out, he criticises them from the same standpoint
as that of recent surgeons. The object of radical operations for hernia
is to produce a strong, firm tissue support over the ring through which
the cord passes, so that the intestines cannot descend through it. It is
rather interesting to find that the surgeons of this time tried to
obliterate the canal by means of the cautery, or inflammation producing
agents, arsenic and the like, a practice that recalls some methods still
used more or less irregularly. They also used gold wire, which was to be
left in the tissues and is supposed to protect and strengthen the
closure of the ring. At this time all these operations for the radical
cure of hernia involved the sacrifice of the testicle because the old
surgeons wanted to obliterate the ring completely, and thought this the
easiest way. Chauliac discusses the operation in this respect and says
that he has seen many cases in which men possessed of but one testicle
have procreated, and this is a case where the lesser of two evils is to
be chosen.

Of course Guy de Chauliac would not have been able to operate so freely
on hernia and suggest, following his own experience, methods of
treatment of penetrating wounds of the abdomen only that he had learned
the lessons of antiseptic surgery which had been gradually developed
among the great surgeons of Italy during the preceding century. The use
of the stronger wines as a dressing together with insistence on the most
absolute cleanliness of the surgeon before the operation, and careful
details of cleanliness during the operation, made possible the
performance of many methods of surgical intervention that would
otherwise surely have been fatal. Probably nothing is harder to
understand than that after these practical discoveries men should have
lost sight of their significance, and after having carefully studied the
viscous exudation which produces healthy natural union, should have come
to the thought of the necessity for the formation of laudable pus before
union might be expected. The mystery is really no greater than that of
many another similar incident in human history, but it strikes us more
forcibly because the discovery and gradual development of antiseptic
surgery in our own time has meant so much for us. Already even in
Chauliac's practice, however, some of the finer elements of the
technique that made surgery antiseptic to a marked degree, if not
positively aseptic in many