Abstract
The familiar snap closure of today's artery forceps appears simplistic yet it required the ingenuity of Joseph Frédéric Charrieère (1803–76), a Parisian instrument maker, or perhaps one of his master forgers to compress the ancient concept of a toothed rack so elegantly. By comparison, earlier methods of closure were clumsy and inefficient, including the pin and hole catch introduced by Charrière in 1858 (Figure 1a). His rack-catch appeared imperfectly illustrated in a Maison Charrière catalogue dated 1862 1 edited by his son Jules Charrière (fl. 1855–62) who stated this was his father's invention although at that time they preferred the pin and hole catch. In consequence a rival maker, Leon Mathieu (fl.1849–64), first advertised complete instruments with the novel catch in 1864, 2 generating many disputes essentially among surgeons claiming its genesis; it was not employed by Thomas Spencer Wells (1818–97) until 1872. 3
(a) Charrière's disarticulating forceps with pin and hole catch, open and closed; 1 (b) Spencer Wells’ final form of rack-catch haemostat, open and closed (Drawn by Frances Lambert)
The rack-catch (Figure 1b) allowed the application and removal of bow-handled pivoting forceps to be efficient unimanual procedures by contrast with the awkward bimanual manipulation of earlier forceps. Surgical practice benefited enormously for, with a choice of rack positions, haemostasis of smaller calibre vessels could be ensured by compression alone and, by retaining the forceps until wound closure, to provide extra hands for surgeons working alone.
Personal details concerning the elder Charrière have been published quite recently. 4 As a simple craftsman, he studied methods of instrument manufacture elsewhere in Europe and especially the manufacture of steel in England. The surgeon Philibert Joseph Roux (1780–1854) stated that before 1820 English steel was the envy of the French but Charrière's research soon produced metal that was as good if not better. He also designed ‘take-apart’ forceps to facilitate their cleaning, contributed to the prototype litho-trite of 1826, ingeniously compressed minor surgical kits into pocket cases, and improved items for anatomical dissection, veterinary surgery and prostheses. His company(!) appointed to the Faculty of Medicine in Paris, to the Army, to the Navy and to many hospitals at home and abroad, supplied numerous surgical instruments at the foundation of St Mary's Hospital, London in 1852. 1 ‘Maison Charrière’ won many international prizes, including at the Great Exhibition of London in 1862. Charrière was made ‘Officier de la Legion d'Honneur’ in 1851.
Instrument makers are vital to sophisticated surgical technique and Charrièré's innovations were among the most successful of his profession, not least the rack-catch still widely used a century and a half later.