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SURGERY AND MIDWIFERY. 271
the patient desired it. One of his servants at last performed
the operation, but the result, as might have been expected,
was- unfavourable. The duke died on the following day*
Temerity and cowardice, the offspring of ignorance, were
the peculiarities which distinguished the great majority of
the German surgeons of that time. Even the Biindth-
Erzney of the German knight, HEINRICH VON PFOLSPRUNDT,
the most prominent surgeon produced by the Fatherland in
the 15th century, cannot be compared with the surgical
works of the Italians and French; for it was really nothing
more than an introduction to bandaging and to the treatment
of wounds and external injuries.
In no country was surgery during the middle ages able
to rise to the height it attained in ancient times. We certainly
find in the writings of certain surgeons remarks
which display a correct knowledge of the tasks of surgery,
an excellent gift of observation and a rich experience, but
the keynote of these works was that intellectual feebleness
which characterized the whole age. T. BORGOGNONI
recommended a treatment of as simple a "kind as possible
and referred to healing per primam (by first intention).f
Among the methods of arresting haemorrhage, ligature was
mentioned by LANFRANCHI and others. LANFRANCHI
endeavoured to advance the diagnosis of fractures of the
skull and confined the operation of trephining to those
cases in which the brain was implicated in consequence of
depressed fragments. J GuiDO DE CAULIACO (Gui de Chauliac)
wrote that the wounded man on holding a metal rod
between his teeth and touching it feels a pain in the skull at
the situation of the fracture. He also gave the precise indications
for trephining and described the operation.§ He
avoided amputation : if mortification invaded an extremity,
* WILLIAM OF NEWBURGH: Hist. rer. Angl. lib. v., c. 8, in Rer. brit. med.
aevi script., Vol. 82, Pt. 2, p. 432 et seq., London 1885.
t Chirurg. ii, c. 27.
X LANFRANCHI : Chir. parva, c. 7.
§ G. DE CAULIAC: Ars chirurg. tr. iii, doctr. 2, cap. 1, Venet. 1546.