Medieval Surgery

Surgery in the medieval period was an area where some progress was made, despite the many challenges faced in other areas of medicine. The frequent wars, such as the Crusades, created a significant number of injured soldiers, providing surgeons with numerous opportunities to experiment with new techniques. However, while some advances were made, medieval surgery was still rudimentary by modern standards and often dangerous.

Medieval Surgical Techniques

Trepanning

One of the most notable and controversial medieval surgical procedures was trepanning, also known as trepanation. This involved cutting or drilling a hole into the skull, often through the top, in an attempt to treat various ailments. The most common belief was that the procedure would allow "bad spirits" or evil influences to escape the body, thereby curing conditions such as mental illness, seizures, or head trauma.

• Risks and Outcomes: While the procedure was extremely dangerous, with most patients dying from infection or complications, some archaeological evidence suggests that a small number of individuals survived. Skull fragments with signs of healing have been found, indicating that in some cases, patients did survive the procedure, albeit with a high risk of infection. The survival of some patients suggests that the surgeons may have been relatively skilled in performing the operation, despite the lack of modern tools or knowledge of sterile techniques.
• Legacy: The practice of trepanning, though now discredited, reflects the limited understanding of anatomy and the brain in medieval medicine, as well as the belief in supernatural causes of illness.

Cauterisation

Cauterisation was another common medieval surgical technique, primarily used to stop bleeding and seal wounds. This method involved heating a piece of iron in a fire and pressing it onto a wound or incision to burn the tissue, thereby sealing the blood vessels.

• Benefits and Drawbacks: While cauterisation could stop severe bleeding, it carried significant risks. The procedure caused extreme pain for the patient, often resulted in severe burns, and carried a high risk of infection. Despite its drawbacks, cauterisation was frequently used because there were few alternatives available for controlling blood loss.
• Effectiveness: While it could sometimes be effective in preventing fatal blood loss, the risks of infection and other complications meant that it was a highly dangerous procedure that could lead to death.

Anaesthetics

In medieval surgery, the use of anaesthetics was extremely limited. Surgeons experimented with various herbal remedies in an attempt to dull the pain of surgery, though these were not always effective or reliable.

• Herbal Anaesthetics: Common ingredients in medieval anaesthetics included opium and hemlock, both of which were believed to have pain-relieving properties. However, the effectiveness of these herbal mixtures was inconsistent, and their use was often risky, as the correct dosage was difficult to determine.
• Lack of General Anaesthesia: For the most part, surgeries were performed without any form of anaesthesia, meaning that patients were often awake and conscious during the operation. As a result, many patients had to be physically restrained to prevent them from moving during the procedure, adding to the trauma of surgery.

Important Medieval Surgeons

Despite the limitations of medical knowledge during the medieval period, a number of surgeons made important contributions to the development of surgical practices.

John Bradmore

John Bradmore was an English surgeon during the reign of Henry IV. He is perhaps best known for his successful treatment of Prince Henry, the future Henry V, who was injured during a battle when he was struck in the face by an arrow.

• Treatment of Prince Henry: Bradmore used honey and wine as an antiseptic to clean the wound, a significant medical advancement at the time. Honey, known for its antimicrobial properties, and wine, with its antiseptic qualities, helped prevent infection and aided in the healing process.
• Surgical Innovation: Bradmore also invented a special instrument to safely remove the arrowhead embedded in the prince's cheek. This invention was crucial in reducing the risks of further injury during the removal process.
• Legacy: Bradmore later wrote about his techniques, sharing his findings with other surgeons. His writings were important in disseminating new ideas and techniques, helping to improve surgical practices across Europe. The prince's recovery and eventual ascension to the throne demonstrated the effectiveness of Bradmore’s methods.

Hugh and Theodoric of Lucca

Hugh of Lucca and his son Theodoric were influential Italian surgeons who questioned many traditional ideas about medicine. One of their major contributions was challenging Galen’s theory that pus in a wound was a sign that it was healing.

• Revolutionary Ideas on Wound Care: Hugh and Theodoric argued that pus in a wound was not a sign of healing but a sign of infection. They began using wine as an antiseptic to clean wounds, which helped to prevent infection and promote healing. This was a significant step forward in the development of antiseptic techniques.
• Herbal Anaesthetics: Theodoric of Lucca also experimented with herbal remedies as possible anaesthetics, exploring natural substances that could ease the pain of surgery. Although these remedies were not as effective as modern anaesthetics, they were a step toward understanding the importance of pain management in surgery.

Barber-Surgeons

In medieval England, barber-surgeons played an important role in providing basic surgical care. These individuals, who were originally trained as barbers, carried out simple medical procedures in addition to their work cutting hair.

• Common Procedures: Barber-surgeons were responsible for a variety of medical tasks, including the removal of teeth, amputations, and bloodletting. They also treated injuries sustained in battle, particularly during times of war. As the primary care providers in many communities, they were often the first point of contact for patients requiring surgery.
• Military Role: Barber-surgeons often worked with the military, providing treatment to injured soldiers during times of war. This exposure to large numbers of trauma patients, particularly on the battlefields of the Crusades, gave barber-surgeons the opportunity to practice and refine their surgical techniques.

Conclusion

While medieval surgery was still rudimentary by modern standards, it represented a significant area of medical progress during a time when other aspects of medicine, such as understanding disease and infection, were still underdeveloped. The frequent warfare in medieval Europe, particularly the Crusades, gave surgeons a large number of patients on whom to test new techniques and methods, leading to important developments in the field. Although surgery in this period was often dangerous and crude, figures like John Bradmore, Hugh and Theodoric of Lucca, and the barber-surgeons made significant contributions to the development of surgical practice, laying the groundwork for future advancements in medicine.