Roger of Salerno (ca. 1140-1195)
Roger of Salerno, the first writer on surgery in Italy. His work, Practica Chirurgiae, was an incredible work for the time. His method of examination for leaks of CSF in a patient with a skull fracture: was to have the patient hold his breath (Valsalva manoeuvre), the surgeon watched for CSF leak or air bubbles. He also wrote about the re-anatomoses of nerves and the treatment of Haemorrhoids.96
Rogers' work maintained the strong tradition of Salerno's medical school, in existence since the ninth century, which pioneered the study of anatomy and surgery.
By the thirteenth century, many European towns were demanding that physicians have several years of study or training before they could practice. Surgery had a lower status than pure medicine, beginning as a craft tradition until Rogerius composed his treatise, which laid the foundation for the species of the occidental surgical manuals, influencing them up to modern times.97