Henri de Mondeville

1260-1320

French Surgeon, Teacher, and Writer

Henri de Mondeville was one of the physicians and surgeons who established a great center for the teaching of medicine, surgery, and anatomy at the medieval university of Montpellier. Very little is known about the early life and education of Henri de Mondeville, who is remembered for his contributions to surgery and medicine. He was born in Mondeville, near Caen, or Emondeville, France about 1260. He died in Paris, about 1320. He is also known as Henry of Mandeville, Henricus de Amondavilla, Armandaville, Hermondavilla, Mondavilla, or Mandeville. According to clues found in his surviving work and contemporary sources, Henri studied medicine and surgery at Montpellier, Paris, and Bologna in Italy. However, it is known that Henri studied theology and philosophy. He was apparently a cleric, and never married, but he never received a salary or grant as a clergyman. Because of his travels and his education, Henri de Mondeville can be considered a link between the Italian and French surgical and anatomical traditions of the thirteenth century.

In 1301, before embarking on his distinguished scholarly career, he served as surgeon to the armies of Philip the Fair. His skill as a surgeon was apparently well recognized and in demand, as demonstrated by the fact that he was in the service of royalty for the rest of his life. His royal patrons included Philip the Fair, Philip's brother Charles of Valois, and Louis X. Although Henri's association with royalty involved travel to various parts of England and France, he often complained that his service on behalf of the king did not provide sufficient financial compensation. By 1303 Henri was also teaching surgery and anatomy at Montpellier. Unfortunately, Henri felt that the demands of his royal patrons and the large numbers of patients and students who sought his attention interfered with the composition of his treatise on surgery.

In 1303 Guy de Chauliac, who is often called the father of French surgery, attended Henri's lectures. According to Guy de Chauliac (1300-1368), Henri had "demonstrated" anatomical matters with 13 anatomical illustrations, or charts of human anatomy. This approach was very innovative at the time and Mondeville is generally considered the first medical teacher to have lectured with the aid of illustrations. Some of the illustrations used in Henri's lectures have survived in the form of miniature copies. As might be expected, although the illustrations show some signs of a novel trend towards naturalization, they were not anatomically accurate.

In 1306, while lecturing in Paris, Henri began composing his Cyrurgia, which was to be a comprehensive textbook on surgery. Originally, Henri expected the Cyrurgia to encompass anatomy, the general treatment of wounds, special surgical pathology, injuries, fractures, poisons, and antidotes. However, his health had deteriorated significantly by about 1316 and he was unable to complete his planned treatise. Modern scholars have found about 20 surviving manuscript copies of Henri's Cyrurgia, or parts of it. Henri's writings and ideas were highly regarded by his contemporaries, but the Latin manuscripts for the Surgery of Henri de Mondeville were not translated and printed until the end of the nineteenth century. A German translation was printed in 1892 under the title Die Chirurgie des Heinrich de Mondeville and a French translation appeared in 1893.

With its clear and concise style, Henri's text reflects a practical, common sense approach to medicine and surgery, as well as considerable familiarity with classical and contemporary medical texts. The surviving manuscript versions of the Cyrurgia contain over 1,300 references to the works of some 60 different authors, including over 400 citations to the works of Galen (c. 130-c. 200). Clearly, Henri respected the work of the ancients, but he was willing to express his own opinions and did not regard even Galen as an infallible or final authority. Like Hugh of Lucca and Theodoric of Lucca, Henri consistently opposed deliberate efforts to make wounds suppurate, i.e. generate pus. An advocate of meticulous cleanliness, Henri urged surgeons to clean wounds without unnecessary probing. To make this approach more practical, he invented an instrument to extract arrows, advised surgeons to remove pieces of iron from the wounds by using a magnet, and developed improved needles and thread holders. His textbook was the first to insist that surgeons adopt two techniques that were essential to the development of modern surgery, that is, cleaning and suturing wounds. The primary goal of wound management, according to Henri, was to allow wounds to close and heal promptly, without infection. Therefore, Henri urged surgeons to keep instruments clean and rejected the use of irritant dressings.

Other intriguing aspects of Henri's work include his interest in the ancient belief in the healing power of light. The use of red light in the treatment of smallpox is primarily associated with the work of John of Gaddesden in 1510, but Henri had already used red light for this purpose. The importance of keeping the patient comfortable, cheerful, and hopeful was another significant aspect of Henri's teachings. Indeed, Henri thought hope was so important to recovery that the surgeon should even consider providing forged letters describing the death of the patient's enemy. The surgeon was urged to see that every aspect of the patient's regimen encouraged joy and happiness, including the use of music and jokes told by cheerful friends and relatives. Even when dealing with leprosy, a disease that Henri considered incurable, he advocated diligent, compassionate, and palliative treatment. No matter what the difficulty, the surgeon must banish anger, hatred, and sadness from the sickroom. Henri de Mondeville is regarded as the founder of the French surgical fraternity of the Collège de St. Côme and a major influence on late medieval medicine and surgery.

LOIS N. MAGNER