Part 9

The Medical School of Salerno, already mentioned, was the principal link between the later Greek physicians and the teaching institutions which remain with us to this day, as, for instance, the universities of Paris, Naples, Oxford, Padua, Vienna, and others of later fame. The origin of the school of Salerno is unknown, but it was certainly in existence in the ninth century. It was long supposed to have developed from a monastic institution, but it is now generally believed to have been always a secular school. Its historian, Mazza of Naples, 1681, quotes an ancient chronicle which names Rabbi Elinus (a Jew), Pontus (a Greek), Adala (a Saracen), and Salernus (a Roman) as its founders, but there is no evidence of the epoch to which this refers. Although other subjects were taught at Salerno, it became specially noted for its medical school, and in the ninth century it had assumed the title of Civitas Hippocratica. William of Normandy resorted to Salerno prior to his conquest of England, and a dietetic treatise in verse exists dedicated to his son Robert. It has been claimed that the works of Hippocrates and Galen were studied at Salerno from its earliest days, but so far as this was the case it was by the intermediary of Jewish doctors, who themselves derived their knowledge from Arab sources, that these were available. The original texts of the Greek and Latin authors were not in the hands of European scholars till Aldus of Venice began to reproduce them early in the sixteenth century.

The pharmaceutical knowledge to which the famous school attained may be judged by the reputation which attended the Antidotary of Nicolas Prepositus, who was director of the school in the first half of the twelfth century. In this Antidotary are found the absurd formulas pretending to have been invented or used by the Apostle Paul and others. “Sal Sacerdotale quo utebantur sacerdotales tempore Heliae prophetae” is among these. In the course of the next century or two medical students from England, Germany, Italy, and France went to Cordova, Toledo, and Seville, and there wrote translations of the medical works used in those schools. These translations by the end of the thirteenth century were so universally accepted as to eclipse Salerno, which from then began to decline in fame, Bologna, Montpellier, Padua, and Leyden gradually partitioning among themselves its old reputation. But the medical school of Salerno actually existed until 1811, when it was dissolved by a decree of Napoleon I.

As evidence of the monopoly of Avicenna in the medical schools of Europe at the beginning of the sixteenth century, and doubtless for a long period previously, the following from the preface to a Latin translation of the works of Paulus Egineta is quoted by Leclerc:--

Avicenna, who is regarded as the Prince and most excellent of all physicians, is read and expounded in all the schools; and the ninth book of Rhazes, physician to the Caliph Almansor, is similarly read and commented on. These are believed to teach the whole art of healing. A few later writers, such as Betruchius, Gatinaria, Guaynerius, and Valescus, are occasionally cited, and now and then Hippocrates, Galen, and Dioscorides are quoted, but all the other Greek writers are unknown. The Latin translations of a few of the books of Galen and Hippocrates which are in use are very corrupt and barbarous, and are only admitted at the pleasure of the Arabian Princes, and this favour is but rarely conceded.

The most notable event in the history of pharmacy after the earlier Crusades was an edict regulating the practice of both medicine and pharmacy issued by Frederick II, the Holy Roman Emperor and King of Sicily. This monarch, probably the ablest ruler in the Middle Ages, who died in 1250, had great esteem for Arab learning. Mohammedans and Jews were encouraged to come to Naples during his reign, and he facilitated by all means in his power the introduction of such innovations as had been acquired from Cordova and Bagdad.

The edict referred to mentions “apotheca,” meaning thereby only the warehouses where prepared medicines were stored. Those who compounded the medicines were termed “confectionarii,” the places or shops where they were sold were called “stationes,” and the persons who supplied them, “stationarii.” It is not quite clear whether the confectionarii and the stationarii were the same persons. Probably they were sometimes, but not necessarily always. Apparently the stationarii were generally the drug importers and dealers, and the confectionarii were the compounders. Both had to be licensed by the Medical School of Salerno; and among the duties imposed upon the physician, one was to inform the authorities if he came to discover that any “confectionarius” had falsified medicines. Longfellow alludes to this provision in the “Golden Legend”--

To report if any confectionarius Mingles his drugs with matters various.

The physician was strictly forbidden to enter into any arrangement with a druggist whereby he would derive any profit by the sale of medicaments, and he was not permitted himself to conduct a pharmacy. The “confectioners” were required to take an oath to prepare all medicines according to the Antidotary of the Salernian School. Their profits were limited and graduated, less being allowed on those of frequent consumption than on those which they had to keep for more than a year. Pharmacies were only allowed in the principal cities, and in each such city two notable master-apothecaries were appointed to supervise them. The “confectioners” had to make their syrups and electuaries and other compounds in the presence of these two inspectors, and if they were detected in any attempt at fraud their property was subject to confiscation. If one of the inspectors was found to have been a party to the fraud his punishment was death.

“It is well known,” says Beckmann in “Ancient Inventions,” “that almost all political institutions on this side the Alps, and particularly everything that concerned education, were copied from Italian models. These were the only patterns then to be found; and the monks despatched from the papal court saw they could lay no better foundation for the Pontiff’s power and their own aggrandizement than by inducing other States to follow the examples set them in Italy. Medical establishments were formed, therefore, everywhere at first according to the plan of that at Salerno. Particular places for vending medicines were more necessary in other countries than in Italy. The physicians of that period used no other drugs than those recommended by the ancients; and as these had to be procured from the Levant, Greece, Arabia, and India, it was necessary to send thither for them. Besides, herbs, to be confided in, could only be gathered when the sun and planets were in certain constellations, and certificates of their being so were necessary to give them reputation. All this was impossible without a distinct employment, and it was found convenient to suffer dealers in drugs gradually to acquire monopolies. The preparation of medicines was becoming more difficult and expensive. The invention of distillation, sublimation, and other chemical processes necessitated laboratories, furnaces, and costly apparatus; so that it was thought proper that those who devoted themselves to pharmacy should be indemnified by an exclusive trade; and monopolists could be kept under closer inspection so that the danger of their selling improper drugs or poisons was lessened or entirely removed. They were also allowed to deal in sweetmeats and confectionery, which were then great luxuries; and in some places they were required to give presents of these delicacies to the magistrates on certain festivals.”

This extract shows how the German provision of protected pharmacy originated. In many of the chief cities the apothecaries’ shops were established by, and belonged to, the King or Queen, or the municipality. Sometimes, as at Stuttgart, there was a contract between the ruler and the apothecary, the former agreeing to provide a certain quantity of wine, barley, and rye; while the apothecary in return was to supply the Court with its necessary confectionery.

Beckmann gives much minute information concerning the establishment of apothecaries’ shops in the chief cities of Germany.[1] He mentions a conjecture that there was a pharmacy at Augsburg in the thirteenth and fourteenth centuries, but exact dates begin with the fifteenth century. There was a female apothecary established at Augsburg in 1445, and the city paid her a salary. At Stuttgart, in 1458, Count Ulric authorised one Glatz to open a pharmacy. There was one existing at Frankfort in 1472. The police regulations of Basle in 1440 mention the public physician and his duty, adding that “what costly things people may wish to have from the apothecary’s shop they must pay for.” The magistrates of Berlin, in 1488, granted to one Hans Zebender a free house, a certain provision of rye, no taxes, and the assurance that no other apothecary should reside in the city. But the Elector Joachim granted a new patent to another apothecary in 1499. At Halle there was only one apothecary. In that year the Archbishop, with the confirmation of the Chapter, granted to his physician, von Wyke, the privilege of opening another, but gave at the same time the assurance that no more should be permitted in the city “to eternity.”

In France apothecaries were in business as such certainly before 1250. A charter of the church of Cahors, dated 1178, describes the retail shopkeepers of the town as “apothecarii,” the term being used evidently as “boutiquiers” is now, and signifying nothing more than shopkeepers. The meaning, however, soon became restricted to dealers in drugs and spices. In the middle of the next century John of Garlande alludes to “appotecarii,” who sold confections and electuaries, roots and herbs, ginger, pepper, cumin, and other spices, wax, sugar, and licorice. Officially, however, these tradesmen were classed at that time among the “espiciers.” The two guilds, indeed, continued in formal association until 1777, but royal ordinances of 1484 and 1514 clearly established the distinction between them. Even in 1271 the Faculty of Medicine of Paris forbade “herborists and apothecaries” to practise medicine. Special responsibilities, duties, and privileges were expressly provided for the apothecaries, and in the ordinance of 1514 it is specifically declared that though the apothecary is always a grocer, the grocer is not necessarily an apothecary. (“Qui est espicier n’est pas apothicaire, et qui est apothicaire est espicier.”)

In the fourteenth century the apothecaries of Paris were required to subscribe to a formal oath before they were permitted to practise. They swore to live and die in the Christian faith, to speak no evil of their teachers or masters, to do all in their power for the honour, glory, ornament, and majesty of medicine, to give no remedy or purge without the authority of a physician, to supply no drugs to procure abortion, to prepare exactly physicians’ prescriptions, neither adding, subtracting, nor substituting anything without the express permission of the physician, to avoid the practices of charlatans as they would the plague, and to keep no bad or old drug in their stocks. An ordinance of 1359 provides that no one shall be granted the title of master-apothecary unless he can show that he can read recipes.

The edict of 1484, issued during the minority of Charles VIII, sets forth that, “We, of our certain science, especial grace, full power, and royal authority, do say, declare, statuate, and ordain” the curriculum to be observed by those who desire to learn the trade of an apothecary. A four years’ apprenticeship was essential, and the aspirant had to dispense prescriptions, recognise drugs, and prepare “chefs d’œuvres” in wax and confectionery in the presence of appointed master-apothecaries. Latin was added to the examination in 1536, and ten years’ experience after the apprenticeship was also insisted upon ultimately before the candidate could be admitted as a master-apothecary. One of the ordinances of the sixteenth century gave to the apothecaries the monopoly in the manufacture and sale of gingerbread.

These edicts all related particularly to the apothecaries of Paris. There were similar ones in the provinces, with some peculiarities. At Dijon, for example, it was provided that no apothecary could receive a legacy from one of his clients. _En revanche_ he had the first claim on the estate of a deceased debtor for the payment of his account.

In 1629 the Hotel de Ville of Paris granted to the apothecaries of that city a banner and blazon, the latter, which I do not venture to translate, being thus described:--“Couppé d’azur et d’or, et sur l’or deux nefs de gueulle flottantes aux bannieres de France, accompagnés de deux estoiles a cinq poincts de gueulle avec la devise ‘Lances et pondera servant,’ et telles qu’elles sont cy-dessous empreinctes.”

In 1682, under Louis XV, after the Brinvilliers panic, the poison register was introduced, and regulations were framed forbidding apothecaries to sell any arsenic, sublimate, or drug reputed to be a poison except to persons known to them, and who signed the register stating what use they intended to make of their purchase. Earlier in the same reign the practice of pharmacy was strictly forbidden to persons professing the reformed religion.

The last of the royal edicts applying to pharmacy was issued in 1777 by Louis XVI, and, as already stated, this was the authority which finally separated the apothecaries from the grocers. Then came the Revolution, and in 1791 all restrictions on trades or professions, including pharmacy, were abolished. Some accidents having occurred, the Assembly passed an ordinance on April 14, 1791, declaring that the old laws, statutes, and regulations governing the teaching and practice of pharmacy should remain in force until a new code should be framed. This did not appear until April, 1803, under Napoleon’s Consulate, and the law, which is still in force, is to this day cited in legal proceedings as the law of Germinal, year XI.

VIII

PHARMACY IN GREAT BRITAIN.

For none but a clever dialectician Can hope to become a great physician: That has been settled long ago. Logic makes an important part Of the mystery of the healing art; For without it how could you hope to show That nobody knows so much as you know. --LONGFELLOW: “Golden Legend.”

BRITISH PHARMACY IN SAXON ENGLAND.

The condition of medicine and pharmacy in Saxon times has been carefully portrayed in three volumes published, in 1864, under the authority of the Master of the Rolls at the expense of the Treasury. These were edited by the Rev. Oswald Cockayne, M.A., and appeared under the title of “Leechdoms, Wortcunning, and Starcraft.” Many old documents were translated and explained, and from these the ideas of medicine in these islands a thousand years ago were made manifest.

Mr. Cockayne gave at length a Saxon Herbarium, written, he supposed, about the year 1000, and professing to be a translation from Apuleius, a Roman physician of the second century, with additions from Dioscorides, and some from native science. A few specimens will suffice to show the character of the herb treatment in England before the Conquest.

CRESS, WATERCRESS (Nasturtium officinale).

1. This wort is not sown, but it is produced of itself in wylls (springs), and in brooks, also it is written that in some lands it will grow against walls.

2. In the case that a man’s hair fall off take juice of the wort which one nameth nasturtium, and by another name cress; put it on the nose; the hair shall wax (grow).

3. For sore of head, that is for scurf and for itch, take seed of this same wort and goose grease. Pound together. It draws from the head the whiteness of the scurf.

4. For soreness of the body (the Latin word is ad cruditatem, indigestion) take this same wort nasturtium, and pennyroyal; seethe them in water, give to drink; then amendest thou the soreness of the body, and the evil departs.

5. Against swellings, take this same wort, and pound it with oil; lay over the swellings; then take leaves of the same wort, and lay them thereto.

6. Against warts, take this same wort and yeast, pound together, lay thereto, they be soon taken away.

MAYTHE (Anthemis nobilis).

For sore of eyes, let a man take ere the upgoing of the sun, the wort which is called Chamaimelon, and by another name Maythe, and when a man taketh it let him say that he will take it against white specks, and against soreness of the eyes; let him next take the ooze, and smear the eyes therewith.

POPPY (Papaver somniferum).

1. For sore of eyes, that is what we denominate blearedness, take the ooze of this wort, which the Greeks name Makona and the Romans Papaver album, and the Engles call white poppy, or the stalk with the fruit; lay it to the eyes.

2. For sore of temples or of the head, take ooze of this same wort, pound with vinegar, and lay upon the sore; it alleviates the sore.

3. For sleeplessness, take ooze of this same wort, smear the man with it, and soon thou sendest the sleep on him.

* * * * *

Many of the herbs named in the Herbarium were employed for other purposes than those for which they were used in later practice. Comfrey is recommended for one “bursten within.” It was to be roasted in hot ashes and mixed with honey; then to be taken fasting. But nothing is said of its bone-setting property. Mullein, subsequently famous as a pectoral medicine, is recommended in the Herbarium as an external application in gout, and to carry about to prevent the attacks of wild beasts. Dill is prescribed as a remedy against local itching; fennel in cough and sore bladder; and madder for broken legs, which it would cure in three days.

To prevent sea-sickness the traveller had to smear himself with a mixture of pennyroyal and wormwood in oil and vinegar. Peony laid over a lunatic would soon cause him to upheave himself whole; and vervain or verbena if carried on the person would ensure a man from being barked at by dogs.

A PROFESSED TRANSLATION.

The next document presented is the Medicina de Quadrupedibus of Sextus Placitus, an unknown personage, who adds to the interest of his narrative by pretending that “a king of the Egyptians, Idpartus he was highten,” sent this treatise to the Emperor Octavius Cæsar, “for,” he said, “I wist thee worthy of this.” Probably this manuscript was not a translation at all; if it was, the pretended authors were almost certainly fictitious. Most of the instructions here given relate to the medicinal uses of animals. The idea that foxes’ lungs will strengthen ours is hardly dead yet. Here it is in this old Saxon document:--

“For oppressive hard drawn breathing, a fox’s lung sodden and put into sweetened wine, and administered, is wonderfully healthy.”

The fox had many other uses. Foxes’ grease would heal many kinds of sores. His sinews soaked in honey would cure a sore throat; his “naturam” wrapped round the head would banish headache; his “coillon” rubbed on warts would break them up and remove them; and dimness of sight could be relieved by his gall mingled with honey. The worst recipe is:

For disease of joints. Take a living fox and seethe him till the bones alone are left. Let the man go down therein frequently, and into another bath. Let him do so very oft. Wonderfully it healeth.

There are scores of cures from parts of animals, some of them very disgusting. A few more specimens of decent ones must suffice.

For oversleeping, a hare’s brain in wine is given for a drink. Wonderfully it amendeth.

To get sleep a goat’s horn laid under the head turneth waking into sleep.

For sleep lay a wolf’s head under the pillow; the unhealthy shall sleep.

Let those who suffer apparitions eat lion’s flesh; they will not after that suffer any apparition.

For any fracture, take a hound’s brain laid upon wool and bind upon the broken place for fourteen days; then will it be firmly amended, and there shall be a need for a firmer binding up.

If thou frequently smearest and touchest children’s gums with bitches’ milk, the teeth wax without sore.

VARIOUS LEECHDOMS.

Some “Fly-Leaf Leechdoms” of unknown authorship follow. In these information concerning the four humours is given, hot and cold, moist and dry remedies are distinguished, and we are told of the forty-five dies caniculares “in which no leech can properly give aid to any sick man.” It is carefully noted that the same disorder may occur from different causes, and quite scientifically the practitioner is advised to vary his treatment accordingly. Thus, for example, dealing with “host” (cough) we are told that “it hath a manifold access, as the spittles are various. Whilom it cometh of immoderate heat, whilom of immoderate cold, whilom of immoderate dryness.” The remedies must depend on the causes of the complaint. The “tokens” of “a diseased maw” of “a half head’s ache” (megrims) and of other distempers are set forth with graphic simplicity, and often sensible advice as to diet and medicine is given. But not infrequently the remedy may not be an easily procurable one. For instance “If one drink a creeping thing in water, let him cut open a sheep instantly and drink the sheep’s blood hot”; and “if a man will eat rind which cometh out of Paradise no venom will damage him.” The writer considerately adds that such rind is “hard gotten.”

The following is apparently adapted from Alexander of Tralles, or some other of the later classical authors.

“Against gout and against the wristdrop; take the wort hermodactylus, by another name titulosa, that is in our own language the great crow leek; take this leek’s heads and dry them thoroughly, and take thereof by weight of two and a half pennies, and pyrethrum and Roman rinds, and cummin, and a fourth part of laurel berries, and of the other worts, of by weight of a halfpenny, and six pepper corns, unweighed, and grind all to dust, and add wine two egg-shells full; this is a true leechcraft. Give it to the man to drink till that he be hole.”

A few other recipes in the Leechbooks may be quoted:--

For headache take a vessel full of leaves of green rue, and a spoonful of mustard seed, rub together, add the white of an egg, a spoonful, that the salve may be thick. Smear with a feather on the side which is not sore.

For ache of half the head (megrim) take the red nettle of one stalk, bruise it, mingle with vinegar and the white of an egg, put all together, anoint therewith.

For mistiness of the eyes take juice of fennel and of rose and of rue, and of dumbledores’ honey; (the dumbledore is apis bombinatrix); and kid’s gall, mixed together. Smear the eyes with this. Again, take live periwinkles burnt to ashes; and let him mix the ashes with dumbledores’ honey.

For sore and ache of ears take juice of henbane, make it lukewarm, and then drip it on the ear; then the sore stilleth. Or, take garlic and onion and goose fat, melt them together, squeeze them on the ear. Or, take emmets’ eggs, crush them, squeeze them on the ear.

For the upper tooth ache:--Take leaves of withewind (convolvulus), wring them on the nose. For the nether tooth ache, slit with the tenaculum till they bleed.

For coughs, mugwort, marrubium, yarrow, red nettle, and other herbs are recommended generally boiled in ale, sometimes in milk.