MEDICALEXAMINER OUR 4 00
th ISS UE!
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FEBRUARY 17, 2023
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Medicine 400 years ago In observance of our 400th issue, we take a peek at the world of medicine 400 years ago
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here may not be anyone who epitomizes the state of medicine in the 1600s better than the unfortunate man above, Jan de Doot. One day in 1651 he sent his wife off on some errand to keep her busy for a few hours. With assistance from his brother, Jan de Doot was planning to perform surgery on himself. Specifically, a lithotomy (litho- stone; -otomy cutting), removing a calculus or stone from the bladder, kidney, or urinary tract. As the old saying
goes, the definition of minor surgery is surgery performed on someone else. Anything on you is definitely not minor, and when you’re both the surgeon and the patient, well, it doesn’t get more major than that. His brother’s task was to hold de Doot’s scrotum to one side while he - de Doot - made an incision in his perineum so that... Hey, you know what? Let’s skip the details and just say that when it was all over de Doot had removed a 4 oz. stone the size and shape of a chicken egg that had been obstructing his bladder. We called him unfortunate a few moments ago, but he survived and went on to live a good long life, which back then could have meant 35 years. That doesn’t necessarily mean people commonly died at that age. It means that so many died in infancy or childhood — as many as 40% never reached adulthood — that average life expectancy was skewed sharply down. Even in the 1600s, if someone could survive child-
hood (and home surgery) they might live into their 50s or 60s. Along the way, any number of horrific encounters with the “medical” profession might occur, like the one above depicting cataract surgery being performed without anesthesia (other than perhaps brandy or whiskey). The crude procedure would leave the patient unable to see well enough to read a book (if they owned one and weren’t illiterate), but no doubt well enough to plow a field. Please see 400 page 3
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