Dr. Eisenbarth
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* Wolf Seufert

At the Council of Tours in 1163 the Church forbade physicians to practise surgery. Because many physicians were men of the cloth, surgery fast became a paramedical, then an extramedical, pursuit. In Germany and northern France, quacks and charlatans of all kinds recognized the potential market and quickly added surgical services to miracle cures and the pulling of teeth at country fairs. The principal acts performed were the removal of clouded lenses and of bladder stones, true or virtual.

It was evidently not good even for an itinerant healer to lose too many patients, and some of the procedures need not be considered primitive. Immense bladder calculi were removed, from the 16th century on, through sectio alta, that is, a horizontal cut just above the symphysis. An incision through the perineum, recommended by Ambroise Pare, was avoided because of the increased risk of infection. The prudent operator had the patient drink a lot of water before-hand, to make sure the intestines were pushed up and out of the way.

With the passing of time, techniques improved and some of the itinerant surgeons became famous. The story of Johann Andreas Eisenbarth (1661-1727) is particularly interesting because we have some of the leaflets he had distributed before his arrival in town. He advertised cures for calculi, scurvy, catarrh, fever, tinnitus, caries, dropsy, "the French disease" (syphilis) and memory lapses, and he peddled medicines produced in his factory in Magdeburg, near Berlin. Eisenbarth was well rewarded with appointments to the courts of Saxony and Prussia and with a load of money. German medical students still sing of his technique, his sleight of hand and his brazen self-glorification. Figure 1

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/4/421/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/161/4/421/F1)

Figure 1. Engraving by Pieter van der Heijden after Pieter Brueghel's De heks van Mallegem. The witch of Mallegem comes to the country fair to be cured of the buzzing in her ears (the "wasp in her head"). Meester Ian, the "doctor," shows a stone he pretends to have removed from the head of the patient leaning on the bench in front of him. In the collection of the Rijksmuseum-Stichting, Amsterdam, The Netherlands.

Wolf Seufert, MD, DSc

Universite de Sherbrooke