The Black Death and Men of Learning

Lessons from Epidemics, Pandemics, and Surgery

“…3 Impact on surgery At the time, there were 3 classes of medical practitioners in Europe: physicians, surgeons, and barber surgeons. 4 Physicians were commonly well respected and universityeducated scholars who subscribed to the ancient Greek humoral theory of illness. 4 They sought to balance humorsdphlegm, black bile, yellow bile, and blooddand used medicines such as laxatives and enemas.…”

“…4 Physicians were commonly well respected and universityeducated scholars who subscribed to the ancient Greek humoral theory of illness. 4 They sought to balance humorsdphlegm, black bile, yellow bile, and blooddand used medicines such as laxatives and enemas. 5 In comparison, surgeons lacked the prestige of physicians; their techniques of bloodletting and boil-lancing were deemed crude and unnecessary.…”

“…5 During this time, physicians sought to solidify their prestige and codify the existing schism between physicians and surgeons by caring for desperate patients. 4 However, humorism was unsuccessful treatment against plague and led to public dissatisfaction and distrust of the medical establishment. 5 The combined failings of existing medical technology and void left by physicians fleeing to the countryside created an opportunity for surgical societies to coalesce and develop into trusted healthcare entities.…”

“…5 Surgical training was legitimized as emphasis was placed on didactics, and surgical students were required to learn Latin. 4 During this time period, surgical manuals became increasingly common. In contrast to work written by physicians during the same time period, surgical manuals tended to describe practical treatments rather than theories of humors.…”

“…5 Two surgical manuals published during the this time periodeGuy de Chauliac's Cyrurgie and John Arderne's Practicaewere translated to vernacular language to be accessible to the public. 4 The manuals incorporated personal anecdotes and observations to provide novel insight into how experienced surgeons practiced techniques such as lancing. 4 Additionally, cadaveric dissection taught by surgeons was increasingly used in an effort to understand human anatomy across European medical schools, reducing stigma historically associated with surgery.…”