The technique of some of these old surgeons is a never-ending source for
surprise. The exaggerated Trendelenburg position in the operation for the
radical cure of hernia--the patient being fastened on an inclined board,
head down, so that the intestines would fall away from the site of
operation--was used by Guy de Chauliac, who probably obtained a hint of it
from Italy. He also employed extension in the treatment of fracture of the
thigh, inventing an apparatus by which this might be continued for a long
time until the muscles were relaxed from overtiredness. He made use for
this purpose of a weight suspended on a cord which ran over rollers. He
also adapted stiffened bandages of various kinds, especially employing
white of egg for this, and sometimes moulding bandages to the limbs in
cases of fracture. Yperman, the Flemish surgeon of this time, knew and
used the oesophagus tube for artificial feeding, and a number of various
kinds of instruments were invented for the urethra, including bougies of
wax, tin, and silver. In diseases of the bladder and in gonorrhoea John
Ardern employed astringent injections.
Probably what ought to be considered the most important work of the French
surgeons of the Middle Ages has been quite misunderstood until recent
years. In his paper on "The Origin of Syphilis," at the Seventeenth
International Congress of Medicine (London, 1913), Professor Karl Südhoff
of Leipzig (see Transactions) reviewed the use of mercury in the form of
mercurial ointment during the later Middle Ages, and the reputation that
it had acquired for the cure of ulcers, skin eruptions of various kinds,
and other distinctly objective lesions. It is perfectly clear now that the
success of this form of therapy was due to the fact that syphilis was
being treated. The French surgeons of the South of France developed the
empiric discovery of the value of this remedy, the first hint of which had
probably come to them from the Italians. It is one of the few specifics in
the history of medicine. Needless to say, it is still with us, and still
the accepted medication in spite, as Professor Südhoff notes, of the
often-attempted replacement of it down the centuries by some form or other
of arsenic treatment, though this has always been afterwards abandoned,
and it would seem as though our generation might furnish another instance
of the triumph of the medieval mercurial treatment over arsenic.
Public-domain text, read in full here on John Shaqi.
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