Chirurgia è Graeco in Latinum conversa, Vido Vidio Florentino interprete, cum nonnullis eiusdem Vidii com[m]entariis...

Paris: Pierre Gaultier, 30 April 1544.

First edition, an exceptionally fine, large and fresh copy, completely unsophisticated, of one of the most beautiful scientific books of the Renaissance, which well deserves the praise lavished on it by Herrlinger, who calls it “a typographically exquisite specimen of Parisian printing craft” and “the most beautiful textbook of surgery to be printed in the 16th century” (History of Medical Illustration (1970), pp. 15, 143). It is a collection of Latin translations of treatises on ulcers, wounds, fractures, dislocations and their treatment by Hippocrates, Galen, Oribasius, and other ancient writers, with commentaries by Galen and by Guidi himself. The treatises were translated by Guidi (usually referred to by his Latinized name Vidus Vidius) from a tenth-century illustrated Byzantine Greek manuscript known as the Nicetas Codex, the earliest surviving surgical codex, which was itself based on a Greek manuscript of the first century BC. Chirurgia contains a series of exquisite woodcuts, many full-page, in the Hippocratic treatises on fractures and dislocations, as well as many smaller images scattered through the pages of Galen’s treatise on bandaging and Oribasius’ treatise on slings; most of these are based upon illustrations in the Nicetas Codex, but many are original. They have been claimed to be by the Italian mannerist Franceso Primaticcio, but it is now thought more likely that they are the work of the school of Francesco [Rosso] Salviati (cf. Hirst, ‘Salviati Illustrateur de Vidius,’ Revue de l’Art (1969), p. 19). The artist of the woodcuts has not yet been identified though there are three ‘signatures’: Denys Janot’s ‘F’ artist, the monogrammist ‘APF’, and another with the Lorraine Cross; the latter suggests to Choulant and to Mortimer that Francois Jollat, the artist of the Estienne De Dissectione (1545), designed at least several of the plates. The origin of the designs has been traced back to the first century BCE; they were undoubtedly transmitted directly from Antiquity to Byzantium and so may be regarded as embodying the genuine Hippocratic tradition of surgical practice (Schne, Apollonius von Kitium, Leipzig, 1896). Guidi (1509-69), a grandson of the painter Domenico del Ghirlandaio, was physician to King Francis I of France and the first professor of medicine at the Collège Royale (1542-48), now the Collège de France. While in Paris he shared quarters with Benvenuto Cellini, who also accommodated the press that produced the present work. Guidi himself discovered the nerve, canal and artery that all bear his name (G-M, 380n). He remains in the eyes of modern critics the pioneer whose beautiful book blended aesthetics with the pursuit of knowledge, occupying an equal place in the history of art, literature, and science. We know of no similarly fine copy having appeared on the market since that offered by Quaritch in 1977 (Cat. 969, no. 120, $11,000). In most copies some of the larger woodcuts were trimmed by the binder, but this copy is exceptionally large with absolutely no cropping.

Provenance: Mid-eighteenth century inscription “Ex libris Laurentii Napolioni” on front pastedown, manuscript notes on front free endpaper. We have not been able to identify the owner, but he must have had a notable library. The same ex libris appears, for example, in Bibliotheca Osleriana 3231 (Liber de morbo gallo, Venice, 1535), and in the copy of de Prézel’s Dizionario del cittadino o sia ristretto istorico, teorico e pratico del commerzio (Nice, 1763) listed in the Bibliotheca Encyclopaedica (p. 118).

Guidi was born in Florence in 1509 from a fortunate union of medicine and art by having a physician as his father and the grand-daughter of the famous Florentine painter Domenico Ghirlandaio as his mother. Her name was Costanza, and she had brought Dr. Giuliano Guidi a dowry of 700 florins. We know nothing of Guidi’s life or studies as a young man, or from where (or indeed whether) he obtained a medical degree. “When he reached his early thirties his attention was drawn by his friend the bibliophile Cardinal Niccolo Ridolfi, commonly recognised as the foremost patron of literature in Italy at that time, to a collection of medical treatises in a Greek manuscript. They had been made by a Byzantine physician, Nicetas. Some of the manuscripts were accompanied by pictures for instructive purposes, notably 30 full sized plates illustrating the commentary of Apollonius of Kitium on the Hippocratic treatise on dislocations and many smaller pictures scattered through the pages of Galen’s treatise on bandaging. They are pen and brush drawings illustrating the various manipulations and apparatus used in reducing dislocations and fractures, the dark brown figures in each case being surmounted by an archway of ornate and highly coloured Byzantine design. Their origin probably goes back to Alexandria or Cyprus where Apollonius wrote his commentary between the years 85 and 51 BC. It is likely that the illustrations were made during or shortly after his lifetime. The Galen illustrations date from the 2nd century AD” (Brockbank, pp. 270-271).

In 1492 or 1495 Greek scholar Janus Lascaris (1445-1535) purchased the Nicetas Codex in Crete for Lorenzo de’ Medici. By 1530 it belonged to Guilio de’ Medici, Pope Clement VII, “who loaned it back to Lascaris for a proposed and never completed edition of the medical and surgical texts it contained. From a copy made by Lascaris, now in Paris in the Bibliothèque Nationale, Ferdinando Balami produced the first Latin translation of Galen’s On Bones (1535). This copy, illuminated by Santorinos of Rhodes, entered the library of Cardinal Ridolfi, who arranged for yet a third copy to be prepared by Christoph Auer and sent as a present to Francis I in 1542. This volume, now also in the Bibliothèque Nationale, was taken to Paris by a young Florentine doctor Guido Guidi, who had prepared a Latin translation of the surgical texts” (Vivian Nutton in: Grafton et al (eds.), The Classical Tradition (2010), p.638)”. Guidi had undertaken the translation at Ridolfi’s suggestion. The woodcuts were probably prepared in Rome before Guidi left Italy. The original Nicetas codex was later acquired by Ridolfi, and is preserved in the Laurenziana (Plut. 74.7 [Codex Niketas]).

On becoming king, Francis had attracted many illustrious persons to France, including Leonardo da Vinci, and in 1530 had founded the Collège Royale to teach the humanities. Learning that Guidi was about to publish a book on surgery, Francis invited him to Paris. Wars then being almost continuous, Francis needed to improve the standard of surgery in his country owing to the terrible mortality among his soldiers. Impressed with the quality of Guidi’s work, Francis appointed him to be his personal physician and the first professor of anatomy and medicine at the Collège Royale. Guidi’s lectures became famous; he is regarded as the founder of medical teaching in Paris.

Soon after Guidi arrived in Paris he began a friendship with the renowned adventurer, goldsmith and sculptor Benvenuto Cellini. Cellini suffered from several diseases – malaria, common in Rome at the time; perhaps typhoid fever; some kind of a skin eruption; possibly also syphilis; and was attended at various times by Guidi and also by Berengario da Carpi. In his autobiography, Cellini describes Guidi as the most cultivated, affectionate, and companionable man of worth he ever knew, an able physician, a doctor of medicine and a nobleman of Florence. Cellini invited him to live in a suite of rooms in a wing of his chateau, the Petit Nesle, which was located just across the river from the main entrance of the Louvre. There, he and Guidi lived together for about six years. The Petit Nesle also contained a number of smaller suites, one of which was inhabited by the printer Pierre Gaultier; nearly the whole of his premises lay inside the chateau. It was Gaultier who printed Guidi’s Chirurgia in 1544. The book was dedicated to the king, who had financed its publication, as well as to the Pope and the Duke of Ferrara. Botallus, writing in 1560, tells us that “the Chirurgia was ‘very rare’ less than 20 years after its publication. It was never reprinted in its original form” (Brockbank, p. 278).

“Surgery had lain dormant for more than a thousand years. Hippocrates died in 375 BC, Galen in AD 200, Oribasius in AD 403. Even the manuscript translated by Guidi was 600 years old … Much of the old Greek teaching was sound … and it did represent the state of surgical knowledge in the middle of the sixteenth century. Not until James Young Simpson gave us chloroform three hundred years later and Lister antisepsis did surgery start to make real progress …

“The artist, whoever he was, was not content with reproducing the ancient drawings which had suffered considerable damage. He very happily interpreted and clarified them in what was to him the modern idiom and he amended the surgical apparatus presumably on the advice and guidance of Guidi, giving in his drawings minute mechanical details. Guidi deserves much credit for choosing such a fine draughtsman and guiding his pen so skillfully but then, there was artistry in his blood. Many of the illustrations were entirely original. He also deserves the greatest credit for his selection of a craftsman to make the woodcuts. They are mirror images of the original drawings which had to be copied in simplified form onto the blocks. The blocks had then to be reversed for printing. The woodcuts are of excellent workmanship and are very numerous. They were probably done by Francois Jollat who was working in Paris at the time” (Brockbank, pp. 276-277).

Guidi included the following treatises in the Chirurgia, with his commentaries:

Hippocrates (c. 370 BCE – 460 BCE): De ulceribus (On sores) (p. 1), De fistulis (On fistulas) (p. 47), De vulneribus capitis (On head wounds) (p. 61);

Galen (129 – c. 210): In Hippocratem de fracturis commentaria (Three commentaries on the book of fractures by Hippocrates) (p. 131), In Hippocratem de articulis commentaria (Four commentaries on the book of Hippocrates on dislocations [composed by Apollonius of Kition]) (p. 215), In Hippocratem de officina medici commentaria (Three commentaries on the Hippocratic treatise of the office of the physician) (p. 343), De fasciis (On bandages) (p. 415);

Oribasius (c. 320 – 403): De laqueis ex Heracle (On a noose or ligature, after Heraklas) (p. 467), De machinamentis ex Heliodoro (On surgical machinery, or apparatus, after Heliodorus) (p. 477).

Guidi’s Chirurgia opens with Hippocrates’ De ulceribus, which offers practical guidance on the preliminary treatment appropriate to all injuries – essentially this is to dry, to drain and to clean the affected part. The recommended treatment depends on whether the injury is recent or remote, and on the location of the injury in the body. The dangers of suppuration, both to the site of the injury and to the body as a whole, are explored, and it is explained that pus is vitiated blood, that is, blood that has suffered alteration and corruption consequent on heating. De fistulis begins with an account of the supposed cause of anal fistulas. The author advises early incision, to forestall the formation of pus, and describes in detail the treatment of a developed case by means of an inserted fabric device containing caustic substances, or by means of abrasive cleansing. An attack accompanied by pain and fever is explained in terms of motion and fixation of bodily phlegm, and treated by the use of hipbath, suppository, ointments and a light diet. Measures to be taken and treatments applied for prolapse of the rectum are also described. De vulneribus capitis describes the diagnosis and treatment of different types of head injuries. It begins with an anatomical description of the skull and its sutures, and goes on to discuss the thickness of the skull and its relationship to the degree of injury, types of skull trauma, the clinical evaluation of the patient, the treatment of different bone fractures, and finally, techniques of trephination (a trephine is a type of cylindrical saw used to remove a circle of tissue or bone). Great emphasis is placed on observation, on taking the patient’s history, and on teaching technical skills. The first two books are not illustrated; the third has pictures of three types of trephine and of some hammers and chisels, none of which occur in the 10th century manuscript.

“It is in the fourth book that the glory begins. This is … the treatise on fractures by Hippocrates. The first picture shows the treatment of a fractured humerus, extension being applied by a sling from the roof to the axilla and by a heavy boulder suspended from the forearm, the hand being supported by a cushion on the table (p. 157) … Then follow four pictures of crude traction apparatus almost as it was used in ancient days. These too are original. One of these shows traction on a lower leg by means of two levers. The traction tapes (lora) were leather thongs. Hippocrates recommended ox-hide (p. 174).

“Next comes the treatise on dislocations in which there is pictured the method of reduction of a dislocated shoulder over the operator’s fist, a manoeuvre only possible if the patient could stand or sit. If he had to lie down, reduction over the heel in the axilla was preferred. Reduction too could be made over the operator’s shoulder, a favourite method in the classical Greek gymnasia (pp. 221 & 226). According to Hippocrates the very best way of restoring a shoulder was reduction over a beam or a door. Note the wooden splint on the medial side of the arm (p. 233).

“Various other methods are clearly illustrated but we must pass on and pause regretfully at the illustrations dealing with the reduction of a dislocation of the spine. This undoubtedly meant scoliosis, kyphosis, or both. Guidi describes and illustrates the classical method of treatment, thus earning a black mark from us for lack of sense and courage (p. 279). Even Hippocrates had expressed his doubts about the value of the method saying that it was used by publicity seeking doctors who were not really interested in the results they produced. Its purpose was to stretch the spine. Galen too was doubtful about its efficacy but described it for any who might wish to use it. The idea was to fix and stretch the patient on a ladder near the affected area, allowing the main weight of the body to do the rest. If the curvature was high up in the spine the patient was fixed in the erect position. If the curvature was low down in the spine he was suspended head downwards. The ladder of course was well padded particularly behind the head. The ankles were tied close together and firmly but loosely to the ladder. Similarly the knees, hips, waist and lower part of the chest were tied loosely to the ladder so as not to prevent the concussion. The arms were extended and tied to the victim’s side, not to the ladder. The ladder was then drawn up to a high tower or the pediment of a house and allowed to fall sharply and vertically on to resistant material. To quote the text: ‘The vertebrae may thus be returned to their normal position.’ Soft ground would absorb the shock and make the operation useless. There is a delightful ending to this account. ‘It is a bad thing in any art, no less in medicine, to collect a large crowd in promise of a great spectacle and use long words and then produce no result.’

“Another method of treatment of kyphosis was even more brutal. The spine was put on traction by means of leather thongs and levers. A beam was then pivoted in a hole in the wall beside the patient and used as a lever to force the apex of the deformity into place. If one man was not sufficient to depress the lever two could be employed (p. 289). Hippocrates was doubtful about the efficiency of this method also. He stressed the necessity for careful padding between the beam and the patient's spine, and said that the operators must be experienced and cautious ‘for it is so powerful a method that it is more suitable for an instrument of torture and not for medicine.’ But he added that he knew of no better way of applying pressure.

“The artist now has a rest, for the next work translated is the Hippocratic treatise on materia medica. He returns in all his glory with 136 woodcuts to illustrate Galen’s account of bandages. The Greek manuscript had been written in two columns each paragraph being followed by a complete male or female figure, a hand, a leg, a foot or a head in a medallion, all in their proper bandages. Guidi’s text is remarkably clear with the aid of the lettering on the figures. Anyone could apply the bandages. But some are so complex that it is doubtful if they would stay in position for long. Let us look at two examples (p. 426).

“No. XVIII. ‘It should begin from the occiput and lead below the bottom of the ear and under the chin to the cheeks. Then it should pass obliquely over the top of the head to the occiput and from there it should go beneath the bottom of the right ear and under the chin to the cheek. After this it should go obliquely between the forehead and the crown to the occiput and there be passed round the forehead.’ No. XIX is similar but rather more complicated.

“The last of the translations is the De machinamentis of Oribasius. There are no illustrations in the original manuscript. It is in this section of the Chirurgia that Guidi and his artists have produced new forms of traction. These are machines that were drawn from wooden models. The first is a windlass applied to one of the lower rungs of a ladder and shown in action for the reduction of a fractured humerus. No description can add to the clarity of the drawing. The operator appears to be correcting lateral displacement (p. 493). Next follows an ingenious machine for reducing a dislocated shoulder or dealing with an injury to the upper limb. On turning the windlass the yoke is raised (pp. 513 & 515) … Notice the stool in the bottom left hand corner. The patient stands on this until the apparatus is exerting the maximum amount of traction. It is then kicked away and the dislocation reduces itself. Or it should do.

“Guidi then turns his attention to the Hippocratic scamnum [bench]. He pictures a more sturdy machine with slots up the middle so that a perineal bar could be used. One of these machines can be seen in the Wellcome Museum in Euston Road. It was found in an ancient monastery in Italy in use upside down as a refectory table. It is thought that the table was made in Florence and might well date from the time of Guidi (p. 519). In effect it was a bench that could be used for the reduction of any fracture. Hippocrates advised that one should be obtained by any surgeon practicing in a large city. It was the standard appliance for the treatment of fractures for several hundred years. Guidi’s modification was a mechanical improvement. He shows it in use for a fracture of the shaft of the humerus (p. 524). But whether it could ever be used to treat a dislocation of the lower jaw is open to much doubt. Nevertheless, it is a nice idea and a splendid example of what happens when someone invents or modifies a therapeutic procedure and tries to apply it to every conceivable disorder. No picture of this kind occurs in the old manuscript. It is unfortunately a Vidian invention (p. 521)” (Brockbank, pp. 277-283).

Francis died three years after the publication of Chirurgia. Guidi had intended to produce an edition in Greek and had retained the old manuscript for this purpose, but with the King’s death the project was dropped, for, almost at once, Guidi was recalled to Italy. It is possible that this is the reason the old manuscript remains in that country whereas the rest of Cardinal Ridolfi’s collection passed over to France. Back in his home town of Florence, Guidi became the personal physician of Duke Cosimo de’ Medici, and taught at the university of Pisa, then a Florentine possession. He was ennobled, took holy orders, and wrote a book on the art of medicine that was left unfinished at his death in 1569 and completed by his nephew between 1596 and 1611. 

Guido’s Chirurgia is deservedly famous for its place in the history of medicine, but it is also a significant work in the history of mathematics – surely one of the very few works to fall into both categories. In fact, Oribasius’ treatise De laqueis ex Heracle (pp. 467-476) may be regarded as the first printed work on knot theory. “Clear depictions of knots are extremely rare on ancient paintings or earthenware; a reason mooted for this is that knots bore magical or religious significance, and artists were afraid to portray them too faithfully. Indeed, the oldest written source on the subject (containing the only known descriptions of knots before the 18th century) is the Iatrikon Synagogus, a medical treatise compiled by a Greek physician, Oribasius of Pergamum, in the 4th century AD. He states that he derives this information from Heraklas, who is believed to have been a physician who flourished about AD 100. The knots recorded in this book were those used by physicians for slings, or as parts of slings, during operations or in the treatment of bone fractures. They are carefully described by C. L. Day in The Art of Knotting and Splicing (US Naval Institute, Annapolis, Maryland, 1970)” (Turner, p. viii). Oribasius’ De laqueis is one of the few parts of his Iatrikon Synagogus to have survived. In this work, Heraklas described 16 different types of knots and slings, including (to use their modern names) the cow hitch and clove hitch, noose, reef (square in the USA) knots, the “true lover’s knot,” and the bottle sling, as well as a string figure known to Aboriginal Australians as “The sun clouded over” (p. 474). Several of Heraklas’ knots are still used in surgery today.

Bibliotheca Osleriana 155 (lacking the last three treatises); Brunet I, 1845; Choulant-Frank, pp. 211-2; Cushing G445; Dibner, Heralds of Science 118; Durling 2204; Garrison-Morton 4406.1; Graesse II, 134; Heirs of Hippocrates 158 (“often considered to be the finest textbook of surgery to be printed in the sixteenth century”); Harvard/Italian 542; Lilly 6; Mortimer French 542; NLM/Durling 2204; Norman 954; Osler 155; Thornton, p. 71; Waller 1960; Wellcome I, 6596; not in Adams, Fairfax Murray or Rothschild. Brockbank, ‘The man who was Vidius,’ Annals of the Royal College of Surgeons of England 19 (1956), pp. 269-295. Kellett, ‘The School of Salviati and the Illustrations to the Chirurgia of Vidius Vidius, 1544,’ Medical History 2 (1958), pp. 264-268. Turner, History and Science of Knots, 1998.

Folio (375 x 242 mm), pp. [36, the last blank], 534, [2], including the final blank (lacking in the Harvard, Durling & Waller copies). Roman and Greek types, numerous woodcut illustrations, ornamental metalcut initials. Contemporary limp vellum. A superb copy, entirely untouched.

Item #5010

Price: $125,000.00