Chauliac, Guy De

(b. Chauliac, Auvergne, France, ca. 1290; d. in or near Lyons, France, ca. 1367–1370),

medicine.

Guy’s family were of the peasant class, and he was aided in his studies by the lords of Mercoeur. He studied medicine first at Toulouse, then at Montpellier, and finally in Bologna. It was at Bologna that he perfected his knowledge of anatomy under the guidance of his master Nicolaus Bertrucius (Bertruccio), and his description of Bertrucius’ teaching methods has often been quoted. After leaving Bologna, Guy traveled to Paris before taking up residence in Lyons, where he was appointed canon of St. Just. He was later appointed a canon of Rheims and of Mende. At this period the popes resided in Avignon, and Guy became private physician to Clement VI (1342–1352), Innocent VI (1352–1362), and Urban V (1362–1370). His service to the popes was valued enough to earn him an appointment as a papal clerk (capellanus). While serving at Avignon, Guy made the acquaintance of Petrarch.

In his works Guy calls himself “cyrurgicus magister in medicine,” and he received his master’s degree in medicine (equivalent to the M.D. of Bologna) from Montpellier. He was one of the most influential surgeons of the fourteenth century; in fact, some nineteenth-century medical historians went so far as to rank him second only to Hippocrates in his influence on surgery. His chief work was the Inventorium sive collectorium in parse chirurgiciali medicine, which is usually referred to by its shorter title of Chirurgia or sometimes Chirurgia magna. Guy completed it in 1363 and dedicated it to his colleagues at Montpellier, Bologna, Paris, and Avignon, places where he had either practiced medicine or been a student. The seven parts or books that make up the Chirurgia passed through numerous editions and served at least until the seventeenth century as the standard work on the subject. The book or parts of it were translated early from Latin into Provençal, French, English, Italian, Dutch, and Hebrew. The prologue (“Capitulum singulare”) is an invaluable essay on general facts that Guy thought every surgeon should know about liberal arts, diet, surgical instruments, and the manner of conducting an operation. It also included a brief history of medicine and surgery in the form of notes on earlier physicians and surgeons and is the source of much information about Guy himself.

Guy regarded his book as a collection of the best medical ideas of his time, and he modestly stated that only a few things were original with him. E. Nicaise, the editor of the standard scholarly edition of the work, found that of some 3,300 quotations made by Guy, no fewer than 1,400 were from Arab writers and 1,100 from ancient authors. All told, some 100 different writers were cited or quoted. Galen led the list with 890 different citations, but frequent references were also made to Hippocrates, Aristotle, Al-Rāzī (Rhazes), Abul Kasim (Albucasis), Ibn Sīnā (Avicenna), Ibn Rushd (Averroës), and many other Arab or classical writers. Chauliac also mentioned and assessed his contemporaries. He thought highly of William of Saliceto but little of Lanfranchi, and he ridiculed John of Gaddesden.

Chauliac urged surgeons to study anatomy and went so far as to say that surgeons who were ignorant of anatomy carved the human body in the same way that a blind man carved wood. In spite of his emphasis on anatomy, his section (Tractatus I) on the subject is the weakest part of his book; Guy shows little real understanding, even though he had undoubtedly assisted at dissections and carried out postmortem examinations. His work may be said to reflect more the teacher than the scientist and is more didactic than scientific; he probably accurately represents the state of medical knowledge at his time.

His work is a mine of information on all kinds of things. In his section on carbuncles, abscesses, tumors, and so forth, Guy also included buboes in the armpits. He then went on to describe the plagues of 1348 and 1360 at Avignon. He pointed out the prevalence of plague in Asia and Europe, indicated the differences between the pneumonic and bubonic types, and then revealed himself to be a man of his time by blaming the disease on the Jews—who, he said, wished to poison the world—or on certain conjunctions of the planets. He did, however, recognize the contagious nature of the plague and recommended purification of the air, as well as venesection and a good diet for the afflicted.

Much of the historical controversy on the place of Guy de Chauliac in the history of medicine has raged over the question of his views on infection. In many standard histories of medicine, Guy is accused of believing that pus (laudable pus) was a necessary part of the healing process. He is also accused of practicing meddlesome medicine by prescribing all sorts of salves, plasters, and so forth instead of depending upon the healing powers of nature. This labeling of Guy as a medical reactionary has in part been discounted by historians such as Jordan Haller, who are extremely critical of the standard treatments of Guy’s medical attitudes.

BIBLIOGRAPHY

I. Original Works. Chauliac’s original MS has long been lost, and so has the archetype of the translation that was made into French. There are, however, several versions dating from the last quarter of the fifteenth century, as well as fragments, commentaries, and abridgments. The first published ed. was a French one, De la pratique de cyrurgie, collated with the Latin text by Nicolas Panis (Lyons, 1478). The first Latin ed. was published at Venice in 1498. An Italian trans. appeared at Venice in 1480; a Dutch trans. at Antwerp in 1500; and Catalan and Spanish trans. at Barcelona in 1492. Most of these went through several eds. An English ed. published in 1541 has not survived, although Robert Coplan’s trans. of the Chirurgia parva, dating from 1541–1542, is still extant. This Chirurgia parva, although often ascribed to Chauliac, is simply a rather poor compendium of some parts of the Chirurgia magna. Guy also wrote a treatise on astrology, Practica astrolabii (De astronomia), dedicated to Clement VI, and two other works that are now lost, De ruptura, a treatise on hernia, and De subtilianti diaeta, a treatise on cataract with a regimen for the patient. The best ed. is that of E. Nicaise, which is a trans. into modern French under the title La grande chirurgie (Paris, 1890). There is an English trans. of Tractatus III, On Wounds and Fractures, by W. A. Brennan (Chicago, 1923). See also The Middle English Translation of Guy de Chauliac’s Anatomy, Björn Wallner, ed. (Lund, Sweden, 1964).

II. Secondary Literature. George Sarton, Introduction to the History of Science, III (Baltimore, 1948), 1690–1694, summarizes much of the information about Guy and includes a discussion of various eds. of his work. Also valuable is E. Gurlt, Geschichte der Chirurgie, 3 vols. (Berlin, 1898), 11, 77–107. See also Leo Zimmerman and Ilza Veith, Great Ideas in the History of Surgery (Baltimore, 1961), pp. 149–157; and Vern L. Bullough, The Development of Medicine as a Profession (Basel, 1966), pp. 64–65, 93–95. A good summary article on whether Guy was or was not a medical reactionary is Jordan Haller, “Guy de Chauliac and His Chirurgia magna,” in Surgery, 55 (1964), 337–343.

Vern L. Bullough

Guy de Chauliac

Circa 1290-Circa 1370

Surgeon

Sources

Wealthy Patrons. Guy de Chauliac was born into the peasant class in southern France, but with the help of aristocratic benefactors, he was able to learn Latin, attend the universities of Montpellier and Bologna, and reach the highest level of professional medicine. Although mainly interested in surgery, de Chauliac studied the liberal arts and advocated a broad philosophical training for surgeons. There was already a tradition of Latin surgical treatises by de Chauliac’s day, dating back to Roger of Salerno’s Practica chirugia (The Practice of Surgery, late twelfth century), but de Chauliac recognized the importance of scrutinizing the available translations of both ancient Greek medical authorities and the Arabic digests and commentaries on them by such authors as Rhazes, Avicenna, and Albucasis. Prominent medical and surgical teachers and students of Montpellier before him, foremost among them Arnald of Villanova and Henri of Mondeville, had recognized the importance of making surgery a learned profession that incorporated the classical philosophical medical theories of Hippocrates, Galen, and Aristotle, while retaining the emphasis on the practical art of healing that Galen’s Arabic followers emphasized in their medical texts. By basing surgery on natural philosophy and deductive logic, Arnald and Henri had supported the inclusion of surgery among the academic professions taught by the universities and commanded the respect of a wealthy clientele. De Chauliac followed their lead, writing in Latin and grounding his opinions in the authority of past medical writers.

Anatomical Instruction. In the early fourteenth century, when he was a medical student, anatomical instruction was just being introduced into the medical curriculum. Mondino da Luzzi was a pioneer in teaching human anatomy at the University of Bologna, where de Chauliac studied surgery. By the end of the fourteenth century, attendance at an annual anatomical demonstration was required of medical students at Europe’s best medical schools. Such instruction was intended to provide physicians with a basic understanding of the place and normal condition of the organs of the body, but it also served to acquaint surgical students with the interior of the body and where it was safe to make an incision. It also provided employment for surgeon-anatomists in the universities and encouraged the practice of anatomy. Mondino’s textbook, Anathomia (1316), became the basis for anatomical instruction in European medical schools for the next two centuries, and commentaries on it were still in use when Andreas Vesalius published his anatomical masterpiece in 1543.

Papal Favorite. Historians of medicine have criticized de Chauliac’s bookish approach to surgery, even arguing that while he professed the surgical procedures of his predecessors and criticized his contemporaries for erroneous methods, he avoided cutting whenever possible. Nevertheless, de Chauliac received a first-rate education, spent much of his adult life in service as surgeon to the Roman Catholic popes, and was one of the first to incorporate anatomical knowledge drawn from Galen’s second century C.E. treatise De usu partium (On the Use of the Parts), which had only recently been translated into Latin and proved too long and complicated to find use in the medieval curriculum.

Astute Observation. De Chauliac survived the Black Death in 1348 and also witnessed the second European epidemic in 1360. He observed that some victims coughed up blood and invariably died within a couple of days of the appearance of the first symptoms, while others developed painful swellings in the armpits, neck, and groin and then either died within several days or survived. This report and others that corroborate it have led scholars to suspect that the Black Death was a disease caused by the pathogen responsible for modern bubonic plague, but spread by two different means. If transmitted from person to person via airborne water droplets that are coughed out—a common way of spreading infection—the pathogen would settle in the lungs first and lead to bleeding and rapid death. On the other hand, the pathogen can be transmitted by fleas and cause a swelling in the main lymph nodes (buboes) draining the area where the fleas have bitten and infected the person, commonly in the armpits, groin, or neck. Fatality in this mode of plague, called bubonic plague, is lower. The actual cause and epidemiological mechanisms behind the Black Death and subsequent epidemics are still debated, but de Chauliac’s observations, coming as they do from a knowledgeable and trained medical observer, cannot easily be discounted.

Surgical Text. Toward the end of his life, de Chauliac wrote a textbook on surgery, Inventorium sive collectorium in parte chirurgiciale medicine (Inventory or Collection on the Surgical Part of Medicine, 1363), commonly called the Chirugia magna (Great Surgery), which was the first such book on the subject to include a chapter specifically on anatomy. Otherwise, de Chauliac drew much of his material from the chief Arabic treatises and has been criticized for being less original and personally engaged in surgical practice than his predecessors William of Saliceto, John of Arderne, and even Henri of Mondeville. Nevertheless, de Chauliac’s Great Surgery proved to be popular as a surgical textbook, perhaps because of his authority as a papal surgeon, and was translated into several vernacular languages, including Middle English. These translations enabled it to be of use outside the university, reaching the majority of surgical trainees, who never learned Latin. When one considers the relative rarity of M.D.s in rural areas, where the majority of Europe’s population lived, the importance of such translations to surgeons and other healers who relied on vernacular treatises for instruction becomes evident.

Sources

Ira M. Rutkow, Surgery: An Illustrated History (St. Louis: Mosby-Year Book, 1993).

Nancy Siraisi, Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago: University of Chicago Press, 1990).

Guy de Chauliac

1300-1368

French Physician and Surgeon

Guy de Chauliac has been called "the most eminent surgeon of the European Middle Ages." Other sources view him in the historical shadow of his French predecessor, Henri de Mondeville (1260-1320), who lived a half century earlier. In large part, Guy's fame is based on his publication of Chirurgica magna, a text on surgery that was in standard use until the seventeenth century. But he is also remembered because he was so successful in his practice of medicine and surgery, serving kings and popes in his long career. His fame as a practitioner, gained by his treatment of wounds, cataracts, ulcers, and fractures, was only surpassed by the enduring popularity of his publications on anatomy and surgery. He is also well-remembered for his willingness to remain in Avignon to treat patients during the Black Death rather than flee to the safety of the countryside.

Born in the French village of Chauliac, Guy initially trained as a cleric but received his medical education and surgical training in Toulouse, Montpellier, and Paris. He also studied anatomy at Bologna. He practiced surgery in Avignon, France, when that city was the residency of the papacy, serving popes Clement VI, Innocent VI, and Urban V.

By practicing in Avignon, then one of the intellectual and scholarship cross-roads of Europe, Guy was fortunate in that he had access to translations of Greek and Arabic texts on surgery and medicine.

Guy de Chauliac was a controversial figure in his day because of his opinions about how wounds should be treated. His methods were considered "meddlesome" by his contemporaries. Guy, who shocked the medical world by stating that nature alone was not sufficient for wound healing, advocated widening, cleaning, and draining wounds rather than letting nature take its course, as was conventional wisdom at the time. He not only removed foreign objects from wounds, but also used purifying agents such as wine, turpentine, and brandy. Guy also advocated binding wounds closed with adhesive tape, sutures, or by cautery. He discussed wounds of different classes, such as "hollow" wounds, contused wounds, ulcerated wounds, and even bites.

During his lifetime two epidemics of bubonic plague, or Black Death, struck in Avignon, first in 1348 and then in 1360. The plague had decimated European cities and Avignon was not to be spared. Unlike many physicians who fled the cities, Guy remained in Avignon and treated patients. Although he contracted bubonic plague and nearly died, his written account of the Black Death, observed in scientific objectivity, gives historians one of the few firsthand, non-mythological accounts of its ravages and estimates of mortality.

Guy noted that the plague came in two types, each with slightly different symptoms. Some struck with the disease died in three days from one type and in five days from the second. By his direction, Pope Clement VI went into seclusion and escaped infection.

In 1363, toward the end of his career, Guy published Chirurgica magna, or "Grand Surgery," a collection of eight books. In them he reviewed the history of surgery and discussed surgery as a science and a part of medical practice, rather than just the tool of barbers and butchers, as was surgery's early status. He also published a chapter on anatomy and stressed that it should be learned and taught through hands-on dissection of the "recently dead" rather than taught through drawings, as was the practice for Henri de Mondeville.

Guy de Chauliac's "Grand Surgery" was not to be replaced until the writing of French surgeon Ambroise Paré (1510-1590) in the mid-1500s.

RANDOLPH FILLMORE

Guy de Chauliac

The French surgeon Guy de Chauliac (ca. 1295-1368), also known as Guido de Cauliaco, was the most famous surgical writer of the Middle Ages. His major work remained the principal didactic text on surgery until the 18th century.

Guy de Chauliac was born, very likely, at Chauliac, a village near the southern border of Auvergne. He was probably of peasant stock. The little that is known of his childhood and early training stems from brief, but frequent, autobiographical comments in his writings.

Because Guy cited the views of one of his Toulousian teachers, he is believed to have begun his medical and surgical studies in that city. At the University of Montpellier, whose medical faculty was renowned throughout the medieval world, he fulfilled the requirements for the degree of master of medicine. Subsequently, that title accompanied his name in most official documents, even though he had previously taken holy orders.

Sometime after 1326 Chauliac attended the anatomical lectures of Nicolò Bertuccio, the student of and successor to the important medieval anatomist Mondino da Luzzi at the University of Bologna. The next trace of Chauliac is in Paris, where during the late 13th century great surgeons such as Lanfranc and Henri de Mondeville had taught and practiced. The courses that their followers offered may have piqued but did not hold Chauliac's interest, for unlike many students, he did not linger in Paris but seems to have drifted slowly southward, perhaps performing surgical procedures to earn his way.

After having practiced surgery in or near Lyons for a decade or more, Chauliac moved to Avignon, where he accepted the post of private physician to Pope Clement VI. The date of his appointment to his office can be fixed between the Pope's election in 1342 and the onset of the bubonic plague epidemic at Avignon in 1348, which Chauliac described as a resident physician in that city. He also served Clement's successors at Avignon, Innocent VI and Urban V. In 1363 Chauliac, who had become papal first physician, composed his most important work, The Inventory of Medicine, or as it is known in Latin, Chirurgia magna.

This book, though not the earliest medieval surgical text, is remarkable in several respects. It begins with a historical account of the development of medicine and incorporates Chauliac's evaluation of the medical sources available in the mid-14th century. He reveals that he prized the Galenic texts recently rendered from Greek to Latin but scorned John of Gaddesden's medical encyclopedia, Rosa Anglica.

Of more interest today, however, are the personal experiences that Chauliac sprinkled throughout his text. These findings, together with his efforts to reconcile them with authoritative statements, contributed to the enormous success of his book; the Chirurgia magna was translated into many languages and passed through innumerable editions and abridgments. Five years after completing it, probably during the month of July, in 1368, Chauliac died.

Further Reading

There is a chapter on Chauliac in Leo M. Zimmerman and Ilza Veith, Great Ideas in the History of Surgery (1961). See also Fielding H. Garrison, An Introduction to the History of Medicine (1913; 4th ed. 1929); Arturo Castiglioni, A History of Medicine (1927; 2d ed. 1947); and W. J. Bishop, The Early History of Surgery (1960). □