I bowed my way from the solar and returned to Galen House for a dinner of stockfish and maslin loaf, and a chardewarden made of the fresh pears of autumn. I saw that Osbert was much recovered, for he ate his fill and more, although he sat stiffly at the table.
Next morn I left Galen House with the Angelus Bell and met Arthur and Uctred walking up Church View Street to assume their posts as sentinels for the souls who resided in my home.
Shortly after noon I arrived at the New Inn, left Bruce with a stable boy, and with my sack of herbs and instruments slung over a shoulder, sought my dinner at the inn. This was also a fast day, so stockfish was all there was to be had, and as I was late for dinner, what remained had the consistency of shavings from a cooper’s drawknife.
I did not linger long over this meal, for the loaf was little better than the fish. ’Tis but a few paces from the New Inn to the abbey gatehouse, between St. Nicholas’s Church and St. John’s Hospital. At the porter’s lodge I asked for Brother Theodore and the porter’s assistant ran to fetch him. The monk soon appeared behind his stained linen shroud, and I felt a sense of satisfaction that here was a tormented soul I could help.
The hosteler saw the bag over my shoulder and his eyes brightened. “Saturn is no longer in the house of Aries,” he said. “You did not forget my suffering.”
“Nay. I am prepared to deal with your fistula — this day, if you are willing.”
“I am. What must be done?”
“I have herbs which will help dull the pain. But I must warn you again, as I did when we first met, that the surgery I must do will be painful.”
“I have thought upon your words, but I will gladly bear brief suffering if it will end what I have endured for so long.”
“Then we may begin. I require a room with a fire, where I may heat a cautery rod, a cup of ale for you, in which I will place herbs to lessen your pain, and an egg. Also some wine.”
“The only room of the abbey with a fire, other than the kitchen, is the calefactory. Will that serve?”
“Aye, if the other monks warming themselves there do not mind my work.”
The calefactory was beyond the monks’ dormitory, attached to the infirmary, where ill and elderly monks might drive away the chill of a winter day. A lay brother kept the blaze in this warming room, and when told of what I intended to do was eager to assist. I sent him for a cup of ale and another of wine. When he returned Brother Bartholomew accompanied him.
Brother Theodore greeted the infirmarer with impolitic words. “Ah, Brother Bartholomew, here is Master Hugh, a surgeon, who is to cure my fistula.”
The infirmarer had surely used his store of knowledge and salves to work a cure, to no benefit, and I feared he might resent my intrusion. I thought to deflect any acrimony, so asked the monk what salves he had tried.
“Many ointments, but none have succeeded. A paste of our lady’s mantle seemed to reduce the discharge, but it soon returned.”
“You have applied adder’s tongue?”
“Aye. Also a lotion of bruised betony leaves, which has brought success in other cases, but not for Brother Theodore. What herbs will you use?”
“None. You have tried the best God gives us. If they brought no healing, the fistula must be cut and burned away.”
“I have heard of such a remedy, but have no knowledge of the method.”
“If you will assist me, you may see how ’tis done. Then, if another brother suffers a similar hurt you may deal with it.
“The first thing is to do what we may to lessen the pain of the surgery. I have pouches of herbs to add to a cup of ale; crushed seeds and the dried juice of lettuce, pounded hemp seeds, and bruised leaves of mandrake.”
“Mandrake?” the infirmarer asked with raised eyebrows.
“Aye. ’Tis a powerful sedative, and I will use little. I prefer lettuce and hemp alone when I must cause a man pain, but cauterizing a fistula calls for greater relief than they provide.”
I placed a strong mixture of hemp seeds and dried and pounded lettuce in the ale, then added a smaller portion of the fragments of mandrake leaves. Mandrake is a strong physic. Too much of the plant will put a man to sleep so that he will awaken in the next world. And its use is known to cause a man to contemplate females with much appreciation. Such an effect in a monk is to be avoided.
It is my observation that herbs to deaden pain, when taken with ale, are most effective an hour or two after the mixture is consumed. Days grew short, and by the time Brother Theodore would be ready the sun would be low in the west. I requested the infirmarer to assist me in moving a table before a west window, and I asked of him also a clean linen cloth and a feather.
Brother Theodore waited upon a bench for me to announce when the surgery would begin. After an hour or so he began to sway, his eyes drooping, and I judged him ready for the procedure. From my pouch I took a bronze tube nearly as long as my foot and the diameter of my thumb, and an iron rod with a wooden handle, small enough to fit through the tube. I gave the rod to the lay brother and asked him to heat it in the fire, being careful not to allow the flames to singe the handle.
I told the monk to take his place upon the table, and when he had done so I bathed his hurt with wine, then selected from my instruments a small blade. With this I enlarged the ulcer so that I could seek its root. It is often necessary to enlarge a wound before it can be healed, much like the grievances between men, which cannot be repaired until the cause be laid bare and excised. Brother Theodore took this cutting well, but worse was to come.
Next I broke an egg into a bowl, removed the yolk, and with the feather swabbed out the incision with the egg white, using the linen cloth to absorb the blood and pus which issued from the wound. Through all this the hosteler remained silent, nor did he twitch in pain or show any other sign of discomfort. That would soon change.
I allowed the egg white to work for a few minutes, then took the iron rod from the fire. The bronze tube I then inserted into the wound, which caused Brother Theodore to open his eyes in alarm. I told him to close his eyes, and when he had done so I grasped the heated rod by its wooden handle, slid it through the tube, and cauterized the root of the monk’s fistula. Smoke and hissing arose from the wound, and the monk, who had seemed near asleep, writhed in pain. This is why the bronze tube is necessary for such a cure. When the heated rod burns away the source of the fistula the patient will jerk and thrash about in torment. The tube prevents the rod from contacting and burning that flesh which is whole.
I dislike causing a man pain, and in such surgery it is tempting to withdraw the heated rod before it has completed the cautery. I resisted the impulse, and continued the treatment until I was sure of the cure. When I withdrew the rod and tube I saw a tear form in the hosteler’s eye and trickle down toward his ear.
With what remained of the wine I washed again the incision and cauterized wound. Brother Theodore winced as the wine touched flesh, but held still when I assured him that the worst was past and the surgery nearly complete. All that remained was to take needle and silken thread and stitch the laceration closed.
When I was done I used what remained of the linen cloth to wipe sweat from my brow. The blaze had warmed the room, and my work required much concentration — so much that I did not notice the calefactory filling with observers as I did the surgery. One of these watchers was the obese abbot, Peter of Hanney.
“You did not seek permission for this surgery,” he said as I mopped my brow and looked about the chamber in some amazement at the audience which had gathered there.
“Saturn is no longer in the house of Aries. Is it necessary to ask permission to do good?”
“God visited him with an affliction for the good of his soul, to bring him to humility and patience, which are virtues.”
“Aye, so they are.” I agreed. I thought to ask the abbot what affliction the Lord Christ had awarded him, that he might be humble and patient, but thought better of it. Too much wit might send me to the abbey dungeon.