French Physician and Surgeon

French Physician and Surgeon

Guy de Chauliac has been called "the most eminent surgeon of the European Middle Ages." Other sources view him in the historical shadow of his French predecessor. In large part, Guy's fame is based on his publication of Chirurgica magna, a text on surgery that was in standard use until the seventeenth century. But he is also remembered because he was so successful in his practice of medicine and surgery, serving kings and popes in his long career. His fame as a practitioner, gained by his treatment of wounds, cataracts, ulcers, and fractures, was only surpassed by the enduring popularity of his publications on anatomy and surgery. He is also well-remembered for his willingness to remain in Avignon to treat patients during the Black Death rather than flee to the safety of the countryside.

By practicing in Avignon, then one of the intellectual and scholarship cross-roads of Europe, Guy was fortunate in that he had access to translations of Greek and Arabic texts on surgery and medicine.

Guy de Chauliac was a controversial figure in his day because of his opinions about how wounds should be treated. His methods were considered "meddlesome" by his contemporaries. Guy, who shocked the medical world by stating that nature alone was not sufficient for wound healing, advocated widening, cleaning, and draining wounds rather than letting nature take its course, as was conventional wisdom at the time. He not only removed foreign objects from wounds, but also used purifying agents such as wine, turpentine, and brandy. Guy also advocated binding wounds closed with adhesive tape, sutures, or by cautery. He discussed wounds of different classes, such as "hollow" wounds, contused wounds, ulcerated wounds, and even bites.

During his lifetime two epidemics of bubonic plague, or Black Death, struck in Avignon, first in 1348 and then in 1360. The plague had decimated European cities and Avignon was not to be spared. Unlike many physicians who fled the cities, Guy remained in Avignon and treated patients. Although he contracted bubonic plague and nearly died, his written account of the Black Death, observed in scientific objectivity, gives historians one of the few firsthand, non-mythological accounts of its ravages and estimates of mortality.

Guy noted that the plague came in two types, each with slightly different symptoms. Some struck with the disease died in three days from one type and in five days from the second. By his direction, Pope Clement VI went into seclusion and escaped infection.

In 1363, toward the end of his career, Guy published Chirurgica magna, or "Grand Surgery,"a collection of eight books. In them he reviewed the history of surgery and discussed surgery as a science and a part of medical practice, rather than just the tool of barbers and butchers, as was surgery's early status. He also published a chapter on anatomy and stressed that it should be learned and taught through hands-on dissection of the "recently dead" rather than taught through drawings, as was the practice for Henri de Mondeville.

Guy de Chauliac's "Grand Surgery" was not to be replaced until the writing of French surgeon Ambroise Paré (1510-1590) in the mid-1500s.

REFERENSES

1.Chauliac in Leo M. Zimmerman and Ilza Veith, Great Ideas in the History of Surgery (1961).

2. Fielding H. Garrison, An Introduction to the History of Medicine (1913; 4th ed. 1929).

3. Arturo Castiglioni, A History of Medicine (1927; 2d ed. 1947); and W. J. Bishop.

4. The Early History of Surgery (1960).

5. The Black Death, 1346-1353. The Complete History (Boydell & Brewer, 2004).

6. DeWitte, S. N. 2010. Age patterns of mortality during the Black Death in London, A.D. 1349–1350. Journal of Archaeological Science 37:3394–3400.

7. Laayounia, H., et al. 2014. Convergent evolution in European and Rroma populations reveals pressure exerted by plague on Toll-like receptors. Proceedings of the National Academy of the Sciences of the U.S.A. 111:2668–2673.

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