The Hospital Surgeon, by Augustine Belloste. Printed in London by J. & B. Sprint and Nicholson, 1713. Lower Library, K.30.30

Augustine Belloste (1654–1730) was a French military surgeon. He wrote this treatise according to the experience and observations he gained in his ten years of practice at the hospital of Briançon, during the War of the Grand Alliance (1688–1697).

Belloste is known for developing a new treatment for skull injuries through trepanning. This featured ‘several innovations compared to classical techniques that had prevailed prior to that time’.¹ He would drill the outer table of the cranium with an awl or trepan, rather than a rasp, creating many holes in close proximity to each other. This ‘allow[ed] the diploe to reach the surface and create granulation tissue that would then allow regrowth of a fleshy covering of the head’.²

As many other physicians and surgeons, he also described the application of protective coverings over the dura mater or brain after the trepanning. Belloste’s innovation was the use of a lead sheet that possessed two ‘wings’ for fastening the sheet to the lateral edges of the skull, for support and strength.³

This book was donated to the Library by Sir James Burrough Miles, master of Gonville and Caius from 1754 to 1764.

In the gallery you can see the illustrated frontispiece, where a patient’s head is being dressed after the trepanning procedure, and illustrations of lead sheets with Belloste’s innovation.

Holey intervention << Awl or nothing >> The armoured man

1. Gennadiy A. Katsevman and Nicholas J. Brandmeir, ‘Trepanation of the Outer Table as a Treatment for Scalping Injuries: Historical Perspective and Modern Applications’, World Neurosurgery 145 (2021): 301.
2. Katsevman and Brandmeir, ‘Trepanation’, 301.
3. Paolo Missori, Antonio Currà, Harry S. Paris, et al., ‘Reconstruction of Skull Defects in the Middle Ages and Renaissance’, Neuroscientist 21, no. 3 (2015): 322–328.