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currentibus eorum.' It is evident that Vigo had had practical experience of the treatment of gunshot wounds, though he does not inform us that he ever served in the field. He tells us that these wounds are always round, contused, scalded and poisoned. It has been suggested that the burning or scalding that he describes may have been partly due to the very short range at which actions were fought; more probably the burns were in many cases the work of incendiary arrows. In emphasising the idea that gunshot wounds were necessarily more poisonous than others, Vigo, who was a very influential writer, became responsible for an immense amount of mistaken treatment and unnecessary suffering. He claimed to be a learned surgeon, and professed that his treatment was based on an aphorism of Galen, contusio et combustio indigent humefactione, venositas exsiccatione.' The wound, he advised, should first be seared with a red-hot iron or heated with boiling oil, and then subjected to the action of a variety of ointments, the number and composition of which provide evidence of more erudition than good sense. The method of treating wounds by means of hot irons (Fig. 2) was not the invention of Vigo. It had its roots in antiquity, and the tradition was doubtless greatly reinforced by the mediæval belief in the curative influence of 'branding,'* a method of treatment still extensively practised by numerous savage and semi-civilised African and Asiatic races. Vigo, however, added the full weight of his influence to the practice; and it was a great misfortune for surgery that his writings were exceedingly popular, and were re-edited in numerous editions and frequently translated into the vernaculars of Europe-English, French, Italian, German, Spanish, and Portuguese.

In Italy, notably, Vigo's doctrine of the poisonous character of musket wounds was closely followed by the Neapolitan Alfonso Ferri (1515-1595), who brought out at Rome in 1552 probably the earliest work entirely devoted to the subject of gunshot wounds, 'De sclopetorum sive archibusorum vulneribus.' Ferri, like Vigo,

* Cf. K. Sudhoff, 'Tabellen, Bild- und Merkschemata zur Kauterienanwendung bei Erkränkungen,' in ‘Beiträge zur Geschichte der Chirurgie im Mittelalter,' erster Teil, Leipzig, 1914, p. 75.

FIG. 2.–CAUTERIZING A WOUND (FROM GERSDORFF). Below is a brazier in which a cautery is being heated. Above are various

was physician to a Pope-Paul III. Although a follower of Vigo in his belief in the poisoned character of gunpowder, he gives an impression of wider experience, sounder common sense, and greater independence of mind than his more influential predecessor. He observed that small pieces of clothing and fragments of mail were often driven into the wound by the bullet or bomb, and gave rise to obstinate suppuration. He advises, therefore, the routine use of a sound or probe to explore the wound for such foreign bodies; but he points out that the best and most delicate of all probes is the finger of the surgeon himself, which should be used when possible. For the extraction of the bullet he adopts a simple and ingenious instrument, the 'Alphonsinum' (Fig. 4 (2)). This consists of three long rods which are drawn together over the bullet or other foreign body by means of a movable ring. Ferri also adopted a method of ligaturing a cut vessel by underpinning. Being without knowledge of the circulation of the blood, surgeons at that date sometimes failed to distinguish between arterial and venous hæmorrhage; and Ferri advises ligature above the wound in both cases. His method, however, is neat and practical, and must often have been of value. Seeing the skill he thus brought to bear on the control of hæmorrhage, it is disappointing to find him yielding to the popular fashion of blood-letting. He shows, however, his good sense by his comparative moderation in the use of such depletory measures. He is also sound and modern in his view that purulent matter must always be given free vent, and that a foreign body buried in a part where it is doing no harm is, like a sleeping dog, best left to lie.

Towards the middle of the 16th century appeared two works which, though not devoted to our subject, were yet destined to have a great influence on its development. The 'Grosse Wundartzney' of Philippus Aureolus Theophrastus Bombastus von Hohenheim, better known as Paracelsus (1491-1541), was published in 1536 in two parts, the first at Ulm and the second at Augsburg, both bearing the dedication to the Emperor Ferdinand I.*

*The third part promised in the preface never appeared. The publication of certain other works of Paracelsus as the third part of this work has introduced much confusion into the already sufficiently confused bibliography of this writer.

This work is in German Swiss, and is difficult reading for one not familiar with the dialect. Its importance in the history of our subject lies in its vigorous plea that the healing power of nature should be allowed free play. It is the first modern work that lays adequate stress on this overwhelmingly important medical principle.

In the year 1543 appeared a second work which had a revolutionary effect on surgery. It was the 'De humani corporis fabrica' of André Vesale of Brussels, published in his twenty-ninth year. This work immediately placed anatomy in the position of a science, and raised its author to a place among that small list of really great medical writers whose work is for all time. From this date onward all good surgical work became primarily conditioned by the exact knowledge of the structure of the human frame inaugurated by Vesale.

The great anatomist was followed by the great surgeon; and the work of Ambroise Paré (1510-1590) (Fig. 3) stands, along with the researches of André Vesale and the suggestions of Paracelsus, as the groundwork of modern surgery. Paré has been the subject of a fine monograph by his countryman, Malgaigne; and the account given of him by Mr Stephen Paget presents to the English reader a picture of a lovable, loyal, and tenderhearted man, whose beneficent earthly course of eighty years was crowded with adventure and incident. Throughout his lifetime France was rent by disastrous wars of religion; and Paré, while belonging fully to neither party, retained the love and affection of both. It has been said that Paré was the only Huguenot in Paris who survived the awful night of St Bartholomew, but this begs the question of his religion, a question that never has and probably never will be decided. For the truth is that he was neither fully Catholic nor fully Huguenot, but a devout and simple-hearted lover of God and man, who went his way and did his work according to such light as was given him, avoiding, so far as was possible in those evil days, all the hatreds and envies that the name of religion inspired.

Paré was surgeon successively to four kings of France -Henri II, François II, Charles IX and Henri III. His attachment to the court and persons of his sovereigns did not prevent his serving on a multitude of battle-fields,