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 THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 LOS ANGELES 
 
 GIFT 
 
 Dr. L.I. helnick
 
 A SKETCH 
 
 OF 
 
 SURGilC-AL 
 
 A A 
 
 A ^ 
 
 ' MiSTORY 
 
 (After Heche r.) 
 
 DR. JOHN HUND. 
 
 1891. 
 ED. ACKERMANN & CO., 
 
 45 LA SALLE STREET, 
 CHICAGO.
 
 Copyright 1889, by John Hand, M. D.
 
 WO 
 l\ 
 
 mi 
 
 PREFACE. 
 
 Neither "a multitudt^ of frieiuls" nor a "general great want"" 
 have forced the pencil into iny hand to draw this outline of the 
 little work at issue and write this Sketch of Surgical History. 
 To the simple fact that there is uo exclusive work of the same 
 character in circulation my task is attributable. This alone 
 was the practical inducement to my undertaking. But the 
 moral intent and final resolution originated in the sad percep- 
 tion that not infrequently confusing, misleading and partial 
 statements regarding our noble predecessors are made, creating 
 a sentiment unfair and unjust against the preceding ages; un- 
 fair and unjust against the noble men and women who have 
 forever appreciated, fostered, supported and protected our art; 
 unfair and unjust against the men who have so bravely battled 
 in behalf of our art and labored for the sake of suffering hu- 
 manity, earning and deserving just recognition and everlasting 
 laurels. 
 
 Ignorance (iiid sinicrsfifioii is nearly always the ready ver- 
 dict when a question of ancient history is at issue. To set aside 
 this, as it seems to me, unjust verdict, and to give our art a new 
 and.i'mpartial trial was the principal motive that ripened in my 
 mind the idea of presenting this humble sketch to my respected 
 contemporaries. There is in it very little originality on my 
 part. Rust and Hecker are responsible for the classification as 
 well as the dates of the book and the tendencies elicited therein. 
 They are sustained by more than twenty-five of the foremost 
 authors of all countries during that age, being the authors of 
 that excellent work entitled, "Die Chirurgische Praxis," Berlin, 
 1840. 
 
 For still more references we may point to the following au- 
 thors and publications: 
 
 Conrad Gessner, De Chirurgia Scrij^tores Oi)timi, Tig. 1555. 
 
 Joh. Hadrian Slevogt, Dissert de Fatis Chirurgia' Jen., 1696, 
 4.
 
 IV. 
 
 Aixlr. Otiomar Grelicke, Historia Chirurgia Antiqua, Halje, 
 1718. 
 
 Benj. Gooch, A Practical Treatise on Wounds and a ShcM't 
 Historical Account of the Rise and Progress of Surgery and 
 Anatomy, 1767, 8. 
 
 Ant. Portal Histoire de rAnatomie et de Le Chirurgie Depuis 
 Son Origin Jus'qu Nons Jours, 6 vols., Paris, 1770-1773, 8. 
 
 To these we could add as many more, but trust that the 
 above will suffice to stamp upon our case the seal of impartial- 
 ity, fairness, nou-partisau.ship and justice. With this assur- 
 ance we fear not for the verdict, and as we follow up the long 
 chain of concise, plain facts embraced by the few leaves of this 
 little book and examine link after link, we find here and there 
 the lustre vanished and mould and rust in its place, but yet th« 
 chain intact. So much so ihat when our investigation leads us 
 to the last link, opened to receive the one hammered out by our- 
 selves, we are overcome by an emotion strange to us perhaps 
 heretofore, and I venture to say that many of us will gladly 
 change our verdict, and fear more for the new link to fit the 
 chain, than the consistence of the great work of ancient dates. 
 Indeed history repeats itself. May we all profit by this fact. 
 
 I part with this little book, and offer it most humbly to my 
 medical brethren as a kind of short corrector of statements 
 made heretofore regarding our ancient times. It may also 
 serve us as a mirror of two distinct qualifications —first to shew 
 us what we are and secondly what we should be, so that our 
 link may fit at least, if not excel in brightness all preceding 
 links in this long uninterrupted chain of surgical history. 
 
 John Hund, M. D. 
 
 Chippewa Falls, Wis., June, 1891.
 
 FIRST PERIOD. 
 
 FKOM PRIMITIVE TIMES TO HEEOPHILUS (1200-300 B. c). 
 
 When we consider surgery as it is most deservingly con- 
 sidered, a science and an art, we have in history the origin of 
 the one quite separated from the other part. 
 
 Old, indefinitely old, is the art of surgery. As it always 
 was the product of a general want, the art or it may be modest- 
 ly called the practice of healing wounds and mitigating visible 
 injuries, dates far back beyond Herophilus (1500 B. C). 
 
 The knowledge at that gray age, was of course very super- 
 ficial — only the simple expression of a natural instinct— but 
 nevertheless it soon gave rise to a somewhat systematic adapta- 
 tion of natural methods of healing, intended for surgical diseases 
 and injuries. Those modes of healing manifested themselves 
 about 1000 years B. C. very universally. So we had, since we 
 had like conditions of origin, about like modes and methods 
 of healing among all nations throughout the civilized world. 
 
 Fragments of scriptures and traditions inform us, that 
 wound dressing including neat bandages, measures to reduce 
 swelling, and means to arrest hemorrhages were then well se- 
 lected and skillfully applied. But simple, like the knowledge, 
 were all manipulations and performances of that time. Conse- 
 quently history refused space for inscription of those pro- 
 ductions, prior to a more enlightened age, when a stride for a 
 higher cultivation and education became noticable. 
 
 It seems, as if the Greeks by their far advanced and early 
 spiritual development, were in the most primitive times, capable 
 of raising surgery to a standard worthy of historical recogni- 
 tion. 
 
 But it was left however to the Trojan war (1194-1184 B. C.) to 
 lay claim on the gratitude of a nation, and with the monuments 
 erected for those who died with bravery, lasting trophies were 
 granted to the life saving, glorious art, the art of surgery.
 
 One of Homer's often {quoted .stanzas reads: 
 
 A wise man skilled, or womuis to heal 
 Is* more than armies to the public weal. 
 
 Machaon and Padamrius, mentioned. first by Homer, cele- 
 brated and said to be the sons of iEscULAP and desciples of 
 Chiron, are the first surgeons to which history has granted an 
 honoral^le mention. As leaders of Thessalian warriors, they 
 accompanied Greek troops, and practiced in those ijositions 
 the noble profession of healing wounds, removing skillfully, 
 deadly arrows, applying artful dressings and administering 
 soothing medicines, accompanied by holy formulas. 
 
 Both of these heroes at their return from the war, took up 
 the temple services of their father, who at that time, was ele- 
 vated to a seat among the gods. They have permanently se- 
 cured for their decendants the ^sculapiades, the, by them and 
 their father, sanctified art of medicine, which was at all times 
 identical with surgery. 
 
 From the temple the practice of the Jj^sculapiades spread 
 over cities and out again on the battle fields, bestowing bliss up- 
 on all sufferers. 
 
 A high appreciation of this noble work manifested itself 
 very soon. 
 
 In the Ninth century, Lycurgus, the great law-maker 
 (886 B. C. ), gave official orders, that all the Spartan troops 
 should be provided with physicians, who during the battles 
 should be free from the duties common to warriors. Wounds 
 inflicted by arms were therefore the primary object of the 
 .^sculapedal surgery. 
 
 The practice at the Koian temple began to become histor- 
 ical about the 6th century B. C. when Nebrus distiiiguished 
 himself as a highly gifted and extraordinarily skillful surgeon. 
 
 The family Nebrus obtained the highest celebrity at the 
 close of the Fifth century, when Hippocrates received the ad- 
 miration of all people striving for science and art. 
 
 The treatment of wounds was simple and agreeable to na- 
 ture and in accordance with the principles of the Humoral path- 
 ology. 
 
 Dressings were applied in a most masterly manner and 
 very tasteful style, and great stress was laid upon the artful aj)- 
 plication of bandages.
 
 Many operations were performed according to some well 
 defined rules and by means of practical instruments. 
 
 Among the more important operations we find trepanation 
 in the first place. This operation was resorted to in all cases of 
 deep seated bone diseases. Craniatomy was undoubtedly known, 
 and where severe hemorrhages threatened they resorted, after 
 other means proved futile, to ligation of bloodvessels. 
 
 The use of the hot iron was much in practice, and the ante- 
 hippocratical surgeons had assigned to this heroic measure all 
 chronic joint diseases. 
 
 Aside from the scientific surgery of the J^sculapians, an- 
 other school, perhaps more one-sided and narrow in its principles 
 but not less salutary to the general welfare of the communities, 
 originated in the numerous fencing schools. Physical exercises 
 and tilting were from primitive times on, a part of a Greek'slife, 
 and with the progress of civilization regular departments at the 
 gymnasia were assigned to said exercises. 
 
 On these fencing grounds accidents like fractures, dislo- 
 cations and similar injuries were common, and consequently 
 the want of ready surgical aid brought forth the so-called gym- 
 nastical surgeons. In their natural dexterity the Greeks soon 
 found means, which they put under a proper system, to meet 
 all emergencies. For the after treatment they relied strongly up- 
 on a vei-y efficient dietetic, in addition to some instructions re- 
 garding baths, ointments, etc., etc. Ikkus from Tarent and 
 Herodikus from Selembria were the most famous gymnastical 
 surgeons during that time. Although these two eminent men, 
 had no successors of like reputation, the gymnastical sur- 
 geons kept their ground, even under much less favorable cir- 
 cumstances, as long as gymnastics among the Greeks and Rom- 
 ans existed. Now the philosophy of the Greeks matured ideas 
 in reference to organic nature, which, since connected with the 
 healing art, could not fail to cause material influence upon sur- 
 gery. 
 
 From Thales (500) to Plato (400) the elementary theory 
 developed, which soon however blended into the Hippocratical 
 Humoral Pathology. 
 
 The Pathagoreans originally worked the segyptician art of 
 their ureat teacher with much enthusiasm. After their expul-
 
 sioii from Ureat Greece tlioy have indeed done more for the 
 cause of surgery outside of the temple, than any otlier nation. 
 In spit3 of their fear of blood, which prohibited venesection, 
 they practiced surgery with good success. 
 
 The Periodeutes of Kroton were for a long time the lead- 
 ing surgeons in Greece and Asia Minor. Democedes of Kroton 
 the most celebrated one among them reached in Jilgina in Samos 
 and in Persia the highest degree of medical distinction. 
 
 Thus developed, surgery presented itself at the close of 
 the Fifth century to the great Hippocrates. The teachings of 
 his forefathers were made by him public property. The sur- 
 gical ventures of the ^sculapiades were no longer a private treas- 
 ui'e and secret of the priests. He first united all mature doc- 
 trines of the foretime into one systematic unity. 
 
 In the Humoral Pathology as well as in the so-called sere- 
 ology an unlimited veneration for nature was noticable and its 
 salutary influence upon wounds and fever eagerly observed and 
 highly regarded. Irrespective of the spirit of the leading school, 
 the aim to heal was the strongest basis of the advancing art. 
 Under these circumstances the knife and the hot iron were put 
 in proper relationship to organic life, and the confidence in 
 those instruments became permanent, intelligent, but they were 
 always subjected to progressive experimentality. 
 
 The conception of the sympathetic law developed itself 
 from experience and added materially to a more circumspected 
 treatment of wounds and to a more clear diagnosis and firm 
 prognosis. The power and activity of nature towards repairing 
 breaches of continuity and the formation of granalation tissues, 
 a knowledge so essential for the successful performance of any 
 surgical procedure, was by Hippocrates appreciated with verj' 
 much intelligence. Not less did this great man appreciate the 
 fatal nerve complications, forenamely tetanus, on which he 
 had very correct views, but no treatment short of a general 
 dosage! 
 
 In regard to inflammations, which were classified according 
 to their semeiotic symptoms, ])us-formation was an essential 
 condition, and looked upoii as a direct endeav()r of nature to re- 
 pair (to heal). 
 
 Inflammations of internal organs were treated, liesides vene-
 
 section by fasting, and the free use of cooling drinks, especially 
 cold water and vinegar. 
 
 (-athartics were, according to empirical humoral pathologi- 
 cal theories, in common use, but their administration required 
 caution, since there were, aside from the mild dietical means, on- 
 ly a few drastic vegetable remedies at hand. Over inflamed 
 wounds, they were in the habit of laying raw cooling herbs or 
 boiled and then cooled poultices of mild astringent remedies, as 
 oak and granat leaves, etc. Salves containing fats and oils were 
 only used in suppurations and always warm. To arrest hemor- 
 rhages the cold water was the first and the ligation of the ves- 
 sel the last resource. Although rich on merits, this period was 
 not free from bad prejudices. 
 
 The cutting for stone in the bladder was already executed, 
 but this operation was mostly in hands of quacks and traveling 
 men, whom the ^sculapiades so earnestly refused recognition, 
 that even Hippocrates declared this operation unworthy to be 
 performed by a surgeon, and that he demanded of his pupils 
 that they pledge themselves never to perform it at all. 
 
 The practice of venesection Hippocrates raised some- 
 what, but he WHS unable to liberate it from prejudice, produced 
 by the total ignorance of human anatomy. Not even the heart 
 was known then, as the center of circulation, and they could not 
 differentiate the arteries from the veins. 
 
 From the adventurous ideas of Polybus, Syennesis and 
 Diogenes from Aix)llonia, that there were only a few pairs of 
 arteries connecting the various parts, the much disputed theory 
 of derivatorical and revulsorical venesection was reasoned out, 
 a theory which has as yet, not entirely fled from the light of 
 physiology. 
 
 The practice of surgery of the descendants and pupils of 
 Hippocrates was markedly lacking in the most essential basis — 
 the knowledge of anatomy. The explanation of the difference be- 
 tween the arteries and veins by Praxagoras, remained unpro- 
 ductive of any higher attainments in favor of ligating vessels, as 
 a footstone to more artful operations, because this deserving 
 and comparatively enlightened dissector held still the opinion 
 that the arteries were simply air-channels, and consequently con- 
 tained no blood.
 
 The practice of venesection had to make room now for Chry- 
 SIPPS of Knidor's views, whose well known segypto-pythagore- 
 an fear of blood brought many disadvantages to a keener prac- 
 tice of surgery. Oil the other hand his methods to relieve ham- 
 ophthysis by tight bandaging and constricting the extremities ar- 
 rested very promptly fatal hemorrhages in geueral, and gave 
 rise to the idea of constriction in cases of amputation, later on. 
 
 In the meantime the treatment of external injuries was 
 the main subject of the higher graded Greek surgeons. 
 
 DiOKLKS, the most celebrated amoug all the Hippocratians, 
 invented an instrument of much utility for the extraction of Ing 
 arrows, and his profound knowledge of anatomy was of a vei-y 
 beneficial influence upon the practice of surgery. Nevertheless, 
 under such circumstances a steady progress in surgery was im- 
 possible. 
 
 A more energetic stimulation had to be expected from ex- 
 ternal causes, and it came with Alexander and his campaigns. 
 All customs in Greece underwent a change and so did surgery. 
 
 SECOND PERIOD. 
 
 FROM HEROrHILUS TO ANTYLLUS (300 B. C — 2S0 A. D.) 
 
 Continual wars made the want of an improved surgery at 
 the close of the Fourth century imperatively felt. The sojourns 
 of Greek troops in tropical regions reminded the army surgeons 
 of Alexander of the inefficient condition of optic surgery. Af- 
 ter the empire of the great conqueror came into the hands of 
 wise rulers, and thriving cities sprang up all over the laud, the 
 longing for science, which the great Aristoteles had first im- 
 planted, and the love of the Greeks for arts of peace could not 
 fail to ripen the sweetest fruits on the field of surgical progress. 
 
 From this epoch we may recognize surgery as a science as 
 well as an art. 
 
 Alexandria represented the school of the healing art. 
 And this school was favored in a manner never seen before. It 
 received contributions of material means in abundance from 
 all sides, and more i>articularly from intelligent and noble lieart- 
 ed potentates. Experimental researches and u«eful investiga- 
 tions on the human body, now found no resistance, and all pro-
 
 liibiti<jii royarding such procedures vanished. Dissection of 
 human subjects, which even Akistoteles dared not try, was 
 now inaugurated and dilligently practiced. 
 
 It was Herophilus the great pupil of Phaxagoras, who 
 in union with Grasistratus and Eudemus, led his contempo- 
 raries first with the torchlight of anatomy. Never before and 
 perhaps at no time before or after were old ideas of superstition 
 more rapidly removed, literally chased out; never at any time 
 did surgery make more earnest progress than at this time of the 
 first glory of the Alexandrian school. 
 
 The ideas regarding bloodvessels and their motorcentre was 
 no longer an obscurity, audit is very evident that the difference 
 between arteries and veins was then clearly understood. 
 
 The brain and the nervous system were thoroughly investi- 
 gated, and motion and sensation assigned to their power alone. 
 The oi-gans of the abdomen were searched in their position 
 and mutual relationships, and even the morbid changes during 
 disease observed. 
 
 Now began a new era of surgery. 
 
 Special branches were essentially improved. So, for in- 
 stance, Erasistratus treated upon the treatment of wounds in 
 a valuable book. Physicians in general now paid close attention 
 to all parts of the practice of surgery. New methods of band- 
 aging were introduced, and much pains were taken in all details; 
 and a lively stride prevailed all over, to surpass all predecessors, 
 and this particularly in things relating to dressings. In this 
 connection Amyntas, Perigenes, Sastratus, Appolonius Ther 
 and the Emperiker Glaucias deserve mention and the fame of 
 the Alexandrian school at large cannot be disputed, since the art 
 of bandaging of our own day is only an inheritance with very in- 
 significant alterations of this old school. 
 
 The treatment of fractures and dislocations gained less 
 benefit through tlieir much complicated apparatus and machin- 
 eries. They left the better path of gymnastic, and tried to re- 
 place muscular power with levers and pullies. They put up 
 clumsy apparati in the gymnasia, and every surgeon made it 
 his object to invent new improvements and to make himself 
 famous therewith, like Philistior, Andreas, Demosthenes, 
 Pasikratus, Nileus, Nymphodorus, all well known inventors.
 
 8 
 
 At the same time the eoiistiiictioii of joints received atten- 
 tion, and their diseases were accordingly treated, of which a 
 work written by Appollonius from Kitium, and now in the 
 library of Nicetus gives a most favorable testimony. 
 
 The next good of this school following the study of anatomy 
 was the foundation of a systematic tlieary on hernias, of which 
 the Hippocratical surgeons had no understanding. 
 
 This theory was advanced by GoKGiAS Hekont Sastratus. 
 Soon however this important, bnt difficult branch of surgery 
 became neglected, and this in abont the same degree, as the 
 study of anatomy cooled down. 
 
 Since e^-ery bloody operation had its stronghold in anatomy, 
 and surgery with the scalpel was again established, the time 
 had arrived, when the operation for stone in the bladder (lith- 
 otomy) was to be liberated from all prejudices of the Hippo- 
 cratians. 
 
 Now this operation took the proper place on the list of 
 operations, which it long before deserved, and the improvements 
 of it were merely brilliant, and it soon advanced to the perfec- 
 tion as we find it by Celsus. 
 
 The medical part of treating surgical deseases varied in 
 consequence of different theories and had to undergo many 
 changes in different schools. 
 
 Hekophilus and his followers and the very numerous 
 empirikers, overloaded their patients with medicines, basing 
 the adniinstration of them u[)on humeral pathological theories. 
 Erasistratus, who pi-acticed bandaging of the extremities, laid 
 more stress upon the conservative use of medicine and abstin- 
 ance of food. 
 
 The traditional instructions regarding dietetics found by 
 him and his scliool affirmation and a new support. The general 
 enthusiasm for the poison doctrine so strongly marked in the 
 Third century, could not fail to have considerable influence on 
 general surgery, since wounds inflicted by poisonous animals 
 came also under this category, and all of the external treatments 
 that Wcis. substantially practical, as cleansing wounds, cupping 
 and favoring supj)uration was from Nicander of Kelophon's 
 days identical with general every day practice. 
 
 In Rome, whicli was looked to with much hope and grand
 
 predictions for surgical progress, we find surgery at tlie close 
 of the Third century, in a very modest — not to say feeble — con- 
 dition. 
 
 The domineering Romans accustomed to receive Greek phy- 
 sicians only as slaves, adopted the healing art with contempt. 
 They declared it legally a profane trade {negotium sordidum) 
 unworthy the consideration of a free born man, — a declaration 
 never heard of before or after, under the sun! 
 
 No wonder that surgery had to suffer great degradation, 
 until a more favorable time and circumstances called it forth to 
 new triumphs. Notwithstanding the fact that Cesar raised 
 the medical profession to high honors, Rome itself re- 
 mained to be the world-meeting place for all adventurers, who 
 sought in the division of the surgical from the medical practice 
 an opportunity to make themselves prominent. Dentists, aur- 
 ists, oculists, Jatrolipticians, traveling quacks, claiming ability to 
 treat certain maladies, as for instance, the Marsers tried to com- 
 pete in confused masses, with the most deserving surgeons, 
 while half of the city population retained the old traditional 
 Roman superstition and sought relief in the temples from 
 gloomy healing-gods, and the wealtliy class determined with 
 undiminshed haughtiness to complete their servant crew with 
 slave physicians. 
 
 In the Second century, this chaos- was somewhat cleared 
 out, by an elaborate medical constitution. 
 
 But the necessity of regular medical academies was not 
 appreciated, and so the progress of surgery was entirely depend- 
 ent upon the labors of a few excellent individuals. 
 
 The school of the Methodists originated in the First cen- 
 tury (B. C.) oil Roman soil, and earned some laudable merits. 
 
 In spite of their inapplical)le, theoretical views, they felt 
 the want of a systematic classification of surgical diseases and 
 their respective cures more than any other school. External 
 injuries, enlargements, deficiency of parts and external poison- 
 ing constituted some of the surgical classes of the Methodists, 
 for which they had certain well defined treatments. 
 
 Although incapable of entering into deeper researches or to 
 penetrate scientific (piestions more exhaustively, they have - to
 
 10 
 
 say the least — laid some foundation for teachers and learners to 
 treat surgical diseases in a somewhat radical manner. 
 
 The (courage and presence of mind of the methodical sur- 
 geons cannot be disputed. They practiced the Alexandrian 
 surgery in its fullest extent, and competed in the use of the 
 knife and the hot iron with all predecessors. 
 
 Themison, the successor of iEsculapiades and the actual 
 founder of the methodical school, favored the practice of insert- 
 ing a three-pointed hot iron ( err ^/r^y trisiilr us) directly into the 
 enlarged spleen, to cause contraction. 
 
 This monstrous instrument was afterwards called the three- 
 fork of Marcellus, and was many centuries in use, since en- 
 largements of the spleen after periodical fevers were of very 
 common occurence. The intn)ductio!i of the leeches by Themi- 
 SON and already prescribed by Nicander, met with great en- 
 thusiasm from all medical schools, while the old laws regarding 
 venesection remained unchanged. Very materially the progress 
 of surgery was aided by the Methodist, Thessalus of Tralles in 
 Rome, who l)ecame famous at the middle of the First century 
 with his establishment of a kind of a clinical school. He was 
 the author of the nietasykrisis, an alterative treatment for old 
 pertinacious, chronic diseases, treatment somewhat similar to 
 the depletive treatment of our day, with the exception that only 
 vegetable constituents came into use. Old chronic ulcers i)artic- 
 ularly were treated metasynkritically, wdiile the internal and 
 probably causal morbid conditions were kept in view and the 
 whole Helkology based upon natui-al principles, subject to nat- 
 ural laws. 
 
 The fact that in this and the previous century, many excel- 
 lent surgeons outside of any defined school made strong and 
 successful efforts, for the cause of surgery finds its explanation 
 in the nature of their noble art, too noble at all times to be gov- 
 erned by narrow theoretical principles. 
 
 Among those not bound down to the regulations of any 
 school, we mention most honorably: 
 
 Thryphon the father, Euelpistus and the highly celebrat- 
 ed Mj:ctEs. 
 
 Surgery prospered not li'ss in the middh' of the First cen-
 
 11 
 
 tury in Rome, where AxHENiEUS founded the so called Pneu- 
 matic school. 
 
 Many operations were with much circumspection performed 
 and improved, and the excellent conduct of this school regard- 
 ing the whole domain of inedicine was followed by happy re- 
 sults, 
 
 Archigenes, the brighest star of the pneumatic school, es- 
 tablished methods unexcelled even in our times; for instance, 
 his amputations of large members, wdiereby light bandaging and 
 very probably constriction of the arteries with a tourniquet-like 
 instrument, was customary. He also practiced dentistry and 
 his teaching on poisoned woimds is the best and most reasona- 
 ble one of that time. 
 
 As far as his skill in amputations is concerned he found 
 unfortunately no successor. 
 
 His contempory Helidoeus, a great surgeon of Rome, dis- 
 carded the compression of vessels and Leonidas of Alexandria, 
 who held the same view, made retrogressive changes and put 
 this operation back to the old and clumsy method of former 
 days. 
 
 In the advent of medical glory, at a time when a profound 
 study of anatomy was established, in the second half of the sec- 
 ond century, Galen, the immortal Galen, made his light-bring- 
 ing appearance. 
 
 His great works in behalf of medical science revolutionized 
 the practice of medicine in general, and the influence of his 
 great genius elevated in particular the science and art of surg- 
 ery, not so mucli by improvements of the technical part, as by 
 perfection of a mostly humoral pathological theory and through 
 his thorough examinations for diagnostic pui-poses. We will 
 only mention here the blood tumors which he firstdescribed un- 
 der the name of aneurysmas. 
 
 Like all the ^jrominent physicians of olden times, did he 
 understand surgery very profoundly and practiced it himself. 
 
 At the age of 29 years, he accepted the position of gladiator- 
 surgeon in his native city, Pergamus. 
 
 The influence of this extraordinary man was so great that 
 all medical examinations of surgical subjects received the Gale- 
 nean aspect, for an indefinite time; but sadly, as it were not to
 
 12 
 
 any ad\aiitag:e for the science in view, then it was only the 
 form that remained, his active spirit had vanished with the last 
 stroke of his noble heart and with his physical vis-a-tergo his 
 moral power ceased. 
 
 THIRD PERIOD. 
 
 FEOM AXTYLLUB TO PITARD (280-1260). 
 
 This period embraces some appearently very unlike sub- 
 divisions, of which all, however, had the same fundamental char- 
 acter, namely, the Greek. 
 
 AxTYLLUS elevated the surgical science to the highest de- 
 gree of scientific perfection, after many and keen strides of his 
 eminent predecessors, made in that direction were fruitless. 
 
 He embraced the whole medical science, and left to the 
 world excellent works treating upon almost all the various 
 branches of medicine and surgery. He improved the medical 
 part of surgery, and his fame as operator is immortal. He ad- 
 vised in cases threatening with suffocation, opening of the air- 
 passage, as the .Esculapiades had insinuated already, and per- 
 formed the operation through the crico thyroid membrane (laryn- 
 gotomy) and through the cricoid cartilage and upper wing of 
 the trachea (laryngo tracheatomy). He attained high merits 
 with his operation on Aneurysmas also. 
 
 His contemporary Philagrius made still greater advance- 
 ments. He advi.^ed a method, which came very near to the Hun- 
 terian operation. 
 
 Antyllub's lessons regarding the extraction of blood are 
 excellent and all statements and traditions are to the effect that 
 he was the first one who accomplished the great work of uniting 
 surgery with the general practice of medicine. The same sci- 
 entific and at the same time practical spirit was dominant dur- 
 ing the Fourth century, and this especially in Alexandria, 
 where the most celebrated Jatrosophists practiced, aside from 
 general medicine, surgery very extensively. Since this cen- 
 tury was not very much in favor of surgery, they at least made 
 with energ}^ and circumspection strong efforts to preserve what 
 others had produced.
 
 13 
 
 A good acquaintance with old authors became now the ob- 
 ject of the higher class, and the stride for collections became 
 manifest; and with this movement the spirit of enterprise, in- 
 vestigation and research awoke. The first who made himself 
 prominent with collections was Oribasius of Pergamus, the able 
 physician of Julian, whose excellent instructions on blood ex- 
 traction furnish undoubted proof of the high standing of ther- 
 apy and surgery of those days. The chrysippean bandage for 
 the arrest of hemorrhage, of vomiting and of convulsions, as in 
 hysteria, was in this century in general use. 
 
 Herodot, the pneumatiker, had the same method, already 
 improved, inasmuch as he substituted for the old painful and 
 unpractical gag used on larger joints, bandages applied from 
 above downward over whole members. This is about all Ori- 
 basius did for the progress of surgery. He even left the prac- 
 tice of the art, with the exception of that intimately connected 
 with medicine, to the gymnastics, who tried to preserve the 
 productions of their celabrated Ikkus and Prodikus. The sur- 
 gical parts of his great and complicated work in a time which 
 had for its object to preserve rather than to enlarge the field of 
 surgery, fully satisfied all requirements; and this particularly 
 in reference to his chapter — yet in existence — treating on sur- 
 gical machines, after Helidorus, and on slings, after Herakles, 
 subjects to which Galens and Soranus's attention were attract- 
 ed. Nc^ less esteeaied are his fragments on fractures and dis- 
 locations. 
 
 How many sul)ordinate specialties of surgery were prac- 
 ticed during the Fourth century is shown in the treatise on 
 dental diseases, by Adamantius, a contemporary of Oribasius, 
 and well known Alexandrian, originally Hebrew Jatrosopher. 
 
 The Greek surgery perished after the Fourth century step- 
 by step. Outside of the old Alexandrian school, which existed 
 for a time, but in a rather feeble condition, the sui'gical students 
 were dependent upon the Archiate colleges in larger cities, 
 which were deficient in pro{)er auxilliaries, as well as in able 
 teachers. So it came that the art and science of surgery pre- 
 sented itself more and more as a feeble reminiscence of a more 
 actice time. 
 
 J^Tius of Amida, a contemporary of the Emperor Justm-
 
 14 
 
 IAN, completed in the middle of the Sixth century, the second 
 great collection of the whole science of medicine. But now be- 
 gan an unfortunate movement, favored by religious-political 
 agitations. The monks took possession of the practice in hos- 
 pitals; another sad reason why from this vigorous science only 
 remnants of insignificant value remained. 
 
 Spirit and life of surgery had vanished. Even the ener- 
 getic and persevering labors of great Alexander Thales prov- 
 ed futile, against the destructive power of ignorance and malice. 
 The Jatrosopher, Theophilus, made another desperate attempt 
 at the beginning of the Seventh century. He once more re- 
 instated the Galenean anatomy, in the expectation of revolution- 
 izing the degraded science and to manifest a new and substan- 
 tial centre. But in vain were all his labors. His energy, asso- 
 ciated with careful circumspection, his self denial and sacrifices, 
 at any other time would surely have been crowned with suc- 
 cess. With the conquest of Alexandria ( A. D., 440) by Amru, 
 the enfeebled Alexandrian school received its death blow. 
 
 But just at this time lived a physician whose labors for the 
 cause of surgery were of the most important consequence. It 
 was Paul of ^gina, a surgeon in the fullest sense of the word, 
 who possessed not only the knowledge, but also the courage 
 and energy of his predecessors, and who actually extorted from 
 the Saracens the highest admiration for his talent and skill. 
 He understood how to connect a certain degree of singularity 
 with his extensive experience. His operations were intelligent- 
 ly considered and his after procedures astonishing. He treated 
 various diseases of the bladder according to an entirely new 
 method, namely, by injections with medical solutions by means 
 of a catheter. Thereby he carried out an idea only in late years 
 rtadopted and introduced into general practice. His state- 
 ments regarding the varieties and respective treatment of ex- 
 ternal injuries are instructive and more perfect than can be 
 found anywhere else. 
 
 Among the Romans we find in the Second century regu- 
 lar classified ship and field physicians, especially physicians to 
 the legions and cohorts, who treated the wounded on the bat- 
 tlefields as well as in the camps. Field hospitals were in Ro- 
 man armies wanting. After the camps were overfilled, patients
 
 15 
 
 were taken to private houses. Hospitals at large did not exist 
 before the introduction of Christianity! In a somewhat indi- 
 rect relationship to the army surgery were the regulations en- 
 forced by Emperor Maukicius (590) purposed to provide for 
 the wounded on the battlefield, where the so-called deputati, a 
 kind of brancardiers, were on duty. 
 
 The Arabian physicians and surgeons practiced during the 
 Seventh century the medical profession, without any fundamen- 
 tality or system. They were imitators of the Greeks only, 
 whose literature they received. It cannot be doubted that their 
 achievements in pharmacy, their mild and most consevative 
 system of treating diseases, as well as their knowledge of ther- 
 apeutics, were of great utility. But of all surgeons of the Ara- 
 bian type, Abdul Kasem was the only one deserving any degree 
 of notoriety. He lived at the end of the Eleventh century at 
 Cordova. He described with great precision surgical instru- 
 ments, and added to his description* cuts and illustrations. He 
 ligated bloodvessels after Greek methods, and his description^- 
 of lithotomy on the female, being the first in surgical literature, 
 as w^ell as his teaching on amputations, speak highly in favor of 
 his dexterity and boldness. It would be a great mistake, how- 
 ever, to assume that Abdul Kasem was the only Arabian 
 surgeon. He was not the only one, but the most bold and skill- 
 ful one. Next to him Rhazes Ali Abbas, Ebn Sina and Ebn 
 ToHR deserve mention. The latter ventured even the project 
 of uniting the separated science of surgery with the general 
 healing art. 
 
 Inasmuch as the oriental bombastic spirit of Arabian au- 
 thors and its disadvantage :ius relationship to Galenismus was 
 incapable of leading those born on a different hemisphere, 
 namely, the European surgeons, and considering the most u^f 
 favorable political influence, it is easy to understand that tit* 
 middle age represents one of the saddest periods of surgery. 
 
 During several centuries the monks were the only practic- 
 ing physicians. Tliey executed only the crudest and most bar- 
 barous operations. Venesection Was practiced with a real 
 thirst for blood. The qualifications of these monks were equal 
 to those of the well known religious nurses in general, and our 
 science and art suffered more abuse and degradation through
 
 16 
 
 those orders than ever before. (Present and f'nture are not to 
 be considered here!!) 
 
 Their standing was decidedly low, and they were looked 
 upon with contempt, and came very near being pronounced 
 "dishonest," in union with the barbers. The church, appreci- 
 ating this statiii^ ([lio, was never tired of directing her judiciary 
 power in that direction, and more than one church counsel for- 
 bade all priests the practice of medicine and forenamely sur- 
 gery. But those orders did notbetterthe condition very much, 
 since there was no opportunity for educating scientific physi- 
 cians; and consequently the monks' practice continued to be a 
 want. The celebrated monks' school of Salerno accomplished 
 but little, although the Benedictines of that convent performed 
 operations in full accordance with the princples of Celsus. 
 Constantine transplanted the Arabian surgery and ocology in 
 the Eleventh century from Africa to Salerno, from whence it 
 spread further over the Occident. 
 
 A great advantage for the cause of surgery iras the law 
 given by FiiEDERiCK III. (1238), according to w^iich the sur- 
 geons within the kingdom of Naples were obliged during each 
 year to hear two medical lectures at Salerno, or at Naples, and 
 to diligently study anatomy. Their text book was Gal"ns, and 
 bogs were the subjects for dissection. A regular, strict exam- 
 ination concluded the requirements. 
 
 As a powerful inducement for a brighter time for surgery, 
 the Crusades (1095-1270) might be considered. The number of 
 hospitals increased every where, and although the monks held 
 their power still, the want of a sounder practice began to make 
 itself felt. A more respectable manifestation secured in the 
 Twelfth and Thirteenth centuries ths establishment of medical 
 schools; and since the citizens formed an adverse party to the 
 nobility, the priesthood and bondage, an effective limitation was 
 set upon the dark practice of the monks. 
 
 Italy before all countries distinguished itself. Tlirough 
 numerous academies and reawakened memories, the light of 
 surgery first began here to" brighten up. Among the oldest 
 surgeons of Italy Roger of Parma, who attained later in Mont- 
 epellier (1266) the highest point of glory, deserves the first 
 honorable mention. He treated the wounds after Galen's
 
 1/ 
 
 principles (moistoniiig method). The knife and hot iron were 
 used by him with boldness. Many of his sugges'iions are pecul- 
 iar, fis for instance his perforation of the sternum in cases of 
 punctured wounds, inflicted by arrows. His treatment for in- 
 testinal wounds, considering the time, is prais^^ worthy. 
 
 Roland of Parma (1217), a pupil of Roger, was active as 
 writer and professor of the University of Bologna, in which po- 
 sitions he did considerable for the welfare of his art. He 
 treated surgery in the spirit of his teacher, but without the lat- 
 ter's peculiarities. 
 
 The influence of these first universities upon surgery as well 
 as upon other arts and sciences was quiet, moderate and of 
 rather little consequence. The imperfection of means and meth- 
 ods of teaching was too great, so that the earnest labors of a few 
 leading men tended only to scattered productions, and con- 
 sequently the Italian school of surgery enjoyed but little uni- 
 versality. Equal to Roland of Parma we consider William V. 
 Saliceto of Piacenza (1277). He practiced surgery in 
 Bologna and Verona. His elaborate work, in which he demon- 
 strated his large experience, is the ablest book of that century. 
 Hugo of Lucca (1215) was the teacher of the more able 
 Theodorich of Cervia (1298) an ecclesiastical surgeon, who 
 advanced to the dignity of Bishop of Bitonti and later of Cer- 
 via and died in Bologna. He deserves the honor to be called 
 the reformer of the fracture treatment, inasmuch as he intro- 
 duced more simple and more practical means to treat fractures 
 and dislocations, and being a strong opponent to the old Gale- 
 nean machines, discarded them as far as he went. 
 
 Bruno of Calabrien (1252) and Theodorich of Cervia are 
 the representatives of that school of surgery, which relied upon 
 heat and caloric remedies of various kinds, purposed to dry up 
 all wounds and sores. This treatment was in strict opposition 
 to the moistening method. 
 
 The controversy of the two schools had no other effect, than 
 the stimulation of the parties interested and the raising of a 
 lively contest. In this manner new achievements were attained, 
 and the substantial character of surgery became firm. In Italy 
 it was liberated from the disreputable monk-practice. In
 
 18 
 
 France a new event secured the most favorable and speedy pro- 
 gress of surgery. 
 
 FOURTH PERIOD. 
 
 FROM PITARD TO PARE (1269-1551). 
 
 The new event was the foundation of the College of Sur- 
 geons, by PiTARD, the physician in ordinary of Louis IX (the 
 saint). He had the opportunity to witness with the king 
 (1248-1254) to what a terrible degree the disaster of a war 
 would grow, where surgeons are deficient. 
 
 After his return, new hospitals were at once erected and the 
 public opinion was also in their favor. The general want of a 
 radical revision of surgical regulations and systematic meth- 
 ods of educating young surgeons seemed to be universally felt, 
 and the establishment of the college of surgeons met undoubt- 
 edly all requirements of that age. (One great and undisputed 
 advantage lay in the provision, that the members of the college 
 were not priests, but taken from the laity.) Many 
 otlier advantages they received, tlirough privileges grant- 
 ed for the purpose of bringing them and their noble art on a 
 higher level. They stood in the ranks with the inagistris in 
 phijsica, and were entitled to wear the same dress as they did, 
 therefore the name, Chirurgiens de robe longiie. A previous 
 two years study with the medical faculty of Paris was required 
 for admission, and this in union with other requirements served 
 as efficient means to bar out all ignorance and profanity. 
 
 PiTARD kept his position as first surgeon to the king also 
 under the regencies of Philip the Keen and Philip the Beauty, 
 and was living yet in the year 1311. 
 
 Although this society of surjjeons cannot claim presistent 
 zeal, it is an undisputable historical fact, that France owes its 
 glory and marked success in surgical advancement to the Col- 
 lege of surgeons alone. Far famed became the college at the 
 end of the Thirteenth century through its connection with and 
 reception of Lanfranchi (1295). He was born in Milana, and 
 a student of Salicebo, and without a doubt the first sur- 
 geon of his time, an 1 highly celebrated throughout the coun- 
 try. Bat political conflicts made him flee to Paris, where he
 
 19 
 
 soon received an invitation to deliver lectures on surgery. 
 Hearers from all parts of Europe streamed to him, and Paris 
 rose now at once above the universities of Italy. He defended 
 as follower of Salicebo the moist treatment of wounds and at- 
 tained in this direction very nominal results. In critical cases 
 of hemorrhage he resorted to ligation, a procedure almost for- 
 gotten and mostly substituted by inefficient therapeutical 
 means. 
 
 He advocated cauterization of hernias energetically and in 
 urgent cases he resorted to castration. 
 
 There now approached for the science and out of surgery a 
 most salutary event, namely the readoption and reinstatement 
 of the inevitable study of human anatom3\ 
 
 MoNDiNi was the first hero, who dissected in Bologna pub- 
 licly (1315 ) two female subjects. Others soon followed and it 
 became finally a custom of all universities, to dissect one or 
 more subjects every year. The Galenian anatomy was by no 
 means therewith discarded. The progress was yet slow, and no 
 sooner than the Sixteenth century permanent results were 
 gained and surgery received the long and sadly wanted foun- 
 dation. We have good reasons to consider Guy de Chauliac 
 (1363), a French surgeon, the restorer of a scientific practice of 
 surgery. Particularly do we find in his time an exhaustive 
 knowledge of anatomy. He was born at Givandan, in southern 
 France, where Henry de Hermondaville, physician in ordi- 
 nary to King Philip the Beauty, had introduced dissections. 
 He received the degr3e of doctor in medicine, and stated an ex- 
 ample of a wonderful combination of surgery with general 
 medicine, an event most necessary for the elevation of the 
 much abused art of surgery. 
 
 After Guy de Chauliac finished his studies he practiced 
 surgery with extraordinary success in Lyons. From there he 
 went to Avignon, where he held for a long time the position 
 of a physician in ordinary to the Popes Clement VII, Inno- 
 cent VI and Urban V. His excellent work he published in 
 the year 1363. He reformed with much circumspection the 
 whole practice of surgery very substantially, and in all its 
 various branches. His treatment was in accordance with 
 simple and practical principles and not based upon sophistical
 
 20 
 
 aud domagogical ideas. He paid special attention to the 
 injuries of the head, of which his predecessoi'a seemed to be so 
 ignorant and backward. He introduced trephining, and his 
 advice and instructions regarding various symptoms and con- 
 ditions were rational and well considered aud many operations 
 he improved. From now on the eiforfcs in behalf of surgical 
 progress increased; the number of scientific surgeons in Italy 
 and France rosa gradually but steadily. 
 
 The first disagreamant bstwesu tlie college of surgeons and 
 the medical faculty began in the first part of the Fourteenth 
 century. The first results of these controversies seemed to be 
 much in favor of the surgeons. Philip the Beauty gave an 
 order, A. D. 1311, in obedience to which all surgeons had to 
 pass a creditable examination byfore the professors of the col- 
 lege. Therewith the surgical education in France was extend- 
 ed and systematically regulated as we find it in no other 
 country. 
 
 At the beginning of the Fifteenth century Petek de Cerla- 
 TA (1415) as professor at Bologna attained great celebrity. 
 Although he could not reach the fame of GrUY de Chauliac, he 
 earned great merits regarding some special branches of sur- 
 gery. His treatise on injuries is excellent. His treatment for 
 gangrene is very practical, and so is his teaching regarding 
 castration, which operation he perfor:ned with undisputed 
 skill. 
 
 The refusal of most prominent physicians to practice su.'gery 
 at all, was certainly a great obstacle for the latter. The dis- 
 gust of the physicians with surgery can readily be explained, if 
 we consider the social standing of the so-called barbers, a deep- 
 ly despised profession, which degraded through crude and pir>- 
 fane acts and procedures the surgical practice to a real 
 negotinm soi -didi ini. 
 
 Emperor Wenzel (1400) in Germany found it necessary to 
 grant a special privelegium to save them from radical denunci- 
 ation and the disrepute of beingpronounced "dishonest." In spite 
 of the imperial origin, this act was of no avail for them or the 
 surgical cause, and up to the Seventeenth century the same 
 condition of things supervened. It is therefore not much sur- 
 prising that HiERONiMus Brunschwig at the close of the
 
 21 
 
 Fifteenth century was the first German surgeon entitled to any 
 degree of notoriety. He practiced in Strassburg and was the 
 first one who mentioned gun shot wounds and declared them 
 poisohous. He treated them with theriac internally, to eli- 
 minate the presumptive poison, while he made external appli- 
 cations of lard in thick layers, covering and envolviug wholly 
 the affected parts. John de Vigo, the eminent Italian surgeon 
 and papal house physician, who lived at the beginning of the 
 Sixteenth century and whose works are not without value, 
 cauterized ball passages with the hot iron or filled them with 
 hot oil or the Egyptian salve "/o Jdll out the poison ivithoutfail." 
 
 Surgeons at that age introduced various escharotics for treat- 
 ing those cases, and the conviction that these wounds were 
 poisonous, was so strong, that Alph. Ferri a Neapolitan sur- 
 geon and house physician to Pope Paul V and Gregory XV, 
 declared even the grazing gun-shot wounds poisonous, through 
 atmospheric impurities. He gave the first hints in regard to 
 the extraction of bullets, and invented for this purpose a 
 clumsy instrument, which was named after him nlphonsinmn. 
 More favorable political circumstances in France helped the 
 college of surgeons considerably and made surgery more pro- 
 gressive in that countr}? than in any other, as in Germany for 
 instance. The barbers in France were kept stricter than they 
 were in Germany. 
 
 In the year 1425 they were forbidden to perform any sur- 
 gical operations and to do any kind of surgical work, with the 
 exception of dressing wounds and excising corns. The miser- 
 able clique of barbers enjoyed, however, the favoritism of the 
 medical faculty, originating from the latter's revengeful envy 
 and hatred toward the college of surgeons. This strong sup- 
 port of the faculty secured (1505) the barbers the right of im- 
 matriculatiou and admission to the lectures on anatomy and 
 other sciences. They now, puffed up as they were, changed 
 their title from horbHonsores to tonsores chiruvgici or chir- 
 ii.rgici a tonstrma. All these movements however had the 
 effect to increase privileges of the college of surgeons. 
 
 William Vavasseur, president of said college and first 
 surgeon to Francis I, succeeded (A. D. 1545) that it was ele- 
 vated to the rank of a literary school with the privilege of con-
 
 22 
 
 f erring the degr e of Doctor in Surgery and all snbordinate 
 titles upon its graduates. 
 
 Herewith the struggling science won a brilliant victory, and 
 strong and vigorous progress was the next result. No longer 
 the abused and humbled servant of the medical faculty, but 
 equal in every respect to the latter, surgery presented itself 
 now for the first time as an independent, substantial art, and a 
 science well gifted with qualities to demand the highest honor 
 and respect. 
 
 Italy made at the same time satisfactoiy progress, and one 
 of its first advancements was probably the p.n'fection of the 
 operation for stone in the bladder. 
 
 John de Romani, a surgeon of Cremona, improved this 
 operation with an apparatus (1525) named after his student 
 Mariano Santo. 
 
 BiONDO, a Venetian surgeon ( b. 1497 and d. 1570), was the 
 first who advocated the use of cold water in eases of injuries. 
 The scientific physicians, /. e. those versed in the old Greek 
 liteiature, began now to pay more and more attention to sur- 
 gery. So for instance the learned and celebrated GuiDO GuiDi, 
 formerly physician in ordinary to Francis I and later general 
 practioneer in Pisa, translated some excellent works on surgery 
 from the Greek into the Latin and facilitated therewith the 
 teaching materially. 
 
 The Italian surgeons, never losing sight of the scientific 
 aspect of the art, neglected not the technical part of surgery. 
 It was in 1452 when Branca, in Sicily, performed the Rhino- 
 plastic operation, and great was the astonishment everywhere, 
 since the most enlightened surgeons of that age would not be- 
 lieve in the possibility of such a procedure. The family Bran- 
 ca conveyed the procedure to the families Bojano and Vianeo 
 and soon this operation found its way to Calabria, where it 
 maintained itself until Tagliocozzi, with its masterly perform- 
 ances advanced it to perfection. It is therefore n^imed after 
 him Taliacofinn operaUoii up to our very day. In the mean- 
 time Leonhard Bertapaylia in Padua ( 1417) tried to sustain 
 the old Arabian traditions, but the Italian surgeons soon sur- 
 passed them, and by and by all taste for Arabian literature 
 ceased, while the stride for natural observations and better
 
 23 
 
 demonstrations gained gionnd in the same degree. Testi- 
 monies thereto are the works of Anton Benivieni, a Florintiue 
 practitioner (d. 1503), and Alexander Benedetti (d. 1525) a 
 learned Lombard, who practiced for a long time in Venetian 
 Greek and who served as Venetian army surgeon with high 
 honors. Paeacelsus, the great but often raisuuderotood re- 
 former of the healing art, had, nevertheless, a most powerful 
 influence (1536). In his position as professor of medicine, he 
 made laudable efforts to unite medicine with surgery. But his 
 results, since he opposed the use of :he knife and relied wholly 
 upon medicatio7is, were more in the direction of the medical 
 part of surgery. 
 
 FIFTH PERIOD. 
 
 FROM PARE TO SEVERIN (1551-1646). 
 
 With Ambrolse Pare (b. 1509, d. 1590) began at the middle 
 of the Sixteenth century a new epoch of surgery. He began 
 his career as army surgeon, in which position he served in 
 several French wars, and advanced finally to the honor of a 
 first royal house surgeon to the kings Francis II and Charles 
 IX. He practiced his profession over fifty years and his 
 whole life was a continuous, uninterrupted chain of glory and 
 victory in behalf of his noble art. One of its greatest merits 
 is undoubtedly the perfection of ligating bloodvessels and the 
 introduction of it in cases of major operations, particularly of 
 amputations. But not only this operation received his at- 
 tention, all branches of surgery ripened under his skillful culti- 
 vation to higher development and matured costly fruits. He 
 removed the prejudice against gun-shot wounds with much 
 earnestness, but was not the first surgeon who opposed the 
 erroneous idea of the poisonous character of gun-shot wounds. 
 To Barth. Maggi (b. 1477, d. 1552), professor in Bologna and 
 later house physician of Pope Paul III, belongs the honor to 
 have brought the first light into those confused ideas of gun- 
 shot wounds, at a much earlier date. 
 
 The defenders of this new view became by this time quite 
 numerous, among them we may mention: BOTALLI (1560),
 
 24 
 
 Fallopia, Caroano Leone, this latter was a Milanian by birth 
 and professor at Pa via (1583 ), and I'ELIX Wuerz, surgeon in 
 Basel, who at the same time earned high merits in the art of 
 midwifery. Pake's famous student, Iac. Gilhemeau (b. 1550, 
 d. 1612) did much for the general welfare of surgery and propa- 
 gated the teaching of his great master faithfully and persever- 
 ingly. He was regular physician to Henry IV, and president 
 of the hotel-Dieu. 
 
 At this time the history of spf?cial operations becomes ex- 
 ceedingly interesting and gives evidence of active progress in 
 surgery, preeminently among the French, Italians and Ger- 
 mans, who surpassed the Englishmen, Dutchmen and Spaniards. 
 The operation for stone in the bladder was much practiced and 
 treated upon. Trepanation was also an object of much mental 
 work and attention, while the theory on hernias and genito- 
 urinary diseases was much neglected. Now and then the sur- 
 gical literature in Germany was noted. Among other German 
 authors Conrad Gessner of Zurich (b. 1526. d. 1565) deserves 
 mention. He was famous as a naturalist and published a 
 series of surgical papers. Next to him comes J AC. Rueff. 
 surgeon in Zurich (1554), an able obstetrician, and Malach 
 Geiger of Munich, who lived in the middle of the Sixteenth 
 century, and wrote a revolutionizing work on hernias. Great- 
 er than all of them was Fabricius V. Hilden, city physician in 
 Berne (b. 1560, d. 1634), whose excellent work made him im- 
 mortal. In Italy it was Tagliocozzi, professor in Bo'ogna 
 (b. 1546, d. 1599), who reinstated the operation of Rhinoplastic 
 and brought it, as stated above, to perfection. 
 
 In Spain Frank de Arce, surgeon in Estremadura. attained, 
 through the successful treatment of old fistulas, a high repu- 
 tation. The Spaniards in general, like the Portugese, English 
 and Dutchmen, had done so little for the progress of surgery at 
 that time, that their names can be here justly omitted. 
 
 SIXTH PERIOD. 
 
 from severin to heister (1646-1718). 
 Marcus Aurelius Severinus deserves the honor to head a 
 new chapter in surgical history.
 
 25 
 
 He was ])orn iu Tursi, Naples, A. D. 1580, and lield for a 
 long time a professorship in Naples, and died A. D. 1650. He 
 elevated with illustrious integrity and devotion the practice of 
 surgery from a degraded and unworthy position to a higher 
 standard, and directed his attention and labors to the careful 
 study of pathology. His results in general practice and es- 
 pecially in comparative anatomy have secured him a permanent 
 place in medical and surgical history. 
 
 Shortly after him Fracassati (1665) and Manfredi (1668) 
 gave rise to the consideration of. transfusion and infusion. In 
 these studies they were howevei- preceded by the Germans. 
 
 Among all operations then practiced in Italy lithotomy was 
 probably the first, /. c, the most advanced one. Alghisi was a 
 well and favorable known lithotomist, while Genga (1672) and 
 MusiTANO (1698) were active as didactic authors. Surgery 
 reached the highest culmination at this time in France. 
 
 Nowhere else in the whole world could surgery be learned as 
 well as under Louis XIV, in France. The most talented teach- 
 ers had here the best facilities. The large hospital in Paris 
 entirely under their control afforded the most gratifying ad- 
 vantages. But the unfortunate quarrel between the college of 
 surgeons and the medical faculty, and the clique of barbers, 
 favored by the latter, continued right on, and ended finally and 
 most uiihappily in a victory for the theorising physicians 
 and the demoralized, corrupt barbers. The defeat of the 
 ''chirui-(/i<'ns (Je rohe loiu/iic'' was sadly ielt up to 1699 when 
 the noble art overcame envy and hatred, fraud and profanity 
 again. But even in the time of the lost cause and disgraceful 
 slavery, surgery never ceased to bring forth here wholesome 
 fruits. 
 
 Many brave and alile authors did just then battle for the so 
 wronged art. 
 
 Let me lay a laurel leaf upon the memory of some of those 
 heroes, so strong in their principles, so determined in their 
 noble duties, so charitable to humanity. Heroes, angels of life, 
 saints and martyrs reflect a ray of your holy splendor also upon 
 our age, glistening, glaring from a transient metal! Barth. 
 Saviard. member of the college of surgeons in Paris ( b. 1556,
 
 26 
 
 d. 1702), clemoustrated with an exhaustive collection of surgical 
 investigations the substantiality of his art. 
 
 John Vigier (1659), physician at Castras in Lanquedoc, 
 gave his whole soul and attention to the medical part of the 
 practice of surgery. 
 
 John Antoine Lambert, surgeon in Marseilly (1656), treated 
 upon dynamic diseases of bone, upon ulcers and fistulas. 
 
 Jacobe Covillard, surgeon in Montelimanel (1639), made 
 valuable surgical experiments and observations. 
 
 De la Vanguyon (1698), made operative surgery and the 
 art of surgical appliances his object. 
 
 Lastly, but by no means leastly, Frank Poupart, in Paris 
 (1695), embraced the whole domain of surgery. At the close 
 of the Seventeenth century Taber Dionis unquestionably was 
 the most able writer. He treated upon Akiurgy (operative 
 surgery) with extraordinary sagacity and his efforts in behalf 
 of anatomy and physiology will be remembered forever. 
 
 The discussions on transfusion and infusion in England gave 
 rise in France to many lively controversies, having the good re- 
 sult of bringing surgery into intimate relationship to physi- 
 ology. Christopher Wren, founder of the society of sciences 
 in London, made A. D. 1657, in consequence of the Harvean 
 theory on circulation, the first suggestions regarding those 
 operations. 
 
 The first experiments were made by Clarke, Egbert Boyle 
 and Henshaw. 
 
 They were soon followed by the celebrated physiologist Rich- 
 ard Lower in Oxford. In Germany John Siegmund Elsholz, 
 A. D. 1661, undertook similar experiments on infusions, which 
 soon was generally adopted as a new method to administer 
 medicine. But all these authors and experimenters were un- 
 able to realize the powerful influence of such a procedure upon 
 the heart's action, until Begnandot published (A. D. 1777) a 
 paper in which he explained the essential course of fever 
 movements, and stated that the analogy of the action of medi- 
 caments, introduced either by way of infusion or stomach was 
 overestimated, while the foreign and fever producing material, 
 from whatever source it inay be derived, was not enough con- 
 sidered.
 
 27 
 
 John Daniel Major, professor in Kiel (b. 1634, d. 1693), was 
 probably the first surgeon who tried transfusion from human 
 to human subjects. In France (Paris) several successful 
 operations of transfusion were performed. In spite of all good 
 results, bitter opponents to this operation sprang up. And 
 those cranks succeeded (A. D, 1668 and 1675) in having a law 
 passed, forbiding this operation in toto. The penalty for the 
 transgression of this law consisted of imprisonment at hard 
 labor. 
 
 In Germany we see at the close of the Seventeenth century 
 Mathias Gottfried Purmann in the first ranks, a surgeon of 
 much experience and highly honored by his contemporaries. He 
 was surgeon in Halberstadt, and lastly, city physician in Bres- 
 lau. His laok of theoretical education was more than over- 
 balanced by his good judgment and his practical sagacity. In 
 his position as Brandenburgian army surgeon (1674-1679) he 
 gained an extensive experience in the treatment of gun-shot 
 wounds and upon which he wrote a treatise indicative of great 
 familiarity with the subject in question. His principal 
 thoughts were however already expressed by Pari and Maggi. 
 At the beginning of the Seventeenth century C^sare Magati, 
 professor at Farrara (b. 1579, d. 1647), introduced a similar, 
 but simpler method, which had for its main object the con- 
 tradiction of frequent changing of dressings and a reasonable 
 confidence in the repairing power of nature. With this as 
 with all theoretical conclusions many prejudices were con- 
 nected. Magati's method was adopted in France and promi- 
 nently executed by the famous army surgeon Augustine 
 Belloste (b. 1654, d. 1730). 
 
 In Italy it was Andr. Sancassani (b. 1659, d. 1737), who 
 advocated this method, while Purmann's teaching (differing 
 from that of Magati only in the use of constructive metomor- 
 photic agents) had very salutary influences in Germany. His 
 literary productions had a large circulation, and his text book 
 on surgery was of great importance. 
 
 Sydenham's immortal works revealed a clear idea of morbid 
 organism, and to this author belongs the fame of having re- 
 instated and reintroduced the antiphlogistic method. The art 
 of surgical dressings and appliances received now the attention
 
 28 
 
 of all authors tliroiij3;hont the world. Thomas Sydenham was 
 boru at Wiuford-Eagle, England, A. D. 1G24. He was physi- 
 cian in London and died A. D. 1G89. 
 
 The French surgeons, always in the first ranks, justified 
 their claim of leadership also in this particular and practical 
 branch. 
 
 Jac du Marque, surgeon in Paris (1018), and Samuel For- 
 MEY, in Moutpelier (1653), introduced and perfected bandages 
 demanding the approval of the whole surgical world. 
 
 Now suggestions in regard to surgical instruments were 
 here and there made, and this essential part of surgery scien- 
 tifically treated upon. The armamentarium of John Schultes 
 (ScuLTETUs), city physician of Ulm (b. 1595, d. 1670), had been 
 fpr a long time in general use and aided materially to a 
 better understanding of presenting cases. The want of a re- 
 view and revision of the now numerous alterations and im- 
 provement of various operations created works of a relative 
 character. 
 
 Deserving honorable mention in this connection is John 
 MuRATT, city physician in Zurich (b. 1665, d. 1733). Finally 
 the Englishmen began to direct their attention to surgery 
 again, after they had neglected this art for a long time. Among 
 the most prominent English surgeons of that age we mention 
 Eichard Wiseman (1676), who advanced to the honorable 
 position of a royal house phj^sician after he served many years 
 as army surgeon in the civil wars of England. Much good he 
 did on the field of operative surgery. His operations on her- 
 nias deserve high recognition and praise. He searched with 
 persevering circumspection the indications of certain advised 
 operations, since most of his ccmtemporaries were wrapped up in 
 shallow and partial customs. J. Brown (1678) treated upon 
 wounds. William Cowper, surgeon in London (1677), whose 
 merits in behalf of anatomy and physiology became historical, 
 contributed to surgical literature very valuable results of his 
 observations. Wm. Salmon distinguished himself as a didactic 
 surgical writer. 
 
 The frequency of diseases caused by calculi gave rise to 
 strong efforts to improve and complete the operation of lithoto- 
 my. With this operation the English-natnralized Belgian.
 
 29 
 
 GitOENEVELT (Greenfield), became first prominent (171U), 
 bnt Chesalden soon eclipsed him. 
 
 Now the Dutch came to the front. J. van Horn, professor 
 of anotomy and surgery in Ley den, a much experienced and, 
 through his excellent anatomical works, well known surgeon 
 published a practical treatise on surgery, A. D. 1663. Not 
 less prominent was Cornelius van Solingen, surgeon in 
 Hague. He expressed, like most of his countrymen, a laudable 
 enthusiasm for deep observations. He improved many oper- 
 ations and assisted energetically the progress of midwift-ry. 
 
 All the eminent Dutch observers took a lively and active 
 interest in the welfare of surgery. Stephen Blancard, a 
 successful writer, at the close of the Seventeenth century, 
 NicoLAUS TuLPius (b. 1593, d. 1674), both in Amsterdam, Cor- 
 nelius Stalpaart van der Wyl, physician and surgeon in 
 Hague, at the middle of the Seventeenth century, and the 
 famous anatomist Fred Kuisch (b. 1638, d. 1701) are among the 
 strongest supporters of the art and science 'of surgery. Next to 
 them might be mentioned John Munniks (b. 1652, d. 1711), 
 Anton Nuck (d. 1692) and Walter Schouten (1704). 
 
 John Jacob Roe, professor of anatomy and surgery in Ley- 
 den (d. 1719), was a very able lithotomist. John Palfyn, 
 surgeon of Ghent (b. 1649, d. 1719), influenced the progress of 
 midwifery, through the advertisement of his instruments very 
 much. As a general rule the Duch undertook pathological sub- 
 jects with more predilection, than the technical part of sur- 
 gery. 
 
 SE VENTH PERIOD. 
 
 prom HEISTER to the beginning of the nineteenth CENTUBl. 
 
 Up to this time the science of surgery had not entered any e€ 
 the German universities. It was in an unworthy connection 
 with the degraded barber trade. Therefore it was of low stand- 
 ing and looked upon with general contehipt. The faculties re- 
 fused all relationship with a profession so disreputed. 
 
 But it was again war with its grave consequences, which re- 
 minded the prejudiced and partial philanthropists of a grosB
 
 30 
 
 neglect of a precious art. The flimsy aud shallow arguments 
 against the life saving art melted under the unrelenting heat of 
 warfare like snowflakes under the sunbeams of a spring day. 
 Regretfully, silently but eagerly the study of surgery was sought 
 for. The application of it seemed now so urgent, so pressing! 
 Under such earnest, solemn influences and often sad impres- 
 sions, surgical schools, in great numbers sprang up all over the 
 country, offering the medical faculties a hot and earnest con- 
 tention. An event of the utmost importance was the founda- 
 tion of the "Collegium Medicum" in Berlin, A. D. 1685, and of 
 still greater importance, the transformation of the same into a 
 general academy by the Surgeon-General, Holtzendokf (1713- 
 1724). This institution protected the surgeons against hostile 
 attacks, and its members, among which some have gained im- 
 mortal fame, educated excellent talent and have spread surgical 
 knowledge in all directions. The most pleasing paragraph of 
 surgical history begins with Loeexz Heistee (b. 1683, d. 1758). 
 He received his education in Holland, whore he was a student 
 of EuiscH and Boerhaaven. In his position of an army 
 surgeon he gained much, valuable experience. He accepted a 
 professorship in Helmstaedt, where he elevated that university 
 to the highest standard, productive of excellent results and 
 affording all facilities and advantages for surgical progress. 
 It was generally considered the training school for surgeons. 
 The number of its students kept pace with the increasing 
 reputation of the school, and the fame and dignity arising 
 therefrom, of the respective art and science itself. This noble 
 mind and conviction of the necessity of a profound medical 
 education for sugical achievements Heistee transplanted from 
 Holland to Germany. A worthy collegian to Heistee wrs 
 Zachaeias Platnee (b. 1694, d. 1747), in Leipzig. He had 
 studied surgery with mucli predilection in Paris. 
 
 Justus Gottfrey Guenz (b. 1714, d. 1754), who was also 
 professor in Leipzig, distinguished through his classical work, 
 attained a reputation with his treatise on hernias, and deserves 
 fully the honor to be put on the list with the most prominent 
 German surgeons of his age. 
 
 Next to the universities of Helmstaedt and Leipzig we 
 might mention the university of Tuebingen, in Wurttemberg,
 
 31 
 
 where Bukchard David Mauchert (b. lG9(j, d. 1751), laid tlie 
 foundation for systematic surgical studies. 
 
 In Jena Karl Fred. Kaltschmidt (b. 1706, d. 1709) fur- 
 nished rare sur.o-ical works. 
 
 Of the Berlin t-chool those who destinguished themselves 
 preeminently were John Theodor Eller, royal physician 
 (b. 1689, d. 1760), as observer, Samuel Schartschmidt 
 (b. 1709, d. 1747), as teacher and practitioner, and the well 
 known observer and investigator, the army physician, Joachim 
 Fred Henkel (b. 1712, d. 1779), who held at the same time 
 the position of surgeon-in-chief in the charity hospital, founded 
 by Frderick Wm. I. This institution was, in accordance with 
 a sjiecial wish of its founder, considered and conducted as a 
 regular training school for yjhysiciaus and surgeons. It was 
 constantly enlarged and became gradually an immense concern, 
 and was, until 1810 the only place where surgical operations on 
 living subjects could be demonstrated. The surgeons-general 
 of the Prussian army were almost all excellent men, who 
 served as teachers in this college and as surgeons-in-chief in 
 the charity hospital to the benefit of students and young sur- 
 geons. Othc3rs did battle for their art in a general way. 
 Among them we mention John Ulrich Bilquer, of Grisoii 
 (b. 1720, d. 1798), who treated upon the injuries of the head 
 and upon amputation, for which operation he set some narrow 
 limitations. 
 
 John Leberecht Schmucker (b. 1712, d. 1786), who received 
 his surgical education in the Parisian school, J. Chr. Ant. The- 
 DEN (b. 1714, d. 1797), Christ. Ludw. Mursinna, a man of 
 extraordinary genius, of rare talent for any art, and very ex- 
 tensive experience, and John Goerke (b. 1750, d. 1822), 
 the founder of the medical and surgical "Frederick William's 
 Institute," A. D. 1795. Of equal importance was the establish- 
 ment in Austria of the medical and surgical Joseph's AcadeBsjr 
 (founded A. D. 1780), and provided with the most valuable 
 means by Joseph II. Maria Theresa had previously laid the 
 foundation to a systematic study of surgery, and had revolution- 
 ized the whole art, through the erection and connection of 
 good clinical schools with all Austrian universities. The con- 
 viction of the necessity of clinical studies became general, and
 
 32 
 
 all Gei'man universities had clinics connected with other 
 branches. Young physicians and surgeons had now an oppor- 
 tunity to observe essential symptoms on the bedside and to 
 realize them better since affirmed by clinical facts. The sur- 
 gical student had the privilege of practicing here the use of 
 the knife. The fact that this institution, like the college of 
 surgeons of former days, had the authority to graduate Docors 
 of Medicine and Masters in Surgery, gave it more dignity be- 
 fore the public, and graduates from there stood high in social 
 circles. In the first ranks of the Vienna school stood John 
 Alex. v. Brambilla, regular physician to Joseph II (b. 1728, 
 d. 1800), Eaph John Steidele, John Hunczowsky, royal 
 house physician to Leopold II (b. 1752, d. 1798), and Jos. Jac 
 Plenk (b. 1738, d. 1807). 
 
 Wuerzburg, with one of the finest hosi^itals in the world, owes 
 its fame in the first place to Karl Casper v. Sieghold, whose 
 clinical lectures revealed the most profound knowledge. But 
 all German surgeons of this age are surpassed by the greatest 
 of all German surgeons, August Gottlob Eichter, in Gottin- 
 gen (b. 1742, d. 1812). He published a series of surgical 
 journals, the circulation of which embraced all civilized coun- 
 tries, the United States not excepted. Herewith he furnished 
 the first means of an universal communication between all sur- 
 geons of the world and putting surger^^ on an equal basis with 
 the other sciences. During Richter's time the number of 
 German writers became so great that it would be impossible to 
 name them all. New ideas, capable of giving surgery a differ- 
 ent direction, were now produced. 
 
 In France the old guardianship of the medical faculty over 
 the college of surgeons as we saw it during Louis XIV time, 
 pressed hard at the beginning of the Eighteenth centur}' up- 
 &^ the struggling art. 
 
 Excellent men, however, made constant and persistent efforts 
 to liberate the suffering art from these shameful bonds, and 
 their labors were not in vain. Surger}^ gained gi'ound foot by 
 foot. Among those brave pilots we feel obliged to mention: 
 
 John Louis Petit (b. 1674, d. 1760). He was royal house 
 physician and stood firmly up for the rights of surgery. His 
 fame as teacher penetrated all regions, and his theorj' on diseas-
 
 33 
 
 es of bones is excellent. Of still greater influence regarding 
 the social standing of surgery were George Mareschal 
 (b. 1658, d. 1736), also regular physician to the king, and his 
 assistant (since 1717) Frank de la Peyronie (b. 1678, d. 
 1747). They demanded with laudable pertinacity political 
 equality of the colleges of surgeons with the medical faculty 
 and reached finally a permanently satisfactory result in the 
 year of grace 1731. 
 
 De la Peyronie accomplished the foundation of the 
 "Academie de Chirnrgie,'' which institution was perfectly 
 separated from the medical faculty. This institution received, 
 twelve years later, valuable privileges, with the special dis- 
 tinction that the degree of maifrc en chiviirgie, i. e. C. M. 
 was to be preceded by the title uiaifre es a)is, i. e. A. M., i. e. 
 that any man who tried to come up for graduation in surgery 
 had to prove his higher literary education. (An ordinance 
 which would be of great utility for our country!) 
 
 This declaration resulted first in a hot and bitter controversy 
 and Pichant de la Martiniere, the successor of De la 
 Peyronie had to meet many and unpleasant incidents. Finally 
 A. D. 1748 and 1751, the academy of surgeons was completely 
 organized and chartered, and the surgeons were professionally 
 separated and put on an equal basis with the medical faculty. 
 
 France was in the Eighteenth century so rich in excellent 
 surgeons, that we can only mention a few of the most fa "nous 
 ones. Among them was Kene Jaeques Croissant de Garen- 
 geot, army surgeon (b. 1688, d. 1759), well known as an 
 anatomist and improver of operative surgeiy. Francois le 
 Dran (d. 1770), first surgeon in the charity hospital, who 
 treated upon the whole field of operative surgery in a series of 
 able papers. Much admiration is due him on account of his 
 excellent treatment of gun-shot wounds. His amputations and 
 his cases of lithotomy were equally admired. 
 
 Wm. Manqtjest de Lamotte (b. 1655, d. 1737), surgeon in 
 Valogne was well known as observer and didactic writer on 
 surgery in general. 
 
 Salvat. Morant, first army surgeon and member of academy 
 of sciences (b. 1697, d. 1773), an excellent physiologist and 
 improver of lithotomy. At this time the study of physiology
 
 34 
 
 ia France began to take a different direction from that in 
 Germany. AVhile the German teachers of anatomy and 
 j>hysiology were not engaged in general practice of medicine 
 and surgery, the French physiologists practiced their profes- 
 sion with good success. The periodical and encyclopedical 
 literature of the French was at this age very extensive. 
 Antoine Louis (b. 1723, d. 1792), hospital physician and 
 secretary of the academy of surgery, was undoubtedly one of 
 the most able surgeons of the Parisian school, and had in the 
 jjeriodical literature of his age a prominent name. Just as 
 famous was Claude Pouteau (b. 1725, d. 1775). He was a 
 careful improver of lithotomy and other operations. So was 
 George de la Faye (d. 1781), at Paris and Louis Blanc, at 
 Orleans. Franc. Onesnay (b. 1694, d. 1774) and Thomas 
 Goulard (1760), professor in Montej^ellier. Among all French 
 surgeons, previous to recent times, Peter Joseph Desault 
 (b. 1744, d. 1795), stands unsurpassed. There were some per- 
 haps, who came very near him in fame, as for instance Raphael 
 Bienvenu Sabatier (b. 1737, d. 1811), who was in anatomy 
 and operative surgery equally able, and Peter Frank Percy 
 (b. 1754, d. 1825). But in scholarship, moral dignity, grasping 
 mental power and general greatness, none of his contempo- 
 raries could measure himself with the immoi'tal Desault. 
 Rich ART, his famous student, after the destructive time of the 
 French revolution, gave his pnysiology a new direction, and 
 this move proved to be of great importance for the new 
 theories of the French school. 
 
 It would not be just to close the chapter without mentioning 
 the English surgeons, Avho, in this period, made wonderful pro- 
 gress in surgery and who had successfully overpowered old in- 
 stitutions and narrow and partial ideas. 
 
 Many English surgeons of the Eighteenth century have at- 
 oned high reputations, Wm. Chesenden's (b. 1688, d. 1752) 
 name as anatomist and improver of varioiis operations will 
 he remembered forever. Alexander Munro, Sen., (b. 1696, 
 d. 1767) in Edinburgh is well known as a comparative anato- 
 mist and as a much experienced surgical writer. Of Percival 
 Pott (b. 1713, d. 1788) we are daily reminded by instruments 
 and diseases first described by him and gratefully named
 
 OO 
 
 after liim. He was first surgeon of the Bartholomaeus hospiW 
 in London. There are many more excellent and deserving 
 English surgeons on the list of this epoch, but space will not 
 permit the naming of them here. We cannot however omit in 
 silence men like the following: Samuel Sharp, surgeon in chief 
 to (xuy's Hospital (d. 1765), Wm. Bromfield, surgeon to St. 
 Luke's Hospital (b. 1712, d. 1792), Jacob Douglas (b. 1675, d 
 1741) in London (the two latter were able lithotomists), Ed. 
 Elanson, surgeon in Liverpool (1779), and Thomas Kirkland 
 in Ashby, both of whom treated successfully upon amputations. 
 
 The most deserving recognition was earned by John Hunter 
 (b. 1728, d. 1793) and William Hunter (b. 1718, d. 1783) as 
 anatomists, physiologists and surgeons in general. The merits 
 of Ben. Bell and John Abernethy are also fresh in memory. 
 
 The Dutch, Danes and Swedes kept pace with the nations 
 just mentioned. The first named have particularly contributed 
 valuable additions to surgical progress. Among the able 
 Dutch writers we mention John Van Schlichting in Amster- 
 dam (1750), Jac Van der Haar in Herzogenbusch (1760), the 
 celebrated physiologist Peter Camper (p. 1722, d. 1789) in 
 Franecker, Amsterdam and Groeningen, Daniel van GesstheU 
 in Amsterdam (1770), Edward Sandifort in Ley den (b. 1732, 
 d. 1814, and Andreas Bonn (b. 1783, d. 1819), teacher in the 
 university of the same name. Many more could be mentioned 
 of an equal and still more of a more moderate character. 
 
 Among the Swedish surgeons we mention only the justly 
 celebrated Olof Acret (b. 1717, d. 1807), and among the 
 Danes Henry Callisen (b. 1740, d. 1824). 
 
 In the Eighteenth, as well as in the preceding centuries, the 
 Spaniards and Portuguese could not keep up with the other 
 nations; and as their scattered results in surgery are so insig- 
 nificant, we omit them here and count up a few of the leadio|f 
 Italian surgeons, who made strong and siiccessful efforts #o 
 keep their old established reputation. Anton Benevoli In 
 Florence (b. 1685, d. 1756). Peter Paul Molinelli in Bolog- 
 na (b. 1702, d. 1764), the two Nanoni in Florence, Angelo, Sen. 
 (b. 1715, d. 1790), and Lorenzo, Jun. (b. 1749, d. 1812), the 
 well known lithotomist Natalis Jos. Palucci in Florence and 
 later in Vienna (b. 1719, d. 1797), Ambrosius Bertrandi 'm
 
 3G 
 
 Turin (b. 1723, d. 1765), Joseph Flajani in Kome (1786), 
 John B. Paletta in Milan (1790), Joseph Nessi in Pavia 
 (1787), are the most celebrated Italian surgeons of this period. 
 But Anton Scarpa, professor in Pavia (b. 1750, d. 1824), sur- 
 passes them all. 
 
 And now a few words regarding our Nineteenth century. It 
 seems almost impossible to enumerate the vast number of sur- 
 geons who have distinguished themselves in our present cen- 
 tury. France, Germany, Italy, Holland, Austria, England, and 
 in fact all civilized nations have done wonders in progressive 
 surgery. Only a few of those who passed away, leaving ever- 
 lasting monuments behind them I may be allowed to mention 
 here. 
 
 Jean Dominique Laeeey was born A. D. 1768, at Bordeaux. 
 He was surgeon-in-chief of the navy under Napoleon I., in- 
 spector general of the medical department of the French army, 
 grand officer of legion of honor, a baron (1816), surgeon -in- 
 chief of the guard and surgeon-general of the house of Inva- 
 lides. He died 1842. His works are translated in all Europe- 
 an languages and his operations too well known to be men- 
 tioned. 
 
 Wm Dupuytren, Baron, the first surgeon of his time ( and 
 perhaps of all times) was born A. D. 1777, at Pierre Buffiere, 
 in Haute, Vienne, chief of the anatomical department, (1803), 
 Surgeon in the hotel Dieu, (1812), profess(H" of surgery in the 
 medical faculty 1815, surgicial director of the hotel Dien, and 
 at the same time physician in ordinary to Louis XVII. and 
 Charles X. He died 1835, after he had for two years suffered 
 from the effects of an apoplectic stroke. 
 
 His correctness and sagacity in diagnoses, his firmness and 
 dexterity in operations wei'e generally admired. He wrote but 
 Mttle himself, but his students published Lecons Orates de 
 Clinique Chirurgicale Faites a rHotelDieu(4 Vols. Paris, 1830, 
 1834) and Traite Theorique et Pratique des Blessures (2 Vols. 
 1804). Both works are translated into all European languages. 
 
 Alfred Armand Velpean was born 1795 in Brache. As- 
 sumed a professorship in 1834 and died 1867 in Paris. His 
 name as clinical teacher and surgeon is also immortal.
 
 37 
 
 Among- the Germans who have planted everlasting immortality 
 upon their graves we mention the following few. 
 
 Carl Ferdinand Graefe, born 1787 in Warsaw; died 1840 
 in Hanover. In 1810, when 23 years of age, he became profes- 
 sor in Berlin. From 1813 to 1815 he was Surgeon General of 
 Division. He was great as writer, masterly as operator. He 
 remodeled many operations, and was really the restorer of 
 Rhinoplastic. 
 
 His son Abrecht (born 1828 iu Berlin, died July 20th, 1870) 
 as professor in Berlin was a worthy successor of his eminent 
 father. 
 
 John N. Rust (b. 1775, d. 1840), professor in Berlin and reg- 
 ular physician to the crown prince of Prussia was in no way 
 inferior to the above named surgeons. Neither was it Konrad 
 John Martin Langenbeck, the well known anatomist and pro- 
 fessor in Gottingen, (b. 1776, d. 1851) and his nephew Bern- 
 hard V. Langenbeck (b. 1810, d. 1887) whose labors for resec- 
 tions are yet fresh in the mind of every surgeon throughout the 
 world. Many more of excellent German surgeons deserve rec- 
 ognition but 'as the number is so great, we must depart from 
 these noblemen, wishing and hoping that eternal reward will be 
 impartially bestowed upon all and every one of them for their 
 sacred devotion and noble deeds. 
 
 The English came in this century also bravely to the front, 
 and while the curtains of the Eighteenth century fall only upon 
 one great brother pair (disregarding a great number of able but 
 inferior men), the immortal Hunters; this first act of the nine- 
 teenth century opened with a stage filled with actors. Aber- 
 combie, a. Cooper, Capelane, Earle, R. Hamilton, E. Home 
 M. Mayo, John Shaw, T. Thompson and Travers are familiar 
 names in English literature. 
 
 To speak of our own country I consider somewhat premature. 
 
 This century is not quite completed, but we are safe to pre- 
 dict, that in the future annals of surgicial history the United 
 States of America will be entitled to a creditable place. The 
 practical character of the American surgeon is making good use 
 of the deeper and more elaborate studies of European investiga- 
 tion and the time will not be far off when the land of the free
 
 38 
 
 and the home of the brave will take the lead in oi)erative sur- 
 gery at least. 
 
 We repeat, this century is not ended; it is hard to t(dl how 
 many stars will rise and be eclipsed again by others, before 
 the day break of the Twentieth century. 
 
 We will therefore mention none, but leave it to the impartial 
 judge, the world history, to crown our heroes. In this we will 
 not be deceived, as we are confident in our American masters of 
 surgery on the one hand and on the other in the truthfulness of 
 Schiller's proverb. 
 
 Die WcUgeschichfe isf das WeUf/ericht, i. c, The world's 
 history is the ivorkV s judgment. 
 
 FINIS.
 
 30 
 CH. MARCHAND'b 
 PEROXIDE OF HYDROGEN 
 
 (MEDICINAL) Ha O2 (Absolutely Harmles..) 
 
 as rapidly arowin;; iii favor with lii«> iiiedi«-al 
 profession. It is tlic most powerful aiilisepti« 
 known, almost tasteless, aii«l odttrless. 
 
 This remedy is not a Nostrum. 
 
 Can be talceu internally or applied externally 
 
 witl» perfect safety. Its turativc properties 
 
 are positive, and its stren<!;tU and purity ean 
 always be reli<'d upon. 
 
 A REMEDY HOR 
 
 DIPHTHERIA ; CROUP ; SORE THROAT, and all inflammatory diseases oh the throat. 
 OPINION OF THE PROFESSION. 
 
 Dr. Geo. B. Hope, Surgeon Metropolitan Throat Hospital, Professor Diseases of Throat, University of 
 Vermont, writes in an article headed, "Some Clinical Features of Diphtheria, and the treatment by Peroxide 
 of Hydrogen (N. Y. Medical Record, October 13, 1S8S). Extract : 
 
 " . . . On account of their poisonous or irritant nature the active germicides have a 
 utility limited particularly to surface or open wound applications, and their free use in reach- 
 ing diphtheritic forn^ations in the mouth or throat, particularly in children, is, unfortunately, 
 not within the range of systematic treatment. In Peroxide of Hydrogen, however, it is con- 
 fidently believed will be found, if not a specific, at least the most efficient topical agent in 
 destroying the contagious element and limiting the spread of its formation, and at the same 
 time a remedy which indy be employed in the most thorough manner without dread of pro- 
 ducing any vicious constitutional effect. 
 
 '•'In all the cases treated (at the Metropolitan Throat Hospital), a fresh, standard 
 Marchand preparation of fifteen volumes was that on which the experience of the writer has 
 been based. . . ." 
 
 Dr. E. R. Squibb, of Brooklyn, writes as follows in an article headed ' On the Medical Uses of Hydrogen 
 Peroxide (Gaillard's Medical Journal, March, 1889, p. 267), read before the Kings County Medical Associa- 
 tion, February 5, 1889 : 
 
 " Throughout the discussion upon diphtheria very little has bean said of the use of the 
 Peroxide of Hydrogen, or hydrogen dioxide ; yet it is perhaps the most powerful of all disin- 
 fectants and antiseptics, acting both chemically and mechanically upon all excretions and 
 secretions, so as to thoroughly change their character and reactions instantly. The few 
 physicians who have used it in such diseases as diphtheria, scarlatina, small-pox, and upon all 
 >liseased surfaces, whether of skin or mucous membrane, have uniformly spoken well of it 
 so far as this writer knows, and perhaps the reason why it is not more used is that it is so 
 little known and its nature and action so little understood. 
 
 " Now, if diphtheria be at first a local disease, and be auto-infectious ; that is, if it be 
 propagated to the general organism by a contagious virus located about the tonsils, and if this 
 virus be, as it really is, an albuminoid substance, it may and will be destroyed by this agent 
 upon a sufficient and a sufficiently repeated contact. 
 
 '. "A child's nostrils, pharynx and mouth may be flooded every two or three hours, or 
 oftener, from a proper spray apparatus with a two volume solution without force, and with 
 very little discomfort ; and any solution which finds its way into the lai7nx or stomach is 
 beneficial rather than harmful, and thus the efiect of corrosive sublimate is obtained without 
 its risks or dangers. . . ." 
 
 Further on Dr. Squibb mentions that Charles Marchand is one of the oldest and best 
 makers of Peioxide of Hydrogen, and one who supplies it to all parts of the country. 
 
 CAUTION. — By specifying in your prescriptions " Ch. Marchand's Peroxide 
 of Hydrogen (Medicinal)," which is sold only in ^Ib., l4-]h., and i-lb. bottles, bearing 
 my label and signature, you will never be imposed upon. Never sold in bulk. 
 
 PREP.\REI) OXI.V I'.Y 
 
 A book containing full explanations concerning the 
 th_'rapeutical applications of both Ch. Marchand's 
 Prroxidf, OF Hydrogen (Medicinal) and Gi.vcozonf. 
 with opinions of the profession, will be mailtcl i.. 
 physicians free of charge on application. 
 
 tW Mention this publication. 
 
 C/iewisl and Graduate of the '' Ecole Central,- dcs Arts el Manufaetmcs dc Pans " {France). 
 SOLD nV LEADING DRUGGISTS. 
 
 Laboratory, lO West Fourth Street, New York. 
 
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