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He is much richer in pathology than most of the older writers, at least of the Christian era; for instance, Gurlt says that he treats this feature of the subject much more extensively even than Paulus Æginetus, but most of his work is devoted to therapeutics.
He quotes altogether more than a score of writers on surgery who had preceded him and evidently was thoroughly familiar with general surgical literature. There is scarcely an important surgical topic on which Gurlt does not find some interesting and personal remarks made by Lanfranc. All that we can do here is refer those who are interested in Lanfranc to his own works or Gurlt.
Perhaps the most striking expression, the word infect being italicized by Gurlt, is: "In elevating the cranium be solicitous lest you should infect or injure the dura mater." For wounds of the scalp sutures of silk are recommended because this resists putrefaction and holds the wound edges together. Interrupted sutures about a finger-breadth apart are recommended.
The external auditory meatus was obliterated. Gurlt speaks of a woman, seven months pregnant, who fell from the top of a ladder, subsequently losing some blood and water from the vagina. She had also persistent pains in the belly, but there was no deterioration of general health.
Gurlt, in his "History of Surgery," has some quotations from Serapion the elder, who is often quoted by Rhazes. In the treatment of hemorrhoids Serapion advises ligature and insists that they must be tied with a silk thread or with some other strong thread, and then relief will come. He prefers the ligature, however.
Gurlt tells us that Bruno owed much of what he wrote to his own experience and observation. He begins his work by a definition of surgery, chirurgia, tracing it to the Greek and emphasizing that it means handwork. He then declares that it is the last instrument of medicine to be used only when the other two instruments, diet and potions, have failed.
It was here that the first Arab physicians were trained, and here that the Christian physicians who practised medicine among the Arabs were educated. Among the Arabs themselves, before the time of Mohammed, there had been very little interest in medicine. Gurlt notes that even the physician of the Prophet himself was, according to tradition, a Christian.
Gurlt also calls attention to Alexander's careful differentiation of certain very dangerous forms of inflammation of the throat from others which are rather readily treated. He says, "Inflammation of the throat may, under certain circumstances, belong to the severest diseases. The patients succumb to it as a consequence of suffocation, just as if they were choked or hanged.
Gurlt, in his "History of Surgery," has abstracted from Alexander particularly certain phases of what the Germans call external pathology and therapeutics. For instance, Alexander's treatment of troubles connected with the ear is very interesting.
In a word, we have a picture of the skilled surgeon of the modern time in this treatise of a fourteenth-century teacher of surgery. Chauliac discusses six different operations for the radical cure of hernia. As Gurlt points out, he criticises them from the same standpoint as that of recent surgeons.
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