Amputations in medieval and early modern Europe were mainly the result of warfare, disease, work accidents, and punishment. Amputations were performed by
barber-surgeons.
Disease One of the major causes of amputation in medieval Europe was disease.
Ergotism (also known as Saint-Anthony’s fire) was a fungus found in rye that caused gangrene that spread from the fingers and toes. If the tissue death from the disease was severe enough, the limb would spontaneously fall off on its own without blood loss.
Warfare Warfare amputations became more necessary in Europe after European armies started using guns in the fourteenth century. At the time, bullet wounds were often too complicated for surgeons to handle, and amputation was their best solution. In the late fifteenth century, we see more documentation of amputations as
Hieronymus Brunschwig and
Hans Von Gersdorff both illustrated amputation scenes, with the latter also writing about gunshot injuries. Gersdorff's writings showed that surgeons at the time struggled with whether the gunpowder on the wound further worsened the injuries. Therefore, it was a common practice to cauterize the wounds with hot oil until
Ambroise Paré discovered that this impeded healing, and concluded that gunshot wounds should not be cauterized. This led to another significant contribution of his to warfare medicine: the revival of
ligature, which replaced cauterization of amputation wounds. Paré updated ligature to make safer, and it became common practice.
Amputation as punishment There is evidence of amputation as punishment dating back to 1750 BCE. The Babylonian Code of
King Hammurabi sanctioned amputation as a punishment. Amputation as a punishment continued in ancient
Peru, where the part of the body amputated had a connection to the crime committed (for example, stealing might be punished by amputating the hand of the guilty). Amputation continued as a form of punishment into the Roman period as well as the Byzantine period, but became less prominent after the collapse of the
Byzantine Empire. These punishments increased again during the
Middle Ages, but declined again after perceptions of punitive amputation changed significantly during the
Renaissance and
Enlightenment. In
medieval England, corpses would sometimes be amputated after death as a form of public shaming or punishment. This would’ve been especially meaningful at the time, as the state of the physical body after death was significant to
medieval Christians. Additionally, archaeologists found evidence of postmortem decapitation from medieval times, which some speculated to be related to rituals or where the soul goes after death. There is also documentation of nose amputation being used as a form of punishment or retaliation. In
France during the 5th and 6th centuries, nose cutting was prominent enough to be classified as its own crime, which would result in a serious fine to the perpetrator. However, it was also occasionally used as a punishment for serious crimes such as threatening royals. The field of
plastic surgery was brought to Europe, specifically
Catania, in the fifteenth century, when Gustavo Branca successfully completed an ancient Indian method of reconstructive
rhinoplasty. Plastic surgery continued to grow as a field across the continent, and the birth of this field is likely related to nose amputation as punishment.
Theories on amputation In medieval Europe, amputation was done on limbs as a last resort when the limb could not be saved. For limbs that were dead or decaying, surgeons categorized them into two main categories: hot fire and cold fire. Hot fire (also called Gangraena) was the first stage of a decaying limb. A body part with hot fire was hot, swollen, and painful. If not treated, the limb would turn cold. Cold fire (also called Sphacelus) was the late stage of limb death, including death of the bone. Symptoms included loss of feeling, coldness, and black and blue coloring. With time, the fire would spread and eventually kill the patient. Followers of
Galen considered hot and cold fire to be based on the humors and an imbalance of hot, wet, dry, and cold in the body. Followers of
Paracelsus believed that hot and cold fire were a result of Mercury, sulfur, and salt. While different surgeons drew from different medical theories of the time, they also used their own experiences to determine the root cause of the fires. There was often debate on whether a particular patient had cold or hot fire, which led to disagreements on treatment methods. One method to stop hemorrhaging after amputation was iron
cautery. This involved taking hot iron instruments to the new stump and burning off the exposed tissue, closing the blood vessels. Another method of cauterization was to apply corrosive chemicals to the fresh wound to burn the blood vessels and stop the bleeding. Both methods were efficient but led to a long healing process. A different method was
ligation. This technique required the surgeon to draw out the individual blood vessels and tie them shut. This process was much more time consuming but healed more quickly
Prosthetics Prosthetics in the early modern period were made from wood, metal, and leather. The majority of prosthetic artifacts from the period still around today were made of metal. In Germany, metal mechanical hands were made with ratchets and springs. The springs allowed for movement of the fingers, while the ratchets locked them in place. The wearer was able to control the fingers by releasing the ratchets through buttons or levers, depending on the hand. The specific mechanics of the hand varied by prosthetic. Mechanical prosthetics were the work of artisans, specifically locksmiths and clockmakers. This was because locksmiths and clockmakers were already using springs and ratchets to make locks, doors, and clocks. ==Etymology==