Much has been made of the lower status held by the surgeon as compared
with that of the physician--during the seventeenth century. On the
continent and in England, at this period, membership in separate guilds
in part distinguished doctor and surgeon; in England, after 1540 and
until 1745, surgeons held common membership with barbers in one
corporate organization. In America, historians agree, the differences
based on specialization of practice between surgeons and physicians
soon tended to disappear, a superior education often being the only
attribute or function of a physician not shared by the surgeon. Barbers
held a unique position, but in performing phlebotomies, a minor
operation, they retained associations with health and disease. Both
barber and surgeon shared a certain expertness with tools, as they do
today.
Evidence abounds in the earlier records that the scarcity of medical
men may have compelled surgeons in Virginia to practice internal
medicine: surgeons prescribed medicine with the same frequency as
doctors. The surgeons, however, did not abandon the treatment of
wounds, fractures, and dislocations; notes on amputations during the
century also exist.
Nor is it reasonable to assume that the isolated physician of the
Virginia countryside would always insist upon referring a patient to a
surgeon. Dr. Francis Haddon, who had a large practice in York County,
Virginia, and who is not identified as a surgeon, left recorded the
course of treatment for an amputation--cordials, a purge, ointments,
and bloodletting--and a dismembering saw, as well.
Other recorded surgical treatments include care of dislocated
shoulders; wounds in various parts of the body; sores of the feet and
legs; cancerous ulcers in the instep; ulcers of the throat, and dueling
wounds. One of the most unusual surgical measures of the period was the
application of weapon salve for battle wounds; the salve was applied to
weapon, not wound.
Surgery has long been associated with the military, and much of the
outstanding surgical work done in Europe during the fifteenth and
sixteenth centuries was performed by military surgeons. Ambroise Pare
(c. 1510-1590), remembered especially for the use of the ligature in
amputations and the abandonment of the burning-oil treatment of wounds,
held a position as a surgeon for the French army. Other surgeons of the
period contributed to the improvement of medical practice by
enlightened measures of quarantine to prevent contagious diseases from
decimating armies.
Insomuch as the first settlers at Jamestown greatly feared attack from
Indians and Spaniards and because the initial landings had the
character of a military expedition, it is not surprising that the first
two medical men to arrive, Will Wilkinson and Thomas Wotton, were
surgeons. Captain John Smith on three occasions, it is to be
remembered, emphasized the importance of the surgeon to pioneer
settlers and explorers in the New World. When injured by the stingray
in 1608, Smith's first thought was of his need for a surgeon and
"chirurgery"; so the success of physician Russell's soothing oils came
as a pleasant surprise. On a subsequent expedition he included the
surgeon, Anthony Bagnall, rather than Dr. Russell, to treat the
stingray wound; and in 1609 when he received the powder burn, he left
Virginia "seeing there was neither chirurgeon nor chirurgery in the
fort to cure his hurt."
Throughout the century surgeons rendered services to colonists engaged
in fighting with, or defending themselves against, the Indians. When
the Indian massacre of 1622 occurred, costing the lives of more than
350 colonists in the settlements, it is possible that the two surgeons
who sailed to Virginia with Dr. Pott in 1621 gave assistance to the
wounded. In 1644, when a retaliatory attack on the Indians was made by
the settlers because of a recent massacre, the General Assembly
provided for a surgeon-general to accompany the militia, at public
expense.
Again, later in the century, the General Assembly gave evidence of
recognizing the importance of surgical care for soldiers when it voted
for supplying a surgeon with "a convenient supply of medicines &
salves, etc. to the value of five pounds sterling for every hundred
men" to each of eight forts planned to protect the settlements against
Indian attacks. Throughout the last half of the century references were
made to surgeons ministering to companies of soldiers or to various
garrisons and forts. Judging by the consistent employment of surgeons
for military duties, it would appear that the profession of surgeon
during the century was much more intimately associated with the
military than was that of physician. The relationship between the
surgeon and the military is similar to the early one between civil
engineer and the army in Europe.