Wolfram von Eschenbach was a medieval German poet who wrote Parzival, an epic poem that includes descriptions of battlefield medicine in the 13th century. The poem follows the stories of Parzival and Gawain across 16 books and depicts medical treatments of the time. Some key medical topics covered include hemothorax, empyema, tension pneumothorax, the mechanics of breathing, and chest tube insertion procedures.

1. Wolfram von Eschenbach

2. Medical Technology:
Battlefield Medicine in Wolfram von Eschenbach’s
“Parzival”

3. Die Doppelwegstruktur
Gahmuret/Parzival: Books 1 - 6
Parzival: Book 9 Gawan: Books 7 – 8, 10 - 13
Reunified storyline: Parzival, Gawan, Feirefiz Books 14 - 16

4. “Gawain and the Wounded Knight”

5. Normal Chest:

6. Hemothorax: blood accumulating in
the pleural space
Hemothorax: X Ray Blood accumulation: MRI

7. Empyema
Traditional Empyema
Empyema and Mucocele of the
gallbladder

8. The Greeks: Hippocrates, Galen & Paul of Ægina

9. Mundinus of Bologna & Munro
Secundus

10. Tension Pneumothorax
CT (Computerized Tomography) Scan

11. The Breathing Mechanism

12. Gas Exchange in Human Breathing
Negative Pressure Breathing: Change of pressure
within the lung cavity relative to the air pressure
outside.
The exchange of oxygen and carbon dioxide
between the air and the blood in the lungs.

13. Although fractured ribs are not necessary for tension pneumothorax to occur, they are
often associated with disruption of either the visceral or parietal pleura.
Image depicting multiple fractures of the left upper chest wall. The first rib is
often fractured posteriorly (black arrows). If multiple rib fractures occur
along the mid-lateral (red arrows) or anterior chest wall (blue arrows), a flail
chest (dotted black lines) may result.

14. Chest Tube Insertion

15. Placement of Thoracostomy

16. Tube Thoracostomy:
Skin Preparation: Local Anesthesia:

17. Tube Thoracostomy:
Skin Incision:
Blunt dissection down to the
intercostal muscle:

18. Tube Thorocostamy:
Palpation of the selected intercostal space
and the superior margin of its inferior rib:
A closed and locked Kelly clamp is used to enter the
chest wall into the pleural cavity. Make sure to guide
the clamp over the upper margin of the rib:

19. Tube Thoracostamy:
A finger is used to palpate the tract and feel for
adhesions before insertion of the chest tube:
The proximal end of the chest tube is held with a Kelly
clamp that is used to guide the chest tube through the
tract. The distal end of the chest tube should always be
clamped until it is connected to the drainage device:

20. Tube Thoracostamy:
Connection of the chest tube to
a drainage system:
A 0 or 1-0 silk or nylon suture is used
to secure the chest tube to the skin:

21. Apply petrolatum (eg, Vaseline)
gauze over the skin incision:
Apply support gauze dressing around the
chest tube and secure it to the chest wall
with 4-in adhesive tape:

22. Chest Tube Thoracostomy from GSW:

23. Re-inflation

24. The Patient

25. Fasciculo di medicina, Venice, 1493

26. René Laennec & Jean Marc Gaspard Itard

27. Wolfram’s Milieu: Schildes ambet ist mîn
art

28. Wolfram von Eschenbach