‘My Design was both of the Ancient and Modern, to extract the very Marrow, and plainly to shew the best way of Curing Diseases belonging to Chirurgery’.
Paul Barbette, Thesaurus chirurgiæ: the chirurgical & anatomical vvorks of Paul Barbette, M.D. practitioner at Amsterdam … (London, 1676), Sig. A3r.
Paul Barbette, Thesaurus chirurgiæ: the chirurgical & anatomical vvorks of Paul Barbette, M.D. practitioner at Amsterdam … (London, 1676), frontispiece and title page.
Paul Barbette (1620-65) was a famous seventeenth-century Dutch surgeon and physician. Having gained his medical degree at the University of Leiden he moved to Amsterdam and set up a practice there, publishing his first book on surgery in 1655 (Chirurgie nae de hedendaeghse pracktijk beschreven). It was followed by books on anatomy and medicine which were brought together in compilation volumes and reprinted many times. Worth inherited his copy from his father, John Worth (1648-88), Dean of St. Patrick’s Cathedral, Dublin, whose signature is visible at the top of the title page.
Paul Barbette, Thesaurus chirurgiæ: the chirurgical & anatomical vvorks of Paul Barbette, M.D. practitioner at Amsterdam … (London, 1676), pp 52-53.
Barbette offers the following description of how the instruments were used during the operation known as paracentesis (a topic also covered by Pierre Dionis):
‘This Manual Operation is ancient, and full of danger; yet sometimes preserves the life of the Patient, Nature and Success have emboldened us now and then to make use of it; but Experience hath taught us, that the greatest difficulty consists herein: 1. That the parts debilitated, and deserted of their natural heat, do easily, after opening, mortifie. 2. That together with the Water, issues out likewise the Spirits. 3. That the pressing water can hardly be so kept in, but it will run out in despight of the Chirurgeon; and if, the better to close the Wound, you do forcibly press in the Pipe, a Gangrene soon and easily ensueth …
As soon as you perceive Water to come forth, take a Golden, Silver, or Leaden small Pipe, that is 1. Smooth. 2. Furnisht at the Head with a Button or Wings. 3. Perforated on the sides with three of four holes. 4. No longer than the thickness of the dissected part, that is, an inch broad. 5. Somewhat crooked at the end. 6. Exactly fitting the size of the Orifice. Put this into the Apertion, lay over it a sticking Plaister (others take a Spunge, or a four double linen Rag) bind up the Patient, and let him rest two or three hours; then open the Bandage again, and take away one, two, three, seldom or never more pints of Water, and so repeating it once or twice a day, till the water be almost all discharged. You must not take away all at first, for the chilness of the parts, following so great an Evacuation, very often causes death. The Pipe is not to be taken out, but must remain all the time of the cure in the Wound, which you must at length heal up according to Art.
For the opening of a Hydropical Belly, this is the safest as hitherto practised way, that is left us by the Ancient; but the industry of their Posterity hath invented for us a much convenienter Instrument, whereby we not only do avoid many of the above-mentioned difficulties, but also with less trouble preserve the lives of otherwise incurable Patients, freeing them from stretching, pain and trouble, according to our pleasure, or the degree of their strength.
This never enough commended Instrument was first of all brought out of Italy; by the experienced Chirurgeon of this City, Mr. Jacob Block, and by him put into practice, to the great benefit of many Patients …’
Paul Barbette, Opera omnia medica et chirurgica notis et observationibus nec non pluribus morborum historiis et curationibus illustrata (Geneva, 1688), p. 3.
Barbette’s works were quickly translated into other vernacular languages and into the lingua franca of academic Europe, Latin. In this image from Worth’s copy of the 1688 Latin edition, we again see Jacob Block’s ’silver pipe’ (trocar) at the top of the page and, underneath it, depictions of various needles. Barbette himself made alterations to Block’s trocar (which in turn was based on that of Sanctorius Sanctorius (1561-1636).
Barbette, Paul, Thesaurus chirurgiæ: the chirurgical & anatomical vvorks of Paul Barbette, M.D. practitioner at Amsterdam … (London, 1676).
De Moulin, Daniel, ‘Paul Barbette M.D.: a seventeenth-century Amsterdam author of best-selling textbooks’, Bulleting of the History of Medicine, vol. 59, no. 4 (1985), 506-14.
Du Moulin, Daniel, A History of Surgery (Dordrecht, 1988).
Text: Dr Elizabethanne Boran, Librarian of the Edward Worth Library, Dublin.