RE: VMs: Strange disorders

["GC" <glenclaston@xxxxxxxxx>]

Bob,
that certainly clears up some of my confusion.  I am of course aware of
certain plants that were used to place the patient in a state of deep sleep
(catatonia), but these were difficult to administer in the proper dosage.
Too little was ineffective, too much was downright poisonous.  I guess what
you're saying is that while there is ample evidence to demonstrate that the
medieval physician had an interest in reducing the pain and suffering of his
patients, major forms of surgery and hence its advancement as a science was
virtually impossible until modern forms of anesthesia were developed.

The only thing here I would have to question, (hoping you'll indulge an
amateur), is the question of anesthesia in reference to surgery on the
skull.  Virtually *all* surgical manuals from the 15th/16th century have
sections on opening the skull, with some very gruesome drawings and woodcuts
to back them up.  Certainly these operations were done to relieve imaginary
humours in many cases, but cutting into and opening the cranium was
apparently a common surgical practice.  Any thoughts on this?

Since you mention antiseptics, this is one of my primary focuses, especially
in widwife practice and the common practice of physicians in this time
frame.  When dealing with wounds, diseases, child birth, or anything
involving touching an infected person, the physicians developed a practice
of anointing the hands with oils made from flowers and other herbs.  The
reasoning they have for this does not include removing infection, since they
didn't know the cause of infection, but in many cases the result was the
avoidance of transmission of infection.  The oils used tended to be acidic
in nature.  Between the ritual of "washing" the hands with these oils and
the acidic nature of the oils themselves, this appears to have limited the
spread of bacteria from doctor to patient or vice versa.  Rosslin's book on
child birth extends the treatment of these oils to the towels and linens
used in the process.  I was following this line of reasoning to see if it
was related to Solanus, which indeed it was.  If you could "think crude" for
a moment, and cast off your modern training, how would you relate this
practice on a scale against boiling cloth and washing hands with lye soap,
or other such pre-modern preventative remedies?

GC




> -----Original Message-----
> From: owner-vms-list@xxxxxxxxxxx [mailto:owner-vms-list@xxxxxxxxxxx]On
> Behalf Of RSRICHMOND@xxxxxxx
> Sent: Tuesday, June 17, 2003 10:49 PM
> To: vms-list@xxxxxxxxxxx
> Subject: Re: VMs: Strange disorders
>
>
> Glen Claston writes, concerning 12th century surgeon John Arderne:
>
> >>What I don't get though is the constant reference by the
> medical profession
> to the lack of anesthesia in surgery and routine medicine during these
> times.<<
>
> It's necessary to distinguish anesthesia and analgesia here. Opium was
> certainly in use (not sure about Europe) by then to relieve pain,
> but analgesics are
> nearly useless when you actually start cutting on somebody. For that, the
> patient needs to be put into a sleep-like state (though it is not
> sleep) called
> anesthesia. No such agents were available until the introduction
> of the two
> early inhalation anesthetics, ethyl ether and chloroform, around
> 1845. It was
> inhalation anesthetics, together with aseptic and antiseptic techniques
> introduced later in the 19th century, that made modern surgery
> possible; until then, it
> was not possible (with a few slightly earlier exceptions) to enter the
> abdomen, the chest, or the skull. - Effective local anesthetics,
> beginning with
> cocaine, first became available around 1880 but were not really
> very useful before
> the introduction of lidocaine (Xylocaine Astra) around 1950.
>
> Bob Richmond
> Samurai Pathologist
> Knoxville TN
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