‘Trotule (Trotula) puts many things on to decorate and embellish the face but I intend solely to remove infection’: L’abbé Poutrel and his Chirurgerie c.1300

Theresa Tyers is a Postdoctoral Research Fellow in the Department of English Literature and Creative Writing at Swansea University, having completed her PhD at the University of Nottingham. She has published several articles on medieval vernacular healthcare manuals.

‘Trotule (Trotula) puts many things on to decorate and embellish the face but I intend solely to remove infection’: L’abbé Poutrel and his Chirurgerie c.1300 

This chapter examines a work produced c.1300 referred to by its translator, Jean de Prouville, as a Ciurge or Chirurgie: ‘A Book of Medicine’. Its contents are based on an earlier Latin surgical work by an Italian writer but it is known to have undergone numerous changes in the course of its transmission. At one point in the text Jean de Prouville’s vernacular version claims that its aim is, unlike the well-known Trotule, only to treat infection and not to embellish. Nevertheless, there are signs that the advice given does more than that and, in doing so, this work authorises its own forms of disfigurement intended to achieve the goal of acquiring a perfect complexion. The present study aims to demonstrate the importance of vernacular medical texts for the circulation of didactical material and the ways in which these texts provided instant, easily accessible surgical advice for their owners. It first discusses the source of this vernacular text and explores a number of the problems that are encountered when dealing with medieval vernacular medical texts. It briefly outlines why their owners sought out texts such as these. In particular, it considers what the treatments, which claim to treat disease rather than embellish, reveal about the author’s understanding of medical practice. The present article uses this vernacular manuscript to explore how medical knowledge was disseminated at the threshold of the early fourteenth century and how owning a text such as this authorises a form of disfigurement in the search for a perfect complexion.

Keywords: medieval; France; vernacular medicine; women; knowledge transfer; disease

Appearing in Approaches to Facial Difference: Past and Present (Bloomsbury: 2018). While you wait, check out other medieval material on our blog.


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A familiar face: wartime facial wounds and William Kearsey

Dr Kerry Neale works in the Military Heraldry and Technology Section of the Australian War Memorial. She completed her PhD thesis through the University of New South Wales on the experiences of disfigured Great War veterans in Britain and the Dominions. She is currently preparing her thesis for wider publication.  This blog is from a forthcoming chapter of a Museums Victoria publication to support the WWI: Love and Sorrow exhibition. You can contact Kerry via email , her LinkedIn profile or Twitter @kreativekurator.

This Friday, 18 August 2017, marks the 100th anniversary of the opening of the Queen’s Hospital for the treatment of facial wound cases at Sidcup, Kent, in England. During a war that saw the rapid advancement of weapons and mass casualties, the number of facial wounds sustained by British and Dominion forces was unprecedented.

I fell upon this topic after listening to a radio talkback program in 2006 – who would have thought all these years later I would still be so intrigued and moved by the stories of these men.  The program was discussing the battle of the Somme, and a man rang in saying that he had series of photographs of his grandfather, who had lost his nose during the battle.  These photos charted his grandfather’s facial surgery journey.  Two things struck me – firstly, I couldn’t even begin to imagine what the results of facial surgery during the First World War would look like.  The other was a comment by the grandson – that in each of the photos, even though his grandfather’s nose was being reconstructed, his eyes seemed to ‘dim a little’, that he ‘lost his spark of life’.  I couldn’t understand this – if his appearance was being repaired, shouldn’t life have been coming back to his eyes as he regained confidence?  And so my search for answers began…

What I found were stories of incredible innovation carried out at the Queen’s Hospital, Sidcup, which had been established specifically for the treatment of severe facial wounds.  Begun primarily as a British endeavour under the direction of Harold Gillies (a New Zealand surgeon working with the British Red Cross), the hospital attracted surgeons and staff from Australia, New Zealand, Canada, and later, a small unit from the United States; and took in patients from all those countries.  Between the hospital’s opening in 1917 and its closure in 1925, surgeons there treated over 5,000 servicemen, and carried out more than 11,000 major operations. Work at the Queen’s Hospital was mainly focused on gun-shot and shrapnel wounds (approximately 80 per cent of all cases treated there); most patients arriving from the Western Front rather than other theatres of the war.[1]

One of the patients who benefited from the remarkable treatment carried out at the Queen’s Hospital was Private William Kearsey from Inverell in NSW. At the outbreak of the First World War, William’s two older brothers, Jack and Stanley, had volunteered for the Australian Imperial Force, but both were found medically unfit for service: Jack suffered from asthma and Stanley had a hearing problem. So when William, a 24-year-old coach builder, went to enlist, we can imagine how frustrated he may have been to find that he was also rejected, because of problems with his eyes. Determined to play his part in the war, he underwent eye surgery in Sydney during 1915. He successfully enlisted with the 33rd Battalion, Australian Imperial Force, in April 1916.


Private William Kearsey, 1916. AWM P10965.001

During the third battle of Ypres, on 3 October 1917, Private Kearsey was in the path of an exploding shell. The wound to his face was so devastating he was initially left for dead. It was only through the efforts of a fellow soldier, Jack Gaukroger, that William made it to an aid post to begin his long journey of repair and recovery.

William spent more than 18 months at the Queen’s Hospital, undergoing more than 25 major operations to repair his face. Returning to Australia in 1919, he spent another six months in Keswick Hospital in Adelaide under the care of surgeon Henry Newland, who had returned to Australia in 1918 after heading the Australian section at the Queen’s.[2]


William Kearsey, c.1920s. AWM P10965.002

Once his treatment ended, William returned to Inverell and, after some early struggles, built a solid reputation for himself as a hardworking wool grower. While he remained single for much of his life, he married at the age of 59 to a woman called Verdun – named for the Western Front battle in 1916, the year she was born. They dedicated many years to bringing out needy children from the United Kingdom under the Big Brother Movement in the 1950s and 60s – thus helping 26 boys find a future in Australia. The last of these they would adopt. William died in 1971, aged 80.

William has become a personal link for me to the experiences of the thousands of disfigured Great War veterans I have investigated. His was one of the first series of photographs I viewed at the Royal Australasian College of Surgeons, Melbourne, and the watercolour painted by Daryl Lindsay depicted such gentle eyes, that I was drawn to the story behind them.

Kearsey at RACS

William Kearsey – original plaster cast, reproductions of photographs, and original watercolour by Daryl Lindsay.  Royal Australasian College of Surgeons, Melbourne.
Photographed by author, 2007.


Just a week after first seeing his records, I found myself speaking to William’s niece, Beryl Taylor. At 87 years of age, Beryl still had the warmest and most vivid memories of her ‘Uncle Bill’.  Beryl had responded to my notice asking for relatives of disfigured Great War veterans to contact me for my research. It turns out that William had grown up in Inverell – the very country town in rural New South Wales where I had spent the first seven years of my life.  It gives me a chill to think that the steps leading to the Post Office (built in 1904) that I remembering running up and down as a child were the very same ones that William walked.

In a strange way, William followed me on my PhD journey.   When searching for images of the hospital ship on which William returned to Australia, I never expected to see William’s face.  But lo and behold, of the hundreds of men on the ship, there he was staring straight at the camera.

Kearsey on Karoola_P01667_002

Soldiers (including William, circled) and nurses aboard No.1 Australian Hospital Ship Karoola, 1919. AWM P01667.002.

In late 2013, I visited Belgium, and while walking through the galleries of the In Flanders Field Museum in Ypres, I stepped into an enclosed obelisk, unsure of what I was to see.  With nothing displayed on the walls, I turned my gaze to the ceiling – who should be staring down at me but William.

Kearsey at Ypres

Photograph of William (top centre) during treatment, as displayed at the In Flanders Field Museum in Ypres. Photographed by author, 2013.

The stories and experiences of facially wounded veterans are only now beginning to be told – for almost 100 years, they were forgotten or (worse still) overlooked in the writing of Great War histories.  But William is no longer forgotten – and indeed, he has become more than just a familiar face to me. I have spoken to his family; I have met his adopted son. William’s story currently features in Melbourne Museum’s First World War centenary exhibition, WWI: Love and Sorrow. His is only one story, but he represents a ‘face’ for so many of the ‘faceless’.


 You might enjoy these other posts about World War I on Effaced from History?.

[1] For some further reading see Harold Gillies, Plastic Surgery of the Face: based on selected cases of war injuries of the face including burns (Frowde : Hodder and Stoughton, London, 1920); Harold Gillies & D. Ralph Millard, The Principles and Art of Plastic Surgery (Butterworth & Co. (Publishers) Ltd, London, 1957); Reginald Pound, Gillies: surgeon extraordinary (Michael Joseph, London, 1964).

[2] Kearsey’s service record and repatriation files are available through the National Archives of Australia. NAA: B2455, KEARSEY WILLIAM; NAA: C138, R55422, KEARSEY William [WW1 repatriation file] [box 16052]

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Archaeological Facial Depiction for People from the Past with Facial Differences

Caroline Wilkinson is the Director of the School of Art and Design and of FaceLab at Liverpool John Moores University. She is the author of Forensic Facial Reconstruction (Cambridge: Cambridge University Press, 2004) and numerous articles.

Archaeological Facial Depiction for People from the Past with Facial Differences 

It has become common for facial depictions to be produced relating to archaeological investigations and historical figures. The methods tend to utilise forensic techniques, anatomical standards and anthropological interpretation. Sometimes individuals are studied who appear to have had facial differences caused by trauma, congenital condition or disease, and depiction of these individuals can be controversial when anthropologists and archaeologists disagree as to the cause of the skeletal deformity/difference, or when the appearance is contrary to other historical evidence. This paper examines a number of cases where facial difference was depicted and the effect of this interpretation on our understanding of people from the past.

Keywords: forensic reconstruction; archaeology; portraits; trauma; disease; body modification

Robert the Bruce

FaceLab recently produced images of Robert the Bruce that showed the effects of leprosy on his face. Photograph: Face Lab/Liverpool John Moores University

Posted in Classical, Early Modern, Festival of Facialities, medieval, Modern, Publications, Representation, Uncategorized | Tagged , , , | 1 Comment

Disrupting Our Sense of the Past: Medical Photographs that Push Interpreters to the Limits of Historical Analysis

Jason Bate is Lecturer in the School of Art and Design at Falmouth University. His PhD was on photography, disfiguration and reconstructive surgery in England during and after the First World War, and he has since published articles in History and Technology and Visual Culture in Britain.

Disrupting Our Sense of the Past: Medical Photographs that Push Interpreters to the Limits of Historical Analysis 

This paper explores photographs of facial plastic surgery cases from the First World War. Drawing on the assumption that a photograph’s meaning comes from its use and the context in which we view it, and emerging from the archive experience and the affect that this encounter has on me as a viewer, I examine how the photographs elicit readings, affect my historical imagination, and shape their content for me as a viewer. The paper begins with a definition of Foucault’s concept of medical discourse as a means of putting the photographs into their historical context. Nevertheless, reading the photographs through medical discourse only takes us so far in understanding what they mean today. These photographs raise difficult questions about their function within, and potentially, across historical discourses. The surgical images are historical photographs, meaningful within the kinds of discursive frameworks Foucault proposed. And yet they can affect me—and not only me—in a way that seems to cut across time and cultural convention, that generates a spark of recognition, a connection—however brief—that cannot be discursively contained. The surgical photographs complicate, or even undermine, my own understanding of history. From one point of view, they are important historical documents, but from another they function in a completely different way.

Keywords: photography; World War I; veterans; hospitals; surgery; empathy; emotion

Appearing in Approaches to Facial Difference: Past and Present (Bloomsbury: 2018). While you wait, check out other World War I material on our blog.

L0044680 Album of photographs of plastic surgery cases

Album of photographs of plastic surgery cases at the King George Military Hospital, (later Red Cross Hospital), Stamford Street, London, taken by Dr. Albert Norman, Honorary Scientific Photographer. Wellcome Images.

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Making up the Female Face: Pain and imagination in the music videos of CocoRosie

Morna Laing is Senior Lecturer at the Chelsea College of Arts, University of the Arts London. Her PhD research explored the representation of the ‘woman-child’ in fashion magazines, and she has published articles in Critical Studies in Fashion and Beauty.

Making up the Female Face: Pain and imagination in the music videos of CocoRosie 

In this paper I theorise the deliberate modification or ‘queering’ of female-gendered faces in the music videos of Coco Rosie. Mary Douglas famously argued that ‘ideas about separating, demarcating and punishing transgressions have as their main function to impose system on an inherently untidy experience’. In terms of gender identity, this equates to a taboo on sameness, under which men and women are punished for failing to inhabit the gendered norm assigned to them from birth. The music of Coco Rosie belongs to the ‘freak folk’ genre, with the two sisters using make-up and wooly faux facial hair to transgress the norm for female faces. The punishment entailed by this transgression is visualised simultaneously through drawn-on beards that resemble bruises and painted tears that make visible their psychological suffering. The violence done to queer faces and queer subjectivities in the present is further underlined by the musicians’ reference to witches, whose non-normative appearance and lifestyles were punished, historically, by pain of death. Ultimately, this paper considers how Coco Rosie’s faces tell the story, both tragically and playfully, of the violence done to the parts of women and men that are not permitted to show through, or that show through only at great cost.

Keywords: music video; playfulness; CocoRosie; witches; facial hair

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Tooth Worms

Today’s guest post is by Geraldine Gnych. Geraldine is a first year PhD student at Swansea University studying medieval oral health, dentistry and speech impediments, with a view to also researching Cleft Lip and Palate. Her research is currently focused on medical sources, although later may include other literary and art sources.

The way our teeth look affects how our face appears: the gleaming white teeth are a sign of the beautiful, whereas the black and decaying teeth are unsightly. This unsightly appearance of decaying teeth has, throughout history, often been attributed to the infamous tooth worm.

N0038311 Cross section of a molar with caries

Figure 1. Cross section of an extracted molar with caries, Wellcome Images.

Tooth worms were supposed to reside within the tooth eating holes in it, and thus creating what we would term dental caries, or cavities. The belief in worms is plausible because they were recognised in other parts of the body including the ears, feet, hands and stomach; so it follows that if there are worms infecting all these parts of the body, there is no logical reason for there not to be a similar explanation for toothache and dental caries. We know now that dental caries are a type to tooth decay that is caused by acids from bacterial action upon sugar, and leads to destruction of the enamel and possibly also the dentine and pulp of the tooth (Oxford Dictionary of Biology, 2004). Figure 1 is a modern example of a tooth with dental caries.




E Gerabek identifies a number of sources across the centuries, though not a comprehensive list, which shows the prevalence of the theory of tooth worms (Gerabek, 1999). The use of tooth worms to explain toothache and dental decay is documented in Roman times and likely dates back far earlier. One Roman author that discusses tooth worms is Scribonious Largus, physician to Emperor Claudius; there are more authors in the Middle Ages, including Hildegard of Bingen, and some even as recently as the eighteenth century with the work of Albrecht von Haller (Gerabek, 1999). These few choice examples serve to demonstrate the enduring nature of the tooth worm, however it is in the medieval that this devil of toothache will be further explored.

AB_0600_Zahnwurm_neu-mk %282%29.jpg

Replica of an 18th-century French sculpture portraying the toothworm inhabiting the pulp of a tooth. On the right, the toothworm devours a man. On the left, the torment of a toothache is equated with the fires of hell. German Museum for the History of Medicine, Ingolstadt. Photo Michael Kowalski.

Toothache is intensely painful; this was not overlooked by medieval medical writers. One text, the Regimen Sanitatis Salernitanum, a hygiene manual written in short verses, offers one possible solution: henbane (Hyoscyamus niger) and leek seeds to be burnt and the smoke funneled into the affected tooth (Regimen Sanitatis Salernitanum, 1505):

Sic de(n)tes serva porror(um) collige grana./

Ne careas iure cu(m) iusq(ui)amo simul ure./

Sicq(ue) p(er) e(m)botu(m) fumu(m) cape de(n)te remotu(m)

(Regimen Sanitatis Salernitanum, 1505)

This may not sound like a terribly effective solution to toothache but it may have been more efficacious than at first thought. The henbane in the recipe, a relation of belladonna, although being an extremely poisonous plant can be used in small quantities as an anaesthetic and sedative so the patient feels no pain, however in large quantities it can prove fatal (Akeroyd, 2000). Gerabek also adds that the effect of the active ingredient, hyoscyamine is developed through fumigation, by which it acts as a ‘surface narcotic’ (Gerabek, 1999). It is possible that the use of henbane, a poison, may have been thought to poison the worms, and thereby prevent them from destroying any more of the tooth.

Henbane is also used in a different recipe of an earlier period in the Leechbook of Bald, an Anglo-Saxon medical work. It is listed in the third recipe for tooth worms, which also contains acorn meal and wax, out of which a candle is made and the ‘reek’ of the candle is let into the mouth (Cockayne, 1865). This recipe, although containing different ingredients to the later one in the Regimen, does show similarities in the use of henbane and the idea of allowing the fumes of the burning ingredients to pervade the aching tooth. Although both of these recipes provide solutions to the worms, neither mentions what happens afterwards. Clearly the patient is left with a hole in the tooth which is at risk of further infection and abrasion, yet there is no remedy for this listed.

Guy de Chauliac, a fourteenth century French surgeon, offers a solution to this. In his Chirurgia Magna, Chauliac first prescribes a mouth wash and that the tooth is stuffed with ‘pills made of small seeds of leek or onion, hyoscyamus, mashed with cow fat’ (The Major Surgery of Guy de Chauliac, trans.2007). The hyoscyamus mentioned is referring to henbane, and as such this bears striking resemblance to the ingredients in the Regimen recipe, although uses a different method of application. Failing that Chauliac recommends using scissors to make a hole in the side of the cavity; cauterizing it, and then removing the tooth, before packing the gap with cloth.

These three recipes, taken from three different centuries, show certain similarities in the medical and surgical responses to tooth worms. They all include henbane, a poison but in small quantities a sedative and two of them use smoke to allow the medicine to make contact with the affected tooth. Although this is not by any means a comprehensive set of remedies for tooth worms it does show the enduring nature of the medical understanding of the cause of dental caries as well as the similarities in the remedies that were used.



Oxford Dictionary of Biology, fifth edn. (Oxford: Oxford University Press, 2004), p. 179.

E. Gerabek, ‘The Tooth-worm: historical aspects of a popular medical belief’, Clinical Oral Investigations, 3.1 (1999), pp. 1-6.

Regimen Sanitatis Salernitanum, Imprint: Venezia: Bernardino Vitali, 1505, Early European Books Online, (Chadwyck).

John Akeroyd, The Encyclopedia of Wild Flowers, (Bath: Parragon, 2000), p. 247.

Rev. Oswald Cockayne, Leechdoms, Wortcunning, and Starcraft of Early England, Vol II (London: Longman, Green, Longman, Roberts, and Green, 1865), Book I Chapter VI, p. 51.

The Major Surgery of Guy de Chauliac, ed. by E Nicoise and trans. By Leonard D Rosenman (n.p. : Xlibris, 2007), p. 533.





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Call for Papers: ‘THE ALL-SEEING EYE’: Vision and Eyesight Across Time and Cultures Workshop

The Effaced from History? group is happy to be co-hosting a workshop at Swansea University with the Research Group for Health, History and Culture on 11 April 2018. The All-Seeing Eye: Vision and Eyesight Across Time and Cultures will explore medical, social, and cultural meanings of the eye and vision in contemporary and historical perspective.

Vision has often provoked fascination within societies and cultures as the most revered sense. In Western Europe, the eye has been viewed scientifically as the most ‘exquisite’ organ, or spiritually as a ‘window to the soul’. These positions have had an influence on how the eye has been perceived, both as a vital organ and, by implication, one that needed to be protected. Whilst the eye could bring delight to its holder, and be symbolic in a variety of ways, it could also, when lost, incur significant impairment. The workshop will explore this vision impairment and correction, and the extent to which sight loss has been stigmatised. It will welcome papers that explore eyesight and its meanings across time and place, to encourage trans-historical and interdisciplinary discussion. Possible subjects include but are not restricted to:

  • Concepts of the eye within scientific, medical, theological or cultural texts and images
  • Vision in relation to the other senses
  • Testing vision
  • Experiences of sight loss, total and partial
  • Restoring and regaining vision
  • Eye loss: stigma and disfigurement
  • Eye contact, staring and social interaction
  • Adornments to the eye: cosmetics, masks, vision aids and prosthetics
  • Visual and literary representations of the eye
  • Challenges to ableist narratives relating to sight loss and visual impairment.

The workshop is convened by Professor David Turner (Swansea University) and PhD candidate Gemma Almond (Swansea University and the Science Museum, London), who invite proposals for twenty-minute papers. Proposals of no more than 200 words, together with the name and institutional affiliation of the speaker should be sent to Gemma Almond. The closing date for submissions is 1st December 2017.

Further information about the workshop and project will be made available on their blog.

Readers with an interest in this area might like to read Gemma’s recent blog post for us: A ‘Spectacle’ of the Face: Eyewear in the Nineteenth Century.

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