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John Arderne, Surgeon of Early England

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John Arderne, Surgeon of Early England JOHN ARDERNE, SURGEON OF EARLY ENGLAND By ALFRED BROWN, M.D. OMAHA T has been stated often and truly that through his religious zeal made an error man is moulded principally by two which was to cost him much of his domina- factors, heredity and environment. tion. The pilgrims, in their journey across Which of these plays the greater role is Europe and the Mediterranean to the Holy still, and probably always will be, a matter Land had been mistreated by the Moslem Ifor argument. In whatever way one until finally these men, searching for con- decides the question, of one thing there secration at Christ’s Sepulchre, began to can be no doubt that in order to evaluate travel in bands under arms. This was taken properly the accomplishments of any man as an opportunity by the cleric to foster an and place him, as best we may in his offensive spirit on the part of Chivalry. fitting niche in history, these two elements, Chivalry had already taught the laity that when possible, should be taken into con- it was proper to defend by force what was sideration. In the case of the first of these, right but as time went on, the idea urged heredity, the feat is at times difficult of by the monk grew, to take the offensive accomplishment, especially when the study and capture from the Moslem the Sepulchre is of a man of the middle ages such as John of Christ and restore it to its proper guard- Arderne who lived during the major part of ian the Christian Church. So this Pilgrim’s the fourteenth century. Of his heredity and Progress turned into a Holy War and the immediate family we know nothing. So knight in his glittering armour came to we must confine ourselves to the study of take his stand beside the monk, both intent his environment and here the problem is on a common purpose. In the attempted different for of this we do know something carrying out of this purpose during the and can partially at least reconstruct it by crusades however the people did not know a review of the general conditions of the whether to follow the monk or the knight, time in which he lived. for the close contact of the warrior and his In the case of John Arderne this study followers with the culture and knowledge carries us back to one of the most interesting of the Saracen resulted in the building of a times in the world’s history, the latter part new Europe through the influx of new ideas. of the medieval period when that flickering While the crusades were in the making, spark of the waning science and art of the Constantine, the African, had come to early Greeks, kept alive by the Arabians Salerno and then to Monte Cassino and through many centuries, was breaking into had translated the works of the early a feeble flame, fanned by the efforts of Greeks, and late Arabians, into Latin and such as Arderne, and destined later to thus taught the continental Europeans the blaze anew and again furnish light for an then advanced surgery. In part through era of progress ushered in by the Renais- his efforts and in part because Salerno sance and continued to the present day. It became the great military hospital for carries us back to the time when two figures, the crusaders the teaching and practice the monk and the knight, held the center of surgery and medicine took firm root in of the stage of the world. The monk, theo- Southern Europe. From there it spread, in retically having little or no interest in part directly and in part through the mundane affairs but practically their guid- Western Caliphate situated in Toledo and ing hand, had, in the eleventh century Cordova, until it reached Paris and Mont- pellier where the great schools were founded, ville had given to surgery at Montpellier and finally surgery reached Oxford, it is possible that this had held over to the England. time of John. Such would have had to be With this revival of medical and surgical the case for de Mondeville died when learning on the continent a veritable suc- Arderne was but eight years of age. As was cession of famous surgeons began. Con- commonly the case with many men of his stantine, the African, was followed at period he did not spend his entire profes- Salerno by Roger, Roland, and the Four sional life in one place. Though generally Masters. Arnold of Villanova and Henri known as John Arderne of Ncwarkc he did de Mondeville worked and taught at Mont- not settle there until he was forty-two years pellier. In opposition to the Paris Faculty old. In 1346 he served as Sergeant Surgeon where clerics only could teach, Jean Pitard in the army of Edward in which fought the founded the College de St. Come to which French at Crecy. After his return he Lanfrancus of Milan came in 1295 and practiced in Wiltshire and was there when after becoming a member began to teach the Black Death swept England in 1348. surgery by lectures and demonstrations. The following year found him moving to Finally in the early part of the fourteenth Newarke where he remained until 1370. century the father of modern surgery arose, There he gained a great reputation as a the great Frenchman, Guy de Chauliac. Surgeon and built up a large practice. In So the stage was set and the pathway spite of this he moved again, this time to made for an Englishman to carry the London, where so far as is known, he surgery of the continent to England and remained until his death, the exact date ol there carve for himself a niche in the Hall of which is uncertain. Fame. Gilbertus Anglicus and John of As one reads the surgery of these years ol Gaddesden had practiced in England and the Middle Ages the constant repetition the latter had become the Professor of of the stone, fistula and hemorrhoids gradu- Medicine at Oxford but there was little new ally forces on the consciousness the great or original in their surgical work. John prevalence of these diseases. Stone in the Arderne grasped the opportunity and bladder, if the diagnosis was not confused became the first great English surgeon. with that of enlarged prostate, was much Born in England in 1307, and practicing more common in those days than it is now. in England most of his life he has left little It offered a good field for a young and autobiographical data. He does not tell us ambitious surgeon save for the fact that where he received his preliminary education its treatment was mostly in the hands of and later studied medicine. That he received the itinerant and ignorant barber surgeons. a fairly good education is self evident for But the treatment of the diseases of the anal he wrote his work in passable Latin, and canal held no such stigma and this young that he studied medicine and received as surgeon, with both preparatory and surgical much instruction as the times could give training and in addition the knowledge of appears reasonable for he describes himself wound treatment he had acquired during his as “Chirurgicus inter Medicos,” Surgeon experience as a war surgeon, evidently among Medical men. Can this mean other decided to devote himself largely, though than that he was educated as a physician not exclusively, to the specialty of fistulae, and attained all the eminence and self not only of that in ano, but also to fistulae constituted authority that the physician in any part of the body. It is, however, as of those days assumed and then took up and the originator of the operation for fistula practiced surgery? Baas1 says that he “had in ano that he is best known. probably studied at Montpellier” and con- Arderne’s original works arc in manu- sidering the impetus that Henri de Monde- script. Certain of them however, have been translated and printed. In 1883 Gore2 1645.” ^^0 manuscript consists of 440 pages described a manuscript entitled “The Works with numerous illustrations. Preceding this, of Master John Arderne, Chirurgeon, of Arderne’s work on fistula had appeared in Ncwarke, in Nottinghamshire, written by the works of Franciscus Arcaeus translated his own hand, in the year of our Lord 1349, by John Read3 in 1588. The latter part of with some Observations collected in blank the title reads “With a treatise on the paper by Walter Hammond, Chirurgeon, Fistulac in the fundament, and other places of the body, translated out of Johannes In this last connection after having told Ardern etc. London 1588.” A still more of a large number of persons that he had recent translation of Arderne’s manu- cured of the fistula John says “Neverthc- scripts is that by Sir D’Arcy Power4 pub- lished in 1922, as the first of the Wellcome Historical Medical Museum Research Studies in Medical History. This manu- script which is entitled “The practice of Master John Arderne of Newarkc in the art of Medicine and Surgery, 1412,” was written after his death but gives consider- able of his work concerning fistula and also gives much of the absurdities of his medical ideas for, though advanced in Surgery, Arderne, bound by the traditions and super- stitions of his time, used the then prevalent ridiculous medical treatment for internal disease. It is interesting to note that Arderne’s manuscripts are illustrated.
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