'Chirurgie’: discover an 18th century surgical manual in need of conservation
Today, medical students and surgeons can watch procedures on screen, study 3D models and access medical knowledge within seconds. Three hundred years ago, learning surgery looked very different. Without photography, film or digital technology, students and practitioners depended on written descriptions and carefully drawn illustrations. One of the books that helped them understand the developing practice of surgery was Chirurgie [Surgery] by Lorenz Heister, published in 1724.
The vellum binding of the book is cracked and presents losses.
Heister is regarded as one of the founders of scientific surgery in Germany. He helped establish surgery as a more systematic and scientific discipline through his work in anatomy, clinical practice and medical education. While many medical textbooks of the period were written in Latin, he wrote Chirurgie in German, opening its knowledge to a wider group of students and practitioners. At the time surgery was not taught at University but learnt through apprenticeship so many practitioners did not learn Latin and texts like this in in other languages became essential for education. The book was later translated into English, French, Italian and Spanish, allowing its influence to spread across Europe. It became one of the most widely used surgical textbooks of the 18th century and remained an important reference for surgeons and physicians for many decades.
Its success reflected the medical world in which it was published. Medical and surgical practice in the eighteenth century was far removed from modern medicine. Learning anatomy also presented significant challenges. Although students learnt through the physical dissection of human bodies, opportunities to observe dissections were limited because the growing demand for anatomical training exceeded the available supply of legally available human bodies. Public opposition to dissection further restricted access with serious objections on religious grounds plus outrage at the illegal trade in bodies that developed to get around the restrictions. Performing surgery presented its own challenges. Modern anaesthesia had not yet been introduced, and knowledge of infection and its prevention remained limited. In this context, Chirurgie became an essential learning resource. Its detailed illustrations enabled students to study anatomical structures, surgical instruments and operative techniques before applying that knowledge in practice. To learn more about the role of anatomical illustrations in medical education, explore the online version of the RCP Museum's 2019 Under the Skin exhibition.
Torn and damaged fold out illustrating surgical equipment and procedures.
The RCP's copy of Chirurgie contains 19 copperplate engravings. Copperplate printing made it possible to produce fine lines and highly detailed images, making it particularly suitable for medical illustration. The engravings depict the human body, surgical instruments and operative techniques. Together with Heister's written explanations, they helped readers understand ideas that were difficult to communicate through words alone. At a time when opportunities for students to observe human dissections were limited, these illustrations offered an important way to study anatomy and surgical practice.
The book’s journey did not end in the 18th century. It later entered the collection of Harvey Cushing (1869–1939), the pioneering American neurosurgeon often described as the father of modern neurosurgery. His work greatly reduced mortality rates from brain surgery and transformed the treatment of brain tumours through advances in surgical techniques and careful observation of neurological disease. Alongside his surgical career, he was also a passionate collector of rare medical books, and his collection later formed the foundation of Yale's Medical Historical Library. His ownership connects two important periods in the history of surgery: the world recorded by Heister and the later development of modern neurosurgery.
The mis-folded pages are visible from the outside of the book and are being further damaged.
More than 300 years after its publication, this remarkable volume still survives. However, time has left its mark on its pages and folded illustrations. Some of the paper is damaged, and several plates have been misfolded and require specialist care. Conservation would help stabilise the volume, clean its pages and protect the illustrations from further deterioration.
You can help ensure that this remarkable volume remains available for future research, display and learning by donating to the RCP's Adopt a Treasure scheme. Without conservation, we risk losing more than a rare 18th century book. We risk losing a remarkable record of how medical knowledge was documented and preserved for future generations.
Shu-Yu Ho
University of Leicester MA Museums Studies placement
Fold out with damage along lower edge from incorrect folding.