Medical Compendium In Seven Books
Marthe Bernskoetter
The seven books of Paulus Aegineta / translated from the Greek, with a commentary embracing a complete view of the knowledge possessed by the Greeks, Romans, and Arabians on all subjects connected with medicine and surgery by Francis Adams. Public Domain Mark. Source: Wellcome Collection.
In the first book you will find every thing that relates to hygiene, and to the preservation from, and correction of, distempers peculiar to the various ages, seasons, temperaments, and so forth; also the powers and uses of the different articles of food, as is set forth in the chapter of contents. In the second is explained the whole doctrine of fevers, an account of certain matters relating to them being premised, such as excrementitious discharges, critical days, and other appearances, and concluding with certain symptoms that are the concomitants of fever. The third book relates to topical affections, beginning from the crown of the head, and descending down to the nails of the feet. The fourth book treats of those complaints that are external and exposed to view, and are not limited to one part of the body, but affect various parts. Also, of intestinal worms and dracunculi. The fifth treats of the wounds and bites of venomous animals; also of the distemper called hydrophobia, and of persons bitten by dogs that are mad, and by those that are not mad; and also of persons bitten by men. Afterwards it treats of deleterious substances, and of the preservatives from them. In the sixth book is contained every thing relating to surgery, both what relates to the fleshy parts, such as the extraction of weapons, and to the bones, which comprehends fractures and dislocations. In the seventh is contained an account of the properties of all medicines, first of the simple, then of the compound, particularly of those I had mentioned in the preceding six books, and more especially the greater, and, as it were, celebrated preparations; for I did not think it proper to treat of all these articles promiscuously, lest it should occasion confusion, but so that any person looking for one or more of the distinguished preparations might easily find it. Towards the end are certain things connected with the composition of medicines, and of those articles that may be substituted for one another, the whole concluding with an account of weights and measures.[1]
Although Byzantine medicine drew largely on ancient Greek and Roman knowledge, however, his works also contained many new ideas as he was a teacher from Alexandria. For example, in several volumes Paul of Aegina talks about bone structure and fractures, as shown below:
The case of a broken thigh is analogous to that of the arm, but in particular, a fractured thigh is mostly deranged forwards and outwards, for the bone is naturally flattened on those sides. It is to be set by the hands, with ligatures, and even cords applied, the one above and the other below the fracture. When the fracture takes place at one end, if' at the head of the thigh, the middle part of a thong wrapped round with wool, so that it may not cut the parts there, is to be applied to the perinaeum, and the ends of it brought up to the head and given to an assistant to hold, and applying a ligature below the fracture, we give the ends of it to another assistant to make extension. If it is fractured near the knee, we apply the ligature immediately above the fracture, and give the ends to an assistant, with which to make extension upwards; and while we put a ligature round the knee to secure it, and while the patient lies thus, with his leg extended, we arrange the fracture. Pieces of bone that irritate the parts, as has been often said, are to be taken out from above; and the rest of' the treatment we have already described in the section on the arm. The thigh gets consolidated within fifty days. The manner of arranging it afterwards will be described after delivering the treatment of the whole leg.
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Paul of Aegina (625-690 AD) was born on the island of Aegina and was one of the most prominent physician-writers of the Byzantine Empire. His work Epitome of Medicine, comprised of 7 books, was a comprehensive compendium of the medical and surgical knowledge of his time and was subsequently translated into multiple languages. Paul of Aegina made valuable contributions to neurosurgical subjects and described procedures for the treatment of nerve injuries, hydrocephalus, and fractures of the skull and spine. His work combined the ancient knowledge of Hippocrates and Galen with contemporary medical observations and served as a bridge between Byzantine and Arabic medicine. He is considered to be one of the great ancient Greek medical writers and his work has influenced the subsequent evolution of Western European and Arab medicine. This paper provides an account of his contribution to the management of neurosurgical pathologies during the Byzantine era, as described in his medical compendium, Epitome of Medicine.
First Latin edition of the first two books, namely the medical and therapeutic section, of "al-Tasrif", a 30-volume Arabic encyclopaedia on medicine and surgery written ca. 1000 CE by the Arab physician Abulcasis, edited by the physician Paul Ricius, and containing "what is probably the earliest description of haemophilia" (Garrison/M.). Abu al-Qasim, hailed as the "father of modern surgery", specialized in curing diseases by cauterization. He designed several devices used during surgery for purposes such as inspection of the interior of the urethra, applying and removing foreign bodies from the throat, inspection of the ear, etc. In his "Tasrif" he described how to ligature blood vessels almost 600 years before Ambroise Par. Al-Qasim was also the first to describe a surgical procedure for ligating the temporal artery for migraine. His use of catgut for internal stitching is still practised in modern surgery.
II: Second Latin edition of the "Medical Compendium" by the 7th century Byzantine physician Paul of Aegina, translated by the humanist and physician Johann Winter from Andernach, first published in Paris in 1532. The "Medical Compendium" in seven books remained a standard text throughout the Arabic world for more than eight centuries. The most complete encyclopedia of medical knowledge of its time, it covers 1) hygiene and dietetics; 2) fevers; 3) topical illnesses from head to toe; 4) skin diseases and ailments of the intestines; 5) toxicology; 6) surgery; 7) the composition of medicines. The sixth book on surgery in particular was referenced in Europe and the Arab world throughout the Middle Ages, and is of special interest for surgical history. Indeed, Paul's reputation was particularly great in the Islamic world: the Arabic translation of his works by Hunayn ibn Ishaq was widely received, and it is said that he was especially consulted by midwives, whence he received the name of "al-Qawabeli", or "the Accoucheur". "Paulus Aegineta was the most important physician of his day and a skilful surgeon. He gave original descriptions of lithotomy, trephining, tonsillectomy, paracentesis and amputation of the breast; the first clear description of the effects of lead poisoning also comes from him" (Garrison/M., p. 7).
Some near-contemporary handwritten marginalia in red and black ink. Bookplate of the French neurologist Maurice Villarett (1877-1946), remembered for his studies and experiments involving precision localization of vascular lesions of the brain, to front pastedown. Binding bears blindstamped initials "BF"; the ornaments include floral and tendril motifs as well as heads and vases. Covers somewhat wormed, slightly rubbed. Interior somewhat wormed throughout, wormholes in the first 21 ff. repaired with Japanese paper. Occasionally brownstained; paper slightly wavy. A good copy of two groundbreaking works in the history of medicine.
Paul was a physician and medical scholar. He was born on the island of Aegina and educated in Alexandria, Egypt. His major work was Medical compendium in seven books, written in the late seventh century. The book remained in use as a standard textbook for the next 800 years. The whole work in the original Greek was published in Venice in 1528, and another edition appeared in Basel in 1538. Several Latin translations have been published. The book was first translated into English with commentary by physician Francis Adams sometime between 1844 and 1848. Rhazes drew extensively from this encyplopedic work.
Paul is best known today for his contributions to surgical practices in medieval times. He was the first physician to put forward the idea of stitching together damaged nerves. He also provided detailed advice for different kinds of surgeries, including a tracheotomy:
The surgeon will know that he has opened the trachea when the air streams out of the wound with some force, and the voice is lost. As soon as the danger of suffocation is over, the edges of the wound should be freshened and the skin surfaces brought together with sutures. Only the skin without the cartilage should be sutured, and general treatment for encouraging union should be employed. If the wound fails to heal immediately, a treatment calculated to encourage granulations should be undertaken. This same method of treatment will be of service whenever we happen to have a patient who, in order to commit suicide, has slashed his larynx (Paul of Aegina, 2010).
Paul practiced medicine in both Alexandria and Rome. Among his patients were those who had speech problems. Some of his observations were suspect, however. For example he wrote that young deaf boys had a swelling below the tongue.
"The bellows are burned, the lead is consumed of the fire; the founder melteth in vain: for the wicked are not plucked away. Reprobate silver shall men call them, because the Lord hath rejected them."
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