Guy de Chauliac (1300–1368)
The most influential surgeon of the 14th and 15th centuries and a writer who demonstrated rare learning and a fine historical sense, Guy de Chauliac exerted an influence so great that he became physician to three popes at Avignon (Clement VI, Innocent VI, and Urban V) and a leading surgeon at the school of Montpellier. His work was copied and translated well into the 17th century and was considered to be the principal didactic surgical text (Collectorium cyrurgie, AD 1363) of this period (Fig. 15).[21,22] Guy posited four conditions that must be satisfied for a practitioner to be a good surgeon: 1) the surgeon should be learned; 2) he should be expert; 3) he must be ingenious; and 4) he should be able to adapt himself (from the introduction of Ars Chirurgica). Guy advocated repair by primary suture and claimed good results. He used egg albumin to stop bleeding and provide adequate hemostasis, which always posed a difficult problem for surgeons. A major error on his part was to reintroduce the concept of laudable pus to the healing of wounds, which set back surgery approximately 600 years, until the time of Lord Lister in the latter half of the 19th century.
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The urgency of operating during the "primary period" (the first 24 hours) was thought urgent in order to avoid the "irritative period" when infection showed itself. Believing the formation of "laudable pus" a sign of healing, surgeons were relieved by this "positive turn". The surgeon seldom had to wait more than three or four days for "laudable pus" to appear. This was believed to be the lining of the wound being expelled, thus clean tissue could replace it and the wound would heal. In fact, it was a sign that Staphylococcus aureus had invaded the wound, and was actively destroying tissue and over time would usually kill the soldier. In the rare cases when no pus appeared, medical practitioners described, "healing by first intention", and admitted that they knew not why.
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Came across 'laudable pus' when reading Ash by Mary Gentle. It's mentioned that hundreds of thousands of soldiers in Christian Europe died due to infection because physicians misunderstood what Galen meant.
So what if the idea of 'laudable pus' wasn't re-introduced to Western Medicine? Hundreds of thousands of soldiers wouldn't die is the first answer but this would have butterflies. Some famous people who would have died from this kind of infection would live as well.
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