Alderotti died 1303 A. D.
Among the writings of Thaddeus Alderotti which have come down to our time there are to be found a number of autobiographical references which are not without interest. In one place, for example, he mentions the fact that he occasionally walks in his sleep, and then proceeds (in Latin) to discuss the phenomenon of sleep-walking as observed in his own case. I give here a free translation of the text printed in Neuburger’s History:—
The fourth question which suggests itself is this: Can the senses during sleep come into active operation? Touching this fourth question I reason thus: It appears as if, when one is asleep, the senses must act, for a person may move about without incurring any harm when he is in that state, as is often observed in the case of those who, like myself, walk in their sleep.... Furthermore, it has been remarked that these people are able to harness a horse and then to ride the animal safely,—acts which it is not possible to perform without the aid of the senses. On the other hand, Aristotle maintains that a man, when asleep, is not capable of using his senses. To this I reply by conceding that during sleep a man certainly does not perceive what is going on about him. Wherefore, if you answer me by saying that the mere fact of a man’s ability to walk while he is asleep furnishes conclusive evidence that he possesses his senses, I reply that movements like that of walking are not the result of an impression made upon the mind (“impressio imaginativa”), but the product of a different mechanism, of a nature which permits it to operate during sleep.... As to the second point to which you call attention—that, namely, with regard to the power of bridling and riding a horse while one is asleep—I make this reply: These acts are performed as a result of an impression made upon the mind through the working of the imagination, and not as a direct consequence of any images created upon the eye; for, if the sleep-walker happens to be in a strange house when the impulse to walk seizes him, he will not go to the stable. The route which he is sure to take will be one with which he is familiar, as happened in the case of the blind teacher who, unaccompanied by any person, walked habitually through the streets of Bologna. And then, besides, I am able to speak from personal experience, for in one of my sleep walks I jumped down from an elevation about four feet above the ground without awaking from my sleep.... When, in the course of one of these walks, I am exposed to cold, or when I hear somebody speaking near me, I refer these phenomena entirely to something within myself, and I return to my bed.
Of the four medical schools to which a brief reference was made on a preceding page, that of Bologna was probably the first to attain a certain degree of celebrity; and it owed this distinction very largely to the work done by men who were primarily surgeons, viz.: Hugo of Lucca; Theodoric, Hugo’s son; William of Saliceto; and possibly, to a very slight extent, Roland of Parma, who spent only a part of his professional life in Bologna. But there was one other who, while he was not a surgeon, yet contributed very greatly to the fame of the Bologna school and at the same time to the real advance in surgical knowledge which characterized the work of the men whose names have just been mentioned—viz., Mondino. These men, especially Mondino, cultivated the study of anatomy much more earnestly than their rivals at Salerno had ever done, and the surgical methods which they adopted were of a more scientific character than those practiced by Roger. In the treatment of wounds, for example, instead of striving to bring about healing by the application of remedies which stimulate suppuration, they favored the dry method; in which practice they were justified not only by their own experience but also by Galen’s teaching: “A dry state of the wound approaches more nearly to what may be considered the normal condition, whereas a moist state is surely unhealthy.” (Methodi medend., IV., 5.) As an offset to the latter authority the Salerno surgeons quoted that particular aphorism of Hippocrates (V., 67) which reads: “Laxa bona, cruda vero mala.”—almost the very opposite of Galen’s doctrine. Then again, the Bologna surgeons effected improvements in other directions: They materially restricted the use of the red-hot cautery iron, and they cast aside as useless many of the complicated apparatuses which had previously been employed in the treatment of fractures and dislocations. It is evident from these facts that the Bologna surgeons were not, as were most of the physicians of the twelfth and thirteenth centuries (Thaddeus of Florence perhaps excepted), slavish followers of the ancients or even of the more modern Arabs, but men who thought independently and who were not afraid to use their own powers of observation.
Hugo of Lucca.—Hugo Borgognoni, more commonly called Hugo of Lucca—was born in that city about the middle of the twelfth century, served as municipal physician to the city of Bologna, accompanied the Bolognese Crusaders on their expedition to Syria and Egypt, was present at the siege of Damietta in 1219 A. D., and died a short time before 1258, at the age of nearly one hundred. He acquired a great reputation as a surgeon and brought up several sons who followed in the same walk of life, among the number being Theodoric, who gained even greater celebrity than his father in the domain of surgery. As Hugo himself left no writings of any kind, we are largely dependent, for a knowledge of his achievements, on the treatises which his son Theodoric wrote. From this source we learn that Hugo recommended, for use in surgical operations, the employment of narcotizing sponges like those described on page 253, and was also an advocate of the plan of treating wounds by the dry method (compresses soaked in wine over which simple dressings were applied). In the treatment of empyema, of abscesses, of penetrating wounds of the chest, and of both complicated and simple wounds of the skull, he emphasized the wisdom of adopting simple measures, of interfering with the parts as little as possible, of abstaining from the use of the probe, and of observing strict cleanliness. In cases of fracture of a rib it was his practice to place the patient in a bath, and then, with fingers which had been thoroughly oiled, to attempt the replacement of the separated ends of the fractured bone. Neuburger regards Hugo of Lucca as the founder of the Bologna School of Surgery.
Theodoric of Lucca, known also as Bishop Theodoric, was born 1206 A. D. While still quite a young man he joined the recently established order of preachers, and not long afterward was appointed Almoner (Poenitentiarius)[60] to Pope Innocent IV. Eventually he became Bishop of Cervia, near Ravenna. By special permission of the Pope, he was able to complete the surgical training which he had received from his father, Hugo of Lucca; and thus, while he still held the office of Bishop, he practiced surgery to some extent in Bologna. In course of time his practice became very extensive and also very lucrative; as a result of which he was able to leave a large fortune to various charitable institutions. The first printed edition of his work on surgery appeared in Venice in 1498, and was followed by numerous later issues.
Theodoric, says Neuburger, was a most uncompromising advocate of the dry method of treating wounds. His (Theodoric’s) words are these: “For it is not necessary—as Roger and Roland have said, as most of their disciples teach, and as almost all modern surgeons practice—to favor the generation of pus in wounds. This doctrine is a very great error. To follow such teaching is simply to put an obstacle in the way of nature’s efforts, to prolong the diseased action, and to prohibit the agglutination and final consolidation of the wound.”[61]
In his enumeration of the different means that may be employed for arresting hemorrhage, Theodoric mentions cauterization, tamponading, the application of a ligature, and the complete division of the injured blood-vessel. He attached great importance to the proper feeding of the patient. In Book III., chapter 49, of his treatise on surgery, he gives minute instructions with regard to the proper manner of employing a salve made with quicksilver, and at the same time he mentions the fact that he observed a flow of saliva as one of the results of its use.
The expressions “healing by first intention” and “healing by second intention” are encountered for the first time in the writings of Brunus, a surgeon who practiced in the cities of Verona and Padua about the middle of the thirteenth century, and who was a vigorous advocate of the dry method of treating wounds. His two treatises (“Chirurgia magna” and “Chirurgia minor”) were printed in Venice in 1546. Neuburger says that although a large part of the text in these volumes consists of extracts from Galen, Avicenna, Hippocrates, Abulcasis and other authorities, there are to be found at the same time not a few observations of an original character.
William of Saliceto.—William of Saliceto (Guglielmo da Saliceto) is accorded by Neuburger the honor of being Bologna’s greatest surgeon—if not, indeed, the greatest surgeon of that period. He was born in the early part of the thirteenth century and spent a large portion of his professional life in Bologna, where he not only practiced medicine but also acted in the capacity of a teacher of this science. During the latter part of his career he lived in Verona, where he held the position of Municipal Physician and Attending Physician of the City Hospital. He died about the year 1280.