Superstition in Medicine

Chapter XII., Vol. I., page 118), that eclipses of certain stars were

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considered to be pregnant with mischief. This superstitious conception has, in some cases, actually caused severe general calamities. Thus, for instance, the Sicilian campaign ended unfortunately for the Athenians only because their general, Nicias, under a superstitious apprehension concerning an eclipse, failed to put to sea. And as this campaign was the cause to Athens of a partial loss of Greek hegemony, we may safely say that astrology had a decisive share in the fall of Athens (Pliny, Book 2, Chapter XXIII.).

The appearance of comets, like eclipses of the sun and the moon, were also reputed to be ominous among the ancients. Comets were considered heavenly mischief-makers of the worst kind, and almost every sort of calamity was ascribed to them. A calamity was supposed to assume various aspects, according to the position and form of the comet. Under some circumstances, however, they were said to prognosticate many events advantageous to mankind (Pliny, Book 2, Chapter XXIV.). Thus Augustus considered a comet, which was seen for an entire week at the northern quarter of the heavens at the onset of his rule, during performances which were given in honor of Venus genetrix, to be his lucky star.

However, not only such extraordinary appearances in the sky as comets, eclipses of the sun and the moon, played a conspicuous part in medical superstitions of the ancients. Even those celestial phenomena which occur with a regularity fixed by natural law, such as the revolution of the sun and the moon, were considered highly important events in therapeutic art. Thus, affections of the eye in man and beast were said to increase and to decrease with the moon (Pliny, Book 2, Chapter XLI.).

All acute diseases were believed to be controlled by the moon, whereas chronic affections were thought to be under the influence of the sun. In fact, everything that happened to man was brought in immediate relationship with appearances in the canopy of heaven. Thus, for instance, it is stated by Marcus Manilius, the well-known author of an astronomical didactic poem dedicated to the Emperor Augustus:

“Omnis cum coelo fortunæ pendeat ordo.”

In the thirteenth chapter of the second book the poet maintains that each part of the human body is subordinate to a distinct sign of the zodiac. Thus, for instance, the head to Aries, etc.

Altho the further development of Occidental as well as Oriental astrology drew its resources from the primeval Assyrian, Babylonian, and Egyptian doctrines, yet from the second century, A.D., the astronomic work of Ptolemy and the exhaustive description of antique medicine by Galen derive their inspiration from _Medicina Astrologica_. Whatever these two great masters were able to report of the dependence of the functions of the body upon celestial bodies was from then on, without further inspection and examination, acknowledged to be true by the great majority of physicians. Only occasionally this or that practitioner is bold enough to oppose the intrusion of astrologic vagaries into the art of healing; among these radicals was the philosophically trained physician, Sextus Empiricus, who lived about the year 193, A.D. However, this protest of brave Sextus, as well as all subsequent ones, scarcely had any influence upon the astrological development of medicine. Astrology could not be arrested on its road to the domination of the world, and until the seventeenth century it controlled the thought of physicians with the same invincible sway that it exercised over the mental life of all other professions and classes. Medico-astrological superstition had become legalized, and this in spite of the fact that Galen himself at last expressed his distrust of the _Medicina Astrologica_, and at least endeavored to extenuate his part in its dissemination.

Let us now scrutinize more minutely the condition of _Medicina Astrologica_ in the second century, A.D. The works of Ptolemy, the “Iatromathematica” of the mysterious Hermes Trismegistus, and the third book of Galen’s writing on the “critical days” furnish sufficient material for outlining the medico-astrological system of that period.

In the first place, the method by which the authors of that period instilled their astrologic dotage into the minds of their contemporaries varied considerably. Either astrological remarks were here and there interspersed in a work on medical or on astronomical subjects, as was the case, for instance, in the “Opus Quadripartitum” of Ptolemy and also in Galen’s book on the “critical days,” or astrology was treated as a special science in the form of a connected system, as is done, for instance, in the “Iatromathematica” of Hermes Trismegistus. Such textbooks of astrology obtained publicity in large numbers from about the fourteenth century on. Whoever may be inclined to cast a glance into the learned work of Sudhoff will be astonished to observe the extent to which iathromathematics flourished in the second half of the middle ages and at the turning-point of the Renaissance. Still another form was to impart to the public their astrological doctrines in the form of short sentences. We find nothing in such works regarding the intricate calculations and methods by which endeavors were made to fathom the language of the stars, but astrological results were communicated in concise, aphoristic sentences. This was done in the “Centiloquium” of Ptolemy, a work which in a hundred brief sayings brings an epitome of astrological wisdom to market. The work enjoyed the highest esteem in the middle ages. Such a book, therefore, would correspond to that form of modern literary production, which, under the title “Method of acquiring this or that accomplishment within a short period,” is advertised to us modern people in the daily press. Moreover, the “Centiloquium” of Ptolemy had many imitators. Such a work is found, for instance, in Arabic literature, and contains astrologic wisdom condensed into 150 brief sentences by the astrologer Almansor, who furnished the handbook upon request of his ruler; the Arabian, Bethem, has produced a similar work. We find analogous works appearing later in the middle ages. Eventually, the doctrines of astrology were put into neat rhymes; thus, for instance, Heinrich von Rantzau, who departed this life 1598 as governor of Schleswig-Holstein, celebrates in 100 well-turned verses the significance of the planets in relation to the physical and mental welfare of humanity. We shall again refer to this subject when considering astrology of the middle ages. The iatromathematic passages in the above-mentioned writings of Ptolemy, Hermes, and Galen furnished the foundation for all later astrologico-medical theories. For what the middle ages believed regarding the medical importance of the sidereal world, especially of the planets and the zodiac, was nothing but the immediate continuation, or elaboration, of the astrologic teachings of Ptolemy and other authors of the first Christian centuries.

In the first place, every portion of the human frame was placed under the influence of a certain celestial body.

The five planets already known to the ancients, as well as sun and moon, governed, according to Hermes, the following parts of the body:

The sun, the right eye. The moon, the left eye. Saturn, hearing. Jupiter, the brain. Mars, the blood. Venus, taste and smell. Mercury, tongue and gullet.

However, the influence which sun, moon, and the planets exercised upon the human body gradually became more intricate. It was no longer satisfactory to enumerate relations between the bodies of heaven and the human organs of such a general nature as given by the above table of Hermes. All parts and functions of the body were to be brought into the closest relations with the planets. Thus, for instance, the celebrated humanist, Marsilius Ficinus, the friend of the Medici (1433 to 1499), depicts most minutely in a book “On Life,” which was much read in its time, the relations between the body and the planets. This was also done by Heinrich von Rantzau, in his “Tractus Astrologicus,” which in its time was very celebrated. There we read regarding these conditions as follows:

SATURN governs the spleen, the bladder, the bones, the teeth, and, in part, the circulating juices of the body; causes the color of the skin of man to be dark yellowish; impedes or promotes growth; causes the eyes to be small, and prevents the growth of the beard.

JUPITER governs the lungs, the ribs, cartilages, the liver, arteries, the pulse, and the development of human semen; causes the white color of the skin, and gives a good figure.

MARS governs the bile, kidneys, veins, and sexual organs, and of these especially the testicles; makes hair red and the temper irascible, and inclined to outrages of various kinds.

VENUS governs the uterus, the breasts, the sexual organs, the spermatic tubes, the loins, and the buttocks; endows man with physical beauty, furnishes him with long hair, round eyes, and a well-formed face; but it is inexcusable on the part of this star that it presented mankind with gonorrhea.

MERCURY governs all mental processes—memory, imagination, the brain with its nerves, the hands, feet, and legs, the bones and the bile; causes man to be light-fingered.

THE SUN governs the brain, nerves, urine, the right eye of the male and the left one of the female, the optic nerves, and the entire right half of the body; gives a good complexion to man.

THE MOON governs the brain, mouth, belly, intestines, bladder, taste, the organs of reproduction, the left eye of the male, the right eye of the female, and the feminine liver, and the entire left half of the body.

The signs of the zodiac, like the planets, exert full control over the various parts of the body. Honest Bartisch, of Königsbrück (1535 to 1606), has given us in his “Eye-Service” an illustration of these relations. Fig. 4 is a reproduction of this plate of Bartisch.

The sun, moon, planets, and zodiac regulated not only the life of the various limbs of living man placed under their special care, but their activity commenced at that moment when the foundation was just about to be laid for the future bodily existence of a mortal—_i.e._, at the moment of conception. If, during this critical process, the respective bodies of the heavens were in an unfortunate conjunction, the members of the future being, the most primitive forms of which had just been founded, were bound to suffer. Naturally, however, only those parts of the body were affected by this destiny which were in the care of stars that happened to be in unpropitious conjunction at the time.

If the act of conception had passed without evil influence on those that were actively and passively participating in it, the product of that hour could by no means be sure that this or that planet would not maliciously thwart the ease and tranquillity of its embryonic and fetal life. For sun, moon, and the seven planets each governed one month of intra-uterine life, as is explained by Jacobus Forliviensis. Saturn reigns during the first month of pregnancy, Jupiter in the second, Mars in the third, the sun in the fourth, Venus in the fifth, Mercury in the sixth, the moon in the seventh; the eighth month is ruled again by Saturn, and this latter planet now shows itself to be so malicious that it immediately destroys all life born in the eighth month. Jupiter again takes control during the ninth month, and, as this star is fond of warmth and humidity, and, therefore, a friend of life in any form, no danger is to be feared for a fetus entering the world during this month. However, after the nine months of pregnancy have passed without evil interference by the planets, Mars once more is in command, and his influence helps in accomplishing a normal birth.

After the fetus had successfully passed all dangers which the planets could cause during the nine months of intra-uterine life, and after it had successfully matured, the hour of birth might, after all, be accompanied with other quite severe sidereal complications. For if any planet was in an unfavorable sign, or if the relations between the signs of the zodiac and the sun or the moon were not quite in their regular order, those members which were presided over by the respective stars were made to suffer. The correct casting of the medical horoscope, therefore, required the most accurate knowledge of the minute of birth, with simultaneous occurrences in the canopy of heaven. Provident fathers, accordingly, were mindful of having an astrologer, during the hour of birth, in the room in which the confinement was to take place, so that he might be able to ascertain as accurately as possible the celestial occurrences which would determine the bodily welfare of the new-born, and to arrange them for the horoscope.

After the young mortal had safely arrived, and if a fortunate destiny had placed in his cradle a favorable medical horoscope, both for the hour during which the first material foundation had been laid for his life and also for the hour of his birth, he had overcome only a small part of the troubles which the starry world might be able to inflict on his bodily welfare. If the various signs of heaven appeared in unfavorable conjunction, or if the moon entered into any fatal relations with the signs of the zodiac, members of the body which were under the influence of the respective celestial bodies were still imperiled. These dangers might threaten not only one individual, but they were capable, eventually, even of calling down epidemics and pestilence upon all humanity. After any form of disease had taken hold of a person its course, treatment, and termination could be clearly read in the stars of heaven. It was necessary, above all, to ascertain the day, hour, and minute when the disease appeared. Unfortunately, this must have been quite difficult at times; for many diseases begin so insidiously that the moment of the attack is completely beyond precise definition. In such a case one did the best that could be done, and probably took as the moment of attack the first complaints of the patient regarding his disorder. After the appearance of the disease was dated in such a manner, the heavenly body, in the ascendant at this period, was then ascertained; thus, the position and the course and the phases of the moon, the relations of sun and moon to the twelve signs of the zodiac, and the planets would be noted. It was necessary to observe whether the moon was in opposition, quadrature, or conjunction to the planets while she stood in the sign of this or that figure of the zodiac. From these observations clear conclusions were first drawn regarding the general condition, the character, the duration, and the prognosis of the affection. These conclusions, however, were by no means satisfactory as yet. An attempt was therefore made to obtain a much more detailed insight into the causes, complications, and therapy of the case in question by means of astrology, and such information was abundantly provided in the _Medicina Astrologica_.

In the first place, the fact that sun, moon, planets, and the signs of the zodiac shared the rule over the various organs of the body, and furnished positive intimations regarding the cause of the disease in question, made it unnecessary for the physician to trouble himself at all with an examination of the patient in order to ascertain cause and localization of the affection. One glance at the conjunctions of the stars was sufficient to show which organ of the patient happened to be endangered by the celestial constellation. If an individual complained, for instance, of disturbed digestion, and if the heavenly body that presided over the liver presented any remarkable phenomena, naturally only the liver was responsible for the case in question, and the diagnosis was made. Complications were to be expected if the stars which controlled the circulation of blood and mucus showed unfavorable signs. It was even possible for the physician well versed in astrology to determine in advance the period of time at which the occurrence of such humoral complications might be expected, as he had learned that the various hours of the day and of the night were to exert a powerful influence upon the juices of the body. For instance, Almanzor explains that the first three hours of day and of night are in closest relation to the blood, whereas the second quarters of day and of night hold sway over the yellow, the third over the black (bile), and the last quarters, finally, over the mucus. However, not only were the various hours of great importance to the course of the disease, but certain days of the disease—so-called critical days—were of still greater significance. It is true, the doctrine of these critical days was by no means the property of _Medicina Astrologica_, but the Corpus Hippocraticum already contained a book Περὶ χρίησὶμων. But the followers of Hippocrates had developed this theory only from humoro-pathological premises, and Galen, in his work χρήἱσιμαι ἡμέραι, had only included astrology in order to explain and to prove the entire doctrine of crises (compare also Sudhoff). He calculated in accordance with moon weeks and months, and in such a manner that a week counted six days and seventeen and one-half hours, and the month of the moon only twenty-six days and twenty-two hours. The seventh, fourteenth, twentieth, and twenty-seventh days were to be considered critical days of the first order. “Contemplate,” says Galen, “the critical days in the course of the moon in the angles of a geometrical figure of sixteen sides; if you find these angles in a favorable constellation, the patient will fare well; badly, however, if evil signs prevail.” But not only were certain hours and certain days of the week said to exert an important astrological influence upon the human body, such an influence was ascribed also to certain years. Such years were called “_Anni Scansiles_”—that is, “climacteric.” The expression “_Anni Climacterici_” was also used, but this designation has nothing in common with the modern conception of the climacteric. It was believed that the condition of the body underwent a thorough revolution during these climacteric years, and that a new stage, as it were, of organic life was reached. Heinrich von Rantzau, the astronomic aristocrat and statesman, accordingly defines the climacteric years as “_anni, in quibus ad sequentis temporis constitutionem sese vertat ætas et inflectat_.” Therefore, such years should in themselves harbor dangers for corporeal existence, and offer no favorable prospect for the course of diseases.

Two kinds of such climacteric years were distinguished. One kind was brought about by multiplication with the figure 7, and they were called _anni hebdomatici_, or _climacterici (stricte sic dicta)_. Accordingly, these were the years 7, 14, 21, 28, 35, 42, 49, 56, 63. These nine years formed the _climactericus parvus_, whereas the years 77, 84, 91, 98, 105, 112, 119, 126 were called the _climactericus magnus_. A multiplication which extended further, to 171, reached the _climactericus maximus_. The other kind of climacteric years was obtained by multiplication with 9, and such years were called _anni enneatici_, or _decretorii_. These were the years 9, 18, 27, 36, 45, 54, 63, 72, 81, 90, 99, 108, etc.

However, these climacteric years did not all present the same dangers, but the peril inherent in them varied considerably. It was determined by the multiplicator, and here especially the 3 and the 7 played a very fatal rôle. The 21st year of life (3 × 7), and the 27th (3 × 9), were one grade higher in the scale of dangers than those obtained by other multiplicators. Still more dangerous were those years arrived at by ascending in spaces of three hebdomads; therefore, the 21st year of life—_i.e._, the period of three hebdomads—namely, 3 × 7; the 42d year, as a period of 2 × 3 hebdomads—_i.e._, 2 × 21; the 63d year of life, as a period of 3 hebdomads—_i.e._, 3 × 21; 84 = to 4 × 21; 105 = 5 × 21, etc. The 49th year of life and the 56th year of life were said to be still more dangerous than these years obtained from the period of three hebdomads. It is true, the cause of the danger is quite obvious in the case of the 49th year; it was the ominous 7 × 7 which here gave rise to forebodings. And it was not quite comprehensible what caused the bad reputation of innocent 56; Rantzau fails to give us a sufficient explanation.

But the most dangerous climacteric year was the 63d, for this was made up of 7 × 9. It was, therefore, an _annus hebdomaticus_ and, at the same time, also an _annus enneaticus_, for it belonged both to the class of those climacteric years which were formed by the multiplier 7, as also to that which were obtained by the multiplier 9. It was most natural, therefore, that a period of life which from two sides was fraught with danger, like the unfortunate 63d year of life, was bound to appear equally suspicious to the healthy and to the sick. It is probable that this year was, therefore, called _androdas_, because, as Rantzau believes, it debilitates and breaks vitality.

It would appear, moreover, that the climacteric years enjoyed general consideration in ancient times as well as in the middle ages, for Rantzau names a number of celebrated men who were said to have expressed themselves regarding the significance of these years, such as Plato, Censorinus, Gellius, Philo Judæus, Macrobius, Cicero, Boëtius, St. Ambrose, St. Augustine, Bede, Georgius Valla, and others. Not satisfied with this statement, Rantzau also mentions in his catalog a multitude of prominent men who all departed this life in their 63d year, and thus, as he believes, had established the dangerousness of this year by their death.

It is probable, therefore, that the 63d birthday was celebrated with great apprehension during the entire middle ages, and the respective individual did not draw an easy breath until after the ominous year had been successfully passed.

However, the stars knew not only how to tell particulars regarding the probable course and possible complications of diseases, but they also gave information regarding very special forms of affections. It was possible, thus, to learn from them at what time diseases of the eye were to be feared, when mental diseases were threatening, when hemorrhages were to be expected, etc. The astrologically trained physician was able to obtain prompt information from the stars regarding contingent surgical accidents; for there existed various conjunctions of the celestial bodies, according to Ptolemy, which surely pointed to wounds, fractures of bones, burns, concussions, and other lesions. In fact, it was possible to see in advance, from the celestial phenomena, what limbs would be exposed to forcible injury; thus, certain conjunctions of the planets were said to prognosticate with certainty wounds of the head; others, of the face; others, again, of the hands and feet, of the fingers and toes, of the arms and legs, of the trunk and neck. Astrology, moreover, was not satisfied with the prognostic and diagnostic activity which we have just mentioned, but it also interfered in therapy, internal as well as external.

Regarding, in the first place, internal medicinal treatment, the astrologer knew how to give positive information about the same; for all terrestrial beings, of an organic as well as of an inorganic nature, were under the influence of the sun, the moon, of the planets, and of the signs of the zodiac. The stars imparted certain powers to the planets, to animals, and to all structures of the inorganic world. If, therefore, it were known what stars happened to appear in the vault of heaven at the beginning of the disease or of its treatment, it was only necessary seriously to consider the organic and inorganic structures under their supervision, and the remedies required for a successful control of the disease were presently at hand. But if the healer wished to be absolutely certain what medicaments to choose, the phases of the moon and the condition of the sun were also to be taken into consideration. Some remedies could be administered only when the moon was in a particular relation to certain planets or stars of the zodiac. These remedies were principally emetics and purges.

Similarly to the internal clinician, so also in surgery, the healer was entirely dependent upon the conjunction of the stars. The primeval Babylonian directed that the body must not be touched with iron during certain conjunctions of the stars, and this was also prescribed in all cases of _Astrologica Medica_. It appears, however, that this direction obtained less general surgical recognition, but referred principally to blood-letting. Even to this limited extent it implied a high-handed interference with the art of the ancient as well as of the medieval physician; for venesection occupied an entirely different position among therapeutic measures during that period than it does to-day. Whereas modern medicine does not consider blood-letting necessary, except in the rarest cases, ancient as well as medieval professors of medicine believed that they could under no circumstances dispense with it; in fact, it is probable that until the seventeenth century there was scarcely any form of disease the treatment of which would have been possible without withdrawal of blood. An actual system of blood-letting had been elaborated under the influence of humoro-pathological opinions. Every vein that could be reached with the lancet was acted upon, and the school of medicine of the period was punctiliously careful in teaching which vessel presented the most suitable point of attack for the hand of the physician in this or that form of disease. The therapeutic subtleties which were thus brought to light are beyond description. Thus, a withdrawal of blood from veins on the right side of the body was said to yield an essentially different effect from left-sided venesection, and each individual vein of the body promised a special advantage which was peculiar to this one vein. The physician of that period surely had enough to do to bear in mind all the numerous therapeutic effects which he was to achieve by the opening of the various veins. To facilitate this difficult art to a certain degree special figures were designed—so-called venesection manikins, in which the numerous points for bleeding were most carefully annotated. Fig. 5 (page 175) shows such a picture. It indicates no less than 53 different localities for venesection, and as each and every one of them again implied four or five, or possibly even more, methods of blood-letting, we may consider that there were many hundreds of different possibilities for phlebotomy. If it was easy to become lost in the labyrinth of this blood-thirsty therapy, the difficulty of a methodical application of venesection was very materially increased by astrology; for astrology differentiated between, first, favorable, then doubtful, and, finally, unfavorable days for venesection, basing this opinion upon certain positions between sun, moon, and planets. Then the various ages of life had also different days for venesection; days, for instance, which promised to be exceptionally successful for venesection in the young, offered very unfavorable prospects to the aged. Thus, for instance, the period from the first quadrature of the moon to the opposition was said to be excellent for bleeding in adolescence, whereas this period was by no means inviting for phlebotomy in those who had reached the senile period. The chances for venesection became rather intricate in their different aspects. Thus, for instance, Stöffler taught:

{the sun prohibits venesection two {days before and one day after. Conjunction of { the moon with { }prohibits venesection one {Saturn }day before and one day {Mars }after.

Quadrature of {Sun }prohibits venesection the moon with {Saturn }twelve hours before and {Mars }twelve hours after.

Opposition of {Sun }prohibits venesection one the moon with {Saturn }day before and one day {Mars }after.

We see, therefore, that the physician of that time was compelled to be well-versed in astronomy unless he meant to commit grave mistakes against the doctrines of _Medicina Astrologica_. Such sins could eventually become rather dangerous to the physician, for the code of Hammurabi (about 2200, B.C., ruler of Babylon) threatens the operator, for not quite unobjectionable surgical procedures, with the loss of his hands (Winckler, page 33, § 218).

In order to satisfy the astrological requirement of the physician most thoroughly, there arose in the middle ages a very peculiar literature. Under the name of an almanac or calendarium, thick folio volumes appeared, which enumerated, in long tables, the various positions of the planets and of the signs of the zodiac, so that the astrologer was enabled to note the fate of mankind rapidly and easily. The contents of such calendaria are beyond description. Apart from remarks which referred to all occurrences of civil life, was stated the exact period when to have the hair cut, when venesection was to be performed, when to draw teeth, when to take a bath, etc. Even the proper time for prayer was indicated by such a calendarium. According to the experience of Peter of Abano, the conjunction of the moon with Jupiter in the Dragon was sure to effect an answer to prayer. Hieronymus Cardanus had discovered, with the aid of astrology, that a request was sure to be complied with if a prayer was offered to the Virgin Mary on the first day of April, at 8 A.M. (Möhsen, Vol. II., page 423). Physicians excelled in the compilation of such calendaria, especially during the fifteenth and sixteenth centuries. Professors, forensic physicians, surgeons—in fact, all representatives of medical art—were equally intent upon instructing the public by calendaria in regard to the most various branches of _Medicina Astrologica_; thus, for instance, David Herliz, physician at Prenzlau, supplied Pomerania, Mecklenburg, and the Margravate of Brandenburg with calendars for fifty years, from the year 1584. The Marburg professor of medicine, Victorinus Schönfelder, played a similar rôle during the same period for western Germany. The physician, as almanac-maker, is probably one of the most wonderful results of medical superstition, and this aberration of medicine clung so firmly to the people that, even in the eighteenth and nineteenth centuries, certain days of the year were considered as especially favorable for venesection, and the calendars took particular pains to call the attention of the public most emphatically to good days for blood-letting.

=Explanation of Fig. 5=

_A._ The astronomic signs which are noted on the different parts of the body indicate the signs of the zodiac, under the special influence of which the respective members of the body are said to be.

_B._ The numerals which are found at the most varied parts of the body refer to indications for venesection, as stated below. In these localities, which are characterized by figures, blood was drawn for the most various affections, namely in:

1. Pains of the eyes and head; affections of the face, including eruptions.

2. Affections of the head; mental disturbances.

3. Affections of the eye of various kinds.

4 and 5. Pains in the ears; lachrymation.

6 and 7. Tinnitus aurium; tremor of the head.

8. Disturbances of hearing.

9. Heaviness of the head; flow from the eyes. Venesection here also renders memory more acute, as well as the activity of the brain in general.

10. Heaviness of the head.

11. Ulcers of the lips and of the gums.

12. The veins of the palate are to be opened in eruptions in the face, in toothache, in affections of the palate and of the mouth, heaviness of the head.

13. Neuralgia and toothache.

14. Headaches, mental disturbances.

15. To render the memory more acute.

16. In all affections of the mouth or of the chest.

17. Fetid breath.

18. Pains in the jaws; fœtor e naso; eruptions of the face.

19. Neuralgia of the head; eruptions.

20. Disturbances in the chest of various kinds.

21. Flow from the eyes; headache; epilepsy.

22. Diseases of the chest of various kinds, including dyspnea; headache; stitches in the side.

23. Diseases of the liver, injuries to the right side of the body; nosebleed.

24. Affections of the head and the eyes; pains in the shoulder-blades; coryza.

25. Pains in the heart, in the sides, and in the mouth.

26. Spasms in the fingers; pains in the spleen and in the limbs; epistaxis; stitches in the liver.

27. Pains of the central parts of the body.

28. Affections of the lower portions of the body.

29. Heart-disease.

30. To render vision more acute, and to strengthen the dexterity of the body.

31. Headache, fever, various kinds of cataract, glaucoma, etc.; cloudiness of the sclera; inflammations of the tongue and of the pharynx.

32. Pains of the head, lungs, spleen.

33. Diseases of the blood; chlorosis; jaundice; affections of the head; stitches in the right side. Blood-letting in this locality purifies liver, spleen, breast.

34. Same as 32.

36. Affections of the spleen, meningeal inflammation; hemorrhoids; stitches in the left side; renal affections; dysmenorrhea.

37. Affections of the spleen and of the bladder.

38. Dropsy; disturbances of digestion; ulcers of long standing.

39. Melancholia; venesection in this locality strengthens the kidneys.

40. Hemorrhoids; strangury; disturbances of digestion; affections of the bladder and of the sexual organs.

41. Venesection here acts upon the proper condition of the body in general.

42. Diseases of the kidney, bladder, stone, testicles.

43. Venesection here strengthens the gait.

44. All kinds of pains of the lower extremities, such as arthritis, gout; also in dysmenorrhea.

45. Affections of the sexual organs; diseases of the kidney and bladder.

46. Diseases of the testicles.

47. Disturbances of menstruation; sterility of women; affections of the bladder and spleen.

48. Various kinds of diseases of the feet.

49. Dysmenorrhea; eruptions in the face and on the legs.

50. Apoplexy; paralysis.

51. Ophthalmia; skin diseases; cough; oppression of the chest.

52. Dysmenorrhea; affections of the testicles; costal pains.

53. Ophthalmia; dysmenorrhea; amenorrhea; skin eruptions.

Such therapy, detached entirely from the actual requirements of the case and based only upon observation of the sky, was bound to be attended with the most unfortunate results. The suffering public was frequently but little cheered by the assistance of its physicians, and often felt the desire to find out what another physician could do. It appears that such a condition occurred quite frequently, for Ptolemy, in number 57 of his “Centiloquium,” gives special directions under what astral conditions such a change of physician could take place. He says: “_Cum septimum locum atque ejus dominum in ægritudine afflictum videris, medicum mutato._” It appears certain, accordingly, that a general change of physicians was inaugurated by the public so soon as the above conjunction was noted in the sky.

Those who desired to be very careful in the choice of their physician did not change only when the conjunction of the stars recommended it as advisable, but they also attempted to ascertain the horoscope of the newly chosen medical adviser, for medical wisdom was found in greatest abundance in a man whose aspects showed a certain form. “_Perfectus medicus erit, cui Mars et Venus fuerint in sexta_,” says Almansor.

This condition of _Astrologia Medica_ was such as to weigh like an oppressive nightmare upon mankind, not only for centuries but for thousands of years, and in this way medical superstition has slaughtered more human beings than the most bloody wars ever did.

However, astrology has not always ruled our kind with equal strength. There were periods during which belief in the fate-determining power of the stars was more dominant, and others in which it was feebler. The ancient world, which was blindly devoted to all kinds of superstition, had also cherished and fostered astrology. But when the ancient theory of life was demolished later on, and the Christian God of love had taken possession of the world, the belief in the fate-determining power of the stars was shaken, and centuries, followed during which _Medicina Astrologica_, altho it did not by any means disappear entirely, was forced more or less to the rear. Astrology did not become resurrected until scholasticism and dogmatism had held back the activity of the mind from independent investigation, thus bringing about the intellectual darkness which for centuries prevailed. This use of astrology truly forms one of the most wonderful pages in the history of the development of our race, for an actual _furor astrologicus_ seized upon the world in the course of the thirteenth century. The movement originated at the court of Emperor Frederick II. The great Ghibelline was so positive and so enthusiastic an adherent of all astrologic doctrines that he did not decide upon any undertaking until he had first learned the opinion of the stars regarding his enterprise. It was his firm belief that the stars prophesied for him a political rôle which was to shake the entire world, and of his astrological prediction he apprised his adversary, the pope, in the following words:

Fata volunt, stellaeque docent, animumque volatus, Quod Fridericus ego malleus orbis ero.

But if a ruler of high mental gifts is always destined to exert a powerful influence upon his epoch, how much more telling is this influence when the contemporaries of such a monarch lead a mental life, fettered by so many religious, philosophical, and physical prejudices as undeniably dominated mankind during the reign of the great Hohenstaufen. If these conditions were of the greatest advantage to astrology in general, circumstances shaped themselves most favorably for _Medicina Astrologica_ in particular. Very soon after the death of the star-learned Hohenstaufen emperor, two highly talented physicians bound themselves body and soul to astrology—namely, Arnald Bachuone, called also, after his birthplace, Villanueva, Arnaldus Villanovanus or Arnald of Villanova (1235-1312), and Petrus, called also, after his birthplace, Abano near Padua, Petrus de Apono or Petrus Aponensis (1250-1315). From that time until the seventeenth century the most eminent representatives of all the sciences and professions devoted themselves to the doctrines of astrology. In the excellent work of Sudhoff is cited a notable number of physicians—by no means the most unskilful of their day—who confessed themselves to be iatromathematicians (_i.e._, _medici astrologici_). Astrology, and with it _Medicina Astrologica_, reigned supreme at most of the princely courts from the thirteenth to the seventeenth centuries. The Hohenstaufen, Frederick II., was, as we have seen, an implicit adherent to astrologic doctrines; likewise the Visconti in Milan. The royal court of Aragon in Palermo offered a sheltering asylum to astronomy and to astrology. Alfonso X. of Castile was so enthusiastic a friend of scientific astronomy that he ordered the planet-tables of Ptolemy to be restored, with an outlay of enormous costs, by fifty astronomers called by him to Toledo. German princes, such as Elector Joachim of Brandenburg, Albrecht, Elector of Mayence, Landgrave William of Hesse, Duke Albrecht of Prussia, not only adhered to the predictions of the stars, but they also subscribed to the statements of astrological medicine. Thus, for instance, Thomas Erastus (died 1583) the well-known opponent of Paracelsus, tells us that, as body-physician to the reigning count of Henneberg, he was not permitted to begin a course of treatment until he had consulted the stars. The German emperor, Charles V., was quite as constant a friend of the astrologists; he was instructed in astrology by his teacher, the subsequent pope, Hadrian VI. The court of Denmark was the center of astrological teachings under Frederick II., as no less a personage than Tycho de Brahe was active there. But not only rulers favored astrology, it met with implicit belief from highly enlightened scholars, statesmen, and naturalists. Thus, Melanchthon was so convinced an adherent of all astrological doctrines that he was incessantly active in their favor by mouth and by pen. And when fatal disease had finally seized upon him, he was soon satisfied as to the issue, in that Mars and Saturn happened to be in conjunction (Möhsen, Vol. II., page 416).

However, men were not wanting who courageously took up the battle against astrological delusions. Thus, for instance, the friend of Lorenzo of Medici, the learned Count Pico of Mirandola (1463-1494); also Girolamo Fracastori (1483-1553), who is known by his didactic poem on syphilis, opposed astrology.

If we now ask how it was possible that a superstition like astrology could for centuries dominate Occidental medicine, and was even able to influence the best minds in its favor, an answer to this question will not be as difficult as might appear at first glance. The very best and the most enlightened minds are always particularly affected by what is enigmatical and mysterious in the phenomena of life. They perceive the narrow limits set to our cognition of nature much more acutely and deeply than the average mind. This consciousness of the insufficiency of our own knowledge, joined with an ardent desire after a broadening of our understanding, tends to turn the mind in strange directions. The result of clearer self-knowledge in this modern epoch of ours is an adverseness to any form of romantic fancy, and is likely to end in a sad resignation that may result in pessimism. But the middle ages, with their exuberant confidence and faith, their belief in wonders, and their romantic ideas, did not suffer to any great extent from scientific apathy. A sharply defined, mystic tendency helped to overcome what was inadequate in the cognition of nature. And for this reason do we find this mystic tendency prominent, especially in those representatives of that period who, owing to their mental capacity, were bound to perceive their defective insight into the manifestations of life much more intensely than this was felt by the average persons of narrower intellect.

The conditions thus described, as well as the diagnostico-theoretical principles on which medicine and natural sciences were based in antiquity and in the middle ages, until late in the eighteenth century led many mentally gifted men to consider astrology rather a refuge from the current defective conception of natural phenomena than a false doctrine.

VI

INFLUENCE EXERTED UPON THE DEVELOPMENT OF SUPERSTITION BY MEDICINE ITSELF

As ancient, medieval, and some more modern theories of medicine have traveled over the same diagnostico-theoretical roads as did the natural science of those periods, they were naturally subject to the same errors and aberrations. But the consequences of their errors differed materially. Whereas natural science, in the early and middle ages, with its faulty diagnostico-theoretical method, too frequently had recourse to supernatural factors to explain terrestrial phenomena, and thus created superstition instead of elucidation, the pathology of ancient as well as of medieval medicine avoided as much as possible any recourse to miraculous agencies in explaining the pathological phenomena of the body. This it was forced to do for the sake of self-preservation. For what would have become of the physicians with their art, which was of a purely material kind, working as it did with drug and knife, if they themselves had traced disease to supernatural causes? No one, under such conditions, would have had any dealings with mundane medical science. It is true, there have been times when such a state of things actually existed. The physician, with his earthly appliances, was always led astray as soon as metaphysical ideas had victoriously entered pathology. History affords numerous examples of this. The cult of relics, the belief in astrology during half of the middle ages, show plainly to what a degrading position the physician was reduced as soon as a pathology reckoning with earthly factors was replaced by a metaphysical theory of disease. Then the physician was either completely thrust aside—ἀλλ’ ὠθεῖται μὲν ἒξω νοσοῦντος ὁ ἰατρός, as says Plutarch (“Superstition,” Vol. I., page 412)—or he was forced to submit to a disgraceful interference. All schools of medicine, therefore, from the humoral pathology of the followers of Hippocrates to the so-called parasitism of the nineteenth century, have avoided as much as possible the acknowledgment that supernatural influences were active as pathological factors. Various as the principles of the countless medical schools may have been, they were all united in assuming as the starting-point of their speculations some material process of the body itself, in accordance with which they applied their therapeutic agencies.

Sometimes, it is true, it would seem as tho medicine, under some circumstances, had recourse to supernatural factors in explaining various phenomena of physiological as well as pathological conditions; as, for instance, in the primeval pneuma-doctrine, or in those conceptions which attribute to a mental or psychical principle a far-reaching influence upon the performance of all bodily functions. Upon closer investigation, however, we shall find that the pneuma, or spirit, the soul, or whatever else the mysterious mainspring of all phenomena of life may be called, was by no means conceived of by medicine as immaterial or supernatural. On the contrary! Medicine, as often as it required a spiritual something to explain the manifestations of the body, has always regarded this unknown quantity as thoroughly substantial. It has not, indeed, been possible to determine more precisely the material nature of this great unknown, altho such attempts are by no means wanting in Democritus, Galen, and others; still it was always considered a corporeal thing. Supernatural qualities were ascribed to it only after death, but so long as the soul animated the body, united with the latter, it was a terrestrial being, and as such obeyed the laws of terrestrial substance. It was possible for medical science, therefore, to reckon with it in the explanation of pathological processes without necessarily expecting a reproach that supernatural agencies were called in for assistance.

Medicine, therefore, altho it has traveled the same diagnostico-theoretical road as natural science, has not, like the latter, directly produced superstition. It is true, it has called forth innumerable erroneous hypotheses. But a wrong hypothesis, altho it may be nonsensical to the utmost and give rise to the most serious practical consequences, is by no means superstition; for both error and superstition—so far as it is a question of medical matters—are two radically different conceptions, because the former concerns itself only with natural, the latter with supernatural factors.

Yet it is quite conceivable that the dissemination of an intellectual principle can be furthered and promoted without overt advocacy of the principle itself, and this was the relation that existed for thousands of years between medicine and superstition; for we learn from this investigation that the representatives of medicine were too often ready to admit all kinds of superstitious views into medicine. Whenever religion, philosophy, and natural science have seriously attempted to influence medicine in a manner promoting superstition, medical science yielded to these attempts, and this is the only reproach which can be justly laid at the door of our science.

However, this reproach is mitigated if we consider that medicine did not accord a home to superstition of its own free will, or even from a predilection for the heresies of other disciples, but it did so under compulsion; for the religious, the philosophical, the physical views which forced the entrance of superstition into medical science were almost always the views of a formidable party. It is a fact sufficiently demonstrated by history that powerful and far-reaching predilections of the popular mind resistlessly hurry along whatever is in their path. Such mental currents are the products of their period; they are the immediate result of the general sentiment and feeling of their time, and for this very reason they successfully overcome resistance. The opinion of a single individual may raise a protest against the spirit of the age, but this resistance is always bound to be in vain. The opinion of a single individual, even if it actually represents the truth, is absolutely powerless to resist the spirit of the age which, with elemental force, compels obedience. Therefore, the courageous, truth-seeking resistance which was offered to the heresies of _Medicina Astrologica_ by Pico of Mirandola and Girolamo Fracastori was bound to be futile, because astrology was a genuine child of its time, and therefore held irresistible sway over thought and sentiment.

If religion and philosophy so often interfered with the development of medicine, this was only possible because the general tendency of the contemporary mind was thoroughly absorbed in this or that religious or philosophical idea. For each domain of human activity must needs be a mere reflection of the tendency which guides the mind of its period. This is a law which, with iron force, dominates the development of culture. Superstition in medicine, therefore, was bound to flourish and thrive whenever it harmonized with the spirit of the age.

This law, tho it may have checked the development of our science, nevertheless holds out the certain promise of a period, the intellectual power of which will thoroughly clear away all relics of superstition, which, still persisting in the minds of the many, drives them to the faith-curist and to the quack.

VII

MEDICAL SUPERSTITION AND INSANITY

The history of medicine is conjoined with the evolution of theology to an extent which makes them almost inseparable, and this may best be seen from a study of the management of the insane, which is a continuous record of cruelty based upon medico-theological superstition. Perhaps the most heartrending chapter of unphilosophical theology teems with the narration of thousands of unfortunate beings murdered, tortured, and mishandled by the finesse in the interpretation of Biblical texts. The greatest triumph of modern medicine has consisted in unfettering the views of effete centuries, born of superstition and misconception, and in placing the treatment of the insane upon a humane, often even a curative, plane. As other afflictions of humanity were attributed to the agency of evil spirits, this was particularly the case with insanity; for if the evil one found it an easy task to control the corporeal acts of humanity, his power over the mental functions of the person afflicted was even greater. Hence, it was not the person who acted, but the evil spirit in him. Thus, the devil and his minions were the specific pathogenic agents.

This conception was not universal, for history shows us that clear thinkers, far in advance of their times, had an almost correct view of the nature of insanity—namely, that it was due to an affection of the mind. Among such men were Hippocrates, Aretæus, Soranus, Galen, Aurelianus, etc., and some of the Mohammedan physicians. These apostles of science taught that insanity was a disease of the brain, and the most efficient remedy, mild, palliative treatment.

The belief which had flourished in most of the Oriental religions from remote antiquity, that the power of evil demons was the active cause of disease, particularly that lunacy was due to diabolic possession, became rooted in the early Christian Church and flourished for eighteen centuries, each leaf of this malignant plant representing countless unfortunates sacrificed to superstition. Later it was thought that the moon had a direct influence upon perturbation of the mind; hence, the term “lunacy” developed.

These doctrines gained special credence in the first centuries after Christ by the dissemination under the Church Fathers of the story of the miracles which they claimed had been performed by Jesus of Nazareth. Did not the Savior cast out devils? Did He not cure madness? The very word “epilepsy” shows by its derivation, ἐπίληψις (to seize upon), that possession was the presumable nature of the malady.

The noble work accomplished by the “pagan” pioneer alienists was discredited or forgotten, and the Church originated a process by which the possessed were to be treated. This method of treatment was derived purely from theologic sources, tempered with sufficient dogma. At first the treatment was gentle, in accordance with the spirit of the great physicians of antiquity, and if the afflicted one was not violent he was permitted to attend public worship. Sacred salves and holy water, the breath or the spittle of the officiating priest, the touching of relics, or a visit to holy places, were the principal therapeutic agents employed. These methods, even if they did no good (sometimes merely the consolation of a kind word from the priest had a beneficial effect), certainly did no harm, even tho such practises were factors in the spread of superstition.

This mild form of treatment did not, however, long continue. Soon measures were directed toward driving out the evil spirit from the possessed. This was attempted in various ways; first, by exorcism, in the period of Justin Martyr, and continued up to almost recent times (see Lecky, “History of European Morals”). “From the time of Justin Martyr for about two centuries, there is, I believe, not a single Christian writer who does not solemnly and explicitly assert the reality and frequent employment of this power.”

One of the chief attributes of the devil was pride, therefore attempts were made by exorcism to pierce this vulnerable point in the armor of the evil one, and the foulest, vilest epithets were used to attain this end. It is impossible to-day to print these expressions, even in a work of scientific character, and it is better, perhaps, to refer such as are especially interested in them to the _Manuale Benedictionum_, by the Bishop of Passau, published in 1849, and similar works. Adjuvants to this form of treatment consisted in “frightening” the devil by long words, difficult to pronounce, commonly derived from Oriental languages, by the administration of malodorous and filthy “drugs,” and similar practises.

It was claimed that many devils were thus driven out, and the annals of the Church contain numerous records of persons cured in this manner. “The Jesuit Fathers at Vienna, in 1583, glorified in the fact that in such a contest they had cast out twelve thousand, six hundred and fifty-two living devils” (White). The prevalence of these ideas to such a degree in the minds of the people may be noted from the fact that, in the churches themselves, such scenes are carved in stone and depicted on canvas. Medieval drama teemed with similar conceptions, and this condition of affairs prevailed for over one thousand years, unfortunately not in this harmless manner, but supplemented by great cruelty, which forms, perhaps, the most terrible chapter in the history of medical superstition.

The subtleties of theologic interpretation soon evolved a more comprehensive method of dealing with the “possessor” and the possessed. As an appeal to pride was ineffectual and noxious drugs unavailing, it was found necessary to whip the devil out, or the unfortunate individuals were imprisoned, and as a refinement of this treatment they were even tortured. Thus the jailer for a long time played the part of a specialist in lunacy, with the clergy in consultation. Places in which the insane were confined were known as “fool towers” and “witch towers.”

This state of things was not altered with the dawn of the Reformation. The writings of Luther conclusively show his ideas in regard to possession and witchcraft, and these views under Calvin reached enormous development. Even Cotton Mather, in many respects far in advance of his times, and who himself had known persecution, was not emancipated from these delusions, and Salem has many a story to tell of possession and witch-baiting. It is true we may quite properly consider these views as the thought of the times, but, in many other respects, Luther, Calvin, and Mather were in advance of their period, and, therefore, a justification for their actions is not quite apparent. Marcus Aurelius also was much superior to his age, yet was grateful to his teachers that they taught him to disregard superstition in all its various forms.

It is not unlikely that conditions of this kind frequently led to epidemics—if not of actual insanity, at least to hysteria—which not rarely developed in cities, nunneries, and monasteries; thus the epidemics in Erfurt in 1237, in the Rhine countries in 1374, and many others (see Hirsch).

It is rather remarkable that while such views and practises prevailed in the Christian Church, the followers of Mohammed not only held different views, but adopted a mode of treatment of the insane which laid the foundation of modern therapeutics in diseases of the mind. In the twelfth century, in Bagdad, a palace called the “Home of Mercy” was built, in which the insane were confined, examined every month, and released as soon as they had recovered. An asylum in Cairo was founded in 1304, while the first Christian asylum expressly for the mad is noted in 1409 (Lecky).

But science fought its way through the barriers of ignorance, misdirected zeal, and superstition. Altho there were physicians and “magicians,” who conformed to the views of the Church, the seed sown by the earlier schools of medicine slowly but surely began to put forth shoots, and the result was a tree of knowledge, the fruit of which may be observed in every modern insane asylum of the world, where the unfortunate sufferer is treated with kindness and skill, which, fortunately, often results in cure.

Scientific reason frequently rebelled against the “insane superstition,” at first mildly, but constantly increasing in strength, until an effectual protest was finally raised by John Weir, of Cleves, who was soon followed by Michel de Montaigne. And now a battle royal was waged between the adherents of theology and the disciples of the “resurrected” truth, and once more in the history of the world was demonstrated the correctness of the saying, that “truth crushed to earth shall rise again.” All over the world the warfare was carried, and at the end of the eighteenth century new champions arose—Jean Baptiste Pinel in France, and William Tuke in England. Their followers are legion, and in the book of life, in letters of gold, many a name has been written of those who trod in the footsteps of these pioneers. Theology no longer interferes in the treatment of the insane; in fact, it would be manifestly unjust not to mention that many Christian theologians subsequently joined in the noble work of lunacy reform, and aided progress greatly.

How great this progress in the treatment of the insane can best be appreciated by some of the older physicians in practise to-day. Who does not remember the chains, the strait-jacket, the dark locked cells of the insane asylum? These conditions existed not very many years ago, and altho the novels of Charles Reade are no doubt greatly exaggerated in regard to the conditions he portrayed in insane asylums, yet _more than a grain of truth_ is probably contained in them. The books did much to bring about reforms in England and elsewhere.

Modern alienists have wrought wonders; their successful operations are not published in the daily press, but any visitor who knows what an insane asylum was fifty years ago, and who spends a few hours in a modern hospital for the treatment of lunatics, will observe what appears but little short of the miraculous. Imagine two thousand or more insane persons dining in a large hall, upon the table a tablecloth, and the insane using knife and fork in a decorous manner, and when the visitor is told that the “violent ward” is also present, and is asked to single these out from among the many, and fails (as he invariably does), the results attained by science, above all other measures, are strikingly apparent.

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Transcriber’s note

Words in italics were surrounded with _underscores_ and words in small capitals with all capitals.

The following corrections were made, on page

18 “conspiculously” changed to “conspicuously” (becomes conspicuously prominent) 30 “explicity” changed to “explicitly” (will be more explicitly referred to) 57 “Julien” changed to “Julian” (led her toward the grave of St. Julian) 77 “guage” changed to “gauge” (gauge the ideas of priests) 91 “Ephesus(500” changed to “Ephesus (500” (the absurd theory which Heraclitus of Ephesus (500 B.C.) has propounded) 116 “invidual” changed to “individual” (to plague an individual being) 192 “person the” changed to “the person” (it was not the person who acted) 196 “manasteries” changed to “monasteries” (nunneries, and monasteries) 203 “autorisirte” changed to “autorisierte” (Deutsche autorisierte Ausgabe).

Otherwise the original was preserved, including inconsistent hyphenation and possible errors in languages other than English, for example the capitalisation in Greek sentences.