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be a good surgeon unless he knows both the art and science of medicine and especially anatomy. The characteristics of a good surgeon are that he should be moderately bold, not given to disputations before those who do not know medicine, operate with foresight and wisdom, not beginning dangerous operations until he has provided himself with everything necessary for lessening the danger. He should have well-shaped members, especially hands with long, slender fingers, mobile and not tremulous, and with all his members strong and healthy so that he may perform all the good operations without disturbance of mind. He must be highly moral, should care for the poor for God's sake, see that he makes himself well paid by the rich, should comfort his patients by pleasant discourse, and should always accede to their requests if these do not interfere with the cure of the disease.” “It follows from this,” he says, “ that the perfect surgeon is more than the perfect physician, and that while he must know medicine he must in addition know his handicraft."
Thinking thus, it is no wonder that he places his book under as noble patronage as possible. He says in the preface that he “ began to write it for the honor and praise of Christ Jesus, of the Virgin Mary, of the Saints and Martyrs, Cosmas and Damian, and of King Philip of France as well as his four children, and on the proposal and request of Master William of Briscia, distinguished professor in the science of medicine and formerly physician to Pope Boniface IV and Benedict and Clement, the present Pope." His first book on anatomy he proposed to found on that of Avicenna and“ on his personal ex
perience as he has seen it.” The second tractate on the treatments of wounds, contusions, and ulcers was founded on the second book of Theodoric “ with whatever by recent study has been newly acquired and brought to light through the experience of modern physicians.” He then confesses his obligations to his great master, John Pitard, and adds that all the experience that he has gained while operating, studying, and lecturing for many years on surgery will be made use of in order to enhance the value of the work. He hopes, however, to accomplish all this “ briefly, quietly, and above all, charitably.” There are many things in the preface that show us the reason for Mondeville's popularity, for they exhibit him as very sympathetically human in his interests.
While Mondeville is devoted to the principle that authority is of great value, he said that there was nothing perfect in things human, and successive generations of younger men often made important additions to what their ancestors had left them. While his work is largely a compilation, nearly everywhere it shows signs of the modification of his predecessors' opinions by the results of his own experience. His method of writing is, as Pagel declares, “ always interesting, lively, and often full of meat." He had a teacher's instinct, for in several of the earlier manuscripts his special teaching is put in larger letters in order to attract students' attention. . . He seems to have introduced or re-introduced into practice the idea of the use of a large magnet in order to extract portions of iron from the tissues. He made several modifications in needles and thread holders and invented a kind of small derrick for the extraction of arrows with barbs. Besides, he suggested the surrounding of the barbs of the arrows with tubes, to facilitate extraction. In his treatment of wounds, Pagel considers that as a writer and teacher he is far ahead of his predecessors and even of those who came after him in immediately subsequent generations. One of his great merits undoubtedly is that Guy de Chauliac, the father of modern surgery, in his text-book turned to him with a confidence that proclaims his admiration and how much he felt that he had gained from him.
One of the most interesting features of Mondeville's work is his insistence on the influence of the mind on the body and the importance of using this influence to the best advantage. It is especially important in Mondeville's opinion to keep a surgical patient from being moody, “Let the surgeon,” says he,“ take care to regulate the whole regimen of the patient's life for joy and happiness by promising that he will soon be well, by allowing his relatives and special friends to cheer him and by having someone to tell him jokes, and let him be solaced also by music on the viol or psaltery. The surgeon must forbid anger, hatred, and sadness in the patient, and remind him that the body grows fat from joy and thin from sadness. He must insist on the patient obeying him faithfully in all things. He repeats with approval the expression of Avicenna that“ often the confidence of the patient in his physician does more for the cure of his disease than the physician with all his remedies.” Obstinate and conceited patients prone to object to nearly everything that the sur
geon wants to do, and who often seem to think that they surpass Galen and Hippocrates in science and wisdom, are likely to delay their cure very much, and they represent the cases with which the surgeon has much difficulty.
Mondeville thought that nursing was extremely important and that without it surgery often failed of its purpose. He says, “ For if the assistants are not solicitous and faithful, and obedient to the surgeons in each and every thing which may make for the cure of the disease, they put obstacles and difficulties in the way of the surgeon.” It is especially important that the patient's nutrition should be cared for and that the bandages should be managed exactly as the surgeon directs. He has no use for garrulous, talkative nurses, and does not hesitate to say that sometimes near relatives are particularly likely to disturb patients.“ Especially are they prone to let drop some hint of bad news which the surgeon may have revealed to them in secret, or even the reports that they may hear from others, friends or enemies, and this provokes the patient to anger or anxiety and is likely to give him fever. If the assistants quarrel among themselves, or are heard murmuring, or if they draw long faces, all of these things will disturb the patients and produce worry and anxiety or fear. The surgeon therefore must be careful in the selection of his nurses, for some of them obey very well while he is present, but do as they like and often just exactly the opposite of what he has directed when he is away.”
We do not know enough of the details of Mondeville's life to be sure whether he was married or not. It is probable that he was not, for all of these surgeons of the thirteenth century before Mondeville's time, Theodoric, William of Salicet, Lanfranc, and Guy de Chauliac, after him belonged to the clerical order; Theodoric was a bishop; the others, however, seem only to have been in minor orders. It is therefore from the standpoint of a man who views married life from without that Mondeville makes his remarks as to the difficulty often encountered when wives nurse their husbands. He says that the surgeon has difficulty oftener when husbands or wives care for their spouses than at other times. This is much more likely to take place when the wives are caring for the husbands. “ In our days,” he says, “ in this Gallican part of the world, wives rule their husbands, and the men for the most part permit themselves to be ruled. Whatever a surgeon may order for the cure of a husband then will often seem to the wives to be a waste of good material, though the men seem to be quite willing to get anything that may be ordered for the cure of their wives. The whole cause of this seems to be that every woman seems to think that her husband is not as good as those of other women whom she sees around her.” It would be interesting to know how Mondeville was brought to a conclusion so different from modern experience in the matter.
For those who are particularly interested in medical history one of the sections of Henry's book has a special appeal, because he gives in it a sketch of the history of surgery. We are little likely to think, as a rule, that at this time, full two centuries before the close of the Middle Ages, men were interested