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Darrera modificació: 2024-09-18
Bases de dades: Sciència.cat
Bakhouche, Béatrice - Berriot-Salvadore, Evelyne - Le Blévec, Daniel (eds.), Gui de Chauliac et sa 'Grande Chirurgie', Turnhout, Brepols (De Diversis Artibus, 111), 2023, 254 pp.
- Resum
- La Chirurgia Magna dont Gui de Chauliac, médecin des papes, achève la rédaction en 1363 occupe une place singulière dans l'histoire de la chirurgie et plus largement dans l'histoire des idées, en portant témoignage de ce que l'on a nommé le «premier humanisme». Les études rassemblées dans ce volume situent d'abord l'œuvre en un temps, celui du grand essor des universités médiévales, et en un lieu : Montpellier à la fin du Moyen Âge. Le contexte scientifique dans lequel a pu s'élaborer cette somme méthodique de théories et de pratiques chirurgicales est approché par l'analyse des sources antiques ou arabes, et aussi par les divergences qu'exprime Gui avec ses prédécesseurs immédiats. La transmission de l'œuvre sous toutes ses formes, éditions savantes et abrégés pour les barbiers-chirurgiens, est mise en lumière : après la première édition en français, en 1478, les maîtres ou docteurs de Montpellier, Symphorien Champier, Laurent Joubert, François Ranchin, s'illustrent en divulguant les apports de la Grande Chirurgie. Ils revisitent un maître qui incarne l'«identité montpelliéraine» et qui pose les grandes questions du statut de la chirurgie, dans son rapport aux autorités comme dans son problématique équilibre entre science et art.
Table des matières:
* Préface
-- I. Gui de Chauliac en son temps
* Verger, Jacques / L'université de médecine de Montpellier au temps de Gui de Chauliac
* Le Blévec, Daniel / Gui de Chauliac, entre Montpellier et Avignon
* Dumas, Geneviève / L'impact de Gui de Chauliac et de sa Chirurgia Magna sur la pratique de la chirurgie dans la ville de Montpellier à la fin du Moyen Âge
* McVaugh, Michael / Étienne Aldebaldi and Gui de Chauliac: fellow students at Montpellier?
-- II. Lectures de la Grande Chirurgie
* Manco, Catarina / Da Galien à Gui de Chauliac: le catalogue des simples
* Bosc, Jean-Louis / D'al-Qūtī à Gui de Chauliac, le cheminement d'une œuvre andalouse
* Bakhouche, Béatrice / Gui de Chauliac et la chirurgie de son temps: le capitulum singulare en question
* Lorblanchet, Hélène & Lise Marandet & Pascaline Todeschini / Faut-il restaurer la Grande Chirurgie de Gui de Chauliac conservée à la Bibliothèque universitaire historique de médecine de Montpellier?
* Beys, Béatrice / Image d'une autopsie – autopsie d'une image: indices structurels, stylistiques et iconographiques de la miniature de la Grande Chirurgie (Bibliothèque universitaire historique de médecine de Montpellier, ms H. 184)
-- III. Transmission et héritage
* Loviconi, Laetitia / Du Compendium de Gilbert l'Anglais à la Practica maior de Michel Savonarole: la place de Gui de Chauliac dans l'histoire de la nosologie et du diagnostic des maladies
* Bazin-Tacchella, Sylvie / Fragments d'un discours chirurgical: la fortune des textes dérivés de Chauliac au XVe sicle
* Demonet, Marie-Luce / Rabelais et les cagots de Gui de Chauliac: de la lèpre à l'insulte
* Berriot-Salvadore, Evelyne / La «leçon» de Gui de Chauliac à la Renaissance
-- Conclusion
* Lavabre-Bertrand, Thierry / Place de Gui de Chauliac dans la mémoire de l'école de Montpellier
On 17 August 1220, the papal legate Conrad of Urach formally recognized the masters of medicine teaching at Montpellier as a universitas medicorum. Though Montpellier later hosted faculties of law and arts, the medical faculty remained dominant, independent, and keenly aware of its historically exceptional stature. Beginning with Jean Astruc's Mémoires pour servir à l'histoire de la Faculté de médicine de Montpellier (1769), Gui de Chauliac (ca 1300-1368), author of the highly successful Inventarium sive Chirurgia Magna, has been celebrated as an embodiment of all that was excellent in Montpellier medicine. Gui's critical synthesis of ancient and Arabic medical and surgical knowledge was widely copied, translated, adapted, and taught. Enlightenment physicians praised its scholarship and methodical organization, and Revolutionary Montpellier hailed the author as the pioneer of the union of medicine and surgery.
The present volume grew out of a colloquium celebrating the 800th anniversary of the 1220 statutes, and focuses on Gui as a Montpellier figure, both during his lifetime and afterwards. The chapters are organized into three sections: Gui de Chauliac, Montpellier and surgery in the fourteenth century; Montpellier's role in shaping the sources and reception of the Inventarium; and the long-term “Montpellier identity” of the author and his book.
Jacques Verger opens part 1 with an overview of the medical university at Montpellier in Gui's time. Gui was a student in the 1340s, but his absence from the university's cartulary makes it difficult to prove that he taught there. Nonetheless, Verger proposed some features of the medical faculty in the second third of the fourteenth century which Gui would have recognized. The new statutes of 1340 reveal a medical faculty that has high standards and a strong sense of its identity and social importance. But the small size of the faculty threw the prickly egos and self-interest of the teachers into high relief. These are reflected in Gui's sense of professional dignity as well as his combative stance towards approaches to surgery that differed from his own.
Daniel Le Blévec (“Gui de Chauliac, entre Montpellier et Avignon”) reminds us that Gui was not only a scholar and papal physician, but also a high-ranking cleric. Even before joining the papal entourage at Avignon in 1349, Gui held a canonry at the wealthy and prestigious church of Saint-Just in Lyon from 1344, and was also a member of the chapter of Vienne. Le Blévec suggests that Gui obtained these prebends thorough his connections to aristocratic and prelatial patients and their families. In shorted Gui leveraged his medical expertise into financial and social status. Finally, Le Blévec demolishes several myths about Gui, notably that he was the particular object of Petrarch's Invective contra medicum.
Geneviève Dumas brings Gui back to Montpellier, so to speak, and attempts to assess whether and how the Inventarium influenced the practice of surgery in the city. In 1349, the absorption of Montpellier into the French kingdom entailed the gradual adoption of a more northern style of occupational regulation. At the same time, one can trace an increased use of the term “surgeon” as a professional identifier, perhaps reflecting the dignity of surgery articulated in Gui's writings. Around 1430, the Montpellier barber-surgeons received statutes that mandated formal examination of candidates, with part of the examination based on knowledge of the Inventarium. Thus the “influence” of Gui on Montpellier surgery is circumstantial for the most part, but nonetheless suggestive.
Michael McVaugh's chapter (“Étienne Aldebaldi and Gui de Chauliac: Fellow Students at Montpellier?”) focuses on the six-book surgical textbook of Étienne Aldebaldi, physician and teaching master at Montpellier. It was composed in the 1330s in Occitan, with a Latin preface, and was dedicated to magistro Guido...dominus super artifices egregios cirurgie Montispessulani, whom McVaugh identifies as Gui de Chauliac. Surgery was not on the official curriculum, but Montpellier had a long tradition of extra-curricular teaching that included surgery from the 1220s at least. Aldebaldi had probably followed extra-curricular instruction in surgery when he was a student in the 1320s; the same is true of Gui, who may also have offered extra-curricular instruction after receiving his master's degree. The link between the two men is established by their unusual references to the shadowy twelfth-century surgical writer Jamerius. Aldebaldi and Gui quote the same passages--a sign that this text played an established role in organized instruction.
The new statutes adopted by the medical faculty in 1340 included optional texts for the first time, including surgical sections of Galen and Avicenna. These ancient and Arabic sources form the backbone of the Grande Chirurgie, and lead us into the second part of this volume.
Caterina Manco (“De Galien à Gui de Chauliac: Le catalogue des simples”) notes that Galen's writings on surgery, but also on regimen and pharmacy, top the list of Gui's sources in the Inventarium's Capitulum singulare. Manco evaluates Gui's use of Galen's On Simples in book 7 of the Inventarium, the Antidotarius. Gui drew on both the Arabic-Latin version by Gerard of Cremona and the Greek-Latin version by Niccolò da Reggio. Moreover, he manipulated his Galenic sources to frame his own views on materia medica and on pharmacological theory, notably of the question of the virtutes (“faculties”). This involved reaching beyond Galen, e.g., turning to Arnaud for definitions of terms like gradus. Gui may have revered pater noster Galienus, but he read him critically, and used him creatively.
Jean-Louis Bosc's chapter complements Manco's essay by looking at one of Gui's Arabic sources. al-Qūtī (Alcoatin) is the second most cited Andalusian authority after al-Zahrāwī, and Gui's use of his work reflects Montpellier's close historical associations with Iberian peninsula. al-Qūtī's surgical text is devoted to eye diseases. It was translated by the Montpellier master Joan Jacme into Catalan--Catalan being the intermediary translation language in Montpellier, as Hebrew was in Toledo. The anonymous Latin translation leaned heavily on the Catalan one. Bosc proposed that Gui asked Jacme to make the translation into Latin, but this depends on interpreting the Gui's reference “Johannes socius” as Jean Jacme; Le Blévec on the other hand asserts that it is John of Parma (Giovanni Gabrielli, another papal physician at Avignon) (27). More plausible is Bosc's suggestion that the geographical diffusion of the Latin manuscripts of al-Qūtī (Germany and Spain) suggests it was copied in Montpellier by students, and therefore formed part of their extra-curricular instruction. Nonetheless, Gui seems to have been the only Latin writer to use al-Qūtī's work.
Béatrice Bakhouche probes Gui's Capitulum singulare to evaluate his views on contemporary surgery. This introductory chapter, a combination of literature review and status quaestionis, articulates Gui's conviction that surgery was a rational practice grounded in the medical science inherited from the ancients. As such, it was inseparable from medicine. In classical times and amongst the great Arab writers, medicine and surgery were part of a single enterprise. Only recently, and in the West, had corruption set in, and surgery declined in status to the practice of empirici. Remarkably, Gui criticizes the very men who pioneered what Michael McVaugh has called the “rational surgery” of the thirteenth and fourteenth centuries--William of Saliceto, Bruno of Longoburgo, Theodoric etc. Gui responded that he judged these authors by their texts but found their practice inferior. Tellingly, Gui presents himself as one who saw many operations (and read many books) but not as an operator. Nonetheless, this Capitulum was re-cast in question-and-answer form as a preparation for examining prospective surgeons.
The two following chapters represent something of a digression, in that they concern a manuscript of one of the French translations of the Inventarium. This late-fifteenth-century codex is now MS H184 in the Bibliothèque universitaire historique de médicine in Montpellier, but it was not made in Montpellier. It is an elegant volume, with generous spaces reserved for illumination at the beginning of each book. However, only one was completed: a miniature showing the opening of the belly of a female cadaver by surgeons, but in the presence of long-robed masters and other onlookers. This image is now in very fragile condition, and the options for restoration are discussed by Lise Marandet, Pascaline Todeschini, and Hélène Lorblanchet. Their chapter is paired with Béatrice Bey's art-historical analysis. Bey argues that the scene is ambiguous: it may be an autopsy (her preferred hypothesis), or an anatomy lesson (hence the master pointing to the incision). The presence of a great bed with its red hangings indicates that the event is taking place in a formal reception space, such as is depicted in Burgundian painting, and not in the dead woman's bedroom. In short, the image is redolent of northern courtly illumination.
The final section is devoted to the reception of the Inventarium. A physician-surgeon, in Gui's view, needs to know the identities, causes, and symptoms of diseases--in short, to master differential diagnosis. Laetitia Loviconi examines Gui's teachings on diagnosis of ulcers, especially herpestiomentus/lupus, and of nasal polyps, haemorrhoids, and cancer, in the context of both his sources (Gilbert the Englishman and Bernard of Gordon), and his reception by later surgical writers, notably Valesco of Tarentum and Michele Savonarola. In the case of herpestiomentus/lupus, Gui separates the two conditions which his predecessors joined, as the first leads to softening and gangrene, while lupus tends to corrosion and induration. Valasco seconded Gui's judgement in this case but declined to follow him when he argued that a nasal polyp was the initial stage of a nasal cancer. Savonarola, on the other hand, concurred, and recommended preventive removal of polyps. In both cases, Gui showed originality when compared to his sources and predecessors and introduced long-term changes in diagnostics.
Sylvie Bazin-Tacchella's contribution tracks the exceptional diffusion of the Inventarium across Europe and from 1363 to the seventeenth century, in manuscript and print, in Latin and different vernaculars, and in commentaries, abbreviations, and questionnaires. The last two are vernacular phenomena and start in earnest in the mid-fifteenth century. Manuscripts of the abridgements are often strikingly elegant productions. They maintain the Inventarium's seven-book structure, but collapse Gui's elaborate internal structure of treatises, chapters, and doctinae into a simple sequence of chapters. By contrast, the “manuscrits de barbier” containing excerpts are more modest. These volumes cluster around Montpellier/Avignon and Paris, supporting Dumas's analysis of Gui's influence on surgery in Montpellier. Comparison with the questionnaires drawn up for examining candidate surgeons (and preparing for this examination) shows that terminology was rendered into French in the abbreviations, but in Latin in the questionnaires. Abbreviations used concrete language and examples, questionnaires more abstract and theoretical terms. The abbreviations were designed to simplify consultation of Gui's texts; the questionnaires were oriented towards memorizing elementary theoretical information.
Marie-Luce Demonet's essay on “Rabelais et le cagots de Gui de Chauliac: De la lèpre à l'insulte” asks why Rabelais satirized hypocrites by calling them cagots. In southern France, a cagot was a member of a community of “white lepers” isolated from the general population. These people did not display any symptoms of leprosy, but were deemed to carry it in latent forms, and hence constitute a danger to the health of others. In short, like hypocrites, cagots were pure on the outside, corrupt on the inside. Demonet proposes that Gui's works--the French Guidon and the Latin Inventarium--lie at the root of this connection, and that Rabelais was exposed to it during his student years at Montpellier. Guidon uses the Occitan term cassot to render the Latin cassatus/cassotus, which denotes those whose leprosy is latent but destined eventually to be symptomatic. The Inventarium lists as of the “equivocal” symptoms of incipient leprosy the desire of patients to conceal their symptoms. Moreover, Gui's commentators (though not Gui himself) stressed hereditary character of disease, which can be transmitted “invisibly.” Thus, Gui links latent leprosy with dissimulation, a link that glossators like Jean Falcon broadened by characterizing these people as tricky and intent on infecting others. This aligns leprosy with heresy, and the term cagot was furnished with a false etymology from “Visigoth,” i.e., Arian heretic.
Continuing with the theme of the reception of the Inventarium in the sixteenth century, Evelyne Berriot-Salvadore analyses how Gui de Chauliac was studied at the medical faculty before and immediately after the establishment of the chair of surgery in 1598. She identifies three milestones: the commentaries of Jean Falcon (1515); the publication of Guidon en françois (1538) and commentary on the Prologue et chapitre singulier (1542) of Jean Canappe; and a spate of publications at the end of the century, including Laurent Joubert's annotated French translation of La Grande Chirurgie, Le chirurgien methodique (1597) of Guillaume des Innocens, and the Questions en chirurgie (1600) by François Ranchin. The Prologue and Capitulum singulare draw most of the attention, with recurring themes being the progress of the sciences (including dissention over Gui's high esteem for Arabic writers), and the place of surgery, where Gui's defence of the unity of medicine and surgery confronts Renaissance commentators who emphasize hierarchy, with medicine in supreme position. With the establishment of the chair in surgery, Gui's “method” becomes the touchstone of rational surgery, differentiating it from craft empiricism. This shifts the focus to debates over terms such as “science” and “art,” “practice,” “experience/expertise,” etc.
Thierry Lavabre-Bertrand's brief conclusion turns to Gui's position in Montpellier's collective memory. In the seventeenth and eighteenth centuries, the Inventarium lost relevance for teaching, but at the same time, Gui's prestige was re-fashioned in Montpellier historiography through monographs and critical editions as a celebrated model of the school's unique stature and influence.
Overall, this is a very satisfying collection. All the essays are of high quality, and the volume's thematic coherence is enhanced by numerous references by the authors to one another's contributions. However, one wishes that the editors had imposed more consistent norms of presentation. In many of the chapters, quotations in Latin, Greek, medieval French or Occitan are not provided with modern-language translations in the text of in footnotes. This limits the potential of the volume to be appreciated as a whole by readers (e.g., students) who lack wide-ranging linguistic expertise.
- Matèries
- Biografia
Història de la medicina
Medicina - Cirurgia i anatomia
- Notes
- Informació de l'editor
 .
Recensions:
* Faith Wallis, The Medieval Review TMR 24.09.04.
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