Part 31

After this, Alcuin and the monks, summoned by Charlemagne, take up the tradition of gathering and diffusing information, and the great monasteries of Tours, Fulda, and St. Gall carry it on. Besides these, in the ninth century Monte Cassino comes into prominence as an institution where much was done of what we would now call encyclopedic work. After his retirement from Salerno Constantine Africanus made his translations and commentaries on Arabian medicine, constituting what was really a medical encyclopedia of information not readily available at that time.

After this, of course, the tradition is taken up by the universities, and it is only when, with the thirteenth century, there came the complete development of the university spirit, that encyclopedias reached their modern expression. Three great encyclopedists, Vincent of Beauvais, Thomas of Cantimprato, and Bartholomaeus Anglicus, are the most famous. Vincent consulted all the authors sacred and profane that he could lay hold on, and the number was, indeed, prodigious. I have given some account of him in "The Thirteenth Greatest of Centuries" (Catholic Summer School Press, New York, third edition, 1910).

It would be very easy to conclude that these encyclopedias, written by clergymen for the general information of the educated people of the times, contain very little that is scientifically valuable, and probably nothing of serious medical significance. Any such thought is, however, due entirely to unfamiliarity with the contents of these works. They undoubtedly contain absurdities, they are often full of misinformation, they repeat stories on dubious authority, and sometimes on hearsay, but usually the source of their information is stated, and especially where it is dubious, as if they did not care to state marvels without due support. Books of popular information, however, have always had many queer things,--queer, that is, to subsequent generations,--and it is rather amusing to pick up an encyclopedia of a century ago, much less a millennium ago, and see how many absurd things were accepted as true. The first edition of the "Encyclopedia Britannica," issued one hundred and fifty years ago, furnishes an easily available source of the absurdities our more recent forefathers accepted. The men of the Middle Ages, however, were much better observers as a rule, and used much more critical judgment, according to their lights, than we have given them credit for. Often the information that they have to convey is not only valuable, but well digested, thoroughly practical, and sometimes a marvellous anticipation of some of our most modern thoughts. There is one of these encyclopedias which, because it was written in my favorite thirteenth century, I have read with some care. It is simply a development of the work of preceding clerical encyclopedists, and often refers to them. Because it contains some typical examples of the better sorts of information in these works, I have thought it worth while to quote two passages from it. The author is Bartholomaeus Anglicus, and the quaint English in which it is couched is quoted from "Medical Lore" (London, 1893). The book is all the more interesting because in a dear old English version, issued about 1540, the spellings of which are among the great curiosities of English orthography, it was often read and consulted by Shakespeare, who evidently quotes from it frequently, for not a little of the quaint scientific lore that he uses for his figures can be traced to expressions used in this book.

The first of the paragraphs that deserves to be quoted, discusses madness, or, as we would call it, lunacy, and sums up the causes, the symptoms, and the treatment quite as well as that has ever been done in the same amount of space:

Madness cometh sometime of passions of the soul, as of business and of great thoughts, of sorrow and of too great study, and of dread: sometime of the biting of a wood hound, or some other venomous beast; sometime of melancholy meats, and sometime of drink of strong wine. And as the causes be diverse, the tokens and signs be diverse. For some cry and leap and hurt and wound themselves and other men, and darken and hide themselves in privy and secret places. The medicine of them is, that they be bound, that they hurt not themselves and other men. And namely, such shall be refreshed, and comforted, and withdrawn from cause and matter of dread and busy thoughts. And they must be gladded with instruments of music, and some deal be occupied.'

The second discusses in almost as thorough a way the result of the bite of a mad dog. The old English word for mad, wood, is constantly used. The causes, the symptoms, and course of the disease, and its possible prevention by early treatment, are all discussed. The old tradition was already in existence that sufferers from rabies or hydrophobia, as it is called, dreaded water, when it is really only because the spasm consequent upon the thought even of swallowing is painful that they turn from it. That tradition has continued to be very commonly accepted even by physicians down to our own day, so that Bartholomew, the Englishman, in the thirteenth century, will not be blamed much for setting it forth for popular information in his time some seven centuries ago. The idea that free bleeding would bring about the removal of the virus is interesting, because we have in recent years insisted in the case of the very similar disease, tetanus, on allowing or deliberately causing wounds in which the tetanus microbe may have gained an entrance, to bleed freely.

The biting of a wood hound is deadly and venomous. And such venom is perilous. For it is long hidden and unknown, and increaseth and multiplieth itself, and is sometimes unknown to the year's end, and then the same day and hour of the biting, it cometh to the head, and breedeth frenzy. They that are bitten of a wood hound have in their sleep dreadful sights, and are fearful, astonied, and wroth without cause. And they dread to be seen of other men, and bark as hounds, and they dread water most of all things, and are afeared thereof full sore and squeamous also. Against the biting of a wood hound wise men and ready use to make the wounds bleed with fire or with iron, that the venom may come out with the blood, that cometh out of the wound.

FOOTNOTES:

[Footnote 1: "Medicinisches aus der Aeltesten Kirchen Geschichte." Leipzig, 1892.]

[Footnote 2: Foulis, London and Edinburgh, 1910.]

[Footnote 3: My attention was called to the interesting story of the Jewish physicians of the Middle Ages and their scientific accomplishment while writing the article on Joseph Hyrtl for the Catholic Encyclopedia. His "Das Arabische und Hebraeische in der Anatomie" (Wien, 1879) has some interestingly suggestive material on these important chapters of the history of medicine. (I owe my opportunity to consult it to the courtesy of the Surgeon-General's library.) Biographic material has been obtained from Carmoly's "History of the Jewish Physicians," translated by Dr. Dunbar for the _Maryland Medical and Surgical Journal_, some extra copies of which were printed by John Murphy and Co., Baltimore, about the middle of the nineteenth century. Baas and Haeser's Histories of Medicine and Puschmann and Pagel's "Handbook" provided additional material, and I have found Landau's "Geschichte der Juedischen Aerzte" (Berlin, 1895) of great service.]

[Footnote 4: Of course there are many absurd things recommended in the Talmud. We cannot remind ourselves too often, however, that there have been absurd things at all times in medicine, and especially in therapeutics. It is curious how often some of these absurdities have repeated themselves. We are liable to think it very queer that men should have presumed, or somehow jumped to the conclusion, that portions of animals might possess wonderful virtue for the healing of diseases of the corresponding special parts of man. We ourselves, however, within a little more than a decade, had a phase of opotherapy--how much less absurd it seems under that high-sounding Greek term--that was apparently very learned in its scientific aspects yet quite as absurd as many phases of old-time therapy, as we look at it. We administered cardin for heart disease and nephrin for kidney trouble, cerebrin for insanity (save the mark!), and even prostate tissue for prostatism--and with reported good results! How many of us realize now that in this we were only repeating the absurdities, so often made fun of in old medicine, with regard to animal tissue and excrement therapeutics? The Talmud has many conclusions with regard to the symptoms of patients drawn from dreams; as, for instance, it is said to be a certain sign of sanguineous plethora when one dreams of the comb of a cock. One phase of our psycho-analysis in the modern time, however, has taken us back to an interpretation of dreams different of course from this, yet analogous enough to be quite striking.]

[Footnote 5: "Maimonides," by David Yellin and Israel Abrahams, Philadelphia, 1903.]

[Footnote 6: "Das Arabische und Hebraeische in der Anatomie," Dr. Joseph Hyrtl, Wien, 1879.]

[Footnote 7: "Anat. Antiq. Rariores," Vienna, 1835.]

[Footnote 8: It seems hard to understand how so useful an auxiliary to the surgeon as the ligature,--it seems indispensable to us,--could possibly be allowed to go out of use and even be forgotten. It will not be difficult, however, for anyone who recalls the conditions that obtained in old-time surgery. The ligature is a most satisfying immediate resource in stopping bleeding from an artery, but a septic ligature inevitably causes suppuration and almost inevitably leads to secondary hemorrhage. In the old days of septic surgery secondary hemorrhage was the surgeon's greatest and most dreaded bane. Some time from the fifth to the ninth day a septic ligature came away under conditions such that inflammatory disturbance had prevented sealing of the vessel. If the vessel was large, then the hemorrhage was fast and furious and the patient died in a few minutes. After a surgeon had had a few deaths of this kind he dreaded the ligature. He abandoned its use and took kindly to such methods as the actual cautery, red-hot knives for amputations, and the like, that would sear the surfaces of tissues and the blood-vessels, and not give rise to secondary hemorrhage. A little later, however, someone not familiar with secondary risks would reinvent the ligature. If he were cleanly in his methods and, above all, if he were doing his work in a new hospital, the ligature worked very well for a while. If not, it soon fell into innocuous desuetude again.]

[Footnote 9: Puschmann: "Handbuch der Geschichte der Medizin," Vol. I, page 652.]

[Footnote 10: The first dentist who filled teeth with amalgam in New York, some eighty years ago, had to flee for his life, because of a hue and cry set up that he was poisoning his patients with mercury.]

[Footnote 11: "Storia de la Scuola di Salerno."]

[Footnote 12: It is probably interesting to note that the word _universitas_ as used here has no reference to our word university, but refers to the whole world of students as it were. In the Middle Ages universities were called _studia generalia_, general studies--that is, places where everything could be studied and where everyone from any part of the world could study. Our use of the word university in the special modern sense of the term comes from the formal mode of address to the faculty of a university when Popes or rulers sent them authoritative documents. Such documents began with the expression _Universitas vestra_, all of you (in the old-time English, as preserved in the Irish expression, "the whole of ye"), referring to all the members of the faculty. The transfer to our term and signification university was not difficult.]

[Footnote 13: Physicians wore a particular garb consisting of a cloak and often a mask, supposed to protect them from infections at this time, so that it was not difficult to make a characteristic picture as a sign for a pharmacy. These symbolic signs were much commoner and very necessary when people generally were not able to read. It is from that period that we have the mortar and pestle as also the colored lights in the windows of the drug stores, and the many-colored barber-pole. Also the big boot, key, watch, hat, bonnet, and the like, the last symbolic sign invention apparently being the wooden Indian for the tobacco store.]

[Footnote 14: _The Medical Library and Historical Journal_, Brooklyn, December, 1906.]

[Footnote 15: Taddeo, who was born in 1215, according to our usually accepted traditions in the matter, would have been seventy-five years of age when Mondino as a youth of scarcely more than fifteen went to the University. It might seem that so old a man would have very little influence over the young man. Taddeo, however, had, as we have said, a very strenuous old age. Everything in life had come to him late. He was well past thirty before he began to study philosophy and medicine, having been a seller of candles from necessity because of poverty in his younger years. His great success in practice came when he was past forty. He first began to teach when he was forty-five, and he was nearly fifty-five before he began to write. According to tradition he married when he was nearly eighty--whether for the first or second time is not said--and while this might be considered, and would in some cases be, an indication of weakness of character (it would probably depend on whether he married or was married), it seems in his case to have indicated a vigor of body and character which shows very clearly how great was the possibility of his influence as a teacher having been maintained even up to this late time of life, and thus influencing a pupil who is to represent the most potent influence at the beginning of the next century.]

[Footnote 16: _Medical Library and Historical Journal_, 1906.]

[Footnote 17: Pilcher (_loc. cit._) tells of her tomb. I venture to change his translation of the inscription in certain unimportant particulars. He says:

"We know the very place where she was buried in front of the Madonna delle Lettre in the Church of San Pietro e Marcellino of the Hospital of Santa Maria de Mareto, where her associate, Agenio, mourning and inconsolable, placed a tablet with this inscription:

D . O . M . Vrceo . Contenti Alexandrae . Galinae . Pvellae . Persicetanae Penicillo . Egregiae . Ad . Anatomen . Exhibendam Et . Insignissimi . Medici . Mundini . Lucii Paucis . Comparandae . Discipulae . Cineres Carnis . Hic . Expectant . Resurrectionem Vixit . Ann . XIX . Obiit . Studio . Absunta Die XXVI Martii . A . S . MCCCXXVI Otto . Agenius . Lustrulanus . Ob . Eam . Demptam Sui . Potiori . Parte . Spoliatus . Sodali . Eximiae Ac . De . Se . Optime . Meritae . Inconsolabilis . M . P .

This inscription may be translated as follows:

In this urn enclosed The ashes of the body of Alexandra Giliani, a maiden of Periceto; Skilful with her brush in anatomical demonstrations And a disciple equalled by few, Of the most noted physician, Mundinus of Luzzi, Await the resurrection. She lived 19 years: she died consumed by her labors March 26, in the year of grace 1326. Otto Agenius Lustrulanus, by her taking away Deprived of his better part, his excellent companion, Deserving of the best, Has erected this tablet."

]

[Footnote 18: This is so striking that I quote their actual words from Gurlt, p. 704: "_Multoties fit percussio in anteriori parte cranei et craneum in parte frangitur contraria._"]

[Footnote 19: "Historical Relations of Medicine and Surgery Down to the Sixteenth Century," London, 1904.]

[Footnote 20: Of course, for any extended knowledge of Mondeville, a modern reader must turn to Nicaise's translation of his "Chirurgia," which, with an introduction and a biography, was published at Paris in 1893. Nicaise's publication of this and of Guy de Chauliac's treatise has worked a revolution in medical history and, above all, has made these old authors available for those who hesitate to take up a work written entirely in Latin.]

[Footnote 21: In the very first book containing some account of human anatomy, a German volume by Conradus Mengenberger, called "Puch der Natur," the date of printing of which is about 1478,--that is, less than ten years after the printing of the very first book, the "Biblia pauperum," which appeared in 1470,--there are, according to Haller in his "Bibliotheca Anatomica," a series of illustrations. This is the first illustrated medical work ever published.]

[Footnote 22: Fordham University Press, New York, 1908.]

[Footnote 23: Fordham University Press, New York, 1908.]

[Footnote 24: See picture of the hospital ward at Tonnerre, in "The Thirteenth Greatest of Centuries," 3rd edit., New York, 1911.]

[Footnote 25: "The Historical Relations of Medicine and Surgery," by T. Clifford Allbutt, M.A., M.D. London: Macmillan & Co., Ltd., 1905.]

[Footnote 26: The beginning of the manuscript copy in the "Bibliotheque Nationale" is extremely interesting as an example of the English of the period, and alongside of it it seems worth while to quote the closing sentence as Nicaise reproduces them:

"In godes name here bygyneth the inventarie of gadryng to gedre medecyne in the partye of cyrurgie compilede and fulfilled in the zere (yere?) of our Loord 1363 by Guide de Cauliaco cirurgene and doctor of physik in the fulclere studye of Mountpylerz.

"On page 191, verso.--Here endeth the cyrurgie of Maistre Guyd' de Cauliaco dottoure of phisik."

The University of Cambridge copy has the title in the colophon. It runs as follows: "Ye inventorye of Guydo de Caulhiaco Doctor of Phisyk and Cirurgien in Ye Universitie of Mount Pessulanee of Montpeleres." The fly-leaf contains the words, "Jesu Christ save ye soule of mich." It is rather interesting to note how much closer to modern English is this copy, made probably not much more than half a century later than the first one and, above all, how much more nearly the spelling has come. At this time, however, and, indeed, for more than a century later, spelling had no fixed rule, and a man might spell the same word quite differently even on the same page. The difference between doctor spelled thus in the early edition, and doctours in the later one, probably means nothing more than personal peculiarities of the original translator or copyist.]

[Footnote 27: In Nicaise this last word is written _crapte_. I have ventured to suggest _crafte_, since a misreading between the two letters would be so easy. In the same way I have suggested tentatively a changing of the _z_ in the title of the Bibliotheque Nationale copy to _y_, making the word _yere_ instead of _zere_.]

[Footnote 28: "A History of Dentistry from the Most Ancient Times Until the End of the Eighteenth Century," by Dr. Vincenzo Guerini, editor of the Italian Review _L'Odonto-Stomatologia_, Philadelphia and New York, Lea and Febriger, 1909.]

[Footnote 29: The first printed edition of Arculanus is that of Venice, 1542, bearing the Latin title, "Joannis Arculani Commentaria in Nonum Librum Rasis," etc.]

[Footnote 30: It is curious to trace how old are the traditions on which some of these old stories, that must now be rejected, are founded. I have come upon the story with regard to Basil Valentine and the antimony and the monks in an old French medical encyclopedia of biography, published in the seventeenth century, and at that time there was no doubt at all expressed as to its truth. How much older than this it may be I do not know, though it is probable that it comes from the sixteenth century, when the _kakoethes scribendi_ attacked many people because of the facility of printing, and when most of the good stories that have so worried the modern dry-as-dust historian in his researches for their correction became a part of the body of supposed historical tradition. It is probably French in origin because in that language _antimoine_ is a tempting bait for that pseudo-philology which has so often led to false derivations.]

[Footnote 31: There is in the New York Academy of Medicine a thick 24mo volume in which three of the classics of older medicine are bound together. They are Kerckringius's "Commentary on the Triumphal Chariot of Antimony," published at Amsterdam, 1671; Steno's "Dissertation on the Anatomy of the Brain," published in Leyden in 1671, and Father Kircher's "Scrutinium Physico Contagiosae Luis quae dicitur Pestis" (Physico-medical Discussions of the Contagious Disease which is called Pest). This was published at Leipzig in 1659. Just how the three works came to be bound together is hard to say. Very probably they belonged to some old-time scholar, though there is nothing about the books to tell anything of the story. The fact that all three of the authors were ecclesiastics of the Catholic Church, Valentine a Monk, Steno a Bishop, and Kircher a Jesuit, would seem to be one common bond and perhaps a reason for the binding of these rather disparate treatises together. In that case it is probable that the book came from an old monastic library dispersed after the suppression of the order by some government. It seems not unlikely that the volume belonged at some time to an old Jesuit library, for they have suffered the most in that way. That these three classics of medicine should have been republished in handy volume editions within practically ten years shows an interest in medical literature that has not existed again until our own time, for during the eighteenth and early nineteenth centuries there was almost utter neglect of them.]

[Footnote 32: Paper read before the first meeting of the American Guild of St. Luke.]

[Footnote 33: Published by Putnams, New York, 1909.]

[Footnote 34: Dublin, 1882.]

[Footnote 35: The material for this chapter was gathered for a paper read before the Medical Improvement Society of Boston in the spring of 1911. In nearly its present form it was published in _The Popular Science Monthly_ for May, 1911, and thanks are returned to the editor of that magazine for permission to reprint it here. The additions that have been made refer particularly to the estimation of Aristotle in the Middle Ages.]

[Footnote 36: New York, Putnam, 1908.]

[Footnote 37: "De Coelo et Mundo," 1, tr. iv., x.]

INDEX

=A=

Abbassides, 73

Abba Oumna, 70

Abbas, 324

Abelard, 189

Abraham, 97, 98

Abu Dschafer, 173

Abulcasis, 123, 170, 226, 317, 318, 323

Abul Farag, 51

Abulkasim, 124

Academy of Bagdad, 135

Acid, hydrochloric, 369

Ackermann, 302

Adalberon, 145

Adelard of Bath, 134

Adhesions, 128

AEgidius, 150

Aetius, 10, 117, 180, 317

Aetius, Amidenus, 28

Afflacius, 151, 171

Affinity, 372

Agenius, Otto, 227

Agricola, 345

A Kempis, Thomas, 345, 361

Alanfrancus, 260

Albertus Magnus, 267, 306, 356, 403

Alchemist, 354

Alcuin, 432

Alderotti, 213

Alexander II, Pope, 83

Alexander of Hales, 108

Alexander of Tralles, 10, 28, 39

Alexandria, 135, 385

Allbutt, Sir Clifford, 247, 254, 257, 304, 355, 421

Ali Abbas, 121, 173, 266, 323

Ali Ben el Abbas, 170

Almansor, 132

Alphanus, 143, 145

Amandaville, 264

Anaesthesia, 17; inhalation of, 295, 296

Anaesthetics, 246

Anathomia, 203

Anatomy, ignorance of, 289; of the teeth, 326

Anatomical material, 224

Anatomical injection, 227

Anatomical preparations, 277

Andrew of Piacenza, 248

Animals, motion of, 414

Anthemios, 40

Angelico, Fra, 360

Angina, 32, 44, 332

Anthon, 407

Antimony, 362

Antiseptic, 253

Antisepsis, 17, 246

Apocalypse, the chemical, 376

Aquinas, 306, 403

Arabian lack of originality, 140

Arabian words in anatomy, 138

Arabs, 7