A New Concept for Surgery in European Hospitals? Records of Practice in Germany, Italy, and Spain During the Sixteenth and Early Seventeenth Centuries.

The recent discovery of a manuscript has allowed historians to understand the medical routine in a hospital known as the Schneidhaus in Augsburg between the sixteenth and nineteenth century. The context of the manuscript shows that at this institution, non-academic specialists, generally members of the guild of barber-surgeons and barbers, routinely performed surgical cures of intestinal hernia, scrotal swellings, and vesical calculus. The Schneidhaus exclusively admitted patients applying for such specialised treatments and offered no other services. Such a degree of specialisation within medical establishments seems to have only existed in the Holy Roman Empire at this institution founded by the Fugger family in Augsburg. We propose that the Schneidhaus was either itself a model hospital or adopted a model from another site in Europe. In this paper, we investigate the connections of the Schneidhaus to the practice of surgeons in both Italy and Spain. In Italy, a momentous new technique for identifying and removing vesical calculi was first published in 1522. Although surgical treatment was established in Italian hospitals, they tended not to specialise in such surgical treatment exclusively. Moreover, at the time of the hospital's foundation, the Fugger shifted their economic and social focus from Venice to the Iberian Peninsula. In Spain, research in the history of medicine is complicated by outdated notions about specialised surgery, not unlike those that were recently still current regarding the Holy Roman Empire. We attempt to disprove these notions and use the exemplary textbook of one academic physician, Francisco Díaz, to approach specialized surgical practice in sixteenth-century Spain. In his work, Díaz describes the new Italian surgical method in detail and recognizes the importance of craftsman surgeons to both its development and application. However, he also argues for an expanded role for academic physicians as supervisors of craftsman surgeons' work. All this is suggestive of a greater network of surgical professionals within which both the methods of the craft and its organisational structures were transported. As such, the Schneidhaus can be seen as a node that embodied the institutionalization of surgical practice as a European phenomenon. Further research is necessary, and we propose how this might be carried out to reveal these historical phenomena in their full complexity.