RELATIONS OF MEDICINE AND SURGERY 199 



Wash the wound scrupulously from all foreign matter; use no 

 probes, no tents -- except under special circumstances; no oily 

 nor irritant applications; avoid the formation of pus, which is not 

 a stage of healing, but a complication; do not, as Galen teaches, 

 allow the wound to bleed with the notion of preventing inflamma- 

 tion, for you will only weaken the patient's vitality (virtus), give 

 him two diseases instead of one, and foster secondary hemorrhage; 

 distinguish between oozing hemorrhage, hemorrhage by jets, and 

 that which pumps out of an inward wound, using for the first, styp- 

 tics, and for the last two the cautery, or, where practicable, digital 

 compression for not less than a full hour; when your dressings have 

 been carefully made, do not interfere with them for some days; 

 keep the air out, for a wound left in contact with the air suppurates; 

 however, should pain and heat arise, open and wash out again, or 

 even a poultice may be necessary, but do not pull your dressings 

 about --nature works better alone; if first intention fail, she may 

 succeed in the second, as a jeweler, if he can solder gold to gold 

 does so, if not, he has to take to borax; these resources, however, 

 we learn well, not by arguing but by operating. By the new method 

 you will have no stinks, shorter convalescence, and clean, thin scars. 

 In wounds of the neck he says that alterations of the voice suggest 

 implications of the larynx. When using the word " nature," he freely 

 admits that the word is an equivocal one, but he would speak of 

 her allegorically as a lute-player to whose melodies the physician 

 has to dance. Again he says: "Every simple wound will heal with- 

 out any notable quantity of pus, if treated on Theodoric's and my 

 instructions. Avoid every cause of formation of pus, such as irritat- 

 ing applications, exposure to air, high diet, edema, local plethora. 

 Many more surgeons know how to cause suppuration than how to 

 heal a wound." Now let me remind you that, until Hugh of Lucca, 

 the universal doctrine was that suppuration or coction is necessary; 

 and that if it does not set in, it must be provoked. 



The greatest of the French surgeons before Pare was Guy of 

 Chauliac, who flourished in the second half of the fourteenth cen- 

 tury. He studied in letters and medicine at Toulouse and Mont- 

 pellier; in anatomy at Bologna. The surgeon, ignorant of anatomy, 

 he says, "carves the human body as a blind man carves wood." 

 The Arabs and Paris said: Why dissect if you trust Galen? but 

 the Italian physicians insisted on verification. Guy was called to 

 Avignon by Clement VI. During the plague of 1348 he stayed to 

 minister to the victims, and did not himself escape an attack, in 

 which he was ill for six weeks. His description of this epidemic 

 is terrible in its naked simplicity. He gave succor also in the visita- 

 tion of 1360. 



His Chirurgia Magna I have studied carefully, and do not wonder 



