Monday, July 23, 2012

Great Surgeon

The history of medicine includes many brave and progressive thinkers who were not willing to follow the herd or be content with what was already known. One such in the Middle Ages was Guy de Chauliac. Born about 1300, he studied at a university in Montpellier known for its expertise in medicine. After becoming a Master of Medicine and Surgery around 1325, he went to Bologna for further study. His reputation became such that he was invited to Avignon to be personal physician to Pope Clement VI, then Pope Innocent VI and Pope Urban V. The papal connection gave him access to a library that included the texts of the Greek physician Galen in their original; most of Europe knew Galen through less accurate Latin translations.

He possibly saved Clement's life during the spread of the Black Death, when he advised the pope to stay near blazing fires. Although many physicians fled Avignon at the arrival of the Plague, Chauliac stayed to study the disease and treat people. He determined that it was contagious, but couldn't figure out the method of contagion. Still, he advised bloodletting, a healthy diet, and exposure to pure air (hence the fires, which would have serendipitously served to keep fleas away). He also realized that there were two diseases involved because of different sets of symptoms: the initial Bubonic Plague, and the follow-up Pneumonic Plague which found its foothold in the weakened population and killed much more swiftly. Chauliac spoke out strongly against those who blamed the Jews for the Plague, explaining that scientifically it made no sense to consider them at fault.

Tools for withdrawing an arrow.
His value to the rest of the world and history was the writing of Chirurgia magna (Great [book of] Surgery) in 1363. Its seven volumes covered every imaginable medical topic of the day: intubation, surgery, disease, anesthesia, hernia, cataracts, ulcers, bloodletting, cauterization of wounds, and the use of special instruments (some of which he designed himself, such as an elaborate contraption for withdrawing an arrow from flesh). Chauliac drew on the past, quoting Galen (129-c.200) and Avicenna (Abu Ali al-Husayn ibn Abd Allah ibn Sina, c.980-1037). He placed great emphasis on learning anatomy, saying that "A surgeon who does not know his anatomy is like a blind man carving a log."

Chauliac was not always accurate. He believed, for instance, that pus was an important part of the healing process and should be left alone. Nevertheless, his Chirurgia became a standard text for the next three centuries, translated into several European languages. Unfortunately for future generations, anti-Islam sentiment caused many translators to leave out knowledge from Islamic scholars, resulting in a less complete and less accurate work. Still, he has been labeled the "Father of Modern Surgery," and his great work was the standard text until the 17th century.

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