Education: How Old The NewWalsh, James J. (James Joseph)
History
Education: How Old The New
Walsh, James J. (James Joseph)
Education -- History
Guy de Chauliac has been given the name of the father of modern
surgery. Any one who wants to see why should read the text-book on
surgery that {135} Chauliac wrote and which for two centuries after
his time (he died about the middle of the fourteenth century)
continued to be the most used text-book of surgery in the medical
schools of Europe. Chauliac, for instance, describes the treatment of
conditions within all three of the important cavities of the body, the
skull, the thorax and the abdomen. Pagel has three closely-printed
pages in small type of titles alone of subjects in surgery which
Chauliac treated with distinction. His description of instruments and
methods of operation is especially full and suggestive. He describes
the passage of a catheter, for instance, with the accuracy and
complete technique of a man who knew the difficulties of it in
complicated cases from practical experience. He even recognizes the
dangers for the patient from the presence of anatomical anomalies of
various kinds and describes certain of the more important of them. He
has very exact indications for trephining. For empyema he advises
opening of the chest and indicates where and how. He says very frankly
that in wounds of the abdomen the patient will die if the intestines
have been perforated and left untreated, and he describes a method of
suturing wounds of the intestines in order to save the patient's life.
His treatment of bone surgery and of fractures and dislocations is
especially interesting and shows how far these very practical men had
reached conclusions resembling those of our time. {136} It was in
hernia particularly that Chauliac's surgical genius manifested itself.
He operated for hernia and its radical cure, placing the patient in an
exaggerated Trendelenberg position, head down, feet fastened to a
slanting board. For such work anatomy had to be known very well, and
Chauliac had made special studies at Bologna under Bertruccio, the
successor of Mondino. Chauliac once declared that the surgeon ignorant
of anatomy carves the human body as a blind man would carve wood. Of
ulcers of all kinds Chauliac writes from a knowledge evidently derived
from experience. Of ulcers due to cancer he has much to say. He
considers them hopeless unless they can be excised at a very early
stage and the incision followed by caustics. For carcinomatous ulcers
there is not much that we can do beyond this, even in our day. It is
no wonder that the great historians of medicine have been unanimous in
praise of this wonderful scientific genius. For my lecture on
"Old-Time Medical Education," before the Johns Hopkins Historical
Club, last year, I quoted some of those opinions. Portal, for
instance, says of him, "It may be averred that Guy de Chauliac said
nearly everything that modern surgeons say and that his work is of
infinite price, but unfortunately too little pondered." Malgaigne
declares Chauliac's "Chirurgia Magna," "A masterpiece of learned and
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