Johannes Scultetus

Johannes Scultetus

Johannes Scultetus (1595-1645), a seventeenth-century German surgeon, is perhaps best known for his Armamentarium chirurgicum olim auctum triginta novem tabulis, first printed in 1653 and subsequently reprinted and translated into a number of languages in the second half of the seventeenth century. His book became a surgical bestseller because it was clearly written, comprehensive in content, and heavily illustrated. Worth owned the 1693 Leiden edition.

Though he was clearly most influenced by contemporaries such as Fabricius ab Aquapendente (1533-1619) he also cites the work of medieval writers, such has Guy de Chauliac. Following his graduation at the prestigious University of Padua he initially set up a medical practice at Venice but was head-hunted by the magistrates of his home town of Ulm who offered him the position of town physician. It was there he published his Armamentarium chirurgicum. Divided into two sections, part one examined surgical instruments and techniques while part two looked at individual case studies. As Zimmermann and Veith point out, part one contained ‘a complete catalogue of all known surgical instruments’.[1] The following extracts focus on just some of the many explanations of instruments provided by Scultetus.

Johannes Scultetus, Armamentarium chirurgicum olim auctum triginta novem tabulis … (Leiden, 1693), plate XII.

Of Crooked Knives.

‘Fig. I. is a little Pen knife, called by the Greeks Σκολοπυμαχαί from the bill of that bird which the Latines call Galinago, a Woodcock, in Greek Σηολόπαξ, because the instrument is long and somewhat crooked at the end like a Woodcock’s bill; with this incision knife wounds of the Thorax that are too narrow are dilated, and great impostumations are opened. Fabritius Aquapendente, commends the same for opening the Abdomen of hydroprical persons under the navel, to let forth the water …

Fig II. and III. are Pen-knives crooked at the point, and like to the Woodcock’s bill knife of the Greeks, wherewith mean Fistulaes in the habit of the body are conveniently cut …

Fig. IV. is a crooked Pen-knife, which the Italians call gammaut; and it cuts on the hollow side, and is blunt on the convex side of it. I use this most frequently for all incisions which is commonly made in every impostume; but principally in small incisions … With this also is the Pericranium parted from the skul, and the haw from the eie.

Fig. V. is a Woodcock’s bill without a handle.

Fig. VI. and VII. are double knifes, which at the end resemble the fashion of myrtle leaves; we use them to cut off women’s breasts that are cancerated.

Fig. VII. is a most sharp needle, long and double, wherewith breasts to be cut are pierced through at the root.

Fig. IX. is a pipe made of gold of Hungarie, and perforated with many holes.

Fig. X. is a stile made of the same mettle, which is thrust into the former pipe, that of them both, one instrument may be made, which in the wounds of the Thorax is profitably applied for a syringe, and draws blood out of the Thorax which is not congealed, or thin corruption … Let the Chirgurgian draw forth the pin out of the pipe, and presentlie the matter contained in the Thorax will run forth …

Fig. XI. is that crooked knife which may be hid in a golden ring, with this Apostems are cut in the face or cheeks of children …

Fig. XII, XIII, XIV and XV. are pipes with shoulders, and perforated with many holes, that they may hold the wounds of the Thorax open; and they have so many holes, that by it through them all, as need requires, the foul matter may issue forth.

Fig. XVI. is a pipe made of the gold of Hungarie, which is thrust into the Urinarie passage, before the making of water, that the Urine may come forth by it; and so that most cruel pain and heat may be abated, which the Patients feel when they make water without the pipe, by reason of an ulcer from in the Urinary passage, from a virulent Gonorrhaea.

Fig. XVII. is an instrument that consists of a needle with three points (a) and the pipe with shoulders (b) with which the navel of hydropical persons, and the scrotum in a watrie hernia are opened to let out the water …

Fig. XVIII. is the small pipe alone, and printed without the needle.

Fig. XIX. is the needle alone, set without the pipe.

Fig. XX. is a round needle with its small pipe; wherewith, for want of a needle with three points, the navel of hydroprical persons is perforated with the like safety; and so is the scrotum of such as have hernias filled with water.

Fig. XXI. is the pipe of the round needle by itself.

Fig XXII is the round needle alone’.

Johannes Scultetus, Armamentarium chirurgicum olim auctum triginta novem tabulis … (Leiden, 1693), plate XIV.

Of Syringotomi.

‘Fig. I. is a crooked knife, which upon the inside (a) hath an edge, and on the outside (b) it is blunt, namely a Syringotomus; which at one end (c) pricks and cuts; this we use in any fistula that hath but one passage, that the end of the fistula may be perforated; and afterwards the space between one hole and another may be cut asunder; at the point hereof we must fasten a button made of white wax, wherewith the pen-knife thrust into the fistula may come to the bottom, without any hindrance, pain or hurt.

Fig. II. and III. are pen-knives to cut fistulaes; both of which are blunt at one end, and have a bullet of iron well polished at the other end. With these the whole passage of deep fistulaes are to be cut.

Fig. IV. is a knife to cut fistulaes, wherewith the wounds of the abdomen are dilated, that the intestines slipt down and swoln with winds may be commodiously thrust back again. It hath a button at one end far greater then the two former knives have, lest being thrust into the wound it should hurt the intestines.

Fig. V. is a needle, or iron instrument, with a double edge; which they of Nursia, in my time in Italy, in this part of Chirurgery (which cures Hernias with cutting forth the testicle) being excellent well skilled, and in that respect the most famous gelders, thrust the wound of the groin to the bottom of the scrotum; which with the point of the instrument (to which always men ought to fasten a small button of white wax, for the reason abovesaid) they perforate; whereby the corrupt matter, which by the wound of the groin descends to the scrotum, may be purged forth. This operation because it is fearful enough, and is not without the greatest danger of life (which the Authors of it knew well; and therefore they take on those they would cure, but as dead men). I will open to such that are studious of Chyrurgery, another use of this instrument which is very safe. Namely, with this are cut, the sloping ends of sinuous ulcers, for which cause fistulaes cannot be cleansed, unless the Patient be so scituated that his head be downwards and his heels upwards, and the corruption may run forth of its own motion …

Fig. VI. is a Catheter or a Probe; by which, being thrust into the passage of the yard, and into the bladder, we prove the innermost turnings of the bladder, wherein the stone useth to lie hid, wherewith oftentimes man’s nature is tormented … It is used to make the urine come forth when it is stopped. It is made of silver that it may be bent, and it is free from all roughness, lest the part that is most exquisite in feeling, should be affected with the Catheter in the passage, and that it may enter into the bladder without pain … Celsus describes the magnitude of the Catheter, lib. 7. cap. 26.

Fig. VII. is a silver Probe which must be so bent, that is fissure which it hath in the middle, as far as the end of it, may be on the back side or gibbous part thereof; The Latines call it a Directory; because, being thrust into the yard, it doth most exactly shew the neck of the bladder; and upon that must incision be made to take the stone out of the bladder.

Fig. VIII. is a latten instrument, wherewith the stone is taken forth which remains in the urinary passage; namely a Probe, which on that part where it is made hollow like a spoon for the ears, is put into the conduit of the yard, so that it may pass beyond the small stone above it, and may lay hold on it with its lip and concavity; this being done, oyl of sweet almonds is poured through the hollow passage of the pin of the Probe, which hath a large orifice, into the Urinary passage, that it may become slippery; afterwards the Probe is gently drawn forth, and the conduit is pressed behind the stone with the finger, until it be driven forth of the Urinary passage.

Fig. IX. is an instrument the most fit to take forth bullets out of a wound. It is made of the best steel, and it consists of three parts; namely, of two small pipes and a piercer. The outward pipe (a) can shut in the innermost pipe; which at one end is divided into two spoons of iron (b) that it may fasten the bullet, that it may not turn about with the piercer, which must be fastned into it. The Piercer (c) is most sharp and somewhat longer than its two pipes; which by the hole of the handle (d) may be seen to be thrust into the pipe.

Fig. X. is a Piercer printed without its pipes.

Fig. XI. is the same instrument with the former (but that it wants a Piercer) wherewith bullets are drawn forth; it consists of two parts of the pipe (a) and the stile (b) which is solid; which at the other end is divided into two spoons which may take in the bullet betwixt them. This instrument doth the very same, that the instrument of Alphonsus … doth.

Fig. XII. is the pipe of the precedent instrument by itself.

Fig. XIII. is the stile of the instrument which is solid half way; and at one end representing the form of spoons with teeth; at the other end like screws, that are bossed with a hilt and a button.

Fig. XIV is the hilt of the stile, with its little button, which is round and hollow.

Fig. IX, X, XI, XII, XIII, XIV. of this Table, must be made a third part greater than they are here printed’.

Johannes Scultetus, Armamentarium chirurgicum olim auctum triginta novem tabulis … (Leiden, 1693), plate XVI.

Instruments for treating Haemorroids and Ulcers

‘Fig. I. is an instrument fit to dry up the Hemrods within, that either side swell or superficially exulcerate the intestine; namely, a small iron pipe, which is put up into the fundament; it hath shoulders, and is shut at bottom, lest the red hot iron (Fig IV.) which is frequently put in and drawn out of the hollow of the pipe, should go in higher then it ought to do.

Fig. II. and III. are pipes also to thrust into the fundament, but they are perforated on the side (according to the situation of a callous and deep ulcer, which will not yield to topical medicaments; into these is thrust a red hot iron Fig. IV.) with these pipes the sound parts are defended from the immediate touch of the fire, that only the ulcer most safely may be touched twice or thrice with a red hot-iron.

Fig. IV. is the stile which is made red hot, and is thrust into the perforated pipes; and into the solid pipe also to dry up the internal Emrods, and those that are swoln and to cure the ulcers of the right gut, be they superficial or deep.

Fig. V. is a hollow, long, narrow glass, having a mouth at one end, which is as great as to receive the nipple; but at the other end it hath a small hole with a long pipe; wherewith the Patient herself, by sucking, draws forth her nipple that lies secret, so that the infant may lay hold of it with its mouth, and draw out the mothers milk’.

The inclusion of instruments to extract bullets was no coincidence: Scultetus was writing during the devastating Thirty Years War in Europe (1618-1648) and he had seen at first hand bullet wounds on the battlefield and, indeed, the varied attempts of barber surgeons to deal with the carnage. He held the great sixteenth-century French barber surgeon, Ambroise Paré (1510-90), in high regard but was well aware that contemporary barber surgeons lacked proper training. The Armamentarium chirurgicum was written to address this problem by providing a training manual which not only addressed how to deal with the wounds of war, but also provided clear and basic training for all surgical operations.

Sources:

De Moulin, Daniel, A History of Surgery (Dordrecht, 1988).

Scultetus, Anke H., J. Leonel Villavicensio and Norman M. Rich, ‘The Life and Work of the German Physician Johannes Scultetus (1595-1645)’, Journal of the American College of Surgery, vol. 196, no. 1 (2003), 130-9.

Scultetus, Johannes, Armamentarium chirurgicum olim auctum triginta novem tabulis … (Leiden, 1693). All English translations are from The Chyrurgeons Store-House … (London, 1674).

Zimmerman, Leo, and Ilza Veith, Great Ideas in the History of Surgery (Baltimore, 1961).

Text: Dr Elizabethanne Boran, Librarian of the Edward Worth Library, Dublin.

[1] Zimmerman, Leo, and Ilza Veith, Great Ideas in the History of Surgery (Baltimore, 1961), p. 250.