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Hugh of Lucca or Hugh Borgognoni (also ''Ugo'') (1160–c.1259) was a medieval surgeon. He and
Theodoric of Lucca ] Theodoric Borgognoni (1205 – 1296/8), also known as Teodorico de' Borgognoni, and Theodoric of Lucca, was an Italian who became one of the most significant surgeons of the medieval period. A Dominican Order, Dominican friar and Bishop of Cervi ...
, his son or student, are noted for their use of
wine Wine is an alcoholic drink made from Fermentation in winemaking, fermented fruit. Yeast in winemaking, Yeast consumes the sugar in the fruit and converts it to ethanol and carbon dioxide, releasing heat in the process. Wine is most often made f ...
as an
antiseptic An antiseptic ( and ) is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection, or putrefaction. Antiseptics are generally distinguished from ''antibiotics'' by the latter's abil ...
in the early 13th century.


Hugh of Lucca

Hugh of Lucca, also known Ugo de Borgognoni, was born in 1160, around the time the teaching of ''
corpus juris The legal term ''Corpus Juris'' means "body of law". It was originally used by the Ancient Rome, Romans for several of their collections of all the laws in a certain field—see ''Corpus Juris Civilis''—and was later adopted by medieval jurists ...
'' was said to be common where the
University of Bologna The University of Bologna (, abbreviated Unibo) is a Public university, public research university in Bologna, Italy. Teaching began around 1088, with the university becoming organised as guilds of students () by the late 12th century. It is the ...
had included the "healing art" of medicine into its subjects of grammar, dialectic, rhetoric, and the free subjects of music and astronomy. He was a physician at the end of the period where medicine was a profession transmitted from father to son via observations. It is assumed that he arrived in
Bologna Bologna ( , , ; ; ) is the capital and largest city of the Emilia-Romagna region in northern Italy. It is the List of cities in Italy, seventh most populous city in Italy, with about 400,000 inhabitants and 150 different nationalities. Its M ...
and continued his profession as a surgeon until his death there. Some regard him as the founder of the surgical school of Bologna as he was the pioneer of a new wound treatment and the starter of a new era. Although it is also declared in some sources that in the early 13th century the Salernitan surgical traditions of the Medical School of Salerno had been brought to Bologna by
Roland of Parma Roland of Parma, also called Rolando Capelluti, was an early 13th-century surgeon. He studied under Roger Frugardi in Parma and wrote a commentary on his teacher's ''Practica chirurgiae'' (Practice of Surgery) around 1230. His commentary, known a ...
, at the time Hugh of Lucca was employed by the city as military surgeon. He is also said to have been a man of action, since he accompanied the Bolognese army on the
Fifth Crusade The Fifth Crusade (September 1217 - August 29, 1221) was a campaign in a series of Crusades by Western Europeans to reacquire Jerusalem and the rest of the Holy Land by first conquering Egypt, ruled by the powerful Ayyubid sultanate, led by al- ...
, visiting both
Syria Syria, officially the Syrian Arab Republic, is a country in West Asia located in the Eastern Mediterranean and the Levant. It borders the Mediterranean Sea to the west, Turkey to Syria–Turkey border, the north, Iraq to Iraq–Syria border, t ...
and
Egypt Egypt ( , ), officially the Arab Republic of Egypt, is a country spanning the Northeast Africa, northeast corner of Africa and Western Asia, southwest corner of Asia via the Sinai Peninsula. It is bordered by the Mediterranean Sea to northe ...
, and being present at the Siege of Dammietta in 1219. He is thought to have gained rich experience with not only the wounds of the soldiers but also with the
Black Death The Black Death was a bubonic plague pandemic that occurred in Europe from 1346 to 1353. It was one of the list of epidemics, most fatal pandemics in human history; as many as people perished, perhaps 50% of Europe's 14th century population. ...
, which was ravaging the opposing armies during the lengthy conflict he witnessed.


Acts in the Crusades

Hugh of Lucca was initially an
empiricist In philosophy, empiricism is an epistemological view which holds that true knowledge or justification comes only or primarily from sensory experience and empirical evidence. It is one of several competing views within epistemology, along ...
, challenging the doctrine of
Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...
by methods rooted in experiments and experiences. He advocated for aseptic theory as opposed to conventional treatments, where suppuration –
pus Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during infections, regardless of cause. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collect ...
formation – was thought necessary for
healing With physical trauma or disease suffered by an organism, healing involves the repairing of damaged tissue(s), organs and the biological system as a whole and resumption of (normal) functioning. Medicine includes the process by which the cells ...
. He condemned the laudable pus theory, which he regarded as "hindering the nature and prolonging the healing". An October 1214 contract with the city of
Bologna Bologna ( , , ; ; ) is the capital and largest city of the Emilia-Romagna region in northern Italy. It is the List of cities in Italy, seventh most populous city in Italy, with about 400,000 inhabitants and 150 different nationalities. Its M ...
as a municipal surgeon stipulated that he would reside in that city for six months of the year and during periods of civil war. Residents, including inhabitants of the nearby countryside, would be treated free of charge. The contract also required that Hugh provide medical services to the army in the field. In return, he was paid 600 Bolognese lire per year and received some property. This has been called "the earliest undisputed example in medieval Italy where a doctor was hired long term by a city to treat its population". Although he was over sixty, Hugh accompanied Bolognese soldiers on the
Fifth Crusade The Fifth Crusade (September 1217 - August 29, 1221) was a campaign in a series of Crusades by Western Europeans to reacquire Jerusalem and the rest of the Holy Land by first conquering Egypt, ruled by the powerful Ayyubid sultanate, led by al- ...
to
Egypt Egypt ( , ), officially the Arab Republic of Egypt, is a country spanning the Northeast Africa, northeast corner of Africa and Western Asia, southwest corner of Asia via the Sinai Peninsula. It is bordered by the Mediterranean Sea to northe ...
between 1218 and 1221. Hugh's wartime experience of treating injured Bolognese soldiers in the field convinced him that the most effective method of healing wounds of the skull was without the encouragement of suppuration. He recommended removing foreign objects from flesh wounds and cleansing the wound with wine-soaked cushions, then drying the wound immediately. Theodoric, who recorded his father and master's techniques, described the procedure of treating wounds as "not only desirable but attainable", and offered an explanation of the process: "Therefore in the case of a simple skin wound, if the lesion should not entail loss of tissue, or should be a lesion of the skull, you will treat it thus: in the first place, the lips of the wound, and all about the wound should be debrided; and then the wound should be completely cleansed of fuzz, hair, and anything else, and let the wound be wiped quite dry with fine lint soaked in warm wine and wrung out. Thus, the lips of the wound may be reunited as well as possible in accordance with their original healthy state and having made compresses from fine clean lint soaked in warm wine and placed upon the wound so as to fit, it be bound up with a light bandage in such a way that the reapproximation of the wound edges cannot be disturbed at all." In 1221, after his return to
Bologna Bologna ( , , ; ; ) is the capital and largest city of the Emilia-Romagna region in northern Italy. It is the List of cities in Italy, seventh most populous city in Italy, with about 400,000 inhabitants and 150 different nationalities. Its M ...
, he was appointed as a legal physician in the city, a position recorded for the first time and concerned with
medical jurisprudence Medical jurisprudence or legal medicine is the branch of science and medicine involving the study and application of scientific and medical knowledge to legal problems, such as inquests, and in the field of law. As modern medicine is a legal ...
. Although he lived into his 90s, and assumedly passed away in 1259, it is continuously stated in sources that he left no written record, and all his achievements were noted down by
Theodoric Theodoric is a Germanic given name. First attested as a Gothic name in the 5th century, it became widespread in the Germanic-speaking world, not least due to its most famous bearer, Theodoric the Great, king of the Ostrogoths. Overview The name w ...
.


Innovations in wound treatment

For those wounded on the medieval battlefield, the odds of survival were not high. Despite being treated, many would die shortly afterwards from infections. In the 13th and 14th centuries, a small group of surgeons believed they had a better way of treating these injuries. But they would have to challenge hundreds of years of medical knowledge. Hugh of Lucca, his pupil and son
Theodoric Theodoric is a Germanic given name. First attested as a Gothic name in the 5th century, it became widespread in the Germanic-speaking world, not least due to its most famous bearer, Theodoric the Great, king of the Ostrogoths. Overview The name w ...
, Bishop of Cervia (1205–96), and French anatomist and surgeon Henri of Mondeville (1260–1320), who learned this method from studying Theodoric's Surgery in medical courses taught by
Jean Pitard Jean Pitard (born ~1228 near Bayeux, France, died in Paris at age 87, in ~1315) was the royal surgeon to Louis IX, Philip the Bold and Philip the Fair Philip IV (April–June 1268 – 29 November 1314), called Philip the Fair (), was King ...
(1235–1330) and
Lanfranc of Milan Lanfranc of Milan (–1315), variously called , or , was an Italian cleric, surgeon who set up practice in France. Lanfranc was appointed personal physician to Philip IV of France and in 1296 published a thesis on surgery under the title Chirur ...
(1250–1306) challenged the conventional treatment of wounds sustained in battle, which involved suppuration, or the encouragement of pus formation, held to be necessary in the healing process. They advocated and practiced a treatment known as the aseptic theory or dry method of wound treatment in which foreign objects were removed,
haemorrhaging Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, va ...
was stopped, and wounds were closed immediately. Upon closure, wounds were dressed in a dry cloth without encouraging pus formation or suppuration. The dry method of healing was controversial for two reasons. Firstly, it rejected conventional medical wisdom based on Galen and other ancient writers who believed that the healing was not possible without the removal of " bad humours". Several experts have argued that the doctrine of the humours was so entrenched in the medieval medical community that to challenge it was an act of heresy. Any medic who opposed the thousand-year method of healing was maligned. Secondly, the dry method of healing repudiated a religious belief system that taught that the evacuation of bad humours was a cleansing of evil from the body. Suppuration was a form of
exorcism Exorcism () is the religious or spiritual practice of evicting demons, jinns, or other malevolent spiritual entities from a person, or an area, that is believed to be possessed. Depending on the spiritual beliefs of the exorcist, this may be do ...
. Medieval people often viewed disease and infection as punishment for bad behaviour. The individual needed to be cleansed both physically and spiritually.


Usage of wine

Wine, throughout the history of medicine, was a commonly used ingredient. It was mainly used as an
anaesthetic An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into t ...
or as an agent to ease and diminish the pain of injured patients. Wine was initially given orally during surgical procedures to induce forgetfulness and be less likely to be traumatized by the procedure. The vast usage of wine by others during operations through history of medicine suggests it was used mostly mixed together with various herbs or numerous oils. Hugh of Lucca used wine, directly on wounds, primarily for its antiseptic properties. There is no record stating the exact date he discovered his technique. His method of treating fresh wounds, followed by soaking lint in boiled wine, was used to clean the wound of any foreign materials as well as to disinfect the area. After this operation was successfully accomplished, he would cover the cleaned wound with a compress that had also been soaked in boiled wine. He tried to prevent the wine from potentially being contaminated through air. Hugh of Lucca relied mostly on practical knowledge by trial and error, as the philosophy he followed, empiricism, regarded experience as the sole source of knowledge. He found oils to be too slippery and hard to use during clinical operations to bond the two edges of the wound in surgeries. He preferred using wine instead, as it vaporized after a period of time, unlike oils in general, and dried along with the wound while disinfecting it.


See also

*
History of wound care The history of wound care spans from prehistory to modern medicine. Wounds naturally heal by themselves, but hunter-gatherers would have noticed several factors and certain herbal remedies would speed up or assist the process, especially if it w ...
*
Cauterisation Cauterization (or cauterisation, or cautery) is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or ...
**
Ambroise Paré Ambroise Paré (; – 20 December 1590) was a French barber surgeon who served in that role for kings Henry II, Francis II, Charles IX and Henry III. He is considered one of the fathers of surgery and modern forensic pathology and a pione ...
** John of Arderne *
Infection An infection is the invasion of tissue (biology), tissues by pathogens, their multiplication, and the reaction of host (biology), host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmis ...
**
Lady Mary Wortley Montagu Lady Mary Wortley Montagu (née Pierrepont; 15 May 168921 August 1762) was an English aristocrat, medical pioneer, writer, and poet. Born in 1689, Lady Mary spent her early life in England. In 1712, Lady Mary married Edward Wortley Montagu, ...
**
Edward Jenner Edward Jenner (17 May 1749 – 26 January 1823) was an English physician and scientist who pioneered the concept of vaccines and created the smallpox vaccine, the world's first vaccine. The terms ''vaccine'' and ''vaccination'' are derived f ...
**
Louis Pasteur Louis Pasteur (, ; 27 December 1822 – 28 September 1895) was a French chemist, pharmacist, and microbiologist renowned for his discoveries of the principles of vaccination, Fermentation, microbial fermentation, and pasteurization, the la ...
**
Robert Koch Heinrich Hermann Robert Koch ( ; ; 11 December 1843 – 27 May 1910) was a German physician and microbiologist. As the discoverer of the specific causative agents of deadly infectious diseases including tuberculosis, cholera and anthrax, he i ...


References


Notes

{{DEFAULTSORT:Lucca, Hugh Of Medieval surgeons