Surgery

Artery forceps (1) by MATHIEU

Valet à patin

The "valet à patin"

"... les premières pinces hémostatiques en usage jusqu'il y a une soixantaine d 'années," valet à patin ", décrit par JJ PERRET était composé de deux branches semblables unies à charnière et munies d'un ressort qui tenait l'instrument toujours fermé; l'intérieur des branches était dentelé et les dents s'ajustaient les unes dans les autres. Cet instrument servait "à tenir un vaisseau pendant qu'on faisait la ligature d'un autre. C'est, d 'PERRET, l'instrument auxiliaire dans l'amputation ", On ne peut exiger désignation plus claire ni plus démonstrative, Cet instrument, primitif et grossier, réalisait à peu de chose près ce que nous obtenons aujourd'hui des Pinces hémostatiques les plus perfectionnées The service of the service and its continuity and the fairness of the ligatures The valet à patin de JJ PERRET and the hémostatique à pression continue Le puissant qui sépare les deux branches et l ' articulation de ces dernières par simple juxtaposition, sans entrecroisement, se trouvent disposés de manière à tenir l'instrument toujours fermé "(Doyen, Eugène Louis, traité de thérapeutique chirurgicale et de technique opératoire) Tome premier: technique chirurgicale générale, Paris: A. Maloine, 1908 p.134).

"Jean Jacques Perret (1730-1784), natif de Béziers, fils de coutelier, commencing the tour of compagnonnage à douze ans pour termé prévôt des couteliers de Paris" S'étant spécialisé dans l'instrumentation médicale il travailla avec de nombreux chirurgiens, en particulier avec Lecat. Il reçut les éloges de l'Académie royale des sciences en 1769. "

In 1770 he wrote a book "La pogonotomie" or "the art of shaving oneself." In 1771 he wrote another book "L'art du Coutelier" or the art of the cutler "This book goes into all phases of cutlery from metal choice to forging, grinding, etc.".

Here is an explanation for the name "valet à patin": "One names this instrument in the French Valet à Patin, the servant of the godmother, because it does of self-services, like a servant, whether one does not hold it, but of the godmother it's the name given to its invention "(Elias Col of Vilars, Doctors of the Art of Medicine, the oldest Decani of the Faculty of Medicine at Paris, Medicinal and Surgical Dictionary, Vol. 5, Altona Bey the Brothers Korte 1747, p.
One possible PATIN was Guy PATIN (1601-1672) (Göttingische Anzeigen von schönten Sachen, dated August 20, 1772).

Denis DIDEROT reproduced the Valet à patin (in the Encyclopédie printed from 1749-1773) on the "planche chirurgicale XVII fig. 4".

Surgery

Bleeding Bowl Cup (1)

How much to take out?
If one makes an otherwise healthy and vigorous man a blood-letting, the amount of blood left should be as much as a strong, thirsty man can drink water on a train.
If one is physically weak, the bloodletting should be as much as entering an egg of ordinary size. For a blood-letting, which is made beyond the measure, weakens the body just like a downpour, which falls on the earth without measures, damages them.

What do you use to catch the blood?
The blood vessels for collecting the blood were made of tin or silver, they had straight sides at first, but in the late 17th century they assumed a slightly convex form. Basically, each bowl could serve as a bloodletting cup, some 18th century bowls show a calibration with an ounce of lines ...
A pelvis built for John WORRELL in Norwich in 1689, who in 1693 was the head master of the Norwich Bath Surgeons' Guild, appears to be the only connecting link between this type of pelvis and bloodletting practice: the strange fact that we have no evidence for which of the instruments that came on us were really used as blood vessels. Even this one instrument may even have been the cause of a century-long misunderstanding. From Michael CLAYTON comes the somewhat annoying statement that probably any instrument could have served this purpose; Since most of the alleged Aderlassbecken date from the period 1625-1730, one wonders, which have been used since then until the end of the 19th century.

Where to go with the blood?
"... the cupping in the bath-rooms near the stove, and the cupping and bathing in private homes, were exempted from the prohibition, that the blood would not be poured or flown into the streets, but would be caught and buried" (John Bapt. History of the entire medical system in the former Principality of Würzburg, representing the Middle Ages and the sixteenth century, Würzburg 1825 p.102) - a sensible arrangement of the city of Würzburg in the late 16th century: the blood was not allowed to be dumped into the gutter or into the river.

Surgery

Bleeding bowl cup (2)

For comparison, we want to show a bowl made in the Netherlands at the turn of the century, which in turn can be clearly identified as a shaving bowl with the side shelf for the shaving brush (stamped: Société Céramique Maestricht, Made in Holland)

Surgery

Bleeding bowl cup (3)

Small bowl (14.5x11 cm) with floral pattern on the edge. On the right in the picture the tin stamp on the back: the English Tudor rose.

Related object: Tin-veining bowl, circa 1745, (diameter 10 cm) by: Division of Medical Sciences, National Museum of History and Technology, Smithsonian Institution, Washington DC).

Surgery

Bleeding cup bowl (4)

Until the Renaissance, it was believed that health was based on the balance of four bodily fluids: blood, mucus, yellow and black bile - a system Hippocrates had already adopted in 400 BC. had developed. To heal someone meant to rebalance their juices. For this harmful juices had to be derived. For this purpose, the vessel system was emptied by means of cupping and bloodletting; the intestine was emptied by means of enema and vomiting, the entire body drained by sweating.

The bloodletting was preventative and therapeutic:
- For the prophylaxis a reduction per year was useful.
Stricter regulations applied to the therapy: Every 14 days the patients in the Strasbourg hospice were given a laxative, once a month a clipper had the adenoids veined and treated their wounds.

The French clinician and pathologist Pierre Charles Alexandre LOUIS (1787-1872) advocated a science-oriented medicine in which a doctor should not rely solely on his intuition. He vehemently advocated the introduction of statistical methods and is considered the founder of clinical statistics. He became known for his rejection of bloodletting. After evaluating numerous medical histories, he was able to prove that this method was useless and sometimes even harmful in the treatment of the then very common found pneumonia. In 1835 his book "Recherches sur les effets de la saigneé dans quelques maladies inflammatoires" was published.

From the Freiburg area comes the presented, 550 g heavy shell of copper sheet. The rolled-up edge prevented the spilling blood during transport, the long neck was used for pressing on the bleeding point and as a carrying handle when removing the left blood.
Dimensions 28.5 x 12.5 x 4.5 cm

Bought in august 2004 at the international flea market in Echternach.

Surgery

Bleeding lancet (1)

Lancets, about 1740            .

About the lancets
First lancets are documented around the 15th century (C.Keith Wilbur, Antique medical instruments, 2003 p.116).
Lancets consisted of a front pointed, double-sided symetrically polished knife which was hidden between 2 protective leaves. These leaves were mainly tortoiseshell or horn, but could also be made of precious mother of pearl. The shape and size of the lancets seem to have changed little over time.

About the cases
Often, the lancets were packed into several in a box (fr chasse) of cardboard, leather or (chased) silver metal, which was provided with a hinged or hinged lid hinged (French lacet (t) ier).
Why are cases made of wood, cardboard and leather often so badly affected? The explanation is surprisingly simple: the patient held it in his hand, as a substitute for the often absent bloodletting rod - in the right, when blood was taken from him in the true elbow and vice versa:
"Pour faciliter la sortie (du sang), on donne à tenir le lancettier au malade, afin qu'en le tournant dans sa main, le sang passe plus vite, par le mouvement des muscles, des veines intérieures dans les extrémités" (Sue le jeune, Dictionnaire portatif de chirurgie, ou Tome IIIe du Dictionnaire de santé, Paris 1771, p. 669). This application of the box he had taken textually by François Moysan "On recommand mal mal de de tourner the lancettier dans sa main, afin que le mouvement of the muscles fasse passer plus vite le sang des veines internes dans les externes" (Dictionnaire de chirurgie contenant la description anatomique des parties du corps humain, Paris 1767, p.456).

About the manufacturer
The instruments of the surgeons were fabricated by the bank of knife manufacturers - the most famous ateliers were in Paris and in Langres. The charm of this ensemble lies in the signature of one of the knives: a shamrock. Thus the manufacturer is certain: Pierre, son of Guillaume VIGNERON. (La Coutellerie depuis l'origine jusqu'Ã nos jours, 1896). "Les manuscrits de Delamarre donnent la liste des maîtres couteliers (87) établis à Paris en 1680". Among them we find the father of "our" Pierre VIGNERON, rue de la Coutellerie, au Trèfle, whose shop was located on the Pont Saint-Michel. The father was married to Cathérine Trifain. "Guillaume Vigneron, coutelier installé rue de la Coutellerie à Paris, à l'enseigne de l'as de trèfle, Il marquit ses outils d'un trèfle".

One of VIGNERON's most famous products is the "Exfoliatif dit d'Ambroise Paré" or "élévatoire tripode" dated 1748 in the collection of the Musée Descartes in Paris.

Origin: Talence near Bordeaux, 2015

Surgery

Bleeding lancet (2)

High blood pressure (recognizable by the warm, moist skin and the reddened face), stroke, gout - there was a whole series z.T. very useful indications for bloodletting.

The bloodletting was also used to remove alleged toxins from the body, such as the plague. In the monasteries he served to weaken the body so far that unchaste instincts passed.

"Council of Chelchitas, 816.- The monks are no longer to be burned on the appointed days. (The monks and nuns were bled every month, on a certain day, for the mortification of the flesh.) This day was in the Calendar referred to as "this aeger" or "this minutionis" "(D'Wäschfra of 5.10.1878).

During the Renaissance numerous factors had to be considered. It all depends on the position of the stars and zodiac signs. As dangerous was the moonrise in the corresponding zodiac. But also age, gender, climate, season, wind direction and the stage of the disease played a role. For each disease, for each organ was a special vein available. From ancient times the dogma came from doing the slaughter in a place as far away as possible from the diseased organ and on the other side of the body. Then in the sixteenth century there was the famous blood-feud dispute: the French doctor Pierre BRISSOT (1478-1522) demanded the opposite and wanted to put the bloodletting as close as possible to the disease.

Presented is a lancet with original box, manufactured by the company Reay & Robinson from Liverpool, 17 Churchstreet. This operation existed from 1837-1851.
- 1829 Thomas Reay
- 1837 Reay & Robinson
- 1851 partnership ended, then Thos. Reay
Mother-of-pearl handle (French nacre). The manufacturers were not concerned with producing a product from biomaterial. It was a matter of fabricating a fashion object to serve vanity-in our case, the vanity of doctors and surgeons. Some objects were so overloaded with embellishments and encrustations that it is questionable whether they could even come to practical use. Some surgical caskets, expensive and pretty to look at, was more of an exhibit than a surgical kit. Pure pleasure!

A not insignificant disadvantage has mother of pearl: it is hydrophilic, attracts water - so in the long run to rust on the joint!

Origin: Snowdonia, UK, 2013. Northern Wales, near Liverpool, the city of the Beatles ...

Surgery

Bleeding lancet (3)

   Surgeons used to buy their instruments from knife manufacturers, French "coutelliers". So I think it is completely normal for them to rummage through their wife's sewing-box every now and then, in search of a particularly fine instrument.

  Noble patients were undoubtedly treated with particularly fine instruments - hardly imaginable that the woman Marquise was with the same knife to the vein as the miller servant.

  The same care should have been exercised in the preparation of corpses: the closer one of the bodies to be prepared had been to life, the more reverentially he was moved to his body after his death. Last obeisance for a nobleman, a lodge-brother: during her embalming the taxidermist used an instrument which he never used before ...

Surgery

Bleeding lancet (3)

Fliet after the Latin "flebotomum" is the Aderlass-Messer with which the Bader performed the bloodletting from the Middle Ages to the 20th century.

Exhibit

The presented lancet has two different sized blades,  sunk in a case of horn [note the bites by clothes moth (Tineola bisselliella).

No manufacturer information.

Doubt arises with such objects, whether human or veterinary. That's it, probably occasionally for humans, but mostly for animals ...

cf. Gordon Dammann, Pictorial Encyclopaedia of Civil War Medical Instruments and Equipment, 1983, Volume 1, page 38.

Surgery

Bleeding lancet (5)

Surgery

Bleeding lancet, hammer

To bring the lancet into the rough skin of pets, it took brute force. Prockeln caused the animal useless pain. Thus, an animal lover invented the "hammer" ("bloodstick" or "fleamstick") with which the blade with a short blow in the skin and the underlying vein was propelled "beaten".

Exhibit

The 31 cm long hammer shown here was bought in 2004 on a flea market in Ceillac in the French Alps.

Links
antiquescientifica.com/archive48.htm
www.scienceandsociety.co.uk/results.asp?txtkeys1=Fleam

Surgery

Bleeding, white (1)

In addition to bloodless and bloody bloodletting, in which blood is "displaced", deriving methods include "white cupping" with cantharvic plasters. Accumulations of "unhealthy body fluids" from the inside of the body are locally conducted to the surface and disposed of there. In this method, therefore, light SERUM is removed, hence the term "white bloodletting".

The Kantharide, "mouche d'Espagne" or "mouche de Milan" [eng. "Spanish fly"] is a beetle native to Central Europe and the countries of the Mahgreb. From it, a powder is produced which, when applied to human skin, causes inflammation comparable to a blast of blast. In this method, already known in ancient times, a lovely ointment is applied to the skin, whereupon a blister forms, as in a 2nd degree burn. The doctor stabs this bladder (preferably sterile) using either a knife or a syringe. Then the skin is covered with a sterile bandage - like a burn.
Kantharidenpflaster.
(Blister plaster, Spanish fly plasters, Emplastrum cantharidum [vesicatorium] ordinarium), a mixture of 2 parts coarsely powdered Spanish flies (Kanthariden), 1 part olive oil, 4 parts yellow wax and 1 part turpentine; is soft, is painted on canvas with a knife back and attached to the skin with adhesive plaster; it draws a bubble in 6-12 hours. The lymphatic flow is stimulated, good results are achieved in many chronic complaints of the joints - knee osteoarthritis, hip osteoarthritis, blockages of the cervical and lumbar spine. Cave: in kidney patients !!

History to the method
The external discharge is already documented by doctors in ancient India. Here, the bladder (Vesikation) was deliberately brought about by mixing ash with caustic lye and applied to the skin. Also in the Roman Empire and in the Arab medicine one worked with this therapy. However, the external application of the Kantharids as vesikans was scarcely in use before the Middle Ages, and from then on it was increasingly used against a large number of painful and inflammatory conditions. Paracelsus praised it as a remedy in the case of gout: "Where nature creates a pain there, she wants to accumulate and emptying harmful substances, and if she does not do it herself there, make a hole in the skin and let it out" (Paracelsus).
The internal use as an aphrodisiac was also already known to the ancient Greeks. The "Canossa-goer" King Henry IV (1050-1106) is said to have consumed Kantharidenpulver against his potency problems. The Marquis de Sade rewarded his whores with anishaltigen pearls, in which Kantharidenpulver was included. When one of these ladies died of Kantharidin intoxication, the horny Marquis had to flee, was picked up and arrested ...

Here is the recipe of the pharmacist GAROSTE from Fos:
Poix noire purifiée ............... 125 grams
Cire blanche ........................ 30 grams
Cantharides en poudre fine ... 60 grams
Essence de Térébenthine ...... 15 grams
Huile d'Olives ....................... 8 grams

exhibit
Presented is a plaster note, acquired on April 22, 2007 in Steinfort. The same product in a round cardboard box from a Parisian pharmacy (Ebay 6/2018).