nticipated nearly everything of importance
that has come to be insisted on even in our own time in the handling of
these difficult cases. It is not unlikely, therefore, that they had also
arrived at the recognition by observations on many patients that the
satisfactory after-course of these cases which were operated on by the
surgeon after due regard to such meticulous cleanliness as is suggested
in the paragraph I have quoted, made it very clear that these aseptic
precautions, as we would call them, were extremely important for the
outcome of the case and, therefore, were well worth the surgeon's
attention, though they must have required very careful precautions and
considerable self-denial. Indeed this whole subject, the virtual
anticipation of our nineteenth-century principles of aseptic surgery in
the thirteenth century, is not a dream nor a far-fetched explanation
when one knows enough about the directions that were laid down in the
surgical text-books of that time.

THE NORTH ITALIAN SURGEONS

After Roger and Rolando and the Four Masters, who owe the inspiration
for their work to Salerno and the south of Italy, comes a group of north
Italian surgeons: Bruno da Longoburgo, usually called simply Bruno;
Theodoric and his father, Hugo of Lucca, and William of Salicet.
Immediately following them come two names that belong, one almost feels,
to a more modern period: Mondino, the author of the first text-book on
dissection, and Lanfranc (the disciple of William of Salicet), who
taught at Paris and "gave that primacy to French surgery which it
maintained all the centuries down to the nineteenth" (Pagel). It might
very well be thought that this group of Italian surgeons had very little
in their writings that would be of any more than antiquarian interest
for the modern time. It needs but a little knowledge of their writings
as they have come down to us to show how utterly false any such opinion
is. To Hugo da Lucca and his son Theodoric we owe the introduction and
the gradual bringing into practical use of various methods of
anaesthesia. They used opium and mandragora for this purpose and later
employed an inhalant mixture, the composition of which is not absolutely
known. They seem, however, to have been very successful in producing
insensibility to pain for even rather serious and complicated and
somewhat lengthy operations. Indeed it is to this that must be
attributed most of their surprising success as surgeons at t