PubMed1999
The Polish Republic entered the 18th century as a country, which exhibited anachronistic organization of social and economic relations in many respects. For surgery this meant preserving the nature of a guild craft, whereas the West European trends moved closer to the area of medicine. The changes in the above state of affairs led to improvement only in the period of the National Education Commission. However, the commenced changes could not cause any significant increase of the level of surgery in the Polish Republic in the 18th century. Although not many facts support the statement that the Radziwills of the 18th century started any activities aiming at increasing the level of surgical care in all the estates, as they focused mainly on their own court, the court surgeons practiced also outside the court. In the 18th century, for the needs of the prince's family a few highly qualified surgeons came from abroad or from the main Polish cities where good surgeons were more available. But the range of duties performed by the Radziwills' surgeons was broader and covered also the activities other than those related to the profession i.e. treatment of wounds, fractures and certain external symptoms of a disease. They frequently entered the area reserved for the physicians. They were usually employed to treat people from lower backgrounds, including courtiers. However, if they treated the members of the prince's family, their role was limited to surgical operations. The findings included in this article, with regard to the availability of surgeons and the quality surgical care in the Radziwills' estates, present two extremities. One of them represents the prince's family and the court who have a team of highly qualified surgeons and attendants, many of whom are foreigners. The other one represents the peasants in the Radziwills' villages who have no access even to attendants. There are no premises to conclude that the Radziwills did anything to ensure the surgical care to the country-folk. The Radziwills' estate which was in many respects governed by separate noble laws was also characterized by a specific nature of medical organization. However, all the weaknesses of inefficient social and economic system were also present in the Radziwills' estates. They were acerbated by inefficient management of such a big estate, which was typical of the Radziwills of the 18th century. The intellectual capacity of the heirs was another impediment to the introduction of new solutions in the area of the surgical organization in the 18th century. The situation in the estates of the Radziwills in the Nieswiez line in the 18th century resulted in focusing the article on the organization of surgical care at the prince's court. However, even if presented from this point of view, they supplement the existing picture of the Polish surgery in the 18th century with the elements which are hardly reflected in the articles published up to this date.