All wounds should be treated only with wine and bandaging.
He emphasized the importance of diet in assisting in wound repair, warned against the wounding of nerves, and suggests bringing ends of cut nerves in proximity to favor repair. It is surprising to find these old surgeons writing of union by first intention, and insisting on cleanliness and antiseptic dressings, such as strong wine. With regard to their treatment of wounds, Professor Allbutt, of Oxford, undoubtedly our greatest English authority on the history of medicine, writes as follows:
They washed the wounds with wine, scrupulously removing every foreign particle; then they brought the edges together, not allowing wine nor anything else to remain within—dry adhesive surfaces were their desire. Nature, they said, produces the means of union in a viscous exudation, or natural balm, as it was afterwards called by Pare and Wurtz. In older wounds they did their best to secure union by cleansing, desiccation and refreshing of the edges. Upon the outer surface they laid lint steeped in wine. Powders they regarded as too desiccating, for powder shuts in decomposing matters; wine, after washing, purifying and drying the raw surface, evaporates.
Theodoric was six centuries in advance of his time when he wrote:
For it is not necessary, as Roger and Roland have written, and as many of their disciples teach, and as all modern surgeons profess, that pus should be generated in wounds. No error can be greater than this. Such a practise is indeed to hinder nature, to prolong the disease, and to prevent the conglutination and consolidation of the wound.
Theodoric, like our present-day surgeons, was proud of his small and beautiful scars produced without using salves "Pulcherrias cicatrices sine unguento aliquo inducebat," while poultices, oils and powders on wounds, he said, incarcerated foul material, "saniem incarcerare," evidence enough that this writer knew not only the art, but also the fundamental principles of good surgery.
William of Salicet passed his early life at Bologna, and later was municipal and hospital physician to Verona. Being himself both a physician and a surgeon, he believed that these two branches of medicine should not be separated. In his book he quotes previous authorities less than his predecessors, and he condemns the abuse of the cautery popularized by Arabian writings, and advocates the use of the knife. He describes operations for the relief of hydrocephalus, various eye conditions, nasal polypi and tumors of the mouth. He relates the history of a tumor, probably an epulis, larger than a hen's egg, which he removed from the gums of the upper jaw, and says that he performed the operation in four steps, the last being the resection of a portion of the jaw bone. He did not hesitate to operate on cystic goiter, but he describes the large veins encountered in certain types of goiter and he warns against hemorrhage from them.
Lanfranc practised at Milan until his banishment about 1290. He
