A very rare example of a richly illustrated copy of one of the most important treatises on surgery from the Middle Ages, here in an Italian translation known in only one other copy.  The lively and very detailed drawings, all carefully colored, function as real illustrations of the content of the text itself.  The earliest owner has left his name in the volume, as well as personal notes related to medicine and to his family.  This book, still in its original blind-stamped leather binding, was surely a treasured possession, reflecting his wealth and status in his community. The volume also includes a health regimen, known in only one other copy, and the celebrated text on surgery by Bruno da Longobucco, in an unpublished Italian translation (very rare on the market; no records in the Schoenberg Database).

74 folios on paper (watermark, pair of scissors no additional motif, similar to Piccard Online no. 122452 and 122455, Udine, 1437, 1438 (with many variations); flower, cup-shaped blossom with pattern, Piccard Online no. 127158, Rome 1447, similar to Briquet Online 6658, Florence 1451 and Lucca 1455-1457), modern foliation in pencil top outer corner recto [cited],  ff. 1-64 with incomplete early foliation in pen added when the volume still included the leave now missing in the first quire: [2], 3-10, 13-67, [68-77], four leaves missing (collation i12 [-1, 11, 12, lacking the first leaf and two leaves following f. 9] ii-iii12 iv10 v-vi12 vii8 [-1, one leaf before f. 68, with loss of text]), no catchwords or signatures, ruled in lead with the top two and bottom two horizontal rules full across, single full-length vertical bounding lines, with an extra vertical rule in the outer margin on a few leaves, prickings remain top and bottom and occasionally in the outer margins (justification 195-191 x 148-146 mm.), written on the top line by at least three (or four) scribes, with a second scribe perhaps copying ff. 58-63, scribe three copied ff. 63v-64 [with additions in at least three hands on f. 64v], and then a fourth(?) scribe copied the final text, ff. 65-72) in a gothico antiqua script in two columns of thirty-four lines, red rubrics and paragraph marks, two- to three-line red initials (f. 31v, 5-line), f. 63v, 3-line red initial with decorative void designs within the initial, infilled in red with red penwork, ONE HISTORIATED INITIAL on f. 1, 7-line red and green initial on a brushed gold ground, with a BORDER EXTENDING FULL-LENGTH of the page and into the top and bottom margins including blue and green acanthus leaves and other motifs, with large gold rayed besants, FOUR INK AND COLOR-WASH DRAWINGS ( ff. 18v, 22, 31v, 42), subjects described below, FULL PAGE PORTRAIT OF THE AUTHOR on the front pastedown, ff. 1-3 with old repairs, confined to the very outer edges of ff. 2-3, f. 1, more extensive repair, with the loss of the first words on lines one and two on the verso, top outer corners ff. 58-59, slightly torn, edges throughout a bit tattered, bottom outer corners rounded, water stains especially through f. 49, on most leaves minor and never affecting legibility, signs of use including thumbing (bottom outer corners of many leaves), and other spots and stains. ORIGINAL BINDING of brown leather over wooden boards, cut flush with the book block, tooled in blind with multiple fillets framing an outer border of a tiny floral stamp within a vine scroll, two broader boarders of rope interlace, and a rectangular panel filled with rope interlace surrounding a smaller rectangle in the center, left blank, spine with four raised bands, traces of four ties remain, top, bottom, and two on the outer edge, in very good condition apart from normal wear to spine and both covers. Dimensions 288 x 216 mm.


1. Written and illustrated in Central Italy in Umbria, perhaps in Perugia, in the middle of the fifteenth century, as suggested by the evidence of the watermark, early ownership and the style of the illumination; it must date before 1457 when the ownership note was added on f. 64v (see below).

2. The codex was owned by, and almost certainly written for, the physician Magister Franciscus Jacobi de Grassellis [or de Grassi] from Gualdo Tadino in Umbria who studied in Perugia; his ownership inscription, now partially erased, on f. 64v begins, “Ego magister Francis[cus] Jacobi de Grassellis de Gualdo …,” dated November 10, 1457, and also mentioning his teacher, the medical doctor (medicine doctoris) Antonius Agnelutius of Perugia.  Franciscus also added recipes and a bloodletting calendar, along with annotations about himself and his family on ff. 73-74v and the back pastedown.  Magister Franciscus and his teacher, Antonius Agnelutius, have not been identified in other sources.

3. Corrected throughout within the text and in the margins; f. 33v, long addition (of an omission by the scribe?) copied in a formal contemporary hand in the outer and lower margin; maniculae in several  hands,  ff. 7v, 31, 11v and 64 (these last two very detailed and carefully executed).

4. Either our manuscript, or the closely related manuscript now at the Wellcome Library in London (see below), were likely sold at Puttick and Simpson, November 11, 1846, Catalogue 157 (Schoenberg Database 69031), and then in the collection of Guillaume Libri (1803-1869); a manuscript described as Guglielmo da Saliceto, on paper with 77 folios was included in the Libri sale, 1866, lot 1794 (Schoenberg Database 74150).

5. Hans Peter Kraus (1907-1988), New York, The Eightieth Catalogue. Remarkable Manuscripts, Books and Maps from the ixthto the xviiithCentury, New York [c. 1956], no. 120.

6. Ernst Weil, London, a bookseller who specialized in the history of science and medicine (Catalogue 26. Old Medicine, London 1958, no. 49; Catalogue 30. Renaissance Medicine, London 1962, no. 60).

7. Sotheby’s, Western and Oriental Manuscripts and Miniatures, June 10, 1963, lot 133.


ff. 1-63, Capitolo primo dell acqua congregata nel capo delli mamoli nouamente nate, incipit, “Ad maestramento generale e chi quactro cose sonno neccessarie ... [Book 5, chapter 8] ...  nel membro forte se in prime ouero se in se in fiche”;

Italian translation of Chirurgia by William of Saliceto (c.1210-c.1280-1285); lacking one leaf at the beginning (presumably with a table of chapters), and two leaves are missing following f. 9v with the end of Book I, chapter 18, chapters 19-21, and the beginning of chapter 22 [f. 8v, Capitolo xviii delle pustole rossie ..., incipit, “Appellase questa infermeta  ... [f. 9v] ... de po lacura//”]; f. 10, incipit, “//sione po mangiare carne ...”].  Book I continues with chapters 23-67; Book II, ff. 31-58, is complete (chapter list and chapters 1-26). Books III, IV, and the beginning two chapters and the concluding chapters of Book V have been deliberately omitted by the scribe; immediately following the end of Book II, he has copied chapters 3-8 of Book V, ff. 58-63.  The chapters and their numbering vary in the incunable editions, but following the Latin, book 5 commonly had ten chapters; our manuscript ends with chapter 8 (on mollifying medicines), leaving out the chapters of medicinal cauteries and the chapter on medicinal simples.

The version of William’s Surgery in our manuscript reflects a deliberate choice on the part of the scribe or original owner of the manuscript to include only these sections of the text.  This version of the text is known in one other manuscript, London, Wellcome Library, MS 724, once owned by  Baldassare Boncompagni.  Like our manuscript, the Wellcome copy includes just books I, II, and chapters 3-8 of book V, in the same Italian translation, and it includes the health regimen that also follows Saliceto’s text in our manuscript; it has been dated c. 1475, based on watermark evidence, and is not illustrated.

William of Saliceto’s Surgery survives in forty-six copies in Latin (Heimerl, 2008; Coco and Di Stefano, 2008, p. 54, and n. 7, list 30 list 40); it was also translated a number of different times into Italian, with twenty-five copies in Italian known, in various versions (Coco and Di Stefano, 2008, pp. 59-60, our manuscript not listed). Our manuscript is not the Florentine or Northern Italian translation, both known in multiple copies, but rather a translation known only in our manuscript and in Wellcome Library, MS 724.  First printed in Venice in 1474 under the title La ciroxia vulgarmente fata.  The original Latin text found its way to print two years later in Piacenza.  There is no modern critical edition of the text; English translation, Rosenman, 2002; translation into modern Italian, Tabanelli, 1965, vol. 2, pp. 499-800.

ff. 63v-64v, Sequitur modus curandi epitimiam secundum magistrum vgonem spaneum sacre maestatis Caruli magni regis francie et salamonis medicum etc., incipit, “Ad laudem et honorem domini nostri yhesu christe et eius matris marie uirginis et sancti sebastinai martiris et omnium appostolorum sanctorum atque sanctarum dei sit nobis ad intrices fine secula seculorum, amen”; incipit, “Primo dum surrexeris de mane ante quam exieris …; [f. 64], incipit, “Si est persona sanguinea conplexione …”; [f. 64], Puluis contra pestis, incipit, “Recipe cinamoni garofani spice nardi … senax turbiti; [f. 64v, continuing in a less formal script, possibly another hand]”… Si est infans minor quinque annorum pone … calidum et sanabitur. Deo gratias”; Natura sanguinei, … Natura malanconici, incipit, “Invidus et tristis …, Non expers fraudis timidus luceique coloris”;

Health regimen for protection against epidemics, Modus curandi epitimiam (The way to cure epidemics), attributed in the rubric to Ugo Spaneus, and concluding, in another hand, with the ownership inscription, now partially erased (see Provenance above).  This is almost certainly unpublished, and is known in only one other manuscript, London, Wellcome Library, MS 724 (not recorded in the Thorndike-Kibre, 1963 or in Nicoud, 2007), discussed above.  Its author may possibly be the celebrated Luccan surgeon Ugo Borgognoni, who taught at Bologna and who probably died around 1252-1258. The health regimen, De salute corporis, often attributed, falsely, to William of Saliceto, is not the text in our manuscript (Nicoud, 2007, chapter 3, sections 13-21).  De salute corporis is found in Paris, BnF, MS lat 16246, ff. 192-200, and in a number of early printed editions from the Netherlands.

Health regimens were an established genre in the Middle Ages from the thirteenth century on, often based on late Antique and Arabic texts; the most well-known example being the Latin translation, the Tacuinum sanitatis, of the treatise by Ibn Butlân (†1068).  These texts stressed the role of diet, regular sleep, exercise, and the control of one’s emotions in the conservation of health (for general background, see Nicoud, 2007).  The text in our manuscript is a very detailed example of the genre, interesting for the way in which it mixes both spiritual and physical advice for healthy living, carefully tailored to the humoral complexion of the patient.

ff. 65-72, Incommença la breue compositione de magistro Bruno, incipit, Ad cio ch della operatione manuale componesse … uale alla salute de le podraghe”; [col. b and f. 72v, blank];

Bruno de Longoburgo, Chirurgia parva, in Italian; our manuscript contains almost the complete text, lacking only part of chapters 6-8, owing to the loss of one leaf before f. 68.  Bruno’s Small or Abbreviated Surgery, was an abridgement, made by the author himself in 1254, of his major work, the Chirurgia magna, completed in Padua c. 1252.  Little is known of the author’s life, apart from his origin in Calabria in the early thirteenth century, and the fact that he was active in Bologna, Padua, and Verona.  He likely died around 1286.  His works brought together the surgical teachings of Ancient and Arabic medicine–Galen, Avicenna, Almansor, and Albucasis–and also drew on his own experience.  Both the long and shortened versions of his Surgery were very popular, circulating broadly in manuscript and in print, in both Latin, Italian and other vernacular languages.  The first printed editions of both versions of the Chirugia appeared in Venice in 1498.  There is no modern critical edition; modern translation, Tabanelli, 2003; in general see McVaugh, 2006; and Hall, 1957.

ff. 73-74v, and back pastedown, Medical recipes and other notes, at least two including dates, 1458 and 1472, partially in the hand of the first owner of the codex, Franciscus Jacobi de Grassellis, including a bloodletting calendar, used to determine when and where to withdraw a patient’s blood.


Saliceto’s Chirurgia is illustrated with a full-page author portrait pasted inside the front board, one illuminated page with historiated initial ‘A,’ and four ink and color drawings in the lower margins depicting scenes of surgical practice and the treatment of wounds.

The illustrations are executed by an anonymous Umbrian illuminator.  Notes added to the manuscript mention Master Franciscus’s training in Perugia and it is likely that the manuscript was illustrated there as well. The design and decoration of Saliceto’s elaborate chair may be compared with the Umbrian example of a decorated seats in an author’s portrait in a manuscript from the middle of the 15th century of Angelo Gambiglioni’s Tractatus de maleficiis, and other texts, Free Library of Philadelphia (MS LC 14 23), dated to 1460 and also illustrated in Umbria (Online Resources).

A recurring, if unsurprising, theme in the illustrations is the clear expression of pain on the faces and in the gestures of the patients. In two scenes (front pastedown and f. 31v) the physician is shown firmly grasping the patient’s arm to hold it steady during the procedure. The methods for examining and interacting with patients depicted here is also remarkable. Paralleling the highly anecdotal nature of Saliceto’s text, the creative illustrations offer supplementary case studies for the practicing physician.

Although there is no standard repertoire of illustrations for Saliceto’s Chirurgia, the historiated initial with two physicians examining the head of a hydrocephalic child (f. 1) is unusual. It is not illustrated in other copies of this text recorded by MacKinney and Herndon (1965). Only the illustration of an operation on a fractured skull (f. 31v) is directly comparable to this same scene in a fourteenth century illustrated copy in Latin of Saliceto’s Chirurgia now in London (British Library, Additional MS 17810, f. 41). Like the illustration of a crowd surrounding a man with an arrow in his throat (f. 42), other illustrated copies of Saliceto’s Chirurgia show scenes of the physician with an audience. However, the wounded man on a wide bench surrounded by what might be the wounded man’s family is an original and highly narrative image. 

MacKinney and Herndon (1965) list only fourteen illustrated manuscripts of Saliceto’s Surgery, ours included in that number; Coco and Stefano (2008) note that four of the manuscripts of Italian translations include illustrations of instruments, and an additional four include the “Vein Man.” Although there has been no comprehensive study of all the manuscripts of Saliceto’s Surgery (there are at least two additional manuscripts of the text with some illustrations, not listed in either of the sources just cited), based on this evidence, we can say with confidence that the majority of illustrated copies either have just an author portrait at the beginning of the text or just illustrations of instruments, often in the margins; a few copies include informative illustrations such as the “Vein Man.”  Only three manuscripts, apart from ours, include narrative illustrations depicting surgical procedures (London, British Library,  Additional MS 17810, four illustrations; Monte Cassino, MS 203, two illustrations, and  Vatican Library, MS vat lat 4468, three illustrations).  The program of illustration of our manuscript, including the elaborate author portrait and vivid narrative illustrations found in the margins, set it apart from almost all the other copies of this text in Latin or in the vernacular.

Subjects as follows:

Front pastedown, full-page author portrait of William of Saliceto wearing a red chaperon and seated in a high-backed wooden chair decorated with a rosette and finials. Saliceto gestures towards a physician who administers treatment to a fistula on the arm of a patient. He is portrayed with exaggerated facial features including a hooked nose and upturned chin, conveying a distinctive likeness fitting for an author portrait. The faces of all three figures have been scratched through. There are two speech banderoles. The first identifies “Magister guiglelmus Lombardus,” which is an unusual way to identify the author of the first text, who is almost always referred to as from Saliceto, or sometimes, Piacenza.  A longer banderole states, “This is a fistula; you will cure it according to his chapter which is in book one, chapter 57” (in Rosenman, 2002, this is book I, chapter 56).  However, it is also possible that the artist is here illustrating book one, chapter 27, which includes a vivid description of how Saliceto treated the abscess deep in the upper arm of Balthazar, the son of Bernard the lawyer;

f. 1, historiated initial ‘A’ with two physicians examining the head of a hydrocephalic child, set on gold frame, with flowers and foliate decorations in the left margin in red, green, and blue;

f. 18v, lower right margin, a physician examining the groin of a nude patient lying on a pillow; this coincides with the chapters discussing abscesses of the groin (Book 1, chapter 42), but it may instead illustrate the diagnosis or treatment of a scrotal hernia, since the doctor appears to be pushing on the man’s groin (Book I, chapter 44);

f. 22, lower right margin, a physician treats an infected penis with a cautery iron, with both figures on a gray ground (illustration to Book I, chapter 48);


f. 31v, lower right margin, a physician operating on a fractured skull, the patient seated on a stool, both figures on a green ground (illustration to Book II, chapter 1);

f. 42, lower margin, a physician approaching a man and woman seated on a wide wooden bench surrounded by a crowd, and a patient with an arrow in his neck.  The physician holds his hands in a gesture of dismay and has removed his chaperon, which rests over his shoulder. To the right of the bench are two men or boys, one holding what appears to be a sling; to the left are two women or girls and three children, one petting a small dog.  The text tells of William’s unsuccessful attempt to treat Bonifacio, who was wounded in the neck with an arrow, and who subsequently dies (illustration to Book II, chapter 7).

William of Saliceto was presumably born in Saliceto di Cadeo, in the province of Piacenza, around 1210.  Little is known about his life apart from what he tells us in his own works.  Historians have theorized that he came to Bologna around 1230, and thus would have studied with Ugo of Lucca (dead after 1258) and perhaps with the Florentine physician, Bono del Garbo (Agrimi and Crisciani, 1994, p. 63, and note 7).  Reading his Surgery, a picture emerges of what the career of a sought-after and famous surgeon was like in the thirteenth century. We know that he practiced widely throughout Northern and Central Italy; he mentions treating patients from all walks of life in Piacenza, Milan, Cremona, Pavia, Bologna, and Verona.

William wrote the first version of his Chirugia (Surgery) in Bologna in 1268 for his students (“ad utilitatem studentium”), based on four years of teaching there, almost certainly within the medical faculty at the University.  A second version was finished in Verona in 1275, where he was employed as the municipal doctor by the commune, after he was forced to leave Bologna for political reasons (McVaugh, 2006, p. 33, note 27, observes that the two versions seem very similar).  His general medical textbook, Summa conservationis et curationis sanitatis (A Summa on the Preservation of Health and on Healing) was almost certainly written between the two versions of his Surgery and was dedicated to his son Leonardino.  William died (reportedly in Piacenza) sometime after 1275, perhaps c. 1280-1285 (Vescovini, 2004).

His Chirurgia (Surgery) was an extremely influential text, which belongs to the tradition studied “rational” surgeons that transformed how surgery was taught and practiced, recently studied by William McVaugh in his ground-breaking monograph, The Rational Surgery of the Middle Ages (2006).  William argued that surgery, like medicine, should be studied as a rational discipline based on general principles and taught to medical students.  Like all medieval writers, he based his work partially on received authority from Antiquity and Arabic sources, but he cites them by name very rarely in his Surgery, and includes numerous lively case studies based on his own experience.  Indeed, he does not hesitate to disagree with the teachings of his authorities when his experience has proven them wrong; in this sense, one can see him an early proponent of experimentation.  It is unlikely that William performed human dissections himself, although he may have practiced animal dissection, but his Surgery was ground-breaking in treating anatomy in a separate book, underlining its importance in the training and practice of surgery.  William’s treatise was thus an important step towards the acceptance of human dissection as part of the training of surgeons and physicians at the medical school in Bologna where they were practiced by 1316, if not before, when the Anathomia by Mondino de’ Luzzi (c. 1270-c. 1316) was written as a guide to such dissections.

William himself was a transitional figure; he must have learned surgery through the old tradition of practice and apprenticeship (surgery as a manual craft), but in his teaching and writing, he argues for the new vision of the surgeon as a professional medical man trained at the University.

A great point of further interest in this manuscript lies in its original ownership. The volume was put together for the physician “Magister Franciscus Jacobi de Grassellis de Gualdo” in Umbria, who used the compilation for his practice. On f. 64v he dated his ownership inscription November 10, 1457, and he added notes about his family and on medicine to the end of the volume.  The identity of this Magister Franciscus Grassellus, or de’ Grassi, born or active in the small Umbrian city Gualdo Tadino, along with that of his teacher, Antonius Agnelutius, remain unknown. However, the commission of an illustrated manuscript clearly reveals the magister’s prestige, and the tradition of surgical practitioners in Umbria is well documented.

Published in:

Loren MacKinney, Medical Illustrations in Medieval Manuscripts, I, Early Medicine in Illuminated Manuscripts, II. Medical Miniatures in extant Manuscripts: A Checklist compiled with the assistance of Thomas Herndorn, Berkeley and Los Angeles, 1965, p. 144, cat. 93.2.


Agrimi, Joel and Chiara Crisciani. “The Science and Practice of Medicine in the Thirteenth Century According to Guglielmo da Saliceto, Italian Surgeon,” Practical Medicine from Salerno to the Black Death, ed. L. García-Ballester et al., Cambridge, 1994, pp. 60-87.

Altieri Biagi, M. Guglielmo volgare. Studio sul lessico della medicina medioevale, Studi e materiali, Università di Bologna. Istituto di glottologia 3, Bologna, 1970. 

Coco, Alessandra, et Francesca Di Stefano. “La Chirurgia di Guglielmo da Saliceto: nuove ricognizioni sulla tradizione manoscritta in volgare,” Filologia italiana 5 (2008), pp. 53-101.

Federici Vescovini, Graziella. “Su alcune versioni scientifiche in volgare italiano tra xiii e xiv secolo,” Filosofia in volgare nel medioevo: Atti del Convegno della Società italiana per lo studio del pensiero medievale (S.I.S.P.M.), Lecce, 27-29 settembr, 2003, Bray and Louvain, 203, pp. 407-418.

Green, Monica. Making Women’s Medicine Masculine. The Rise of Male Authority in Pre-Modern Gynaecology, Oxford, 2008.

Hall, S. P. “The Chirugia magna of Bruno Longoburgensis.  A Critical Edition,” D. Phil. Thesis, Oxford University 1957.

Heimerl, Christian, ed. A Critical Edition. Based on Cambridge, Trinity College MS R. 14.41 with a Parallel Text of The Medieval Latin ‘Anatomia’. Edited from Leipzig, Universitätsbibliothek MS 1177, Middle English Texts 39, Heidelberg, 2008.

Jones, Peter Murray. Medieval Medical Miniatures, London, 1998. 

McVaugh, M. R. The Rational Surgery of the Middle Ages, Micrologus’ library 15, Florence, 2006.

McVaugh, M. R. “Surgical Education in the Middle Ages,” Dynamis. Acta hispanica ad medicinae scientiarumque historiam illustrandam 20 (2000), pp. 283-304.

Nicoud, Marilyn. Les régimes de santé au Moyen Âge :naissance et diffusion d’une écriture médicale, XIIIe-XVe siècle, Bibliothèque des Écoles francaises d’Athènes et de Rome 333, Rome, 2007.

Pifteau, Paul, transl. Guglielmo da Saliceto, Chirugie, Toulouse, 1898.

Rosenman, Leonard, transl. The Surgery of William of Saliceto: Written in 1275. Translated and Edited by Paul Pifteau, Philadelphia, 2002 (English translation from Pifteau’s French translation of the Latin).

Siraisi, Nancy. “How to Write a Latin Book on Surgery: Organizing Principles and Authorial Devices in Guglielmo da Saliceto and Dino del Garbo,” in Practical Medicine from Salerno to the Black Death, ed. Luis García-Ballester et al., Cambridge, 1994.

Siraisi, Nancy. Medicine and the Italian Universities 1250-1600, Leiden, Boston, Cologne, 2001.

Tabanelli, M. The Surgery of Bruno da Longoburgo: An Italian Surgeon of the Thirteenth Century, Pittsburgh, 2003.

Tabanelli, M. La chirurgia italiana nell'alto medioevo, Biblioteca della Rivista di storia delle scienze mediche e naturali 15, Florence, 1965.

Thorndike, Lynn and Pearl Kibre. A Catalogue of Incipits of Mediaeval Scientific Writings in Latin, Cambridge, MA, 1963.

Zucconi, T. Guglielmo da Saliceto e la chirurgia dei suoi tempi, Piacenza, 1977.

Online Resources

MacKiney Collection


Enrico Pispisa, “Bruno da Longobucco,” Dizionario biografico degli italiani 14 (1972)


London, Wellcome Library, MS 724



French translation of Saliceto’s text by Pifteau https://archive.org/details/chirurgiedeguill00gugl/page/146

Philadelphia, Free Library, MS LC 14 23 (compare f. 1, author, and many of the marginal ink drawings)


The medium of ink and watercolor can also be compared to 15th-century Franciscan manuscripts from Assisi, including a manuscript dated 1427 in Florence (Biblioteca Medicea Laurenzia, Gaddi 112).


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