Inventarium sive chirurgia magna, Volume One: Text 9004107061, 9789004107069

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GUIGONIS DE CAULHIACO (GUY DE CHAULIAC)

INVENTARI UM SIVE CHIRURGIA MAGNA VOLUME ONE: TEXT

STUDIES IN ANCIENT MEDICINE EDITED BY

JOHN SCARBOROUGH

VOLUME 14,1

GUIGONIS DE CAULHIACO (GUY DE CHAULIAC)

INVENTARIUM SIVE

CHIRURGIA MAGNA Volume One: Text edited by

Michael R. McVaugh

EJ.

BRILL

LEIDEN • NEW YORK • KOLN 1997

The paper in this book meets the guidelines for permanence and durability of the Committee on Production Guidelines for Book Longevity of the Council on Library Resources.

ISSN 0925-1421 ISBN 90 04 10706 1 90 04 10785 1 ISBN (set)

© Copyright 1997 by EJ. Brill, Lei.den, The Netherlands

All rights reserved. No part of this publication may be reproduced, translated, stored in a retrieval .rystem, or transmitted in any farm or by any means, el£ctronic, mechanical, photocopying, recording or otherwise, without prior written permission ftom the publisher. Authorization to photocopy items far internal or personal use is granted by EJ. Brill provided that the appropriate fees are paid direct!Y to The Copyright C/,earance Center, 222 Rosewood Drive, Suite 910 Danvers MA 01923, USA. Fees are subject to change. PRINTED IN THE NETHERLANDS

CONTENTS

Preface

vii

Introduction

ix

The Inventarium Proemium Capitulum singulare

2

Rubrice

11

Tractatus primus de anathomia

23

Tractatus secundus de apostematibus, exituris, et pustulis

57

Tractatus tercius de vulneribus

134

Tractatus quartus de ulceribus

206

Tractatus quintus de algebra et extencione et restauracione ossium fractorum et dislocatorum

250

Tractatus sextus de omnibus egritudinibus que non sunt proprie apostemata neque ulcera neque ossium passiones pro quibus habetur recursus ad cyrurgicum

272

Tractatus septimus qui antydotarius dicitur

391

Variant readings

467

PREFACE

In 1971 the Early English Text Society published the first of a projected two volumes of The Cyrurgie of Guy de Chau/iac, edited by Margaret S. Ogden. That first volume contained a transcription of a Middle English translation of Guy's lnventarium or Chirurgia magna; the second was planned to include a commentary on the Middle English translator's technique, on his errors and peculiarities of style, but also on the sources of Guy's original Latin version, since errors made by Guy when interpreting those sources had sometimes left their traces in the subsequent English. By 1981 Dr. Ogden had decided that she would be unable to complete the commentary volume, and she proposed that I should take it over. She and I had long had a personal connection, for I had known her when I was growing up in Ann Arbor while she was at work on the Middle English Dictionary, but I had only become aware at the end of my graduate training, in the mid-1960s, that this mother of my high-school friends was at work in the same general area of scholarship-the history of medieval medicine-that I had come to mark out for myself. My interest in Arnau de Vilanova and the medical faculty at Montpellier in the early fourteenth century, where Guy was trained, had led to continuing correspondence between us and thus made her eventual proposal a natural one. le, It also meant that I felt competent to take over the commentary-but, as I warned her then in 1981, I could not hope to devote much time to Guy for some years to come; I had just committed myself to explore the social history of medicine in Arnau de Vilanova's world, a project that I expected would require many years to complete. She understood the need for delay, and graciously passed over to me all her research materials. In the next few years I was able to set aside a little time for work on the commentary, familiarizing myself with the problems involved and sending her a draft of a commentary on book I of the Cyrurgie for her criticism and suggestions, but this was all I was able to do before her death in 1988. My social history was finally published in 1993 and left me free to devote more ofmy time to Guy.

viii

PREFACE

Dr. Ogden had recognized from the beginning that her plans for the commentary were ambitious and that it might have to be altered or reduced in scope. As I worked more and more on that aspect of the commentary that she had done least with, the identification of Guy's Latin sources, and consulted with the editors of the EETS, it became obvious that the eventual product would be far too large to be published as a whole. Realizing that her projected volume might be thought of as comprising one commentary on the Middle English and a second on the Latin Guy, with only slight overlap between them, I concluded that the two might be dissociated and published separately. To publish a commentary on the Latin Inventarium, however, meant providing an accompanying Latin text, which again raised the problem of undue length, and I am very grateful to Dr. Julian Deahl (and to E. J. Brill) for agreeing to the publication of so large a work. Volume I of this study, therefore, contains the complete text of Guy's Inventarium; volume 2 will contain a commentary on the text that identifies the sources of Guy's citations and discusses some aspects of his Latin terminology. Dr. Ogden's commentary on the Middle English translation, which was virtually complete at the time of her death, is expected to be published later by the EETS. During the thirty years or so that this work has been in the making in one form or another, many people have offered advice and encouragement to its authors: among others, Patrick Browder, Luke Demaitre, Richard Durling, Roger French, Katherine Kube!, Peter Jones, Loren MacKinney, Julia McVaugh, Vivian Nutton, Tiziana Pesenti, Kari Anne Rand Schmidt, William Sharpe, Nancy Siraisi, Helen Valls, Linda Voigts, and Mary Jane Williams. Dr. Ogden would no doubt have acknowledged the help of still more scholars of whom I am unaware, and I apologize for their inescapable omission. She would have wanted me too, I am sure, to express her thanks for the John Simon Guggenheim Memorial Fellowship and for the support from the Horace H. Rackham School of Graduate Studies of the University of Michigan that made possible much of her work on Guy de Chauliac. I am myself deeply thankful to my own University of North Carolina for granting me a research leave and to Clare Hall, Cambridge, for a Visiting Fellowship in the fall of 1994, during which much of my final work on this study was carried out.

INTRODUCTION

It would be by no means unreasonable to assert that the Inventarium (often called the Chirurgia magna) 1 of the French surgeon Guy de Chauliac, completed in 1363, marks the end of medieval medicine-"end" understood both as fulfillment and as termination. Certainly it brought medieval surgery to a close. During the previous two hundred years, Western Europe had developed a tradition of surgical literature, something quite unknown in the Greek or Arab world, producing a series of texts that grew more elaborate, more highly organized, and more physiological in character. Beginning with Ruggiero Frugardi in the late twelfth century and his various commentators in the early thirteenth, and continuing with independent works by Bruno Longoburgo, Teodorico Borgognoni, and Guglielmo da Saliceto, what had originally been an Italian tradition came to France with Lanfranco about 1300 and was continued there by Henri de Mondeville a decade later. Guy de Chauliac is the next figure in this tradition, but with Guy this steady production of Latin surgical texts abruptly comes to an end. Guy was evidently quite conscious that he stood in such a surgical tradition. His lnventarium begins with a capitulum singulare that contains a remarkable history of surgery; 2 it was no doubt modeled on the histories of medicine with which certain Arab authors (e.g., Haly Abbas and Rasis) had begun their works, but its willingness to critically evaluate earlier authorities is much more obvious, particularly in its account of European authors of the previous two centuries: [Before Avicenna] everyone was both physician and surgeon, but afterwards, whether because of greed or because of too much to do, surgery was set apart and given into the hands of mechanics. The first of these were Ruggiero, Rolando, and the 1 The title that the work bears in manuscript is "Inventarium seu collectorium in parte cyrurgicali medicine"; "Chirurgia magna" was the title given it by Renaissance editors. 2 See Chiara Crisciani, "History, Novelty, and Progress in Scholastic Medicine," Osiris, 2nd series, 6 (1990), 118-139, esp. 131-132.

INTRODUCTION

X

Four Masters, who wrote separate works of surgery into which they put much of an empirical character. Then came Iamerius, who wrote a crude surgery in which he said many stupid things, but often followed Ruggiero. Afterwards came Bruno, who correctly adopted the teachings of Galen and Avicenna and the techniques of Albucasis, though he did not have a complete translation of Galen's books and left out anatomy almost entirely. Immediately after him came Teodorico, who wrote his book by stealing everything that Bruno said and adding a few tales from his master Ugo da Lucca. Guglielmo da Saliceto was a notable figure, and wrote two texts, one in medicine and one of surgery, and in my judgment he wrote well about what he treated. Lanfranco also wrote a book in which he put very little besides the things he found in Guglielmo, though he reordered them. At this time master Arnau de Vilanova flourished in both areas and wrote many good books. At Paris, Henri de Mondeville began a treatise in which he tried to harmonize Teodorico and Lanfranco, but it was left incomplete at his death. 3 Guy's overall judgment that Western surgery had steadily advanced has decisively shaped the interpretation presented by many later historians of medieval Latin surgery as a progressive, rational, text-oriented but anatomy-based enterprise. For Guy had come to believe that the most important thing for a surgeon, ranking ahead even of practical experience, was learning-and not just of the principles of surgery but of medicine too, both theory and practice: As regards theory he has to understand the res naturales, res non naturales, and res contra naturam. First he has to understand the res natura/es, especially anatomy, without which nothing can be done in surgery.... Let him understand complexional doctrine too, because medicines must be adapted to the different bodily natures ... and the same is true of the faculties. He also has to understand the res non naturales, air and food and drink and the like, since these are the causes of all health and illness. He must also understand the res contra naturam, especially disease, because the program of treatment is derived directly from this, and let him not be ignorant of cause, because if he cures without understanding it the reward should be not his but fortune's. And let him not overlook symptoms, for they 3

For the Latin text, see below, pp. 6/26-7/3.

INTRODUCTION

xi

sometimes are more important than the cause itself and overturn the whole course of treatment. . . . In practice he must know how to regulate diet and drugs, because without them surgery, medicine's third tool, cannot be brought to perfection. 4 Medical learning and a preparation in anatomy were the things that Guy valued and recognized as emerging in the surgical tradition before him, and these are the features that he tried to emphasize in his own text. In this sense, then, the Inventarium can be seen not merely as the end but as the culmination ofa distinctive medieval surgery. But the Inventarium stands, unusually, in a medical as well as a surgical tradition, precisely because surgeons like Guy had grown more ready to insist that the best surgery was based on medicine. Medicine and surgery had evolved separately in the early Middle Ages-the one always with some claim to rational, "scientific," knowledge, the other a more purely manual craft. Physicians were understood to cure the body within; surgeons, external conditions. The emergence of a tradition of surgical literature around 1200 probably reflects surgeons' desire to imitate medicine by acquiring the dress of learning, and in the thirteenth century surgical writers strengthened the parallel with medicine by developing and appealing to their own authoritative texts, which they began to cite regularly-in particular, the fourth book of Avicenna's Canon and, above all, the Surgery of Albucasis. Henri de Mondeville and Guy de Chauliac exemplify what would be the final stage in this assimilation of surgery to medicine, in which a close knowledge of scholastic medical literature was insisted upon as a necessary foundation for surgical practice, something that would distinguish true surgeons from mere empirics or mechanics. Thus, paradoxically, Guy de Chauliac's career appears to have been that of an academic physician; aside from the lnventarium, there is nothing distinctively surgical about it. Guy was born in a village in the Gevaudan, in south-central France, probably in the last years of the thirteenth century. He studied for a time at Toulouse, but his most intensive medical studies were at Montpellier. Here he was the disciple of Raymond de Moleriis, whose teaching Guy mentions several times in the Inventarium, and under whose supervision he eventually received the title of magister in medicina. Master Raymond was chancellor of the medical faculty in 1335 (though Guy does not give him that title), and we can guess that Guy's Montpellier medical education took place in the 1320s, a time of considerable intellectual vitality in the faculty there. At some 4

For the Latin text, see below, p. 9/6-21.

xii

INTRODUCTION

point, probably later, he studied medicine at Bologna with Alberto de Zancariis and with Bertruccio, who had been the student there of Mondino de' Liuzzi-but it was Montpellier's teaching with which Guy always identified particularly closely. We might guess that he studied surgery at Bologna, given his connection with Bertruccio and his tendency to distinguish Bolognese from Parisian preferences in such things as trepans and bandages,5 but he never identifies his surgical teachers as he does his medical ones, speaking only of his contemporaries in that field. By 1344 he had established himself in Lyon, but as a physician rather than a surgeon. At about the same time he entered the employ of the Avignonese papacy, and he served successively Clement VI, Innocent VI, and Urban V, until his death in July 1368.6 Guy's long training in the theoretical basis of medicine-the Montpellier curriculum of 1309 required six years of study-is stamped on his undl!rstanding of what surgery should be (though it is also in keeping with the direction being taken by all professionally ambitious surgeons): manual skill and experience are no longer enough. It is no wonder, then, if the Jnventarium often seems as much a medical as it does a surgical textbook. It is divided into seven treatises or books, of which the first deals with anatomy and the last with some of the complements of surgery-bloodletting, therapeutic cauterization, and the use of drugs-but the remaining five cover the various complaints a surgeon may be called upon to treat, grouped under the headings 'apostemes' (swellings and abscesses), 'wounds,' 'ulcers,' 'fractures,' and 'other diseases.' Guy follows Galen's advice and discusses each ailment in terms of its definition and cause, symptoms, and treatment. As a result, the Inventarium is not merely a manual of surgical techniques, it is a broad survey of pathophysiological theory covering any condition a surgeon might be called on to treat-many of which might equally well be treated by a physician, for except for obvious external problems like fractures at one end of the pathological spectrum and purely internal conditions like fevers at the other, there was a considerable area of overlap. Guy generally begins his account of treatment with medical remedies, diet and drugs, before turning as a last resort to specifically surgical procedures. More than once he becomes so carried away by issues of medical theory or practice that he has to catch himself up with an abrupt, "but such things are best left to physicians."

Below, pp. 189 and 182. The most thorough biographical account remains that of E. Nicaise, La grande chirurgie de Guy de Chauliac (Paris: Akan, 1890), pp. lxxvii-cv; see also the pieces justificatives, pp. 171-187. 5

6

INTRODUCTION

xiii

Guy's formation in the scholastic medical community is nowhere plainer than in the extraordinary frequency with which he makes use of citations and quotations from other authors to express his views. His sixteenth-century editors were so struck by this feature of the work that they listed his authorities and counted his references, enumerating 3,523 of them-and their count was in fact too low. By tracing his references back to their sources we can see how variously Guy worked: sometimes he quoted his authority at length, sometimes he paraphrased, sometimes summarized, sometimes simply called attention to a parallel discussion. As a result, the Inventarium becomes a kind of medieval medical chrestomathy, a distillation of the literature of his field. And that field is as much medicine as it is surgery. By the sixteenth-century count, Galen (who wrote no specifically surgical text) is cited most often by Guy, 890 times. Next most frequently referred to are the great Arabic authorities, Avicenna (661 times), Albucasis (175), Rasis (161), and Haly Abbas (149), of which only Albucasis is an exclusively surgical writer; then Hippocrates (120); and only then the representatives of the Western surgical tradition: Lanfranco {102), Ruggiero/Rolando (96), and Teodorico (85); Henri de Mondeville (86) and Guglielmo da Saliceto (68); and Bruno (46). All in all, Guy refers to the works of some fifty authors (as well as to procedures employed by another dozen or so contemporaries). It was not of course his Montpellier training alone that gave Guy this command of the medical literature; his privileged position at the A vignonese court was evidently crucial, for it provided him with regular access to a library that most of his contemporaries could not have matched. Most importantly, it gave him access to the translations of Galen being made (from the Greek) by Niccolo da Reggio in the kingdom of Naples, in southern Italy: Guy tells us in his historical introduction that Niccolo "sent them to us at court."7 Guy was thus among the very first to be able to use Niccolo's new translations, and he made the most of the opportunity, referring to a dozen of them in the lnventarium. Only in the few cases where Niccolo had retranslated a work already known in an AraboLatin rendition did Guy occasionally use both versions. He usually cited Hippocrates' Aphorisms in the old Arabo-Latin translation, probably because the older text had become so familiar from two centuries of use in the medical faculties, but he ordinarily stayed with Niccolo's revision of Galen's commentary on account of its greater accuracy and clarity. 8

"Eos nobis in curia transmisit"; below, p. 7/6. Margaret S. Ogden, "The Galenic Works Cited in Guy de Chauliac's Chirurgia Magna," Journal of the History of Medicine 28 (1973), 26. 7

8

xiv

INTRODUCTION

Guy's Galenism was nothing new in the fourteenth century. Taddeo Alderotti at the end of the thirteenth century had already shown an interest in establishing which translation of Galen's De interioribus was to be preferred. 9 At Montpellier, the curriculum introduced only a decade or so before Guy studied there was an independent assertion of the same priority of the "new Galen," 10 but at that moment only a very few of Niccolo's translations had been produced. Guy's readiness to make use of all the Galen available to him is very much in that Montpellier tradition. There can be no doubt, as has already been said, that Guy consciously thought of himself as a member of that (medical) tradition, and of his lnventarium as in line with such medical compendia as Bernard Gordon's Lilium medicine, completed at Montpellier in 1305, a work that Guy thought highly of and quoted often. In addition to Bernard and his own master, Raymond de Moleriis, he quotes three other recent masters of the school (Arnau de Vilanova, Etienne Arlandi, and Jordan de Turre), and in addition he often refers generally to the "common opinion of our school [meaning Montpellier]." Here too the lnventarium marks the end of a tradition: the first half of the century had been particularly productive intellectually for the school, but the second would be far less so; Guy, along with Jean de Tournemire and perhaps Jacques Angeli, is witnessing to the last stage of medieval Montpellier's medical success. When the school returned to prominence in the sixteenth century, its medical teaching was taking a new direction. Yet the later history of the lnventarium offers a bridge between those two worlds, the later Middle Ages and the Renaissance. Guy's text was repeatedly copied in the later fourteenth and fifteenth centuries, and was even occasionally quoted as a kind of public standard. It was completed just at the moment when European vernacular translations of scientific works were beginning to be produced in large numbers, and by 1500 it had been translated into English (at least four times), French, Italian, Hebrew, Dutch, and Proven~al. The Latin text was first printed in 1490, and published a dozen times more in the next sixty years. 11 But the sixteenth century found Guy's Latin rough and his use of Arabic terms out of date in a new humanistic age, and his successive Renaissance editors often modified his text in the interests of modernization. The last and most influential of these editors was Laurent Joubert, professor in the Montpellier faculty of medicine and for a time chancellor, who prepared first a 9 On Taddeo's Galenism, see Nancy G. Siraisi, Taddeo Alderotti and His Pupils (Princeton: Princeton University Press, 1981 ), pp. 100-102. 10 Luis Garcia Ballester, "Arnau de Vilanova (c. 1240-1311) y la reforma de los estudios medicos en Montpellier (1309)," Dynamis 2 (1982), 97-158. 11 Nicaise, La grand chirurgie, pp. cvi-clxx.

INTRODUCTION

xv

French translation of Guy's work with identification of sources, notes, and indexes (published in 1579), and then a Latin text, still more thoroughly modernized, which his son Isaac saw through the press in 1585, two years after his father's death. The result of these reworkings, as Edouard Nicaise expressed it in a study of the Inventarium and its history that remains fundamental, was that "ce n'est plus du Gui de Chauliac." 12 But as Gundolf Keil has pointed out, by modernizing Guy in this way Joubert ensured the work's continuing success: "Gerade de Modemisierung, wie sie in Jouberts Bearbeitung zum Ausdruck kommt, sicherte der Chirurgia magna ihre Wirkung Uber das 16. Jh. hinaus und gab dem Textjene Gestalt, die eine Ausstrahlung bis ins 18. Jh. erlaubte." 13 Despite its historical importance, the Inventarium is today not easy to consult in its original Latin version. Joubert's Latin edition was reprinted in photofacsimile in 1976, and is therefore readily available, but its language has been too consistently reworked to be trustworthy as a record of Guy's own thought. In Nicaises's monumental study he published, slightly revised, Joubert's French translation, which has similar problems. Margaret Ogden's edition of the Middle English translation in MS Paris, BN angl. 25, is, curiously, the closest text in a modem edition to Guy's Latin, and scholars often quote it by default. Bjorn Wallner is in the process of editing a second ME translation of the Inventarium, based principally on MS New York, Academy of Medicine 12, a translation that is appearing book by book, and he has included in appendices to the several fascicles a transcription of the Latin; 14 but for purposes of consulting a standard text this transcription is unsatisfactory, scattered as it is among a series of publications, not based on the same manuscript throughout, and (at the time of this writing) still incomplete. The text of the Inventarium presented here is based closely on MS Vat. Palat. Lat. 1317 (= V). 15 My attention was first drawn to this manuscript of the Inventarium by its colophon, which identifies the copy as having been completed in Montpellier in 1373-that is, only ten years Ibid., p. cxlix. Guy de Chauliac, Chirurgia magna (rpt. Darmstadt: Wissenschaftliche Buchgesellschaft, 1976), p. xii. 14 Bjorn Wallner, The Middle English Translation of Guy de Chauliac's Anatomy (Lund: Gleerup, 1964); idem, The Middle English Translation of Guy de Chauliac 's Treatise on Fractures and Dislocations (Lund: CWK Gleerup, 1969); idem, The Middle English Translation of Guy de Chauliac's Treatise on Wounds, Part l (Lund: Gleerup, 1976); ibid., Part 2 (Stockholm: Almqvist & Wiksell International, 1979); idem, The Middle English Translation of Guy de Chauliac 's Treatise on Ulcers, 2 vols. (Stockholm: Almqvist & Wiksell International, 1982-84); idem, The Middle English Translation of Guy de Chauliac's Treatise on "Apostemes," 2 vols. (Lund: Lund University Press, 1988-89). 15 Ludwig Schuba, Die medizinischen Handschriften der Codices Palatini Latini in der Vatikanischen Bibliothek(Wiesbaden: Ludwig Reichert, 1981), pp. 411-412. 12 13

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INTRODUCTION

and eighty kilometers distant from the original that Guy drew up in Avignon, and only five ·years after Guy's death. Tiziana Pesenti has kindly inspected the manuscript for me and confirmed the likelihood of the date's being correct rather than simply a copy of a previous colophon. 16 An examination of sample passages from V made it evident that the text it supplied was in general an excellent one and, moreover, was close to that from which the Middle English translation published by Ogden (= E) must have been prepared. I have transcribed the whole of the Jnventarium from a microfilm copy of V and have collated against this the text furnished by MS Oxford, Magdalen College 208 (= 0), which Ogden and Wallner (following her suggestion) have both used as a referent for their editions because of its closeness to the Middle English versions. 17 I have also compared the text of V systematically with Joubert's edition of the Latin (= J); even when Joubert altered Guy's language, the results usually make clear which of two variants Joubert understood to be correct. In general, my text is that of V. Occasionally I have followed Ofs readings, and in all such cases, as well as in many other cases where the readings of OJ seemed to me to be at least worth noting, I have included the variants in the list that closes this volume. Often VO agree in inconsistencies of gender or in other apparent grammatical errors that J corrects; I have tended to preserve these in my text, except when they seem so egregious as to make it doubtful that they originate with Guy rather than a copyist. Finally, in a few passages I have been guided in my choice of readings by the text of an author being quoted by Guy, typically Galen. I must make it clear, however, that my text does not claim to be a critical edition of the Jnventarium, not even a diplomatic transcription of the text of V. I have not bothered to indicate all V's trivial scribal corrections and deletions. My edition is intended simply as a reading text that will bear witness to the Jnventarium in the form in which it circula16 She has written (personal communication, 9 February 1996): "La scrittura corrisponde perfettamente alla datazione de! colophon. E' infatti una corsiva librarizzata della seconda meta de! sec. XIV, vergata probabilmente da una mano tedesca ("Cremen" e forse Krems an der Donau, in Austria?), come provano le a "a due piani", le s edf con aste a fuso, le forme delle g, r e t. Tuttavia la mano del copista varia: nel colophon adotta la cancelleresca, mentre nei tituli e nelle rubriche tende alla textura. "Per essere ancora piu certa della datazione ho provato a esaminare le filigrane. Non si rilevano bene, poiche la carta e molto spessa, con vergelle distanziate, e tutti i fogli sono scritti. Nei primi sei fascicoli (f. 1-76) trovo una filigrana a doppio fiore (campanula) con croce centrale posta sul filone, riconducibile al tipo BRIQUET 6678: Paris 1371, e V. A. MOSIN et S. M. TRAUIC, Filigranes des Xllf et XIV" ss., II, Zagreb 1957, 4117: 1371. Questa prima filigrana conferma dunque la datazione del colophon." 17 See Margaret S. Ogden, review of The Middle English Translation of Guy de Chauliac 's Anatomy, ed. 8. Wallner, Review of English Studies 17 (1966), 427-428.

INTRODUCTION

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ted at Montpellier virtually in Guy's own lifetime, while serving as a basis to which to refer my annotated account of Guy's sources in volume 2 of this study. And I hope that it may eventually prove a useful reference to have at hand when the commentary volume to Margaret Ogden's Cyrurgie finally appears. My editorial policies reflect these goals. I have tried to be as faithful to V's orthography as possible, but I should make plain that I have chosen arbitrarily to write -cio, -cii, etc. instead of -tio, -tii, unless the consonant follows an 'x' or an 's,' in which case I print 't' rather than 'c.' I have expanded 'ros.' as 'rosatum' whenever it appears. Certain words are spelled out by V's scribe in more than one way (e.g., menbrum!membrum; corupcio/corrupcio; petrocil/i/petrocilini; etc.); when these words occur in an abbreviated form, I have expanded them into the more customary spelling. As a rule, cardinal numbers from one to twelve have been written out and those higher than twelve have been expressed numerically; thus, even if V reads '201i, I give '20' rather than 'viginti.' However, all cardinal numbers occurring in medical recipes are given in numerical form. Ordinal numbers have almost always been written out, except when Guy uses them in a citation; in that case they appear in numerical form (though, exceptionally, I give 'primo' rather than '1 °'). I have punctuated freely to make meaning and structure clear; the punctuation is essentially my own, although in difficult passages I have taken guidance from the texts of Joubert and Nicaise. Most of the illustrations, too, have been imported from V, even if they have not always been reproduced in actual size. However, the illustrations of the olivare and dacti/are on pp. 417--418 have been taken from MS Paris, BN angl. 25 (f. 172v), a manuscript whose drawings of instruments are in general very similar to those in V; 18 in V, unfortunately, a portion of these illustrations lies so deep in the gutter of the manuscript that they cannot easily be reproduced. All the manuscripts of the Jnventarium that I have been able to consult agree in giving the title, chapter headings, subheadings, and colophon in a heavier script than the body of the texts, though the different manuscripts do not always emphasize the same subheadings. Imitating this practice, I have set the title and colophon in bold face, chapter headings in capitals, and subheadings (those emphasized in V) in italics. The foliation of Vand the pagination of Ogden's edition (E) have been given in bold face in the text. The numbers placed in brackets in the long list of

18

See Bjorn Wallner, "Drawings of Surgical Instruments in MS. Bibi. Nat. Angl. 25,"

English Studies 46 ( 1965), 182-186.

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INTRODUCTION

rubrics placed before the first book of the work, a list that Guy intended to serve as a table of contents, refer to page numbers in this edition.

ABBREVIATIONS

0 V

MS Bristol, City Reference Library 10 The Cyrurgie of Guy de Chau/iac, ed. Margaret S. Ogden (EETS, 1971) Chirurgia Magna Guidonis de Gauliaco, ed. Laurent Joubert (Lyon, 1585); rpt. Darmstadt, 1976 MS Oxford, Magdalen College 208 MS Vatican City, Vat. Palat. Lat. 1317

dr. lib. M. quart. s. scr. unc.

dragma libra manipulus quarta, quartarium semis scrupulus uncia

B E J

IN DEi NOMINE. INCIPIT INVENTARIUM SEU COLLECTORIUM IN PARTE CYRURGICALI MEDICINE COMPILATUM ET COMPLETUM ANNO DOMINI 1363° VEL M° CCC0 LXIII 0 PER GUIGONEM DE CAULHIACO, 5 CYRURGICUM, MAGISTRUM IN MEDICINA IN PRECLARO STUDIO MONTISPESSULANI. B. M.

1o

15

20

25

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Postquam prius gracias egero Deo, largienti vitam perpetuam animarum et sanitatem corporum et medicanti morbos magnos per graciam quam obtulit omni carni ex virtutibus sanitatem conservantibus et protegentibus a langore, danti intelligi artem medicine et ingenium sanitatis divinis et animosis intelligentibus, dabo operam ad commentandum et assumandum. In primis igitur, aggrediens quandam commentacionem seu colleccionem artis cyrurgie, ago gracias Deo vivo et vero qui omnibus tribuit esse, sine quo nullum rite fundatur exordium, ad eum devotissime recurrendo, totis viribus cordis mei supplicando ut in hoc opere et in cunctis aliis mittat michi auxilium de sancto, et de Syon tueatur me, felix principium tribuendo et felicius medium gubemando, et iubeat complere quod fiat utile ad finem optimum deducendo. Racio huiusmodi commentacionis seu colleccionis non fuit librorum defectus sed pocius unitas et profectus. Non enim quilibet omnes libros habere potest, et si haberet, tedium esset legere et divinitus omnia in mente retinere. Varia Ieccio delectat, certa prodest, et in construccionibus semper occurrunt melioramenta. Sciencie enim per additamenta fiunt; non enim est possibile eundem incipere et finire. Pueri enim sumus in collo gigantis, quia videre possumus quicquid gigas et aliquantulum plus. Est ergo in construccionibus et assumacionibus unitas et profectus. Verum quia (ut ait Plato eximius) ea que scribuntur brevius quam expediat sunt diminuta et obscura, ea vero que longius videntes fastidiunt, vix est liber qui reprehencionem (Vl vb) effugiat. Et propter hoc michi ad solacium senectutis et ad exercicium mentis vobis dominis meis medicis Montispessulani, Bononie, Parisius, atque A vinioni, precipue papalibus qui me in servicio Romanorum pontificum associastis, cum (E2) quibus audiendo, legendo, et operando fui nutritus, mediocritatem observando, moderata compendiositate perstringam sapientum

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dicta que in diversorum librorum voluminibus de cyrurgia tractaverunt; propter quod inventarium seu collectorium cyrurgie vocabitur liber iste. Nee de meo proprio aliquid nisi forsan paucissima addidi, que iuxta modicitatem mei ingenii utilia reputavi. Si quid tamen inperfectum, dubium, superfluum, et obscurum ibidem fuerit, correccioni vestre submitto, et supplico ut paupercule sciencie mee venia concedatur. CAPITULUM SINGULAR£ IN QUO PREMITTUNTUR QUEDAM COMMUNIA VALDE NECESSARIA CUI CUMQUE VOLENTI PROFICERE IN ARTE CYRURGIE. Carissimi domini mei, quia huiusmodi commentacio ad modum inventarii civilis hereditatis ordinatur et in inventario civili prescribantur communiora et digniora hereditatis tocius, ita et in isto premittitur capitulum singulare, in quo ponuntur quedam communia valde necessaria cuicumque volenti proficere in arte cyrurgie. Et hoc est quod nobis indicat philosophus in primo Phisicorum: lnnata est nobis via a communioribus ad specialia procedere. Dicatur ergo primo quid est cyrurgia; et licet multi multipliciter earn diffinierunt, omnes tamen fundamentum a patre nostro Galieno in Introductorio medicine sumpserunt, dum dicit: Cyrurgia est pars terapentice per incisiones et ustiones et articulaciones ossium sanans homines--cui diffinicioni addit in commento primi Regimenti acutorum, et per alias, manuum operaciones. Et ita est complete descripta secundum quod ipsa consideratur stricte prout est tercium instrumentum medicine. Ut autem consideratur magis large prout est sciencia curandi egritudines in quibus cadit seu intenditur operacio manualis sine exclusione aliorum duorum instrumentorum medicine, pocionis videlicet et diete, talis descripcio ex dictis omnium assignatur: (E3) Cyrurgia est sciencia docens modum et qualitatem operandi, principaliter consolidando, incidendo, et alias operaciones manuum exercendo, sanans homines secundum quod est possibile. Sciencia ponitur ibi loco generis; nee valet quod obicitur quod in multis locis nominatur ars, quia hie large (V2ra) et non propriissime sumitur nomen sciencie. Habitus autem anime tantam colliganciam habent quod unus pro reliquo multociens nominatur. Veritas tamen habet quod cyrurgia est duplex: docens, que appropriatur nomine sciencie, quam potest habere aliquis et si nunquam fuerit operatus; et utens, que nomine artis appropriatur, et istam nullis scire potest nisi viderit earn, quam Aristoteles inter artes mechanicas numeravit. Et hoc est quod Galienus dicebat in primo De alimentis: Ex libro autem nee gubernatorem aliquem posse fieri nee alterius artis opificem; sola enim doc-

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trina que exercitando habetur artifices operantur. Reliqua ponuntur pro differencia; sed quia loycum est, pretermittatur. In cauda tamen ponitur secundum quod est possibile sanans homines, quia (ut dicebat in Montepessulano magister meus Raymundus) non omnia in omnibus sed certain 5 certis: Non est in medico semper relevetur ut eger. Querere a medico plane demonstracionem est querere a traulo sermocinacionem: uterque caret instrumentis, ut doctor dicebat subtilis; sufficit facere quod ars precipit. Ubi advertendum quod in omnibus egritudinibus ars precipit curam IO propriam, exceptis tribus casibus in quibus sufficit cura larga, preservativa aut palliativa. Primus casus est quando morbus est simpliciter incurabilis, ut lepra; secundus quando morbus est curabilis de se, est tamen in paciente inobediente aut penam sustinere non valente, ut cancer in membro particulari; tercius est quando cura illius morbi generaret peiorem 15 egritudinem, ut malum mortuum inveteratum-aut emorroydas antiquas sananti, nisi una relicta fuerit, periculum est (E4) ydropisim aut maniam fieri, inquit Ypocras. Et hoc innuebat Galienus 14° Terapentice: Curacio habet unum modum, operari indolorose et absque fallacia; salvare corpus et non perimere boni medici est, non sinistri ( 12° Terapentice). Et hoc est 20 facere quod est possibile, et non propter pecuniam promittere impossibiIia. A malis curis et a falsis promissionibus caveas, ne nomen mali medici subeas neque super corpus tuum accipias. Dicitur autem cyrurgia a cyros, quod est manus, et gios, quod est operacio, quasi sciencia de opere manuali. Apparet enim ex predictis quod 25 corpus humanum sanabile et egrotabile per scienciam cyrurgie est subiectum in cyrurgia, et quod removere egritudinem et servare sanitatem secundum quod est possibile cum sciencia ipsius cyrurgie est finis et intencio istius sciencie. Et hoc est. Partes cyrurgie secundum lohannicium in genere sunt due, operari vi30 delicet in membris (V2rb) mollibus et operari in duris. In specie vero sunt quinque, videlicet sciencia docens operari in apostematibus, vulneribus, et ulceribus et sciencia docens operari in restauracionibus et in aliis in quibus cadit operacio manualis. Operaciones cyrurgicorum in predictis partibus sunt tres, scilicet soluere continuum, iungere separatum, extir35 pare superfluum. Soluitur continuum flebotomando, scarpellando; iungitur separatum consolidando vulnera et reducendo algebras; exstirpatur superfluum cum curantur apostemata et glandule resecantur. Instrumenta cyrurgicorum cum quibus ista complentur sunt multiplicia, quia quedam sunt communia, quedam propria. Communia quedam 40 sunt medicinalia, quedam ferralia. Instrumenta medicinalia sunt regimina et pociones, sanguinaciones, unguenta, emplastra, pulveres. Instrumenta ferralia quedam sunt ad incidendum, ut forpices, rasoria, et lancete;

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quedam ad cauterizandum, ut sunt olivaria et cultellaria; quedam ad extrahendum, ut tenacule et picecarole; quedam ad probandum, ut probe et intromissi; quedam (ES) ad suendum, ut acus et canule. Propria sunt ut trepana in capite, faux in ano, et cetera. Ex quibus apparet quod cyrurgicus artificialiter operans debet secum 5 portare quinque unguenta, scilicet basilicon ad maturandum, unguentum apostolorum ad mundificandum, unguentum aureum ad incamandum, unguentum album ad consolidandum, dyalteam ad dulcorandum. Item in pennorolo (Olra) debet portare quinque instrumenta, scilicet forpices, picecarolas, probam, rasorium, lancetas, et acus; et talis cyrurgicus sic IO munitus potest predictas operaciones in corpore humano utiliter exercere--dumtaxat quod recte fuerit curativarum intencionum informatus. Informatur enim curativis intencionibus, secundum Galienum per totam Terapenticam, ab indicacionibus assumptis a rebus preter naturam primo, 15 consequenter a rebus naturalibus et non naturalibus et ab eisdem annexis. Incipere quidem oportet (secundum eundem Galienum in 2° Terapentice) a primis, transire vero hinc ad eas que consequentur, deinde ad illas que illis adherent; et hoc faciendo, non cessare antequam perveniat ad finem rei quesite, que est curacio uniuscuiusque egritudinis. Principium autem nos ducens ad hanc viam est egritudinis noticia, 20 scilicet qualis sit per sui naturam; consequenter, discurrendo per aliam, indicacionem secundum singulum accipere non visam a pluribus; consequenter, inventis indicacionibus, oportet secundem eundem intenciones inquirere que sunt possibiles et que non perfici; ultimo, invenire 25 oportet cum quibus et qualiter compleantur. Ubi advertendum, versus finem (Vlva) 3i et i, quod si intenciones sint pauce et concordes, ut in ulcere seu vulnere simplici, !eve quidem est; si vero sunt multe et contrarie, ut in ulcere concavo, sordido, apostemoso, iuxta membrum nobile, et cetera. Scrutare enim oportet tune in talibus complicacionibus-pr i30 mum quidem a qua maxime periclitatur homo, secundum vero quod quidem ex ipsis racionem habet cause, tercium ex quibus inpossibile est sanari ante aliam. Nam ubi ab aliqua disposicionum magnum periculum eminet, intencio est ad id quod magis properat; ubi (E6) vero hoc quidem faciens seu conservans, que ad causam; ubi vero non est possibile curari 35 hoc ante illud, que ab ordine, ut in exemplo prefato Galienus 3°, 4°, 7° Terapentice declarat evidenter. Et propter hoc dicebatur in 3° quod non est idem quid ut causam scrutari, vel ut racionem eorum sine quibus non optinens, vel ut quod properat. Aliquando vero tale est quod properat ut cogat incuratam relinquere particulam, ut in punctis, nervis, et emorrogi40 antibus venis et in musculis percussis et articulacionibus que cum ulcere fiunt.

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Modus et fonna operandi utiliter cum predictis instrumentis secundum Amaldum elicitur ex quatuor consideracionibus: primo debet considerare cyrurgicus artificialiter operans que sit illa operacio quam debet exercere in corpore humano, secundo quare applicatur, tercio utrum sit necessaria et possibilis, quarto rectum modum applicandi. Primum habetur per divisionem et subdivisionem operacionum cyrurgie, ut dictum est. Secundum cognoscitur per generalem intencionem cyrurgicorum, que precipit operaciones eorum in humano corpore fieri debere secundum utilitatem cum fiducia securitatis. Tercium concipitur per consideracionem effectuum operis et particularum a parte corporis occurrencium. Quartum ignotescit ut omnia que conveniunt corpori, secundum quod talis operacio sibi applicatur et secundum quod ipsi subicitur vel ad earn comparatur, convenienter exerceantur--et hoc ante applicacionem et in actu applicacionis et post ipsius actum. Verbi gracia: volumus extrahere aquam ydropicorum. Primo debemus considerare que sit talis operacio, et scimus per divisionem operacionum cyrurgie quod est soluere continuum cum rasorio. Secundo debemus considerare quare fit, et scimus per generalem intencionem cyrurgicorum ut curetur ydropisis velut saltim passio allevietur. Tercio debemus considerare utrum talis operacio sit necessaria et possibilis, et scimus quod est necessaria, quia aliter non potest curari ydropisis confinnata; et ideo si paciens debilis est non erit possibilis, si fortis extrahetur (E7) paulatine. Quarto debemus considerare rectum modum extrahendi, et est quod situetur supinus paciens et pellis (V2vb) ventris subtus umbilicum-a latere dextro si passio venerit a sinistro, vel e contra si fuerit in dextro---trahatur ad superius et perforetur cum rasorio usque ad locum vacuum; et applicata canula, aqua iuxta tolleranciam infinni extrahatur et postea extracta canula cutis dimittatur et descendendo claudet vulnus myracis et aqua non exibit. Et quando volueris iterum extrahere, ducatur cutis et ponatur canula ut prius et exibit quantum volueris et poterit tollerare et ita patet operacio. Operatores istius artis quorum noticia et doctrina fuit apud me, et quorum dicta invenientur in hoc opere ad hoc ut sciatur quis melius dixit alio, bonum est eos in quodam cathologo ordinare. Primus omnium fuit gloriosus Ypocras, qui ut legitur in Introductorio medicine superavit omnes et primo duxit ad lucem perfectam apud grecos medicinam. Ipsa enim, ut dixit Macrobius, et Ysidorus 4° Ethimologiarum (quod eciam recitatur in prologo Tocius continentis), ante Ypocratem siluerat per quingentos annos a tempore Appollinis et Asclepii, qui fuerunt primi eius inventores. Ipse enim vixit 95 annis et scripsit multos libros cyrurgie, ut patet in 4° Terapentice et in multis locis per Galienum; sed credo quod propter bonam ordinacionem librorum Galieni libri Ypocratis et multorum aliorum fuerunt omissi.

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Galienus secutus est eum, et que Ypocras seminavit tamquam bonus agricola excoluit et augmentavit. Unde multos libros scripsit in quibus multa de cyrurgia inmiscuit, et specialiter librum De tumoribus preter naturam assumavit et primos sex libros Terapentice de vulneribus et ulceribus et duos ultimos de apostematibus et de multis egritudinibus aliis in quibus cadit operacio manualis composuit; et septem libros Cathagenorum (licet non habeamus nisi summam) ordinavit. Fuit autem maximus in sciencia demonstrativa tempore Anthonii imperatoris post Christum quasi per 150 annos. Vixit 87 annis, ut in De vita et moribus philosophorum recitatur. (ES) Inter Ypocratem et Galienum fuit tempus mirabile, ut dicit Avicenna in 4° de fracturis-300 et 25 annorum, ut glosatur ibidem. Post Galienum invenimus Paulum, qui (ut testatur Rasis in Toto continente et Haly Abbas in libro de Regali disposicione) multa in cyrurgia fecit; librum tamen sextum cyrurgie sue inveni. Subsequenter invenitur Rasis, Albucasis, et Azarani, qui-sive fuerint idem vel diversi--0ptime se habuerunt, maxime in libris Almansoris et Divisionum et in cyrurgia Albucasis dicta, et (ut dixit Haly Abbas) in illis sua (V3ra) specialia posuit; in Toto vero continente, qui Elhavi Arabice dicitur, eadem replicavit, et omnium predecessorum suorum maiorum dicta congregavit, quia cum non elegit et longius et indeterminatus, apreciatus minus fuit. Haly Abbas magnus magister fuit, et preter seminacionem in libris Regalis disposicionis, nonam partem i sermonis de cyrurgia ordinavit. Avicenna princeps illustris secutus est eum, et valde ordinate, ut de aliis in 4° libro suo de cyrurgia tractavit. Et usque ad eum inveniuntur omnes fuisse phisici et cyrurgici, sed post, vel propter lasciviam vel occupacionem curarum nimiam, separata fuit cyrurgia et dimissa in manibus mechanicorum. Quorum primus fuit Rogerius, Rolandus, atque quatuor magistri, qui libros separatos de cyrurgia ediderunt et multa emperica in eis immiscuerunt. Deinde invenitur lamerius, qui quandam cyrurgiam brutalem edidit in qua multa fatua nominavit; in multis tamen Rogerium secutus fuit. Subsequenter invenitur Brunus, qui satis discrete dicta Galieni et Avicenne et operacionem Albucasis assumavit; translacionem tamen librorum Galieni totam non habuit et anathomiam penitus dimisit. Post ipsum inmediate venit Thedericus, qui rapiendo omnia que dixit Brunus cum quibusdam fabulis Hugonis de Luca magistri sui librum edidit. Guillelmus de Saliceto valens homo fuit, et in phisica et in cyrurgia duas summas composuit, et iudicio meo quantum ad (E9) illa que tractavit satis bene dixit. Lanfrancus eciam librum scripsit, in quo non multa posuit nisi que a Guillelmo recepit, in alio tamen ordine mutavit. In hoc tempore magister Arnaldus de Villa Nova in utraque facultate tloruit et multa pulchra opera fecit. Hinricus de

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Hermondavilla Parisius tractatum per notabilia incepit in quo nitebatur de Theoderico et Lanfranco facere matrimonium; ipsum tamen tractatum morte preventus non complevit. In hoc tempore in Calabria magister Nicholaus de Regio, in lingua 5 Greca et Latina perfectissimus, ad requisita regis Roberti multos libros Galieni translatavit et eos nobis in curia transmisit, qui alcioris et perfeccioris stili videntur quam translati de arabica lingua. Ultimo nunc insurrexit una fatua Rosa anglicana que michi mandata et visa; credidi in ea invenire odorem suavitatis, et inveni fabulas Yspani, (V3rb) Gilberti, et Io Theoderici. Tempore autem meo fuerunt cyrurgici operantes: Tholose, magister Nicholaus Cathalanus; in Montepessulano, magister Bonetus filius Lanfranci; Bononie, magister Peregrinus atque Mercadantus; Parisius, magister Petrus de Argentina; in Lugduno, ubi practicavi longo tempore, ma15 gister Petrus de Bonanto; in Avinione, magister Petrus de Arlate et socius meus magister Iohannes de Parma. Et ego Guigo de Caulhiaco, cyrurgicus, magister in medicina, de confinibus Alvemie dyocesis Mymatensis, medicus et capellanus commensalis domini nostri pape, vidi operaciones multas et multa scripta predictorum-precipue Galieni, quia quot reperi20 ebantur libri in utraque translacione habui et eos cum diligencia qua potui studui; et per multa tempora operatus fui in multis partibus. Et nunc eram in Avinione, anno domini millessimo ccc0 lxiii0 , pontificatus domini Urbani quinti anno primo, in quo ex dictis prenominatorum et meis experienciis cum auxilio sociorum meorum hoc opus compilavi, iussu 25 Dei. Secte que currebant tempore meo inter operatores istius artis-preter duas generales que adhuc vigent, (EIO) loycorum videlicet et empericorum, reprobatas a Galieno in De sectis et per totam Terapenticam-fuerunt quinque. Prima fuit Rogerii, Rolandi, et quatuor magistrorum, qui 30 indifferenter omnibus vulneribus et apostematibus saniem cum suis pultibus procurabant, fundantes se super illo 5; Amphorismorum: Laxa bona, cruda vero mala. Secunda fuit Bruni et Thederici, qui indifferenter omnia vulnera cum solo vino exsiccabant, fundantes se super illo 4i Terapentice: Siccum enim sano est propinquius, humidum vero non sano. 35 Tercia vero secta fuit Guillelmi de Saliceto et Lanfranci, qui volentes mediare inter istos procurant omnia vulnera cum unguentis et emplastris dulcibus, fundantes se super illo 14i Terapentice, quod curacio unum habet modum, quod absque fallacia et dolore tractetur. Quarta secta est fere omnium Theotonicorum militum et sequencium bella, qui cum coniuriis 40 et pocionibus et oleo et Jana atque caulis folio procurant omnia vulnera, fundantes se super illo quod Deus posuit virtutem suam in verbis, herbis, et lapidibus. Quinta secta est mulierum et multorum ydiotarum, qui ad

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solos sanctos de omnibus egritudinibus infirmos remittunt, fundantes se super illo: Dominus michi dedit sicud placuit, Dominus michi (V3va) auferet quando placebit; sit nomen Domini benedictum, Amen. Et quia iste secte in processu libri redarguentur, obmittuntur de presenti. De uno tamen miror, quod ita se secuntur sicut grues: unus non dixit 5 nisi quod alter. Nescio si est propter timorem aut amorem, neque dedignantur audire nisi consueta et auctoritate probata; male legerunt Aristotelem in 2° Methaphisice, ostendentem quod ista duo sunt que magis impediunt viam et cognicionem veritatis. Dimittantur tales amicicie et 10 timores, quia amicus est Socrates vel Plato, sed magis est amica veritas. Sanctum et