Thesoro de la verdadera cirugía y vía particular contra la común (Bartolomé Hidalgo de Agüero; read in the Barcelona printing of 1624)
A Seville surgeon's argument that head wounds should be closed and dried rather than opened with scraping-irons and trepan drills, made not only from Galen and Hippocrates but from a tally he had drawn off the register of the Hospital del Cardenal: 456 wounded admitted in 1583, 436 discharged healed, 20 dead, and a separate two-and-a-half-month run of head wounds, 57 admitted, 50 healed, 7 dead. The comparison he wanted the numbers to win is the one part he never counted.
Why this wins its question: English-language accounts of when surgery began arguing from counted outcomes start at Lind's scurvy trial of 1747, or at Paré's accidental comparison of 1537, and jump from there to nineteenth-century hospital statistics. A Seville surgeon who had a hospital's wound register tallied for a calendar year, and who had one class of case entered separately so that it could be counted on its own, is almost never in that story in English. This object quotes the tally from the page that carries it, with the marginal note the printer set beside it, and quotes the royal censor's line that experience is to be attended to more than the sayings of the ancients. It also refuses the anachronism the tally invites: the comparison group was never counted, the figures are the author's own report of a register nobody can now inspect, "discharged healed" is an exit category rather than a measured outcome, and the same paragraph reaches for Galen the moment the numbers end.
Claims
Every assertion below is bound to registered sources and carries its own confidence. Weight them; do not treat the page as uniformly authoritative.
The copy read here is the Barcelona printing. Its title page reads "THESORO DE LA VERDADERA CIRVGIA Y VIA PARTICVLAR contra la Comun. COMPVESTO POR EL DOTOR Bartolome Hidalgo de Aguero Medico y Cirujano, con la qual se haze vn perfeto Cirujano", dedicated "a Diego Hexarch Dotor en Medicina", dated "Año 1624", and imprinted "CON LICENCIA, Barcelona, Por Sebastian de Cormellas. Y a su costa". The title states the book's thesis as an opposition: a particular way against the common one.
The crown's own censor signed off on the book with an epistemic claim, not merely a devotional one. The censura bound into this copy is by "el Licenciado Dionysio Daça Chacon, Medico y Cirujano de la Magestad del Rey don Felipe Segundo nuestro señor", who writes that he has seen the book "que V. Magestad me cometio", that it is "muy doto y de mucho trabajo", that it should be licensed "por la gran vtilidad y provecho que se seguira a la Republica con su mucha erudicion y experiencia", that it "tiene aprouada de doze Medicos y Cirujanos los mas dotos que residen en la dicha Ciudad", and - the sentence that matters - "a la qual experiencia se ha de atender mas, que a los dichos de los Antiguos". It is dated "en Madrid, en 25. de Março de 1596".
The method is stated negatively, by the instruments it refuses. On page 322 the author writes that a great number of medical students find themselves daily watching him treat "en el Hospital del Cardenal en Seuilla, sin legras ni taladros, ni leuantadores, sino solo con medicamentos capitales desecantes" - without scraping-irons, drills or elevators, with drying capital medicaments only. The doctrine he is refusing is quoted on the same page: that not only the outer table of the skull but the second must be perforated when extravasated blood lies over the dura mater, and that the membranes themselves be perforated to give the offending matter an exit. He calls that "perniciosa dottrina, y absurdissima".
The argument's unusual move is a count taken off a hospital's own register. On page 66, beside a marginal note reading "El numero de los heridos que sanan por esta via, es mayor que por la comun", the text says: "Hize regular por el libro del dicho Hospital del Cardenal, donde se assientan los heridos, y se ha visto que el año passado de mil y quinientos y ochenta y tres años, entraron quatrocientos y cinquenta y seys heridos de todas heridas, y salieron sanos quatrocientos y treynta y seys, y murieron veynte. Y en dos meses y medio que hize assentar de por si los heridos de cabeça, entraron cinquenta y siete, y salieron sanos cinquenta, y murieron siete." Both sets balance: 436 and 20 make 456, and 50 and 7 make 57.
He also states that he had head-wound cases entered separately in the register for that two-and-a-half-month stretch - "hize assentar de por si los heridos de cabeça" - which is a deliberate act of record-keeping, undertaken to make one class of case countable on its own. The same page gives his standing: he claims to have treated for more than twenty years and to have held "lugares publicos, como es el Hospital del Cardenal de Seuilla, y otros", with a concourse of students, and to have practised the particular way "por la misma orden que la comun" so as to compare them.
The comparison the numbers are meant to win is the part he never counted. The figures given are for his own way only; the common way appears in the same paragraph as an unquantified assertion - "Y en los años que han curado mis antecessores, è yo por la comun, se halla mayor numero de los muertos que de los viuos" - with no year, no admissions total and no deaths. Nothing in the pages read states whether all 456 of the 1583 admissions were treated by his method or only some, and the register itself is not reproduced.
The count does not stand alone in his own argument, and he does not present it as sufficient. Immediately after the figures he turns to authority: "desto tenemos testimonio de Galeno en el sexto del Methodo capit. vltim. donde alabò la via que seguian aquellos dos viejos q en su tiempo, y en Roma exercitauan la via particular desecando", praising them for saying only that more of those treated their way were saved. The marginal apparatus of page 322 cites Falloppio commenting on the Hippocratic book on head wounds. This is an argument that uses a tally as one instrument among the ancient authorities, not a replacement for them.
The book prints its own controversy rather than only its conclusions. The pages in the 300s carry the running head "Respuesta del dotor Hidalgo", and the text there is addressed to opponents in print: "Secreto es todo a los que se atreuen a escriuir, sin auer visto los efetos dela via particular, y a reprehender lo que no saben", and again "digan como saben poco los que escriuen contra esta verdad infalible que vemos con nuestros ojos". The reader therefore learns from the volume itself that the method was contested by named writing opponents, though their side is present only as he reports it.
What the pages read do not contain bounds the claim that can be made. There is no independent audit of the register, no denominator for the common way, no dates for the two-and-a-half-month head-wound series, and no follow-up beyond discharge - "salieron sanos" is an exit category, not an outcome measured later. The volume is also posthumous and partisan: its censura is dated 1596, this printing 1624, and it is the case for one side of a surgical dispute, printed at the printer's own cost.