Our subject here is the use of medicines by the surgeons during the years between 1170 and 1325, those which we can find in the modem editions of the old works. The great surgeons of that era, as we have noted, were well educated. Their books included descriptions of the medicines which had been used by their ancient and more recent predecessors who had compiled herbals, antidotaries, pharmacopeias, formularies, materia medica, etc., call them what you wish. All of them contained lists of the ingredients which were called Simples, and they described the mixtures which were called Compounds. Many names included the places of origin and cited the authors of the recipes. Nearly every book contained instructions for formulating the compounds.
The doctrines of Galen (130-200 AD), the Greek physician - a surgeon as well - at Rome, were accepted by all the clerical surgeons. He said that therapeutics should have three stages. Many ailments were to be treated by diet alone, a regimen which included sleep, exercise and proper ventilation as well as the choice of foods and beverages, their portions, their preparation, the times of meals and abstentions, etc. When that dietary regimen was inadequate, the physician used his medicines, selecting from his vast armamentarium, preparing them himself or, more often, ordering them from an apothecary. When that strange admixture of medications, prayers, incantations and expostulations failed, or when the ailment was clearly beyond the scope of the physicians, wounds or fractures as examples, only then was the surgeon called to manipulate, to cut, to sew and to use the cautery. Early in that epoch, the surgeon performed the phlebotomies, scarifications and cuppings, and he applied leeches. As time went on the clerical surgeons assumed some of the airs of their physician-models and they turned away from the menial business of phlebotomy and the like as being unworthy of their station. They gave it over to the barbers and other lay practitioners. In time the latter became more and more skillful as operators. By the time of Ambroise Pare and Pierre Franco in the 16th C they were the premier surgeons.