The Oculist's Eye: Connections between Cataract Couching, Anatomy, and Visual Theory in the Renaissance.

We now know that cataract couching involves depressing an occluded crystalline lens to the bottom of the vitreous chamber, but from the time of Galen until the seventeenth-century cataracts were thought to be separate concretions arising between the crystalline lens and the pupil. From Antiquity through the Renaissance, the combination of visual theory in which the crystalline humor is the author of vision, and surgical experience­that couching cataracts restored some degree of sight­resulted in anatomists depicting a large space between the crystalline lens and the pupil. In the Renaissance, oculists­surgical specialists with little higher education or connections to learned surgery or medicine­overwhelmingly performed eye surgeries. This article examines how the experience and knowledge of oculists, of barber-surgeons, and of learned surgeons influenced one another on questions of anatomy, visual theory, and surgical experience. By analyzing the writings of the oculist George Bartisch (c. 1535­1607), the barber-surgeon Ambroise Paré (1510­1590), and the learned surgeon Hieronymus Fabricius ab Aquapendente (1533­1619), we see that the oculists' understanding of the eye­an eye constructed out of the probing, tactile experience of eye surgery­slowly lost currency among the learned toward the beginning of the seventeenth century.

John Ranby FRS, William Hogarth and the Barber Surgeons.

The progress of dentistry towards a profession allied to medicine and surgery was incremental, and a most important step in that process was the separation of the surgeons from the barbers in 1745. Hogarth's illustration of a dentally active barber has been discussed previously in the British Dental Journal. In this paper, his probable contribution to the campaign for separation led successfully by his friend, surgeon John Ranby FRS (1703-1773), through the dramatic and much analysed painting The death of the countess (1743), is analysed. In this paper, it is suggested that William Hogarth was not only aware of the tensions between the physicians, surgeons and barbers that had come to a head, but that he modified the first thoughts, seen in a sketch (now at the Ashmolean, Oxford), to incorporate in this painting, and the print made from it a conspicuous sub-scene, almost central in a composition where the dying countess would be expected to be the only subject, as a satirical comment on that internal conflict.

First steps in the management of pericardial effusion: who was first to relieve the pericardial sac--Larrey or Romero?

Early reports told us that the first pericardiotomy was performed by Baron Dominique Jean Larrey, Napoleon's chief military surgeon. In this article, we reveal a previous operation of that kind and its publication by Francisco Romero, who had a 9-year head start over Larrey's performance. The aim of this article was to briefly review the two-century-old history of pericardial fenestration.

[Artisanal Surgery in the Early 17th Century. The Practice Journal of a Barber-Surgeon in Münster]. / Handwerkschirurgie im frühen 17. Jahrhundert. Das Praxisjournal eines Münsteraner Barbiers.

This paper presents and analyzes the practice journal of a barber-surgeon in the town of Münster, in Northern Germany, in which he recorded about 950 cases he treated between 1602 and 1614. Based on this source, it examines the clientele and the fees of a German barber-surgeon in the early seventeenth century, and looks at the injuries and complaints for which patients sought his treatment.

Wilhelm Fabry's 1614 report on a giant condyloma of the penis.

For many years it has been the work of Buschke and Löwenstein that has justified calling the exophytic, locally destructive tumour of the anogenital mucosal surface 'giant condyloma of Buschke and Löwenstein' or GCBL. In order to investigate the early history of this rare disease we examined the writings of the barber-surgeon Wilhelm Fabry (1560-1634) who had a serious interest in dermatological disorders and their treatment. We analysed Fabry's 600 Latin case reports and identified the case of a 'monstrous penile tumour'. We then translated this text into English and compared it point by point with later publications. This was followed by a cursory review of surgical treatises from the 16th to the 18th centuries. In 1614 Fabry described and depicted a tumour of the penis; the clinical characteristics (gradual formation of a warty lesion, considerable size, invasive growth, absence of metastases) indicated it was a giant condyloma. His mention of the urethral fistulization enables discrimination from 'common' condylomata acuminata, and the survival period of 10 years after amputation allows exclusion of a 'true' carcinoma. This report is singular among 17th-century case histories. The neoplasias described 300 years later are most probably biologically identical. Thus, Fabry's is the first clinical report; the histological classification, however, belongs to Buschke and Löwenstein. From now on the disease should be designated with the eponym giant condyloma of Fabry-Buschke-Löwenstein or GCFBL.

From bloodletting to apheresis in Japan.

The ancient therapy of bloodletting that was universal in the West traveled to Japan 500 years ago on the trading vessels that carried physicians and barber-surgeons to care for the body and Christian missionaries to care for the soul. Then bloodletting was replaced by blood transfusion in the 19th century, only to return less than 50 years ago as apheresis. An understanding of those transitions can be gained from the story of the introduction of Western medicine to Japan and the events that have led to the practice of apheresis there today.

[Historical notes on the management of infection during the development of surgery]. / Apuntes históricos sobre el manejo de la infección en el desarrollo de la cirugía.

Surgery and medicine have not evolved in parallel. There have been discrepancies, bellicosity, contempt and even separate university studies during a long time. The Saint Cosme Brotherhood, founded to supervise the professional practice of barbers (short robe surgeon-barbers) in France in 1260, was opposed by the Faculty of Medicine in Paris. The conflicting interests of the university, Brotherhood and Barbers, that persisted until the 18 th century, impaired the progress of surgery. In the first half of the 19 th century, the advance of surgery continued facing pain, hemorrhage and infection. The control of the latter had to consider antisepsis, asepsis and finally the appearance of antimicrobial substances, sulfonamides and antibiotics that allowed surgeons to approach and solve major problems of the specialty.

The transplant of the white man's leg: a novel representation of Cosma and Damians miracle.

The history of the miracle performed by the patron saints of medicine Cosma and Damian is well known: physicians and historians have dealt with this subject on many occasions, giving rise to a large range of literature. The Author brings up the problem again, on the ground of a novel Spanish painting which has never previously been taken into consideration from a medical point of view but which reserves some surprises and offers a possible psychological consideration of the matter.

Honor, brotherhood, and the corporate ethos of London's Barber-Surgeons' Company, 1570-1640.

As the largest and most civically active body of medical practitioners in the late Tudor and early Stuart period, surgeons played a vital role in London's urban landscape, but remained precariously vulnerable to abasement due to the regular contact with death and disease necessitated by their work. Based on an analysis of guild records, printed surgical manuals, and conduct literature, this study explores the emergent corporate ethos of London's Barber-Surgeons' Company and addresses the identity formation of surgeons in the late-sixteenth and early-seventeenth centuries. By implementing codes of conduct and uniform standards of practice, punishing transgressions of propriety, and developing legislation to limit the activities of unlicensed and foreign practitioners, Company officers ardently sought social and occupational legitimacy within a milieu characterized by a tremendous emphasis on status and hierarchy. Rooted in methodology drawn from the social history of medicine and cultural anthropology, this study argues that in response to the persistent stigma associated with their work and London's increasingly prevalent culture of credit, surgeons, like other artisanal groups, sought to enhance their social legitimacy and occupational respectability by manipulating contemporary social rituals, reinforcing the honorable associations of their work, and preserving the veneer of brotherhood and camaraderie.

Oncologic conceptions of Ambroise Paré (1509-1590), father of surgery.

Ambroise Paré, one of the leading surgeons of the 16th century, is acknowledged as the father of surgery. He exercised vast influence on several fields of medicine and surgery through his writings. This article presents and criticizes Paré's conceptions on oncology.

[Dental aspects of general symptoms in the 18th century]. / Altalános kórképek fogászati vonatkozásai a XVIII. században.

In the 18th century, numerous diseases with symptoms of oral cavity were cured by chirurgien-dentist, barber-surgeons, or tooth drawer. The so called "dentitio difficilis" was blamed for the high children mortality, therefore gum cut or use of leeches was advised as a treatment. Both acute and chronic type of gum inflammation was called scurvy. It seems that the mechanical removal of plaque was enough to cure the scurvy as it was written in advertisements from that time. Syphilis was present in the everyday life throughout centuries, and assumed to cause different stigmas in the oral cavity. Today we consider theses stigmas as the toxic signs of mercury treatment.

[The Unknown Hospital of the Augustinian Hermits of St. Jerome in Rijeka. Contribution to the History of Medicine in Rijeka] / Nepoznati hospital augustinaca pustinjaka rijeckog sv. Jeronima Prilog povijesti medicine u Rijeci

The Order of St. Augustine (Ordo Eremitarum Sancti Augustini) was the first religious community in Rijeka. The monastery of St. Jerome, founded by the noble families of Devin and Walsee, existed from the 14th century till 1788, when it was dissolved by Joseph II. Unfortunately, the past of the Augustine Monastery of St. Jerome is mostly unknown. On the basis of largely unexplored sources in Croatia and overseas, the author reveals several facts about the relation between Rijeka's Augustinian community and medicine. The paper includes an important piece of information concerning the existence of a hospital on the lo-cation of Andrejscica in Rijeka, founded in the 15th century, which has so far been unknown. Augustinian's sources (16th and 18th century) show the presence of several shaver-surgeon (barbitonsorius) and other various relevant topics for the history of medicine in Rijeka - pharmacopola, aromatarius etc.

Barber-Surgeons in Military Surgery and Occupational Health in Finland, 1324-1944.

Barber-surgeons have existed as a medical profession in multiple countries for centuries. This article outlines the exciting history of the barber-surgeons in Finland, focusing on a time frame covering over 600 years, from the Middle Ages until the last barber-surgeon in Finland finished his practice during the Second World War. The barber-surgeons were the first healthcare professionals who focused on the healthcare of soldiers during times of both peace and war. They were able to treat wounds, conduct minor and even major surgeries and perform amputations. The development of the profession and the education and skills of the barber-surgeons are summed up and illuminated. New genealogical sources are also reviewed to profile the barber-surgeons as men, married and of multinational origin. This review summarizes the history of the profession, who the barber-surgeons in Finland were and where they came from. It concludes by noting that the barber-surgeons had a remarkable impact on the development of the professions of surgeons and physicians as well as on the development of occupational healthcare as a whole. However, these impacts are not sufficiently appreciated today.

[Lectures, hospital practice, and a popular audience in relation to the popularization of medical thought during the 1830ies: the Magdeburg physician August Ferdinand Brüggemann]. / ..... Eine populäre und zweckmässige Darstellung von Gegenständen, die dem denkenden Menschen wichtig sind." Lehre, Krankenversorgung und Laienvorträge in ihrer Beziehung zur Popularisierung medizinischen Wissens in den 1830er Jahren. Das Beispiel des Magdeburger Arztes August Ferdinand Brüggemann.

Medical thought can be spread in different ways. This article deals with popular handbooks, lectures, medical teaching and hospital practice performed by August Ferdinand Brüggemann during the 1830ies. The physician from Magdeburg was no university teacher of great renown, like the professors lecturing at the centres of academic research in Berlin, Jena or Leipzig. Instead he taught former barber surgeons at a small medical academy to make them fit for the requirements of a more modern medical care. Analyzing his papers, popular books, lectures and bedside teaching may cast some light on how everyday practice and medical thought changed during a period which has been pompously described as the dawn of scientific medicine. These more basic approaches may have substantially contributed to the popularization of scientific thought.

Paré and prosthetics: the early history of artificial limbs.

There is evidence for the use of prostheses from the times of the ancient Egyptians. Prostheses were developed for function, cosmetic appearance and a psycho-spiritual sense of wholeness. Amputation was often feared more than death in some cultures. It was believed that it not only affected the amputee on earth, but also in the afterlife. The ablated limbs were buried and then disinterred and reburied at the time of the amputee's death so the amputee could be whole for eternal life. One of the earliest examples comes from the 18th dynasty of ancient Egypt in the reign of Amenhotep II in the fifteenth century bc. A mummy in the Cairo Museum has clearly had the great toe of the right foot amputated and replaced with a prosthesis manufactured from leather and wood. The first true rehabilitation aids that could be recognized as prostheses were made during the civilizations of Greece and Rome. During the Dark Ages prostheses for battle and hiding deformity were heavy, crude devices made of available materials - wood, metal and leather. Such were the materials available to Ambroise Paré who invented both upper-limb and lower-limb prostheses. His 'Le Petit Lorrain', a mechanical hand operated by catches and springs, was worn by a French Army captain in battle. Subsequent refinements in medicine, surgery and prosthetic science greatly improved amputation surgery and the function of prostheses. What began as a modified crutch with a wooden or leather cup and progressed through many metamorphoses has now developed into a highly sophisticated prosthetic limb made of space-age materials.

[Between barber's and hospital: the role of barber-surgeons in Osijek in the period from 1687 to 1746]. / Izmedu brijacnice i bolnice: uloga kirurga-ranarnika u Osijeku u razdoblju od 1687. do 1746. godine.

This paper presents emergence and role of medical practitioners especially surgeons and barbers in particular in Osijek in the period marked by the Christian liberation in 1687 to the pronouncement of Regulationenfür Baderen in 1746. On the bases of archival sources we have revealed their identity, origin, number and reputation, and demonstrated differences in their duties in comparison to the other towns of the Habsburg Monarchy. We argued that their presence and activities can be explained by the position of Osijek as an important military fortification at the Othoman Empire's border, as well as with deficiency of physicians. The data presented in this paper demonstrate the very beginnings of medical practitioners in Osijek and are therefore important in understanding of the further development and the organization of health on this territory.