker 1: to Brussels, where he recovered from his wounds, and then

410
00:23:49,440 --> 00:23:52,240
Speaker 1: he traveled on to Paris to be reunited with his family.

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Speaker 1: When Napoleon was forced to abdicate and was sent into

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Speaker 1: exile in eighteen fifteen, Domini Jean Lere paid a price

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Speaker 1: for his association and his loyalty to the former emperor,

414
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Speaker 1: although it was not perhaps as steep as you might imagine.

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Speaker 1: Uh Initially, his honors and his titles that have been

416
00:24:08,440 --> 00:24:11,560
Speaker 1: bestowed upon him were taken away, including his rank as

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Speaker 1: Inspector General of Hospitals and his pension of three thousand francs.

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Speaker 1: But his reputation created a very high demand for his work.

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Speaker 1: Other nations started asking if he would like to work

420
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Speaker 1: for them, including Russian Emperor Alexander the First, who offered

421
00:24:26,640 --> 00:24:29,919
Speaker 1: Laria position as head of his army's medical division. But

422
00:24:30,040 --> 00:24:33,359
Speaker 1: Lay only wanted to stay in France, and so he

423
00:24:33,400 --> 00:24:36,560
Speaker 1: turned it down in eighteen eighteen. Out of respect for

424
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Speaker 1: Laray and his work, His pension was restored. When the

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Speaker 1: Academy de Medicin was founded in eighteen twenty, Larrey was

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Speaker 1: named as one of its inaugural members. Louis the eighteenth

427
00:24:47,240 --> 00:24:50,320
Speaker 1: made him surgeon of the Royal Guard in eighteen twenty one,

428
00:24:50,840 --> 00:24:53,840
Speaker 1: but those things had turned around for him personally. The

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00:24:53,920 --> 00:24:56,920
Speaker 1: news of Napoleon's death in May of eighteen twenty one

430
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Speaker 1: hit Larey really hard. Napoleon referred to Array and his

431
00:25:00,640 --> 00:25:03,639
Speaker 1: will as quote the worthiest man I ever met, and

432
00:25:03,760 --> 00:25:06,800
Speaker 1: left him a hundred thousand francs. Still grieving the man

433
00:25:06,920 --> 00:25:09,960
Speaker 1: he had so loyally served, Laray turned to his work

434
00:25:10,000 --> 00:25:13,840
Speaker 1: for solace. He had been writing a comprehensive guide to surgery,

435
00:25:14,000 --> 00:25:16,439
Speaker 1: and in eighteen twenty six he decided to travel to

436
00:25:16,480 --> 00:25:19,320
Speaker 1: England with his son, who also became a surgeon, to

437
00:25:19,400 --> 00:25:22,800
Speaker 1: study surgical techniques there as part of his research, and

438
00:25:22,880 --> 00:25:25,479
Speaker 1: his report on all that he learned there earned him

439
00:25:25,480 --> 00:25:28,800
Speaker 1: a place in the Academy of Sciences in eighteen nine.

440
00:25:29,480 --> 00:25:32,760
Speaker 1: When the Three Day July Revolution broke out in Paris

441
00:25:32,760 --> 00:25:36,320
Speaker 1: in eighteen thirty Laray once again tended the wounded, treating

442
00:25:36,320 --> 00:25:39,439
Speaker 1: them at the military hospital at girl Cayou. When the

443
00:25:39,480 --> 00:25:42,639
Speaker 1: hospital was stormed by armed men, Laray stood up to

444
00:25:42,640 --> 00:25:44,959
Speaker 1: them and sent them packing, asking do you know that

445
00:25:45,000 --> 00:25:47,520
Speaker 1: the sick and wounded here belonged to me? That it

446
00:25:47,640 --> 00:25:49,919
Speaker 1: is my duty to defend them, and that is also

447
00:25:50,000 --> 00:25:52,919
Speaker 1: your duty to respect the unfortunate. I love him for

448
00:25:52,960 --> 00:25:56,280
Speaker 1: so many reasons. After this, he was sent to Belgium

449
00:25:56,320 --> 00:25:59,400
Speaker 1: to help them set up their armies mobile medical units,

450
00:26:00,000 --> 00:26:02,040
Speaker 1: and then he returned to Paris, where he was named

451
00:26:02,040 --> 00:26:04,879
Speaker 1: a surgeon in chief at the Hotel des a Valid.

452
00:26:05,280 --> 00:26:07,920
Speaker 1: Even then in his sixties at this point, he kept

453
00:26:07,960 --> 00:26:10,960
Speaker 1: up a very rigorous schedule. He woke up at three

454
00:26:11,040 --> 00:26:14,080
Speaker 1: am every morning so he could spend several hours writing

455
00:26:14,160 --> 00:26:17,040
Speaker 1: and researching, and then at six am he began his

456
00:26:17,160 --> 00:26:20,600
Speaker 1: rounds at the hospital. When rounds were done, he lectured

457
00:26:20,640 --> 00:26:23,200
Speaker 1: to medical students, and then he spent extra time with

458
00:26:23,240 --> 00:26:26,600
Speaker 1: any of them who had questions or needed additional time

459
00:26:26,680 --> 00:26:29,119
Speaker 1: with this surgeon who had become a legend in his

460
00:26:29,240 --> 00:26:33,600
Speaker 1: own time. In the afternoons, if time permitted, Laray visited

461
00:26:33,600 --> 00:26:36,719
Speaker 1: the wards once again, often checking in on patients who

462
00:26:36,800 --> 00:26:40,199
Speaker 1: had been soldiers that he had served alongside. In eighteen

463
00:26:40,240 --> 00:26:44,480
Speaker 1: thirty four, Laray traveled to Italy with his son, but

464
00:26:44,520 --> 00:26:48,040
Speaker 1: first he traveled south to Boudion and visited his first

465
00:26:48,160 --> 00:26:51,119
Speaker 1: teacher at be Grasse, the priest who had taught him

466
00:26:51,119 --> 00:26:53,920
Speaker 1: as a child. Then he traveled across the southern half

467
00:26:53,920 --> 00:26:56,600
Speaker 1: of France towards Italy, making a number of stops along

468
00:26:56,640 --> 00:27:00,280
Speaker 1: the way. In Italy, he traveled to Rome and fle Rinths,

469
00:27:00,280 --> 00:27:02,760
Speaker 1: where he was warmly received, before making his way back

470
00:27:02,800 --> 00:27:06,960
Speaker 1: to Paris. Despite his advancing age, when the thirty five

471
00:27:07,040 --> 00:27:10,840
Speaker 1: cholera outbreak hit France, Laray traveled to all of the

472
00:27:10,880 --> 00:27:14,480
Speaker 1: cities where it hit the hardest. He offered medical assistance

473
00:27:14,560 --> 00:27:17,959
Speaker 1: and he reassured both patients and medical personnel that they

474
00:27:17,960 --> 00:27:20,600
Speaker 1: would get through it, gave them best practices for how

475
00:27:20,640 --> 00:27:23,600
Speaker 1: to handle things, and then he wrote a very detailed

476
00:27:23,600 --> 00:27:27,199
Speaker 1: report to his superiors once he returned to Paris. Incidentally,

477
00:27:27,240 --> 00:27:30,439
Speaker 1: he subscribed to the animal cules theory on how disease

478
00:27:30,480 --> 00:27:34,280
Speaker 1: was spread. Not long after this, Laray retired from his job.

479
00:27:34,760 --> 00:27:37,679
Speaker 1: When Napoleon's ashes arrived in Paris to be interred on

480
00:27:37,720 --> 00:27:41,320
Speaker 1: December fifteenth, eighteen forty Laray insisted on going out into

481
00:27:41,400 --> 00:27:44,240
Speaker 1: the cold to watch the procession and told the friend

482
00:27:44,240 --> 00:27:47,600
Speaker 1: who accompanied him, quote, never has my heart, which though

483
00:27:47,640 --> 00:27:50,880
Speaker 1: I am old, is not hardened, been more agitated by

484
00:27:50,880 --> 00:27:55,159
Speaker 1: my souvenir. Yeah. There is some speculation that Laray's retirement

485
00:27:55,200 --> 00:27:57,879
Speaker 1: was because he had some sort of disagreement with the

486
00:27:57,920 --> 00:28:02,119
Speaker 1: government over something having to do with Napoleon, but we

487
00:28:02,240 --> 00:28:06,200
Speaker 1: don't really know. Laray was very, very loyal to Napoleon

488
00:28:06,720 --> 00:28:11,879
Speaker 1: for his entire life. Um, but it's all pretty speculative

489
00:28:12,040 --> 00:28:15,560
Speaker 1: as to what actually happened. In eighteen forty one, Larrey

490
00:28:15,640 --> 00:28:18,920
Speaker 1: made a trip to Algiers to inspect the military hospitals there,

491
00:28:19,400 --> 00:28:22,040
Speaker 1: and this was a dangerous trip, both because of unrest

492
00:28:22,040 --> 00:28:25,520
Speaker 1: in the region and because of Domini Jean's advancing age.

493
00:28:26,040 --> 00:28:29,199
Speaker 1: Once again, his son was with him and along the journey,

494
00:28:29,200 --> 00:28:33,359
Speaker 1: though Laray's health really deteriorated. He landed back in France

495
00:28:33,400 --> 00:28:36,200
Speaker 1: at the port of Toulon in July. At that point

496
00:28:36,240 --> 00:28:38,800
Speaker 1: he had inflammation in his chest and he was told

497
00:28:38,840 --> 00:28:41,960
Speaker 1: to stay in Toulon and recuperate before moving on, but

498
00:28:42,040 --> 00:28:44,360
Speaker 1: Laray really wanted to see his wife, and so he

499
00:28:44,400 --> 00:28:47,719
Speaker 1: continued to travel. Lay did not make it back to Paris.

500
00:28:48,120 --> 00:28:50,680
Speaker 1: He died in Leone at the end of July eighteen

501
00:28:50,680 --> 00:28:53,600
Speaker 1: forty two, at the age of seventy six. What he

502
00:28:53,680 --> 00:28:56,000
Speaker 1: didn't know when he passed was that his wife had

503
00:28:56,000 --> 00:28:59,160
Speaker 1: also died at home in Paris. Laray's body was brought

504
00:28:59,200 --> 00:29:02,160
Speaker 1: to Paris and cremated, and his ashes were interred at

505
00:29:02,200 --> 00:29:05,920
Speaker 1: pearl Ches. In eighteen fifty a statue was erected in

506
00:29:06,000 --> 00:29:09,480
Speaker 1: honor of Lay at the court of valde Grass Military Hospital.

507
00:29:10,080 --> 00:29:14,000
Speaker 1: While peril Ches is the final resting place of many luminaries,

508
00:29:14,560 --> 00:29:17,360
Speaker 1: it was not where Laray had wished to be buried.

509
00:29:17,640 --> 00:29:20,080
Speaker 1: He wanted his remains to go to Les Invalid, near

510
00:29:20,160 --> 00:29:25,040
Speaker 1: Napoleon's tomb. A hundred and fifty years after his death, Dominique,

511
00:29:25,080 --> 00:29:27,680
Speaker 1: Jean Larrey got his wish. His ashes were moved in

512
00:29:29,040 --> 00:29:31,960
Speaker 1: and in an introduction to a biography about Laray, which

513
00:29:32,000 --> 00:29:34,000
Speaker 1: is written in eighteen sixty one, there's a really, really

514
00:29:34,040 --> 00:29:36,560
Speaker 1: lovely passage that kind of sums up his life. So

515
00:29:36,600 --> 00:29:38,239
Speaker 1: I thought this was a good point to end on,

516
00:29:39,120 --> 00:29:41,800
Speaker 1: and it is quote amid the tempest of bullets and

517
00:29:41,840 --> 00:29:45,160
Speaker 1: the bursting of shells, the French surgeon Larrey has been

518
00:29:45,160 --> 00:29:49,280
Speaker 1: seen calm intrepid and also prodigal in the resources of

519
00:29:49,280 --> 00:29:53,680
Speaker 1: a surgical skill, which was incomparable non combatant as Laray

520
00:29:53,760 --> 00:29:57,440
Speaker 1: professionally was against men. Yet his life might be aptly

521
00:29:57,520 --> 00:30:01,600
Speaker 1: designated a long combat against death. Us. I like him

522
00:30:01,640 --> 00:30:04,400
Speaker 1: because it's uh, not only is it cool just in

523
00:30:04,520 --> 00:30:07,480
Speaker 1: terms of how much he innovated, but it's a fairly

524
00:30:07,560 --> 00:30:12,719
Speaker 1: uplifting story. Yeah. Yeah, um, he there's not a lot

525
00:30:12,760 --> 00:30:18,560
Speaker 1: of surprise misery in it, um, and he really left

526
00:30:18,680 --> 00:30:22,440
Speaker 1: a pretty great legacy. And even when the regime change happened,

527
00:30:22,440 --> 00:30:24,400
Speaker 1: which we've talked about those things happening on the show

528
00:30:24,440 --> 00:30:28,040
Speaker 1: many times before. Often the people loyal to one regime

529
00:30:28,160 --> 00:30:30,840
Speaker 1: really get into hot water when the change takes place.

530
00:30:31,680 --> 00:30:36,640
Speaker 1: But he was so awesome that everybody loved, which it

531
00:30:36,680 --> 00:30:40,080
Speaker 1: makes me happy you can be more of that. Yeah, um,

532
00:30:40,120 --> 00:30:42,240
Speaker 1: are you are you going to tell us why you

533
00:30:42,360 --> 00:30:44,960
Speaker 1: wish you had known before we went to Paris? Yes,

534
00:30:45,000 --> 00:30:47,480
Speaker 1: because we could have gone un scene where he's interred

535
00:30:47,480 --> 00:30:51,080
Speaker 1: at lesamp Lad when we were there. Um, that was

536
00:30:51,200 --> 00:30:54,600
Speaker 1: my guests at the beginning. I was like, I have

537
00:30:54,680 --> 00:30:57,280
Speaker 1: a guess, and I thought about saying I'm gonna see

538
00:30:57,320 --> 00:31:00,360
Speaker 1: if I guess correctly, but I've held my tongue. Yes,

539
00:31:00,520 --> 00:31:04,880
Speaker 1: that's the one. So Um. Theoretically, if our trip to

540
00:31:04,920 --> 00:31:10,480
Speaker 1: Italy still takes place at the uh now shifted time

541
00:31:10,880 --> 00:31:14,480
Speaker 1: in October, I'm hoping that my husband and I can

542
00:31:14,680 --> 00:31:17,080
Speaker 1: do a quick trip to Paris beforehand and then meet

543
00:31:17,160 --> 00:31:19,960
Speaker 1: up with everybody in Italy and if so, going back

544
00:31:20,000 --> 00:31:24,680
Speaker 1: to Lasa valid. It's also just cool to look at

545
00:31:24,760 --> 00:31:28,480
Speaker 1: Napoleon's tomb because it's quite a beautiful space anyway, but

546
00:31:28,720 --> 00:31:31,960
Speaker 1: it's a beautiful space and if you are a doctor

547
00:31:32,000 --> 00:31:37,360
Speaker 1: who fan, it also has just a particular resonance. Yeah,

548
00:31:37,360 --> 00:31:40,920
Speaker 1: and it's just it's a fascinating thing that the tomb

549
00:31:40,920 --> 00:31:46,920
Speaker 1: alone is a wild design of many tombs within tombs

550
00:31:46,920 --> 00:31:51,040
Speaker 1: within tombs, but it's also just super beautiful. I have

551
00:31:51,360 --> 00:31:55,400
Speaker 1: I have some silly ish listener male pertinent to our times. Um.

552
00:31:55,520 --> 00:31:59,160
Speaker 1: This is from our listener Philip, who left a question

553
00:31:59,360 --> 00:32:01,960
Speaker 1: on our face book page. You're out, good evening, ladies.

554
00:32:01,960 --> 00:32:04,360
Speaker 1: I'm a longtime listener to the podcast and I believe

555
00:32:04,440 --> 00:32:07,400
Speaker 1: my first episode was the Lady Jane episode. As we

556
00:32:07,400 --> 00:32:09,080
Speaker 1: are in the middle of this pandemic, I see all

557
00:32:09,120 --> 00:32:11,400
Speaker 1: of the panic over toilet paper on the news and

558
00:32:11,480 --> 00:32:14,160
Speaker 1: posts on social media, and this sparked a query in

559
00:32:14,200 --> 00:32:17,080
Speaker 1: my mind. Where did toilet paper come from? What sparked

560
00:32:17,120 --> 00:32:19,960
Speaker 1: the need? When did this item become an everyday need?

561
00:32:20,400 --> 00:32:22,040
Speaker 1: At first? Was this an item for the well to

562
00:32:22,080 --> 00:32:24,200
Speaker 1: do folks? Thank you for what you do and expanding

563
00:32:24,200 --> 00:32:26,920
Speaker 1: my knowledge, phil Uh So, I thought I would do

564
00:32:26,960 --> 00:32:29,040
Speaker 1: the quick rundown on this because it's not really enough

565
00:32:29,080 --> 00:32:32,320
Speaker 1: to ever make a full episode, I don't think, um,

566
00:32:32,360 --> 00:32:35,720
Speaker 1: but so you will often see the name Joseph Gayetti

567
00:32:35,880 --> 00:32:39,520
Speaker 1: touted as the first person to invent toilet paper. Uh.

568
00:32:39,560 --> 00:32:42,479
Speaker 1: He was the first to create like a commercial toilet paper,

569
00:32:43,480 --> 00:32:46,960
Speaker 1: which was a medicated paper for hemorrhoids that had his

570
00:32:47,040 --> 00:32:50,640
Speaker 1: name printed on every sheet, which I find kind of adorable. Um,

571
00:32:50,680 --> 00:32:53,239
Speaker 1: this was kind of slow to catch on. Prior to

572
00:32:53,320 --> 00:32:56,160
Speaker 1: this in the US, things like catalogs were filling the

573
00:32:56,240 --> 00:32:58,360
Speaker 1: same need and they were free. I mean, if you

574
00:32:58,360 --> 00:32:59,920
Speaker 1: go back in ancient history, there have been a lot

575
00:33:00,000 --> 00:33:03,520
Speaker 1: of different ways that people have have done hygienic cleaning, um,

576
00:33:03,560 --> 00:33:07,440
Speaker 1: including like sponges and water in Rome, and you know,

577
00:33:07,560 --> 00:33:11,239
Speaker 1: various uses of water throughout periods of time. But at

578
00:33:11,280 --> 00:33:14,720
Speaker 1: this point, paper yep, fine, the Scott Brothers introduced the

579
00:33:14,720 --> 00:33:18,880
Speaker 1: toilet paper role in the eight nineties because Guyett's version

580
00:33:18,920 --> 00:33:20,760
Speaker 1: was not really catching on. People thought it was silly

581
00:33:20,760 --> 00:33:22,200
Speaker 1: to spend money on it when you can just tear

582
00:33:22,280 --> 00:33:25,120
Speaker 1: up a catalog. Toilet paper still a little stigmatized by

583
00:33:25,120 --> 00:33:28,640
Speaker 1: that point. Really, the thing that kind of move toilet

584
00:33:28,640 --> 00:33:33,120
Speaker 1: paper into the more standard and accepted and needed item

585
00:33:33,400 --> 00:33:37,960
Speaker 1: was the increase of people with indoor plumbing because you

586
00:33:38,000 --> 00:33:43,000
Speaker 1: couldn't really flush catalog pages without creating a big problem. Um,

587
00:33:43,040 --> 00:33:46,200
Speaker 1: all of this is a very Western view. Hey, the

588
00:33:46,280 --> 00:33:50,560
Speaker 1: Chinese were using toilet paper hundreds of years before, and

589
00:33:50,680 --> 00:33:54,440
Speaker 1: go back to the sixth century. There's evidence of you know,

590
00:33:54,520 --> 00:33:59,120
Speaker 1: even really luxurious scented toilet papers in China, way before

591
00:33:59,160 --> 00:34:02,360
Speaker 1: anybody in the Western world ever was like, hey, you

592
00:34:02,400 --> 00:34:05,880
Speaker 1: know what we should do? Uh So, um, as just

593
00:34:06,000 --> 00:34:11,560
Speaker 1: sort of a pandemic p s A. Do not flush

594
00:34:11,640 --> 00:34:17,080
Speaker 1: flushable whites. They are not really fleshable. Um. I know

595
00:34:17,200 --> 00:34:19,480
Speaker 1: the city where I live has issued some mornings that

596
00:34:19,520 --> 00:34:21,880
Speaker 1: are like, hey, I know they say fleshable on the label,

597
00:34:21,960 --> 00:34:24,560
Speaker 1: but we are seeing a big increase in sewer backups

598
00:34:24,600 --> 00:34:29,040
Speaker 1: because they're they're not really even though they say fleshable

599
00:34:29,040 --> 00:34:31,960
Speaker 1: on the label, they are still likely to stop up

600
00:34:32,000 --> 00:34:36,720
Speaker 1: some pipes, especially in places where maybe the sewage system

601
00:34:37,560 --> 00:34:40,759
Speaker 1: could use some work. Yeah. I feel like that goes

602
00:34:40,840 --> 00:34:43,520
Speaker 1: for a lot of things that are labeled as fleshable, right,

603
00:34:43,600 --> 00:34:47,239
Speaker 1: Like fleshable cat litter is a thing. There are many

604
00:34:47,440 --> 00:34:50,280
Speaker 1: reasons you should actually not flush it, including this bread

605
00:34:50,320 --> 00:34:53,560
Speaker 1: of um talk of plasmosis, which, especially if you live

606
00:34:53,560 --> 00:34:56,880
Speaker 1: in a coastal place, is very bad for um once

607
00:34:57,080 --> 00:34:59,839
Speaker 1: that kind of gets into the water table and can

608
00:35:00,000 --> 00:35:02,440
Speaker 1: get out to the oceans over a long series of things,

609
00:35:02,880 --> 00:35:06,760
Speaker 1: very bad for animals. Um. Yeah, maybe don't don't flush

610
00:35:06,800 --> 00:35:10,080
Speaker 1: things if your instinct is is this really fleshable? Go

611
00:35:10,200 --> 00:35:13,480
Speaker 1: with no? Yeah? Um. I remember when I was a teen,

612
00:35:13,719 --> 00:35:18,640
Speaker 1: my mom like specifically taught me that pads are not flushable,

613
00:35:18,719 --> 00:35:22,560
Speaker 1: but tampons are, and that's also false. You should not

614
00:35:22,600 --> 00:35:26,200
Speaker 1: flush either. One. Oh the talks I have had with

615
00:35:26,200 --> 00:35:29,400
Speaker 1: plumbers over this issue and I'm like, but it says

616
00:35:29,480 --> 00:35:35,080
Speaker 1: and they're like, no, just don't. Uh. If you would

617
00:35:35,120 --> 00:35:36,799
Speaker 1: like to write to us, you could do so at

618
00:35:36,880 --> 00:35:39,600
Speaker 1: History Podcast at I heart radio dot com. You can

619
00:35:39,640 --> 00:35:42,160
Speaker 1: also find us on social media, where we got today's

620
00:35:42,160 --> 00:35:45,440
Speaker 1: listener mail as Missed in History pretty much everywhere you

621
00:35:45,440 --> 00:35:47,239
Speaker 1: would like to subscribe to the show, you can do

622
00:35:47,320 --> 00:35:50,400
Speaker 1: so on the I heart Radio app, at Apple podcast

623
00:35:50,560 --> 00:35:57,920
Speaker 1: or wherever it is you like to listen. Stuff you

624
00:35:57,960 --> 00:36:00,960
Speaker 1: Missed in History Class is a production of I heart Radio.

625
00:36:01,000 --> 00:36:03,560
Speaker 1: For more podcasts from I heart Radio, visit the i

626
00:36:03,640 --> 00:36:06,840
Speaker 1: heart Radio app, Apple Podcasts, or wherever you listen to

627
00:36:06,880 --> 00:36:08,640
Speaker 1: your favorite shows. H