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Out of Time: Nottingham Doctor John Arderne, England’s First Surgeon

19 April 20 illustrations: Natalie Owen

As the most devastating pandemic recorded in human history, the Black Death decimated Europe in the 14th century, killing somewhere between 30-60% of the continent’s entire population. But amidst the death, misery and chaos, one Nottingham doctor named John Arderne blazed a medical trail that still sees him referred to as England’s first surgeon…

It’s been said that it wasn’t until World War One that medicine reached the levels of knowledge and practice that had been refined under the Romans. How valid that claim is remains debatable, but it’s evident that the fall of the Roman Empire and subsequent Dark Ages plunged Europe into a time of superstition and religious fervour. By the time that the Black Death started to rip through Europe’s population, medical knowledge was so poor that people were effectively helpless to stop it. 

 John Arderne was a man seemingly born ahead of his time. Little is known about his early life, other than he was born in 1307 – forty years before the plague reached Europe – he was presumably well educated, owing to the fact that he wrote his own manuscripts in Latin, and that he practiced medicine in Newark. But his name lives on in countless medical books for his pioneering work in surgery, which was groundbreaking enough for Dr. Logan Clendening to label him as England’s first true surgeon in his Source Book of Medical History. In a time when medical practice overwhelmingly favoured putting your trust in God and the Church to heal the sick, Arderne’s research and fieldwork saw him develop medical practices that are still in use today. 

 While the exact nature of his medical training remains a mystery, Arderne’s own writings tell us that he spent much of his young adult life gaining surgical experience during the Hundred Years War, serving first under the Duke of Lancaster and then under John of Gaunt. As bloody and barbarous as the battlefields of Medieval Europe were, there could have been no better schooling for a surgeon, and removing mangled limbs, healing sword and knife wounds and attempting to fix broken bones would have been a regular occurrence. He was even present at the Siege of Algeciras where, for the first time in European warfare, gunpowder was used. His experiences clearly made a great impression upon Arderne, as his later writings are filled with references to his time spent on the field of battle. 

Amidst the worst health crisis in recorded history, the surgeon from Newark created a medical legacy that remains over 600 years after his death

After leaving military service in 1349, a 42-year-old Arderne returned to Newark where he engaged in a civilian surgical practice. It was here that he gained notoriety for revolutionising surgical practice. He practiced using opium as soporific and as an external anaesthetic so the patient “shall sleep so that he shall feel not cutting,” as well as taking a special interest in the rectum; he became the first surgeon to successfully treat an anal fistulae – a condition in which a large, painful lump appears between the bottom of the spine and the anus, a common injury among knights that came as a result of prolonged periods of horse riding. The understanding of the condition and subsequent treatment is still used by modern doctors to cure pilonidal cysts. He also pioneered an ointment for treating arrow wounds and clysters made from hemlock, opium and henbane, which proved far more successful than any other contemporary methods of treatment. 

But more than specific surgeries, Arderne is remembered for developing a code of conduct that the ideal practitioner should adhere to. While he treated the wealthy, including politicians, statesmen, landowners and ranking military officers, he believed that financial standing should never be a barrier to seeking his medical help. As such, he offered his services to wealthy and destitute alike, charging rich men as much as possible, and providing remedies for the poor free of charge. 

 By the time the Black Death had reached its peak, the population of England had been reduced from an estimated 6 million to just over 3.5 million. It had ravaged rich and poor alike, mercilessly tearing through the country’s population without prejudice. Not only did Arderne survive the plague, but he thrived despite it, ensuring that generations to follow would all benefit immensely from his trailblazing work.  

After over twenty years as a surgeon in Newark, Arderne moved to London where he was admitted to the Surgeon’s Guild and continued to practice until his death in 1390. And, with the average life expectancy during the plague reduced to less than 30, reaching 83 was no mean feat. From his surviving writings – in which Arderne refers to himself as a ‘Master Surgeon’, we learn the names, professions and ailments of specific men he helped, as well as detailed analysis of how and why the treatments worked. From this work, undertaken amid the worst health crisis in recorded history, the surgeon from Newark created a medical legacy that remains over 600 years after his death. 

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