[Footnote 24: This is a very striking reflection on the necessity for the study of anatomy for the practice of surgery to have been made within a half century after the supposed prohibition of dissection by the Popes, and at a time when, according to President White, "even such serious matters as fractures, calculi and difficult parturition, in which modern science has achieved some of its greatest triumphs, were dealt with by relics," and when "there were religious scruples against dissection," and surgery "was denounced by the Church," and when "pastoral medicine had checked all scientific effort in medical science." And the reflection was made by a chamberlain of the Papal household.]
"Thence he paid a brief visit to Paris, where for a moment, by the renown of Lanfranc, Jean Pitard, and Henry of Mondeville, surgery was in the ascendant. For the moment the Church and the faculty had not succeeded in paralyzing the scientific arm of medicine. [Footnote 25] [{187}] Guy began practice in Lyons, whence he was called to Avignon by Clement VI. as 'venerabilis et circumspectus vir, dominus Guido de Cauliaco, canonicus et propositus ecclesiae Sancti Justi Lugduni, medicusque domini nostri Papae.' In Avignon he stayed, while other physicians fled, to minister to the victims of the plague (A.D., 1348), and he may have attended Laura in spite of Petrarch's tirades against all physicians and even against Guy himself. His description of this epidemic is terrible in its naked simplicity. He did not, indeed, himself escape, for he had an attack with bubo, and was ill for six weeks. He gave succor also in a later epidemic in Avignon, in 1360. His 'Chirurgia Magna' or Inventarium seu Collectorium Artis Chirurgicalis Medicinae--so called in distinction to the meagre little handbooks or Chirurgiae Parvae compiled from the larger treatises--was in preparation in 1363. This great work I have studied carefully, and not without prejudice; and yet I cannot wonder that Fallopius compared the author to Hippocrates, or that John Freind calls him the Prince of Surgeons. It is rich, aphoristic, orderly and precise. As a clerk he wrote in Latin, in the awkward hybrid tongue that medical Latin then was, containing many Arabian, Provençal and French words, but very little Greek."
[Footnote 25: It is worthy of remark, how even Prof. Allbutt, in a passage like this, where he is providing abundant material for the contradiction of the English Protestant tradition of the supposed opposition of the Church to science, and especially to surgery, yet cannot break away from the influence of that tradition entirely. It has been bred in him, and even while showing its falsity he is not entirely convinced himself, because the old mode of view has so firm a hold on him that he is not open to conviction. A little later in this same passage he speaks of taking up the study of Chauliac, prejudiced against him, and being convinced of his greatness against his will. Verily history has been a conspiracy against the truth, in which many people have joined almost unconsciously, led astray by feeling, not intellect.]
Guy de Chauliac's Instruments:--15, 16, cautery apparatus with canula for cauterizing the uvula and tonsils; 17, bistoury; 18, amputation knife; 19, small sickle knife for opening abscesses and fistulas.
Guy de Chauliac's Instruments:--21, bow for extracting arrows the head of which had penetrated a limb; 22, mechanical trephine revolved by up-and-down movement of cross-bar.
We have seen that there was great surgery in Italy, in France, and in the Netherlands, but it had also crossed the channel into England.
There was a famous English surgeon during the [{188}] fourteenth century by the name of John Ardern. He was educated at Montpelier and practiced surgery for a time in France. About the middle of the century, however, according to Pagel, he went back to his native land and settled for some twenty years at Newark, in Nottinghamshire, and then for nearly thirty years longer, until nearly the end of the century, was in London. He is the chief representative of English surgery during the Middle Ages. His Practice, as yet unprinted, contains, according to Pagel, a short sketch of internal medicine, but is mainly devoted to surgery. Contrary to the usual impression with regard to works in medicine and surgery at this time, the book abounds in references to case histories which Ardern had gathered, partly from his own and partly from others' experience. The therapeutic measures that he suggests are usually very simple, in the majority of cases quite rational, though, of course, there are many superstitions among them; but Ardern always furnished a number of suggestions from which to choose. He must have been an expert operator, and had excellent success in the treatment of diseases of the rectum. He seems to have been the first operator who made statistics of his cases, and was quite as proud as any modern surgeon, of the large numbers that he had operated on, which he gives very exactly. He was the inventor of a new clyster apparatus.
Daremberg, the medical historian, who saw a copy of Ardern's manuscript in St. John's College, Oxford, says that it contains numerous illustrations of instruments and operations. His work seems really to be a series of monographs or collection of special articles on different subjects, which Ardern had made at various times, rather than a connected work. Pagel bewails the fact [{189}] that a more thorough consideration of Ardern's work is impossible, because the greater part of what he wrote remains as yet unprinted.