Part 693

"Galen strongly denied being attached to any of the sects of his day, and regarded as slaves those who took the title of Hippocratists, Praxagoreaus, or Herophilists, and so on. Nevertheless his predilection in favor of the Hippocratic writings is well marked, for he explains, comments upon them, and amplifies them at length, refutes the objections of their adversaries and gives them the highest place. He says, 'No one before me has given the true method of treating disease; Hippocrates, I confess, has heretofore shown the path, but as he was the first to enter it he was not able to go as far as he wished. … He has not made all the necessary distinction, and is often obscure, as is usually the case with ancients when they attempt to be concise. He says very little of complicated diseases; in a word, he has only sketched what another was to complete; he has opened the path, but has left it for a successor to enlarge and make it plain.' This implies how he regarded himself as the successor of Hippocrates, and how little weight he attached to the labors of others. He held that there were three sorts of principles in man—spirits, humors, and solids. Throughout his metaphysical speculations Galen reproduces and amplifies the Hippocratic dogmatism. Between perfect health and disease there were, he thought, eight kinds of temperaments or imperfect mixtures compatible with the exercise of the functions of life. With Plato and Aristotle he thought the human soul to be composed of three faculties or parts, the vegetive, residing in the liver; the irascible, having its seat in the heart, and the rational, which resided in the brain. He divided diseases of the solids of the body into what he called distempers; he distinguished between the continued and intermittent fevers, regarding the quotidian as being caused by phlegm, the tertian as due to yellow bile, and the quartan due to atrabile. In the doctrine of coction, crises, and critical days, he agreed with Hippocrates; with him he also agreed in the positive statement that diseases are cured by their contraries."

_Roswell Park, Lectures on the History of Medicine (in MS.)._

MEDICAL SCIENCE: 7-11th Centuries. Medical Art of the Arabs.

"It probably sounds paradoxical (though it is not) to affirm that, throughout the first half of the Middle Ages, science made its home chiefly with the Semites and Græco-Romans (its founders), while, in opposition to the original relations, faith and its outgrowths alone were fostered by the Germans. In the sterile wastes of the desert the Arabians constructed a verdant oasis of science, in lands to-day the home once more of absolute or partial barbarism. A genuine meteor of civilization were these Arabians. … The Arabians built their medicine upon the principles and theories of the Greeks (whose medical writings were studied and copied mostly in translations only), and especially upon those of Galen, in such a way, that, on the whole, they added to it very little matter of their own, save numerous subtle definitions and amplifications. But Indian medical views and works, as well as those of other earlier Asiatic peoples (e. g., the Chaldeans), exercised demonstrably, but in a subordinate degree, an influence upon Arabian medicine. The Arabians interwove too into their medical views various philosophical theorems, especially those of Aristotle, already corrupted by the Alexandrians and still further falsified by themselves with portions of the Neo-Platonic philosophy; and finally they added thereto a goodly share of the absurdities of astrology and alchemy. Indeed it is nowadays considered proven that they even made use of ancient Egyptian medical works, e. g., the papyrus Ebers. Thus the medicine of the Arabians, like Grecian medicine its parent, did not greatly surpass the grade of development of mere medical philosophy, and, so far as regards its intrinsic worth, it stands entirely upon Grecian foundations. … Yet they constantly advanced novelties in the sciences subsidiary to medicine, materia medica and pharmacy, from the latter of which chemistry, pharmacies and the profession of the apothecary were developed. … The mode of transfer of Greek medicine to the Arabians was probably as follows: The inhabitants of the neighboring parts of Asia, including both the Persians and Arabians, as the result of multifarious business connexions with Alexandria, came, even at an early date, in contact with Grecian science, and by degrees a permanent alliance was formed with it. In a more evident way the same result was accomplished by the Jewish schools in Asia, the great majority of which owed their foundation to Alexandria. Such schools were established at Nisibis, at Nahardea in Mesopotamia, at Mathæ-Mechasja on the Euphrates, at Sura, &c., and their period of prime falls in the 5th century. The influence of the Nestorian universities was especially favorable and permanent, particularly the school under Greek management founded at Edessa, in Mesopotamia, where Stephen of Edessa, the reputed father of Alexander of Tralles, taught (A. D. 530). …. Still more influential in the transfer of Grecian science to the Arabians was the banishment of the 'heathen' philosophers of the last so-called Platonic school of Athens, by the 'Christian' despot Justinian I. (529). These philosophers were well received at the court of the infidel Chosroës, and in return manifested their gratitude by the propagation of Grecian science. … From all these causes it resulted that, even as early as the time of Mohammed (571-632), physicians educated in the Grecian doctrines lived among the Arabians. … Arabian culture (and of course Arabian medicine) reached its zenith at the period of the greatest power and greatest wealth of the Caliphate in the 9th and 10th centuries. At that time intellectual life was rooted in the schools of the mosques, i. e., the Arabian universities, which the great caliphs were zealous in founding. Such Arabian universities arose and existed in the progress of time (even as late as the 14th century) at Bagdad, Bassora, Cufa, Samarcand, Ispahan, Damascus, Bokhara, Firuzabad and Khurdistan, and under the scholastic Fatimides (909-1171) in Alexandria. Under the Ommyiades (755-1031), after the settlement of the Arabians in Spain in the beginning of the 8th century, were founded the famous universities of Cordova (possessing in the 10th century a library of 250,000 volumes), Seville, Toledo, Almeria and Murcia under the three caliphs named Abderrahman and Al Hakem. {2130} Less important were the universities of Granada and Valencia, and least important of all, those founded by the Edrisi dynasty (800-986) in the provinces of Tunis, Fez and Morocco. In spite of all these institutions the Arabians possessed no talent for productive research; still less, like the ancient Semites, did they create any arts, save poesy and architecture. Their whole civilization bore the stamp of its foreign origin. … 'The Prince of Physicians' (el Sheik el Reis—he was also a poet) was the title given by the Arabians to Abu Ali el Hossein ebn Abdallah ebn Sina (Ebn Sina, Avicenna), 980-1037, in recognition of his great erudition, of which the chief evidences are stored in his 'Canon.' This work, though it contains substantially merely the conclusions of the Greeks, was the text-book and law of the healing art, even as late as the first century of modern times."

_J. H. Baas, Outlines of the History of Medicine, pages 216-229._

"The Saracens commenced the application of chemistry, both to the theory and practice of medicine, in the explanation of the functions of the human body and in the cure of its diseases. Nor was their surgery behind their medicine. Albucasis, of Cordova, shrinks not from the performance of the most formidable operations in his own and in the obstetrical art; the actual cautery and the knife are used without hesitation. He has left us ample descriptions of the surgical instruments then employed; and from him we learn that, in operations on females in which considerations of delicacy intervened, the services of properly instructed women were secured. How different was all this from the state of things in Europe: the Christian peasant, fever-stricken or overtaken by accident, hied to the nearest saint-shrine and expected a miracle; the Spanish Moor relied on the prescription or lancet of his physician, or the bandage and knife of his surgeon."

_J. W. Draper, History of the Intellectual Development of Europe, volume 2, chapter 2._

"The accession of Gehwer to the throne of Mussulman Spain, early in the eleventh century, was marked by the promulgation of regulations so judiciously planned, touching medical science and its practice, that he deserves the highest commendation for the unwavering zeal with which he supervised this important branch of learning taught in the metropolis. Those evils which the provinces had suffered previous to his rule, through the practice of medicine by debased empirics, were quickly removed by this sagacious Caliph. Upon the publication of his rescripts, such medical charlatans or ambulatory physicians as boldly announced themselves to be medici, without a knowledge of the science, were ignominiously expelled from the provincial towns. He decreed that a college of skilled surgeons should be forthwith organized, for the single specified function of rigidly examining into the assumed qualifications of applicants for licenses to exercise the curative art in municipal or rural departments, or sought professional employment as physicians in the numerous hospitals upon the Mahometan domains."

_G. F. Fort, Medical Economy during the Middle Ages, chapter 17._

"Anatomy and physiology, far from making any conquests under Arabian rule, followed on the contrary a retrograde movement. As those physicians never devoted themselves to dissections, they were under the necessity of conforming entirely to the accounts of Galen. … Pathology was enriched in the Arabian writings by some new observations. … The physicians of this nation were the first … who began to distinguish eruptive fevers by the exterior characters of the eruption, while the Greeks paid but little attention to these signs. Therapeutics made also some interesting acquisitions under the Arab physicians. It owes to them, among other things, the introduction of mild purgatives, such as cassia, senna, and manna, which replaced advantageously, in many cases, the drastics employed by the ancients; it is indebted to them, also, for several chemical and pharmaceutical improvements, as the confection of syrups, tinctures, and distilled waters, which are very frequently and usefully employed. Finally, external therapeutics, or surgery, received some minor additions, such as pomades, plasters, and new ointments; but these additions were very far from compensating for the considerable losses which it suffered by their abandoning a multitude of operations in use among the Greeks."

_P. V. Renouard, History of Medicine, page 267._

MEDICAL SCIENCE: 12-17th Centuries. Mediæval Medicine.

"The difficulties under which medical science laboured may be estimated from the fact that dissection was forbidden by the clergy of the Middle Ages, on the ground that it was impious to mutilate a form made in the image of God. We do not find this pious objection interfering with such mutilation when effected by means of the rack and the wheel and such other clerical rather than medical instruments. But in the reign of Philip the Second of Spain a famous Spanish doctor was actually condemned by the Inquisition to be burnt for having performed a surgical operation, and it was only by royal favour that he was permitted instead to expiate his crime by a pilgrimage to the Holy Land, where he died in poverty and exile. This being the attitude of the all-powerful Church towards medical progress, it is not surprising that medical science should have stagnated, and that Galen and Dioscorides were permitted to lay down the law in the sixteenth century as they had done since the beginning of the Christian era. Some light is thrown upon the state of things here from resulting by a work translated from the German in the year 1561, and entitled 'A most excellent and perfecte homish apothecarye or physicke booke, for all the grefes and diseases of the bodye.' The first chapter is 'Concerning the Head and his partes.' 'Galen sayth, the head is divided into foure partes: in the fore part hath blood the dominion; Colera in the ryght syde, Melancholy in the left syde, and Flegma beareth rule in the hindermost part. If the head doth ake so sore by reason of a runninge that he cannot snoffe hys nose, bath hys fete in a depe tub untill the knees and give him this medicine … which riseth into hys head and dryeth hys moyst braynes. Galen sayth He that hath payne in the hindermost part of hys head, the same must be let blood under the chynne, specially on the right side; also were it good ofte to burn the heyre of a man before hys nose. The braynes are greved many wayes; many there are whom the head whyrleth so sore that he thinketh the earth turneth upsydedoune: Cummin refraineth the whyrling, comforteth the braynes and maketh them to growe agayne: or he may take the braynes of a hogge, rost the same upon a grede yron and cut slices thereof and lay to the greved parts.' {2131} This doctrine of like helping like was of universal application, and in medical works of the Middle Ages we meet constantly with such prescriptions as these:—'Take the right eye of a Frogg, lap it in a peece of russet cloth and hang it about the neck: it cureth the light eye if it bee en flamed or bleared. And if the left eye be greved, do the like by the left eye of the said Frogg." Again—'The skin of a Raven's heel is good against the gout, but the right heel skin must be laid upon the right foot if that be gouty, and the left upon the left. … If you would have a man become bold or impudent let him carry about him the skin or eyes of a Lion or a Cock, and he will be fearless of his enemies, nay, he will be very terrible unto them. If you would have him talkative, give him tongues, and seek out those of water frogs and ducks and such creatures notorious for their continuall noise making.' On the same principle we find it prescribed as a cure for the quartane ague to lay the fourth book of Homer's Iliad under the patient's head; a remedy which had at least the negative merit of not being nauseous. … For weak eyes the patient is to 'take the tounge of a foxe, and hange the same about his necke, and so long it hangeth there his sight shall not wax feeble, as sayth Pliny.' The hanging of such amulets round the neck was very frequently prescribed, and the efficacy of them is a thing curiously well attested. Elias Ashmole in his diary for 1681 has entered the following—'I tooke this morning a good dose of elixir, and hung three spiders about my neck, and they drove my ague away. Deo gratias!' A baked toad hung in a silk bag about the neck was also held in high esteem, as was a toad, either alive or dried, laid upon the back of the neck as a means of stopping a bleeding at the nose: and again, 'either frogg or toade, the nails whereof have been clipped, hanged about one that is sick of quartane ague, riddeth away the disease forever, as sayth Pliny.' We have even a striking instance of the benefit derived from an amulet by a horse, who could not be suspected of having helped forward the cure by the strength of his faith in it. 'The root of cut Malowe hanged about the neck driveth away blemishes of the eyen, whether it be in a man or a horse, as I Jerome of Brunsweig, have seene myselfe. I have myselfe done it to a blind horse that I bought for X crounes, and was sold again of XL crounes'—a trick distinctly worth knowing."

_E. A. King, Mediæval Medicine (Nineteenth Century, July 1893)._

"If we survey the social and political state of Europe from the twelfth to the sixteenth century, in its relation to the development of medical art, our attention is at once arrested by Italy, which at this period was far ahead of the rest of the world. Taking the number of universities as an index of civilization, we find that, before the year 1500, there were sixteen in Italy,—while in France there were but six: in Germany, including Hungary, Bohemia, Bavaria, &c., there were eight: and in Britain, two; making sixteen in all,—the exact number which existed in Italy alone. The Italian Universities were, likewise, no less superior in number than in fame to those of the north. … In many of the Italian republics, during the twelfth, thirteenth, and fourteenth centuries, the power was chiefly in the hands of the middle classes; and it is probable that the physicians occupied a high and influential position among them. Galvanis Flamma describes Milan in 1288, as having a population of 200,000, among whom were 600 notaries, 200 physicians, 80 schoolmasters, and fifty transcribers of manuscripts or books. Milan was about this period at a pitch of glory which has not been equalled since the Greek republics."

_J. R. Russell, History and Heroes of the Art of Medicine, chapter 5._

"Three schools, as early as 1158, had a reputation which extended throughout the whole of Europe: Paris for theological studies, Bologna for Roman or civil law, and Salerno as the chief medical school of the west."

_G. F. Fort, Medical Economy during the Middle Ages, chapter 24._

"In 1215 Pope Innocent III. fulminated an anathema specially directed against surgery, by ordaining, that as the church abhorred all cruel or sanguinary practices, no priest should be permitted to follow surgery, or to perform any operations in which either instruments of steel or fire were employed: and that they should refuse their benediction to all those who professed and pursued it. … The saints have proved sad enemies to the doctors. Miraculous cures are attested by monks, abbots, bishops, popes, and consecrated saints. … Pilgrimages and visits to holy shrines have usurped the place of medicine, and, as in many cases at our own watering places, by air and exercise, have unquestionably effected what the employment of regular professional aid had been unable to accomplish. St. Dominic, St. Bellinus, and St. Vitus have been greatly renowned in the cure of diseases in general; the latter particularly, who takes both poisons and madness of all kinds under his special protection. Melton says 'the saints of the Romanists have usurped the place of the zodiacal constellations in their governance of the parts of man's body, and that "for every limbe they have a saint." Thus St. Otilia keepes the head instead of Aries; St. Blasius is appointed to governe the necke instead of Taurus; St. Lawrence keepes the backe and shoulders instead of Gemini, Cancer, and Leo: St. Erasmus rules the belly with the entrayles, in the place of Libra and Scorpius; in the stead of Sagittarius, Capricornus, Aquarius, and Pisces, the holy church of Rome hath elected St. Burgarde, St. Rochus. St. Quirinus, St. John, and many others, which governe the thighes, feet, shinnes, and knees.' This supposed influence of the Romish saints is more minutely exhibited, according to Hone, in two very old prints, from engravings on wood, in the collection of the British Museum. Right hand: the top joint of the thumb is dedicated to God, the second joint to the Virgin; the top joint of the fore-finger to St. Barnabas, the second joint to St. John, the third to St. Paul: the top joint of the second finger to Simon Cleophas, the second joint to Tathideo, the third to Joseph; the top joint of the third finger to Zaccheus, the second to Stephen, the third to the evangelist Luke; the top joint of the little finger to Leatus, the second to Mark, the third to Nicodemus. Left hand: the top joint of the thumb is dedicated to Christ, the second joint to the Virgin: the top joint of the fore-finger to St. James, the second to St. John the Evangelist, the third to St. Peter; the first joint of the second finger to St. Simon, the second joint to St. Matthew, the third to St. James the Great; the top joint of the third finger to St. Jude, the second joint to St. Bartholomew, the third to St. Andrew; the top joint of the little finger to St. Matthias, the second to St. Thomas, the third joint to St. Philip. … {2132} "The credulity of mankind has never been more strongly displayed than in the general belief afforded to the authenticity of remarkable cures of diseases said to have been effected by the imposition of royal hands. The practice seems to have originated in an opinion that there is something sacred or divine attaching either to the sovereign or his functions. … The practice appears to be one of English growth, commencing with Edward the Confessor, and descending only to foreign potentates who could show an alliance with the royal family of England. The kings of France, however, claimed the right to dispense the Gift of Healing, and it was certainly exercised by Philip the First; but the French historians say that he was deprived of the power on account of the irregularity of his life. Laurentius, first physician to Henry IV, of France, who is indignant at the attempt made to derive its origin from Edward the Confessor, asserts the power to have commenced with Clovis I, A. D. 481, and says that Louis I, A. D. 814, added to the ceremonial of touching, the sign of the cross. Mezeray also says, that St. Louis, through humility, first added the sign of the cross in touching for the king's evil. … If credit is to be given to a statement … by William of Malmesbury, with respect to Edward the Confessor, we must admit that in England, for a period of nearly 700 years, the practice of the royal touch was exercised in a greater or lesser degree, as it extended to the reign of Queen Anne. It must not however be supposed that historical documents are extant to prove a regular continuance of the practice during this time. No accounts whatever of the first four Norman kings attempting to cure the complaint are to be found. In the reign of William III, it was not on any occasion exercised. He manifested more sense than his predecessors, for he withheld from employing the royal touch for the cure of scrofula; and Rapin says, that he was so persuaded he should do no injury to persons afflicted with this distemper by not touching them, that he refrained from it all his reign. Queen Elizabeth was also averse to the practice, yet she extensively performed it. It flourished most in the time of Charles II, particularly after his restoration, and a public register of cases was kept at Whitehall, the principal scene of its operation."