Paul of Aegina
625-690
Greek Physician and Surgeon
Paul of Aegina was a Greek physician and surgeon whose writing contained almost everything that was known about Western medicine in his time. Because his work had such an influence on Arab medical practice, and Arab medical texts were the primary references for medieval medicine in Europe, it had a lasting influence on Western medieval medicine. Paul's greatest work was Epitomae medicae libri septem (Medical compendium in seven books). Abu al-Qasim (c. 936-c. 1013), one of the most important Islamic surgeons, borrowed extensively from the sixth book of Epitome when compiling his own work on surgery.
Paul was born on the Greek island of Aegina and lived during the reign of the Emperor Heraclius (575-641, r. 610-641). Very little is known about his life, but most sources agree that he was educated at the University of Alexandria. He is best known for his descriptions of surgical techniques in the Epitomae. Paul described amputation of a breast, lithotomy (surgical removal of a stone in the bladder), trepanation (removal of a disk of bone from the skull), tonsillotomy (removal of part of the tonsils), and paracentesis (removal of fluid from a body cavity). For a hernia in the groin, he recommended the removal of the testicle on the affected side. This treatment, though drastic, was acceptable during his time.
Paul knew how to use an emergency tracheotomy to open an airway and how to close it once the danger of suffocation was over. He described 62 types of pulses associated with disease and treatments for strokes and epilepsy, and gave the one of the first known descriptions of lead poisoning. The Epitomae also included a lengthy description of the removal of a fishbone from the throat. This possibly reflects the society in which he lived, for the diet at the time must have included a great deal of fish in order to warrant so much attention to this type of trauma.
The first book of Epitome contains information about the complaints of pregnant women, while the third book describes diseases of women. Perhaps Paul's best-known work is on difficult labor, a lengthy description which is probably compiled from Aëtius, an earlier Greek physician. The fact that he could describe pregnant women shows that Paul had experience in a field that was usually limited to midwives. He must have been a trusted and respected individual because few men at the time were allowed to examine a woman's body. Midwives reportedly asked Paul to help difficult cases, and he became known as a man-midwife. He was aware that obesity presented a risk for women in labor. He wrote on the different positions of the fetus in the uterus (known as presentations) and gave instructions for turning the baby. He also explained how to give psychological encouragement to a woman who was in "low spirits" or who was giving birth for the first time.
Paul was knowledgeable about menstruation, and advised that irregular or profuse bleeding during menstruation could be stopped by the use of ligatures around the limbs (another treatment that would seem rather drastic in modern times). He recommended the same treatment for hysteria, as hysteria was attributed to a "wandering" womb, which presumably would be controlled by the ligature. He also described the use of a speculum to gain visibility of the cervix.
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