Arderne, John of (English, 1307–1392)

Illustrations and frontispiece from De Arte Phisicali et de Chirurgia (The Art of Medicine and Surgery)

Reference Type:
after 1412
John of Arderne (1307-1380), has been called the Father of English surgery. Born in Newark, England, he gained experience as a military surgeon in France, where gunpowder was used for the first time in battle. Around 1370 he moved to London, joined the Guild of Military Surgeons, and began to write about his career. Unlike most surgeons, who were less trained barbers capable only of simple procedures, Arderne was respected by his physician colleagues and proudly described himself as “a surgeon among physicians.” Arderne’s best-known work was the Practica (De Arte Philiscali et de Cirurgia), which was used to teach surgery in medieval medical schools throughout Europe. The cadaver here, which is split in two from the hips up, reflects fifteenth-century surgeons’ lack of anatomical knowledge. The hand above the cadaver holding the string refers to one of the procedures he describes—treatment for anal fistulae, which prior to this time had no effective remedy. After tying the string to a probe, he passed it from the opening in the skin through the tract to the rectum. He then cut open the entire tract, allowing it to heal from the inside out. He designed new tools for the process, and treated the wound with ointments and oils rather than with the usual more corrosive materials. Arderne claimed that his technique, which shared basic principles with today’s treatments, had a survival rate of 50%—extremely high for that time. His book had other interesting features as well. Arderne was a well-educated man, able to write in Latin, but never attended university. Nonetheless, on the frontispiece he is represented wearing the long robes of a university-trained physician (surgeons and barber-surgeons most commonly wore robes above the knee). Although it is a book that describes surgeries, most of his fellow surgeons would have required translation, unlike his physician colleagues. Also, he filled the text with comments that aligned him with physicians, thus raising the status of both himself and his profession. He also warned his readers that they should not share his anal fistula technique with barbers, or they would put patients in danger with their attempts to perform it. In addition, Arderne included opinions on how surgeons should behave with patients: for example, they should dress “like a clerk and not like a minstrel;” that when speaking “be the words short, and, as much as he may, fair and reasonable and without swearing;” and that they should be ready to calm patients with comforting and moral stories if they are in pain or become upset. ( Notes by Mariann Smith
History of Medicine
The Royal Library, Stockholm