Treatises of fistula in ano, hæmorrhoids, and clysters / by John Arderne, from an early fifteenth-century manuscript translation. Ed., with introduction, notes, etc., by D'Arcy Power.

  • Arderne, John, active 1307-1370.
Date:
1910
Catalogue details

Licence: Public Domain Mark

Credit: Treatises of fistula in ano, hæmorrhoids, and clysters / by John Arderne, from an early fifteenth-century manuscript translation. Ed., with introduction, notes, etc., by D'Arcy Power. Source: Wellcome Collection.

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    XVII died in 1306, the year before John Arderne was born, contents himself with saying that fistulae are incurable, and he utters a lamentable cry against those who would attempt to operate even if it were only by applying a corrosive.1 Henri de Mondeville (1260('?)-1320(?)) merely enlarged the orifice of the fistula with a tent, and utterly condemns the teaching of the school of Salernum, as represented by Roger and Roland, who would operate and afterwards apply a painful corrosive,2—and de Mondeville was in Paris what Arderne was in London, a first-rate surgeon. Guy de Chauliac (d. 1368), prince of the mediaeval writers of surgical text-books, published his “ Great Surgery ” thirteen years before Arderne wrote his treatise on Fistula. After the manner of text-books various operations are described for the cure of fistula, each with insufficient details, and the reader is left in doubt as to which, if any, is to be employed.3 Arderne’s Operation for Fistula. John Arderne’s operation is clearly a modification of the method recommended by Albucasis, and, like a good surgeon, he preferred a clean incision to fretting the fistula through with a ligature tied tightly. He recommends that the patient should be secured in the lithotomy position. A probe—called appropriately enough, sequere me—is passed through the fistula until it is felt in the rectum. The eye of the probe is then threaded with a ligature of four strands—the frsenum Csesaris—which is drawn through the fistula as the probe is pulled out of the rectum until one end hangs out of the anus and the other from the opening of the fistula. These two ends are knotted together and the whole ligature is tightened by means of a peg—the wrayste—fixed into the widest part of a gorget—the tendiculum—in the same way that a violin peg tightens the strings passing round it. The use of the ligature is partly to control the bleeding and partly to maintain a correct line while the fistula is being divided. The gorget or tendiculum is pushed well up into the fistula and a grooved director with a curved end—the acus rostrata, or snowted needle—is passed along it until the end projects into the rectum where the probe had 1 Lanfrank’s “Science of Cirurgie,” Early English Text Society, No. 102, pp. 292-3. 2 “ Chirurgie de Maitre Henri de Mondeville.” E. Nicaise. Paris, 1893, p. 465. 3 “La Grande Chirurgie de Guy de Chauliac, compos^e en l'an 1363.” E. Nicaise. Paris, 1890, p. 134.