Old-Time Makers of Medicine: The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle AgesWalsh, James J. (James Joseph)
History
Old-Time Makers of Medicine: The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle Ages
Walsh, James J. (James Joseph)
Medicine, Medieval; Physicians
The most interesting thing in the first book of his surgery is
undoubtedly his declaration that all wounds should be treated only with
wine and bandaging. Wine he insists on as the best possible dressing for
wounds. It was the most readily available antiseptic that they had at
that time, and undoubtedly both his father's recommendation of it and
his own favorable experience with it were due to this quality. It must
have acted as an excellent inhibitive agent of many of the simple forms
of pus formation. At the conclusion of this first book he emphasizes
that it is extremely important for the healing of wounds that the
patient should have good blood, and this can only be obtained from
suitable nutrition. It is essential therefore for the physician to be
familiar with the foods which produce good blood in order that his
wounded patients may be fed appropriately. He suggests, then, a number
of articles of diet which are particularly useful in producing such a
favorable state of the tissues as will bring about the rebirth of flesh
and the adhesion of wound surfaces. Shortly before he emphasizes the
necessity for not injuring nerves, though if nerves have been cut they
should be brought together as carefully as possible, the wound edges
being then approximated.
Probably the most interesting feature for our generation of the great
text-books of the surgeons of the medieval universities is the
occurrence in them of definite directions for securing union in surgical
wounds, at least by first intention and their insistence on keeping
wounds clear. The expression union by first intention comes to us from
the olden time. They even boasted that the scars left after their
incisions were often so small as to be scarcely noticeable. Such
expressions of course could only have come from men who had succeeded in
solving some of the problems of antisepsis that were solved once more in
the generation preceding our own. With regard to their treatment of
wounds, Professor Clifford Allbutt says:[19]
"They washed the wound with wine, scrupulously removing every
foreign particle; then they brought the edges together, not
allowing wine nor anything else to remain within--dry adhesive
surfaces were their desire. Nature, they said, produces the
means of union in a viscous exudation, or natural balm, as it
was afterwards called by Paracelsus, Pare, and Wurtz. In older
wounds they did their best to obtain union by cleansing,
desiccation, and refreshing of the edges. Upon the outer
surface they laid only lint steeped in wine. Powders they
regarded as too desiccating, for powder shuts in decomposing
matters wine after washing, purifying, and drying the raw
surfaces evaporates."
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