On July 8, 256 years ago, Dominique-Jean Larrey, the French military doctor who became Napoleon Bonaparte’s chief surgeon of the Grande Armée, was born in the small village of Beauden in the Pyrenean Mountains.

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In the course of his career, Larrey helped treat and save hundreds of lives on the battlefields during Napoleonic times. But it’s his introduction of the first purpose-built ambulances and creation of the triage system which have undoubtedly proved to be his most significant legacy.

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Often referred to as the ‘father of modern-day ambulance services’, Larrey’s contributions to medicine continue to live on in common procedures and healthcare systems today. It’s the reason why July 8 has been chosen as a fitting date for International Paramedics Day because not only is today a celebration of all emergency responders around the world, it’s also the anniversary of Larrey’s birth.

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The son of a shoemaker, Larrey was orphaned at 13 and sent to live with his uncle, a surgeon, whose footsteps he would follow in. He studied in Paris under the tutelage of respected French surgeon, Pierre-Joseph Desault and once his formal training was complete he joined the French Navy as a medical officer.

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When the French Revolutionary Wars began in 1792, and France went to war with Great Britain, Austria, Prussia, Russia and several other monarchies, Larrey volunteered to join the Army of the Rhine where he witnessed first-hand the need to reform how soldiers were evacuated off the battlefield.

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As a regimental surgeon-major, Larrey and his medical team were forced to remain at least three miles behind the frontline so if wounded soldiers needed treatment they would either have to find their own way to the field hospital or be carried there by their comrades. It meant ordinary soldiers would often have to wait days for treatment because those of a higher rank would be prioritised, and in many cases they never received any treatment at all.

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In order to counter this problem, Larrey came up with the idea of a ‘flying ambulance’. He argued that using a light transport vehicle to move soldiers from the battlefield would not only reduce response times, it would also increase survival rates. Despite some pretty fierce opposition from the military, the following year at the Battle of Metz, light horse-drawn carriages, complete with strong padding and suspension for patient comfort, and a fold-down ramp to use as a makeshift operating table were introduced on the battlefield.  These ‘flying ambulances’ would later be used in all of the battles fought during the Revolutionary Wars.

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During these early conflicts, Larrey also adopted a new system of treating the wounded which would lay the foundations for the modern-day triage system used by paramedics and first responders today. By implementing this system, the wounded would be treated according to the seriousness of their injuries rather than their rank or nationality. Soldiers of enemy armies, as well as those of the French and their allies would also be treated. In addition, this new system established that the critically injured should be operated on first and as soon as possible. Larrey correctly theorised that surgical procedures should be done within an hour of receiving the patient because when the patient is in shock the muscles are more relaxed and blood pressure is lower, meaning that if amputation was necessary, the procedure would be shorter, cleaner, safer and less painful. A highly skilled surgeon, Larrey reportedly performed 200 amputations in 24 hours at the Battle of Borodino in 1812.

 

He continued to fulfil his duties in treating the wounded during the campaigns of not only the Revolutionary Wars but also the Napoleonic Wars and was bestowed a great number of honours for his service.

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In 1815, after the French lost at the Battle of Waterloo, Larrey and his ambulances had their retreat blocked by the Prussian Army, and in a bid to try and break through the blockade, Larrey was injured, lost consciousness and left for dead.

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Once he regained consciousness, he tried to flee on his own to the French border but was captured by the Prussian soldiers whose general ordered Larrey to be shot. It was only when a Prussian surgeon stepped forward to bandage Larrey’s wound before his execution that the surgeon recognised Larrey and convinced the general not to go through with the execution.

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Larrey was then brought before General Blucher who immediately pardoned him because some years earlier Larrey had saved the life of his son.

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After his release, Larrey returned to France and was reunited with his wife, Marie-Elisabeth Le Roulx de la Ville whom he’d married in 1794. The couple had two children. Larrey spent his twilight years writing and working as the medical director of the veterans’ hospital, Hôtel des Invalides. He died on July 25, 1842, aged 74, three days after his beloved wife.