This chapter will explore the fortunes of one particular fourteenth-century English surgical text, written by the master surgeon John Arderne (1307–c. 1380), which remained in active use (that is to say it continued to act as a guide to practice) until late into the seventeenth century. It will argue that the long life of this text, particularly in its manuscript form, overturns assumptions made about periodisation and the coming of print culture to Europe. The first of these assumptions is ingrained in modern scholarly disciplines. The year 1500 is often taken by historians and literary specialists to be the point at which ‘medieval’ turns into ‘early modern’. Scholars in these fields define their individual specialisms by identifying with one side or another of the divide at 1500. They will typically write books and articles that use this date as a boundary beyond which they do not trespass. To take one pertinent example, The Cambridge History of Science, Volume 2 (Lindberg & Shank Reference Lindberg and Shank2013) deals with Medieval Science, Volume 3 with Early Modern Science (Park & Daston Reference Park and Daston2006), with 1500 as an implicit dividing line, and they employ different sets of contributors. A second similar assumption is paradigmatic for book history, in which the incunabular era (pre-1501) is distinguished from later printing, and which treats manuscript books as co-existent with incunables, but as having more or less lost the battle for media supremacy by 1500. Admittedly this assumption has been questioned vigorously over the last twenty-five years, but here again specialists in manuscripts and specialists in printed books still tend to retain career identities predicated on this division of manuscript and print eras. The Cambridge History of the Book in Britain divided its Volume 3 (Hellinga Reference Hellinga1999) from Volume 4 (Barnard Reference Barnard2002) at 1557, taking the royal charter given to the Stationers’ Company in that year as marking a more significant boundary for books than the year 1500. But the theme of Volume 3 is the transition from manuscript to print, thus perpetuating the idea of modernity attaching to print first stated so compellingly by Sir Francis Bacon in his Instauratio Magna of 1620.

2.1 Arderne’s Writings

The publishing history of the Practica on fistula in ano written by the English surgeon John Arderne (Jones Reference Jones2004) in 1376 will be the subject of this chapter, and will be used to test the assumptions described in the paragraph above. John Arderne’s writings on surgery for fistula in ano and his book of medical recipes or ExperimentaFootnote ¹ both enjoyed a wide circulation in England in the century afterwards (Power Reference Power1910; Jones Reference Jones, Garcia-Ballester, French, Arrizabalaga and Cunningham1994; Sharpe Reference Sharpe1997: 202–4). There are more surviving manuscript copies of Arderne’s texts than of any other English surgical writing. He wrote in Latin, but at least four separate Middle English translations of his works were also made (Jones Reference Jones and Minnis1989).Footnote ² Deviating from the organising conventions of scholastic surgeries written by his university-trained competitors, Arderne visualised and described his surgical operations in temporal sequence from beginning to end. He could be said to provide a ‘how-to’ descriptive manual for an apprentice surgeon, rather as if demonstrating how to assemble flat-pack furniture or repair a car. The crucial accompanying pictures were called for in the text. Thus manuscripts of Arderne’s writings were heavily illustrated within and alongside the text-block on the page, reinforcing the bias of the text towards visualisation and personal witness (Jones Reference Jones, Prinz and Beyer1987, Reference Jones and Edwards2002). All but one of the manuscripts are codices, some produced by highly proficient ‘professional’ scribes and illuminators; others were copied by the owner in their own hand with crude illustrations. In one spectacular exception Arderne’s Experimenta are sampled in a text written and illuminated on a roll (London, c. 1420) made up of six parchment membranes sewed together. The illustrations on the roll include a sequence of fistula in ano operations, but not the text that describes the operations. It is almost certain that this manuscript was commissioned by a very high-status individual whose interest was not in carrying out surgery but in enjoying the anecdotal flavour of Arderne’s text and a collection of spectacular medical images (Svenberg & Jones Reference Svenberg and Jones2014).Footnote ³

2.2 Arderne Manuscripts after 1500

After 1500 John Arderne’s writings on surgery and his Experimenta continued to be copied by hand in England, in both Latin and English. This is not such a surprise given that the essential techniques of fistula in ano surgery have not changed radically up to the present day, and the condition itself is still encountered by surgeons in modern hospitals. The need for guidance on how to perform Arderne’s operations thus remained a constant, we may suppose. But it is less obvious why Arderne’s text was not replaced or updated in the sixteenth and seventeenth centuries. In its original Latin version the text of the Practica on fistula in ano is not a very polished work and, despite its focus on describing the fistula in ano operations in time sequence, there are interpolations of a puzzling kind that suggest a jumbling of several different texts. One at least of the Middle English translations attempted to reorder and give the Practica text a more coherent organisation; the translator was also in effect an editor. This was the translation that had the longest textual tradition, the only one represented after 1532 (Power Reference Power1910). Even so, the Middle English Arderne text of the early fifteenth century must have seemed increasingly difficult for sixteenth- and seventeenth-century readers, with regard to both its grammar and lexis (Jones Reference Jones and Carruthers2015). Examination of manuscripts of Arderne’s text written in the sixteenth century may help us to understand the dynamics of this textual transmission.

One feature shared by these later manuscripts of Arderne copied in the sixteenth century is significant. They were commissioned or owned by practising surgeons and medics, rather than by university teachers, scholars, or lay patients. This is not so clearly the case with most of the earlier manuscripts. The Stockholm roll of Arderne is exceptional in its format and the liberties that it took with text and illustrations, but it is like most other Arderne codices from the fifteenth century in that it cannot plausibly be claimed to have been made for surgical practitioners to follow as a guide. Very few of the other late medieval manuscripts have any clear evidence as to commissioning, ownership, or use. One that does, Cambridge, Gonville & Caius MS 190/223, seems to have been put together for the Premonstratensian abbey of Hagnaby, Lincolnshire. It is not very likely that one of the canons practised surgery given the prohibitions in canon law against shedding blood (McCall Reference McCall2016; Jones Reference Jones2019).Footnote ⁴ We do know, however, that one manuscript of Arderne was bequeathed in the will of the London surgeon Henry Assheborne in 1442 (Talbot & Hammond Reference Talbot and Hammond1965: 75).

There are three extant sixteenth-century manuscripts of Arderne. Two contain distinct Middle English translations of the Practica, while the other is in Latin. British Library, Sloane MS 776, can be dated to 1532, and was written for Charles White or Whyte, a London barber-surgeon, by one Nicholas Browne (Watson Reference Watson1979: no. 926).Footnote ⁵ An inscription in the manuscript calls Charles Whyte the compiler of the book, but on the basis of the text his role seems to have been that of a commissioner, rather than someone who selected, combined, or edited different texts as might be expected of a compiler. In Whyte’s will of 1545 this manuscript (‘namyd John of Ardren’) is bequeathed to the surgeon Nicholas Archepolle.Footnote ⁶ Another medical book compiled by Charles Whyte and supposedly written by Nicholas Browne was quite possibly one of those books left by Whyte to his apprentice John Colmay, and was sold at Christie’s in 2016.Footnote ⁷ Sloane MS 776 contains the longest Middle English translation of Arderne, containing both the Practica and the Experimenta; this translation is otherwise known only through the early fifteenth-century manuscript Cambridge, Emmanuel College MS 69 (Power Reference Power1913). Sloane MS 776 is profusely illustrated in ink and colour wash, and the images are related in appearance to the programme in the Cambridge manuscript (Jones Reference Jones and Edwards2002: 211–13). While we cannot know for certain if Charles Whyte used his Arderne manuscript as a guide to performing fistula operations, he evidently thought of it as a useful handbook of practical information for himself and surgeons like Archepolle who belonged to the guild of barber-surgeons.

Glasgow University Library, Hunter MS 403, was written in the distinctive hand of Robert Green or Greene of Welby (Rampling Reference Rampling2020), and dated by Greene himself to 1544 (Young & Aitken Reference Young and Aitken1908: 321–2). This is the last known reference to Greene, who wrote or owned a number of other manuscripts containing alchemical and medical texts (Watson Reference Watson1985; Thomson Reference Thomson2011). In one of these (Oxford, Bodleian MS Ashmole 1415), Greene tells us that he was seventy-one years old in 1538, so was born c. 1467. Greene seems to have been both a medical practitioner and an experimental alchemist, to judge from the contents of his manuscripts. Alongside Greene’s copy of the Latin Practica and Experimenta of John Arderne, the manuscript also contains the gynaecological treatise known as The book of Rota (on pp. 347–63), a late medieval translation of the Trotula corpus very much presented as if made for a male practitioner of women’s medicine (Green Reference Green2008: 190, 285, 340). The manuscript also contains Robert Greene’s own compilation of plasters and ointments (‘Compilacio emplastrorum et unguentorum’). It is possible that Greene was still practising surgery in his seventies, though it would have unusual to have undertaken the complexities of the fistula operation at such an age. But it is clear in any case that he was very interested in the practice of surgery.

London, Wellcome MS 7117, is a compendium of medicine in English compiled for use by an unknown Elizabethan practitioner around the year 1575.Footnote ⁸ It contains an incomplete English translation of John Arderne’s treatise on fistula, hundreds of medical recipes, notes on medical astrology, and lists and classifications of diseases and medicaments. There is also an illustrated guide to urine diagnosis. There are two distinct hands, a fine, cursive secretary hand, with headings in italic, for the treatise on fistula and the uroscopy section (fols. 5r–39v, 119r–22r), and a more stolid Tudor hand for the rest. Both, however, are probably the work of the same scribe. Arderne’s treatise on fistula in ano in this manuscript is based on the most commonly met of the four Middle English translations, and is organised in twenty-five numbered chapters. The other contents of the manuscript (not the Arderne treatise) align closely with those of Cambridge, Trinity College MS R.14.52, copied by a single scribe (the ‘Hammond’ scribe) in the third quarter of the fifteenth century (Tavormina Reference Tavormina2006, vol. I: 7–13, 40–6). The Trinity manuscript has many sixteenth- and seventeenth-century annotations, suggesting it was regarded as current and useful for long afterwards. One of the Trinity annotators, Henry Dyneley, twice dates his interventions to 1573, close to the date of writing of the Wellcome MS, though the Wellcome MS does not copy the Trinity MS directly.

2.3 Arderne in Print

The treatise on fistula in Wellcome MS 7117 corresponds quite closely to the first (and only) printed version of Arderne’s Practica of fistula in ano dated to 1588. It is the same Middle English translation that forms the basis of both, and the chapter headings correspond. This printing formed a section of a compendium of various tracts on surgery edited by John Read, a surgeon. Its title was A most excellent and compendious method of curing woundes in the head, […] With a treatise of the fistulae in the fundament, and other places of the body, translated out of Iohannes Ardern. And also the description of the emplaister called dia chalciteos, with his vse and vertues. With an apt table for the better finding of the perticular matters, contayned in this present worke (Read Reference Read1588). Read was practising in Gloucestershire in 1587, but must have arrived in London that same year, since he was licensed to practise surgery by the Archbishop of Canterbury in January 1588. In June 1588 he married the daughter of John Banister, lecturer in anatomy to the London Company of Barber-Surgeons. Read never joined the Company himself, but associated with some of its most prominent members, including Banister, William Clowes, and Thomas Gale, and like them sought in writing to associate himself with a tradition of learned surgery, and to disassociate himself from those he called ‘quacks’. His one printed work appeared in 1588, but was evidently completed in the preceding year; it was entered in the Stationers’ register on 10 November 1587 (Symons Reference Symons2004). It is for the most part a translation of De recta curandorum vulnerum ratione by Franciscus Arcaeus, but also includes John Arderne’s Treatise translated from the Practica, as well as an English version of the Hippocratic oath, various miscellaneous pieces, and substantial interpolations by Read. At the end of Arderne’s Treatise there are two notes about practising on patients with fistula in ano by Read himself. The first begins:

It is very clear here that Read’s motive for publishing Arderne in translation was to make ‘secrets’ available to those who wanted to provide the most effective surgical treatment for fistula in ano.

What is remarkable about both Read’s printed book and Wellcome MS 7117 is that neither contains any illustrations of the fistula in ano operations. There are illustrations of urine glasses in Wellcome MS 7117, probably scribal rather than the work of a professional, and there seems no good reason why the scribe should not have also copied the surgical images from their exemplar. Similarly amateur illustrations are found in fifteenth-century manuscripts of Arderne (for example London, British Library, Harley MS 5401). The Middle English translation copied by the scribe of Wellcome MS 7117 was usually accompanied in earlier manuscripts by a manageable number of line illustrations, not the full suite of two hundred or more images found in Sloane MS 776. For its part the failure of the Read printing to include illustrations of fistula in ano should be considered in the context of other printed works of surgery of the same generation. The works of William Clowes, Thomas Gale, and others were illustrated with a limited repertoire of woodcut images copied from earlier continental works of surgery (wound man, surgeon’s chest, etc.), rather than using original images to convey surgical technique. The English barber-surgeons perhaps wanted, in any case, to identify themselves more closely with scholarly works of learned medicine and surgery than with artisanal handicraft (Chamberland Reference Chamberland2010). John Banister, Read’s father-in-law, did in fact make spectacular use of painted anatomical tables to teach anatomy to English surgeons, but did not carry this practice over as illustration into his printed output of writings on anatomy and surgery. Instead he borrowed the woodcuts of Andreas Vesalius’s De fabrica, or rather the pirated versions of these first printed in England by Thomas Geminus (Banister Reference Banister1578). It may be that the English surgical authors, or their printers (if they met the costs), were simply deterred from commissioning new woodcut illustrations because of the expense. The effect of such policies, however, was to limit significantly the effectiveness of the Arderne Practica in print as a practical tool, since the author explicitly points from the text to the illustrations found in manuscript copies of his work to convey essential information about the presentations of fistula, the instruments to be used, and the sequence of operation.

The only other appearance of Arderne in print was in the seventeenth century, when three of his remedies were credited to the fourteenth-century surgeon in the Pharmacopoeia Londinensis of 1632 (Royal College of Physicians of London 1632). This edition enlarged slightly on the original Pharmacopoeia issued by the College in 1618, and three entries under Unguenta (ointments) were taken from Arderne: Valentia scabiosae, Tapsivalencia, and Tapsimel were all drawn from the Practica on fistula in ano. The Pharmacopoeia Londinensis has a note about Arderne, remarking on his origin in Newark, and that he flourished around 1370. The note claims that the three remedies from Arderne were excerpted word for word from an ancient manuscript (‘ipsissimis verbis ex antiquo manuscripto excerpta’). Many of Arderne’s remedies indeed continued to circulate in manuscript, for instance those to be found in London, Wellcome MS 674, probably compiled in the late sixteenth century.Footnote ⁹ These particular three remedies remained in print in successive editions of the Pharmacopoeia. As late as 1733 James Alleyne’s A New Dispensatory in Four Parts […] was still recommending the three remedies from Arderne, quoting from the Pharmacopoeia Londinensis in English translation (Alleyne Reference Alleyne1733: 336–7). John Freind in his History of Physick (1725) gave a favourable account of the English surgeon, and cited the same three remedies by Arderne as still current. Freind was aware of John Arderne manuscripts in circulation in his own time:

2.4 Walter Hamond, Chirurgian, and the Lentaigne Manuscript, 1645

Freind’s surprise at Arderne’s works not having been printed in his own time may be shared today. But the failure to print the Practica was not a matter of it having fallen out of surgical use. There is one valuable piece of evidence revealing a seventeenth-century English surgeon making use of a fifteenth-century manuscript of Arderne as a guide to the fistula in ano operation. This is a manuscript now in Dublin, in the Library of the Royal College of Surgeons in Ireland (RCSI), MS 97. It is also known as the Lentaigne Manuscript after its donor, Sir John Lentaigne, who gave it to the RCSI in 1851 (see Figure 7 in the Image Gallery). A former owner, Walter Hamond, ‘Chirurgian’, had the manuscript bound in leather in 1645 and interleaved the vellum leaves with paper pages for his own notes. It is not known how the manuscript came into Sir John Lentaigne’s possession. The main texts of the manuscript are the Practica of fistula in ano and Arderne’s Experimenta in Latin, written in an English hand of the early fifteenth century. Walter Hamond wrote the interleaved notes, which, though far from the complete commentary he may first have intended, provide evidence of his understanding of Arderne’s text and of its importance to his own practice of the fistula in ano operation.Footnote ¹⁰

Figure 7 From the Lentaigne manuscript: Dublin, Royal College of Surgeons in Ireland, MS 97, f. 128v. The manuscript was used in the seventeenth century by Walter Hamond (d. 1648), ‘Cirurgian’.

Image courtesy of the Royal College of Surgeons in Ireland

Walter Hamond, whose date of birth and origins are unknown, was apprenticed to Arthur Doughton in the Barber-Surgeons’ Company of London, and made free in 1616 (McConnell Reference McConnell2004). In 1617 he was responsible for the publication of The method of curing vvounds made by gun-shot […] (Hamond 1617). This work was dedicated to Arthur Doughton, and described itself as intended for students and apprentices of the craft of surgery, more especially those who do their country service on the seas. Hamond was in the service of the East India Company. In 1630, as surgeon to the Charles and the Jonas (Captain Weddell), bound for the Far East, he spent four months on the island of Madagascar. This voyage gave Hamond the material for writing in 1639 a short pamphlet in favour of colonising the island for naval purposes (Hamond Reference Hamond1640). An expedition planned for 1639 never left port, but another opportunity arose in 1643, giving rise to Hamond’s second advertisement (Hamond Reference Hamond1643). This expedition was much delayed but finally sailed in 1645. It is very unlikely that Hamond went himself. In any case, the colony soon failed. At Hamond’s death in May or early June 1648, he left a wife, Marie, to execute his modest estate, but his will provided no clue as to his then residence or desired place of burial.

From the little we know of Walter Hamond, it seems then that he was for much of his life a sea surgeon. However, when in 1645 (the year the Madagascar expedition sailed) he assembled the interleaved volume of Arderne and had it bound, he was probably in his fifties, and was no longer practising his craft at sea. On the title page he wrote ‘The Workes of Master John Arderne, Chirurgian, of Newark in Nottingham Shire written by his own hand in the yeeare of our Lord 1349 – with Some Observations collected in blank paper By Walter Hamond Chirurgian, 1645’ (Widdess Reference Widdess1943: 80; O’Doherty Reference O’Doherty2013). On the first page of his ‘Observations’, opposite the first vellum leaf of Arderne’s Experimenta, Hamond recorded a running title ‘The Practice of M[aste]r John Arderne’, and he began by translating Arderne’s charm for staunching blood at the beginning of the text:

So Hamond does not distinguish between the Experimenta and the Practica, all being subsumed as ‘The Practice of M[aste]r John Arderne’, and nor does he balk at what might be regarded as ‘superstitious’ or ‘magical’ experiments. Hamond’s writing out of his ‘Observations’ soon become sporadic on the interleaved pages. He has nothing to say about the coloured illustrations in the Experimenta part of the Lentaigne Arderne manuscript.

This lack of interest in illustration changes dramatically when it comes to the section of the Practica where the instruments and the operative sequence for fistula in ano are described. In the Lentaigne Practica the images of the instruments to be used for the operation are found inserted within the text-block. On the blank page opposite Hamond drew his versions of the same instruments, with his own descriptions of the instruments in English. Neither the images nor the descriptions of them are straightforward copies of Arderne. On page 163 Hamond drew the probe, giving it the same title as Arderne, ‘sequere me’ (‘follow me’). His description runs:

He follows Arderne in emphasising pliability, but Arderne’s version declares that the instrument should be like the pin that women use in their hair, and made of the same metal, and does not specify the need for an eye. In the medieval and early modern periods such pins were usually made of copper alloy (brass wire) or of iron – not lead as Hamond suggests. Hamond is specific about how to make the frenum caesaris where Arderne is not:

For his drawing of the Acus rostrata, or pointed needle made of silver recommended by Arderne, Hamond writes: ‘This Acus Rostratus [sic] semes onely to cut the orifices one unto another to passe the frenum cesaris.’ For the siringa or clyster-pipe, Hamond draws what is evidently a seventeenth-century version of the instrument for administering enemas, with a circular fat pipe and plunger, and a narrower part for insertion. The drawing in the Practica does not have a plunger or the narrower part for insertion. Hamond calls his version ‘The Siringue a Common Instrument needfull in this case’ (see Figure 8 in the Image Gallery).

Figure 8 Instruments to be used for the treatment of fistula in ano, drawn by Walter Hamond. The drawings are versions, interestingly modified, of those originally provided for the medieval treatise composed by John Arderne (c.1307–c.1377). From the Lentaigne manuscript, Dublin, Royal College of Surgeons in Ireland, MS 97, f. 83r.

Image courtesy of the Royal College of Surgeons in Ireland

But the most significant departure from Arderne’s model comes in relation to the tendiculum, an instrument Arderne claims to have invented himself. Hamond’s tendiculum bears little resemblance to Arderne’s, having a saw-toothed dial at the centre with which the frenum caesaris is progressively tightened once it is passed through the anus and comes out of the fistula hole. Hamond substitutes on page 163 of the manuscript his instrument for that of Arderne:

Arderne specifies that his tendiculum should be made of box wood. The Hamond instrument was devised for operating on a named patient, Richard Wild, presumably to the entire satisfaction of both. By naming the patient Hamond is following Arderne’s example, for the earlier surgeon identified at the beginning of the Practica a series of patients he had successfully operated on for fistula in ano. But although the revised tendiculum performs the same function as that of Arderne, Hamond evidently wished to draw attention to his ability to strike out independently and to register his own improved design.

Hamond was interested in comparing the fees for the fistula in ano operation that Arderne claimed to charge with what he charged himself when operating on Richard Wild in 1630:

Hamond was every bit as interested as Arderne in how much to charge for this difficult operation. It seems that Hamond recognised that Arderne’s fees were very high for that period, but that in the case of Mr Wild, Hamond himself charged an amount quite outside his own usual fee structure. Perhaps Wild was the only patient he performed this operation on, or perhaps he charged others less in accordance with their ability to pay. But, like Arderne’s statement at the beginning of the Practica, Hamond used his ‘Observations’ to show how much such outstanding skill might earn.

What is significant in the ‘Observations’ is the deep level of Hamond’s engagement with this ‘ancient’ surgical text, and his ability not only to read Arderne’s idiosyncratic Latin but also to grapple with the palaeography of a manuscript more than two hundred years old. The reward for his engagement was that he could compare his own practice of the tricky fistula in ano operation with that of Arderne. Hamond could also record for the use of others how to make improvements on the necessary surgical instruments Arderne described and illustrated, and what kind of fee to charge. Opposite the leaf on which Arderne depicted the successive stages of the fistula in ano operation, Hamond wrote:

We learn two things here. First, that Hamond was writing on this page on 5 September 1645, making it likely that his ‘Observations’ on Arderne all date from that year. Second, that his friend Mr Geoffrey Guilbert gave Hamond this Arderne manuscript. We know nothing more of Guilbert, unfortunately. He does not appear to be recorded as a barber-surgeon under the name Guilbert or Gilbert. Guilbert must have known that Hamond would put the manuscript to good use. It is probable that Hamond interleaved the manuscript for his ‘Observations’ because he wanted to supplement Arderne’s teaching with the fruits of his own experience. Within three years of Guilbert’s death, however, Hamond himself was dead, and the Arderne manuscript does not feature in his will, nor is there any other sign of his giving it in turn to another surgeon. Nevertheless, it is safe to assume that Hamond hoped that other surgeons would be able to profit from his ‘Observations’.

2.5 Other Practical Users of Arderne in the Seventeenth Century

There is other significant evidence that the currency of Arderne’s manuscripts in the seventeenth century was connected with their practical usefulness. Sir Theodore Turquet de Mayerne (1573–1655), the Huguenot court physician (Nance Reference Nance2001: 8–9; Trevor-Roper Reference Trevor-Roper2006: ch. 22), copied in his own hand from a Latin manuscript containing both the Practica of fistula in ano and the Experimenta. He described his own transcript as ‘collecta ex libro manuscripto’ (collected from a manuscript book).Footnote ¹¹ The other works excerpted in this volume in Mayerne’s hand were by sixteenth- and seventeenth-century authors, English and continental. Mayerne dated the Practica accurately to 1376, but clearly felt that the considerable gap in time between Arderne’s date of writing and his own did not reduce the usefulness of the earlier surgeon’s work. Mayerne also cited a passage in Latin from the Experimenta concerning a charm against spasm and cramp in his commonplace book De amuletis (On amulets) (Skemer Reference Skemer2006: 145, n. 53). Another lengthy excerpt from the Experimenta is to be found in a fifteenth-century manuscript acquired by Sir Kenelm Digby (1603–1665), Bodleian Library, Digby MS 161. Digby is known to have been collecting medical recipes and experiments for his own use from 1625 onwards, and Digby MS 161, one of those he acquired after he inherited the library of Thomas Allen, reflects this interest clearly. Digby was a friend and collaborator of Mayerne (Foster Reference Foster2004; Moshenka Reference Moshenka2017). These men are not surgeons like Hamond, and belonged to a rather more courtly milieu (though Digby also was a sea voyager). But they were eager to learn from the unusual methods and practical bent of Arderne, the medieval surgeon, and to this purpose sought out his manuscripts and copied from them.

Another such practically minded user of an Arderne manuscript, but this time an ecclesiastic, was Samuel Knott (1613–1687). Knott obtained his BA at Trinity College in Oxford on 16 May 1632. He became vicar of Broadhembury in Devon in 1634, and in 1635 was nominated rector of Combe Raleigh, also in Devon. Ejected from the church in 1647, he was restored in 1660, only to be suspended again by the bishop in 1663 and definitely prohibited from preaching in 1664, as he did not conform to the Act of Uniformity. Knott acquired a considerable collection of early manuscripts, most liturgical or theological, but twenty medical manuscripts now in the British Library Harley collection were also once Knott’s. His very distinctive hand is found in all of these medical books. Relevant for our purposes is that Knott owned and annotated Harley MS 3371, a fifteenth-century Latin manuscript containing the Practica and Experimenta of Arderne, inter alia, and the exemplar for one of the Middle English translations (Jones Reference Jones and Brownrigg1990). It is clear from Knott’s notes that he regarded these texts as important guides to medical practice. Knott’s manuscripts later came into the hands of Robert Burscough (1650/1–1709), prebendary of Exeter in 1701, archdeacon of Barnstaple in 1703, and rector of Cheriton Bishop in 1705. The Arderne manuscript was no. 60 in his collection. In 1715 Robert Harley (1661–1724) acquired Burscough’s manuscripts by purchase from the rector’s widow, a purchase negotiated by Humfrey Wanley, which included all Knott’s medical manuscripts (Nuvoloni Reference Nuvoloni2008).

2.6 Collecting Arderne Manuscripts

The single most important gathering of Arderne’s manuscripts was that of Sir Hans Sloane (1660–1753). No fewer than fifteen of the Sloane manuscripts now in the British Library contain Arderne texts, and one now in the Hunterian collection of Glasgow University Library (MS 339) formerly belonged to Sloane. This means that almost a third of the surviving Arderne manuscripts today were once in Sloane’s collection. Although Sloane was a collector of collections on a scale unknown in his day or since, the concentration of Arderne manuscripts cannot be simply an accident caused by his absorbing so many smaller collections. His fortune was made as a medical practitioner (and through investments in land and slavery), and he was committed to collecting medical history. Arderne was arguably the most important English medical author before William Harvey, and so would have appealed to Sloane’s patriotic instincts as well. No doubt the extraordinary illustrations were an attraction, for Sloane also collected illuminated manuscripts. Sloane’s own medical practice would not have included treating fistula in ano surgically, as he defined himself as a physician and not a surgeon (Delbourgo Reference Delbourgo2017: 124), although he did certainly collect reports of successful remedies. Unlike Hamond, Mayerne, Digby, or Knott, Sloane did not collect these Arderne manuscripts primarily to improve his practice or to test Arderne’s remedies. His interest was principally that of an antiquarian or connoisseur, whose specialist field of collecting was medical (Hunt Reference Hunt, Hunter, Walker and MacGregor2012; Delbourgo Reference Delbourgo2017: 202–11, ch. 6).

Although Sloane’s collections were not much used by scholars in his lifetime, Humfrey Wanley (1672–1726) did gain access to Sloane’s manuscripts and took a particular interest in the Arderne texts held by Sloane (Heyworth Reference Heyworth2004). Wanley’s work on Edward Bernard’s Catalogi librorum manuscriptorum Angliae et Hiberniae (1697) had already introduced him to Sloane’s acquisitions (264 Sloane manuscripts were included), and when he moved from Oxford to London Wanley worked as Sloane’s assistant while the latter was Secretary of the Royal Society (Blakeway Reference Blakeway2011: 23–5). After 1708 he settled down as library-keeper to Robert Harley and to his son Edward Harley, building up the great Harleian collection of manuscripts (Jackson Reference Jackson2011). Wanley then was in a unique position to make a study of the Arderne manuscripts in both collections, and he took advantage of it. He was no doubt instrumental in the acquisition of several of these manuscripts and Wanley’s hand is found in the margins of Arderne manuscripts owned by both Harley and Sloane. Wanley collated the various manuscripts and his notes in the margins are a result of this collation. We can see this impressive activity as the purest expression of the instincts of the textual scholar and librarian – while Sloane was Wanley’s doctor, there is no hint that Wanley was interested in practising medicine himself. John Arderne and his Practica of fistula in ano were still very much relevant to the continuing practice of the surgical operation, but the manuscripts were no longer being quarried medically in the way that they had been in the sixteenth and seventeenth centuries.

2.7 Conclusion

On the basis of the evidence provided by the sixteenth- and seventeenth-century manuscripts of John Arderne’s writings, it is clear that the work of the medieval surgeon was valued highly for its contemporary practical usefulness by surgeons, physicians, and apothecaries. He was of course far from being the only medieval medical author whose works enjoyed a long early modern afterlife.Footnote ¹² Given that Arderne appeared late in print (1588) and that copying his work in manuscript remained attractive to early modern medical practitioners, there is no question of the supposed distinction between manuscript and print eras acting as an obstacle to his continuing popularity. Nor did his ‘barbarous’ Latin or Middle English translations (Jones Reference Jones and Carruthers2015) put off those who were used to reading and writing in early modern English. Only towards the end of the seventeenth century do we begin to find Arderne’s manuscripts being treasured for their linguistic and editorial interest or for the light they throw on the historical past of English surgery, rather than their immediate practical usefulness.