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CHAPTER II
OF THE CHIRURGERY OF THE ANCIENTS
1.
AS to the subject of this chapter, I cannot entertain my reader
better than by presenting him with an extract of Mr. Bernard’s
thoughts upon it, who was first surgeon to king William. Here follows
a faithful translation of a part of a memoir, which he imparted
to his friend, air. Wotton.
“ If we attend
well to what the moderns have added to the surgery of the ancients,
we shall be obliged to own that we have not the least right to
despise them, as those do who know nothing of them, nor have ever
read them; and who give the strongest proofs of their own ignorance
and pride, in the manner wherein they presume to treat those great
men. I do not say, that the moderns have in no respect contributed
to the advancement of surgery; but what I say is this, that the
merit of the moderns consists rather in having re-introduced the
inventions of the ancients, and set them in a better light, than
in any important discoveries that they themselves have made in
this science. Whether the art of curing wounds, falling immediately
under the observation of sense, has for that reason been the study
of men of the earliest times, and by that means sooner acquired
a degree of perfection, than the other branches of medicine: or
that the most part of those who afterward assumed the profession,
were mere empirics, and ignorant of it: which ever of these be
the case, it is certain this art has not for some ages past been
cultivated, as it might have been: and to prove this, we need
only to reflect how few the number of good writers are upon this
subject, in comparison of those who have written upon other branches
of the arts and sciences. Whoever is conversant with the writings
of the ancients, and has skill to judge of their merit in his
own practice, will ingenuously own, that what renders the reading
of them more useful than those of the moderns, is, that they are
more exact in describing the symptoms and indications of disorders,
and more just and precise than the moderns, in distinguishing
the different species of ulcers and tumours. if our age has retrenched
some superfluities of practice, as it must be owned it has, yet
it cannot be shown that these methods came from the ancients.
It is much more probable, that they were in a great measure introduced
by the ignorant professors of a later date. There is no doubt
but that the perfection to which surgery has been carried in
these last ages, is principally owing to the discoveries which
have been made in anatomy, by means of which we are enabled to
give a reason for many of the phenomena, which were before inexplicable.
But the most essential parts the art of curing wounds, to which
all the other parts ought to give way, remains almost in the very
same state, in which the ancients transmitted it to us. What 1
have said is incontestible: and for proof of it, I appeal to every
course of surgery that has been published by the most celebrated
among the moderns, all of which appear to be but transcripts of
one another, excepting those of greatest note, which are taken
from the ancients. Among all the writers of systems, few deny
the pre-eminence of Fabricius ab Aquapendente, a man of exquisite
learning and judgment, but who is not ashamed to declare that
Celsus, among the Latins, Paul Eginetus, among the Greeks, and
Albucasis, among the Arabians, are those to whom he is most indebted
in the composition of his excellent work. But it will be said,
that a great many methods of Operation are at present in use,
which were unknown to the ancients. I fear, on the contrary, that
an impartial examination into this would discover many more, and
of greater utility, either omitted or discontinued, than of new,
which we have introduced: provided their inquiry were entered
upon with an impartial and unprejudiced mind,
3.
“To begin with the operation for the stone, there is nobody
doubts but they bare a right to claim that as their own. Celsus
and many others have given us exact descriptions of it ; though
it must he owned that the method of operation, deserving the preference
in many respects, and known by the name of the grand operation,
was the invention of Johannes de Romanis, of Cremona, who lived
at Rome in the year 1520, and published his work at Venice in
1535. The instrument that we make use of in trepanning, was doubtless
first used by the ancients, and only rendered more perfect by
Woodall and Fabricius ab Aquapendente. Tapping likewise is in
all respects an invention of theirs. Laryngotomy, or the opening
of the larynx in the quinsy, was practised by them with success
; an operation which, though safe and needful, is almost out of
use at present.
4. “The
cure of the hernia intestinalis, with the distinguishing differences
of the several species of that malady, and their method of cure,
are exactly described by the ancients. It was they who taught
us the cure of the peterygion and cataract, and treated the maladies
of the eye as judiciously as any of our modern oculists, who,
if they would act with honour, should confess, that they do nothing
more but practice over again what those great masters taught.
The opening of an artery, and of the jugular vein, is no more
a modern invention, than the application of the ligature in the
case of an aneurism, which certainly was not well understood even
of late by Frederick Ruysch, that celebrated anatothist of Holland.
The extirpation of the amygdales, or of the uvula, is not at all
a late invention, though it must be owned the efficacious cauteries
now used in the case of the former, were neither practised nor
known by the ancients. The method we now use of treating the fistula
laclirymalis, a cure so nice and difficult, is precisely that
of the ancients, with the addition that Fabricius made of the
canula for applying the cautery.
5.
“ As to the real caustic, which makes a considerable article
of Surgery, although Casteus, Fienus, and Severinus, have written
simply on that subject; yet it is evident from a single aphorism
of Hippo crates, that this great physician knew the use of it
as well as those who have come after him: and besides, it is frequently
spoken of in the writings of all the other ancients, who without
doubt used it with great success in many cases where we have left
it off, or know not how to apply it. The cure of the varices,
by incision, scarcely so much as made mention of now, appears
to have been a familiar practice among the ancients, as is manifest
from the works of Celsus and Paulus Eginetus; and whoever is conversant
in the treatment of varicous ulcers, will agree, that this operation
is absolutely necessary for the effectual cure of them. The polypus
of the ear is a malady so little understood by the moderns, that
we meet but very rarely with the name of it in their writings;
and yet the description of its cure has not been omitted by the
ancients. They were entirely well acquainted with all kinds of
fractures and luxations, and the means of remedying them; as well
as with all the sorts of sutures in use amongst us, besides many
which we have lost. And though some have advanced that cauteries
were unknown to them, we may easily convince ourselves of the
contrary, by observing what Celsus and Coelius Aurelianus have
said of them, allowing withal that they seem not to have known
our method of placing and continuing them.
6. “Nor
ought I to omit what is so manifest, that nobody will deny it,
that all sorts of amputations, as of limbs, breasts, &c. were
performed among them as frequently, and with as great success,
as we can pretend to. As to the art of bandaging, so very important
and necessary, though much neglected at presents and which the
French so much pique themselves upon, as if in this they excelled
all others; the ancients knew it to such a degree of perfection,
that we do not even flatter ourselves with having added any thing
considerable to what Galen hath taught us, in the excellent tract
he has written on this subject. And although the moderns claim
an advantage over the ancients, in regard to the variety of their
instruments, it is nevertheless evident, that they were ignorant
and destitute of none that were necessary: nay, it is highly
probable, from what Oribasius, nay and many others have said,
that they had great variety of them. As to topics, or the remedies
which are externally applied, it is certain that we are indebted
to them, for having instructed us in the nature and properties
of these we now use ; and as to general methods of cure, the ancients
have so eminently excelled, particularly in that of treating the
wounds of the head, that those of the moderns who have written
most judiciously upon it, thought they could do no better service to posterity
than comment upon that admirable book which Hippocrates wrote
on this subject.
7.
“ it would require more leisure and ability than I have,”
concludes Mr. Bernard, “to enter into a detail of more particulars,
and to show what bath been invented, set aside, or lost in different
ages. What I have already advanced, sufficiently makes it appear,
that we ought to talk of the ancients with great respect; not
that we should blindly yield to their authority, or imagine that
they left nothing to be perfected in following ages; but we ought
to imitate the celebrated Bartholin. ‘We make but an ill
judgment of our own interest,’ says that great man, ‘when
we so plunge ourselves in the study of the moderns as to neglect
or contemn that of the ancients, whose writings are so necessary
to throw light upon every part of the science.’ And in another
place he says, ‘I have always shown a particular regard to
the opinions and maxims of the moderns, yet never without paying
due homage to antiquity, to which we are indebted for the very
prime foundations of our art.’”
Chapter 3
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