Part 14

This custom, for that matter, is by no means yet abandoned. When I was first studying in Vienna, in 1882, I remember a young German nobleman who was reduced to such an extent that he lived absolutely on the charity of others. He kept a little book in which he had it set down that on such a day such a person had promised to give him so much toward his support, and he called regularly on his list of supporters, and almost daily, in order that the gulden which they had promised him might be forthcoming.

There is the good old story you know, also, of the three students who were so poor that they had but one cappa or gown between them, in which they took turns to go to lectures. In the small university towns, where thousands of students gathered together during a part of the year--where means of carrying food were scanty, and food itself not abundant--it is not strange that student fare was often of the most meagre sort.

The matter of food was not the only hardship of student life in those days about which we are talking. At that time such a thing as a fire in a lecture-room was unknown, there being no source of warmth or comfort, save, perhaps, straw or rushes upon the floor. The winter in the northern university towns must have been severe, but it is not likely that either in the lecture-room or in his own apartments did the student have any comfort from heat. This was true to such an extent that they often sought the kitchens for comfort. In Germany it was even one of the duties of the head of the college to inspect the college-rooms lest the occupants should have supplied themselves with some source of heat. In some places, however, there was a common hall or combination room in which a fire was built in cold weather. You must remember, also, that glass windows were an exceptional luxury until toward the close of the period under discussion. In Padua the windows of the schools were made of linen. In 1643 a glass window was for the first time introduced into the Theological School at Prague. In 1600 the rooms inhabited by some of the junior fellows at Cambridge were still unprovided with glass windows. Add to these hardships the relative expense of lights, when the average price of candles was nearly two pence per pound, and you will see that the poorest student could not afford to study by artificial light. Some of the senior students may have had bedsteads, but the younger students slept mostly upon the floor. In some places there were cisterns or troughs of lead, or occasionally pitchers and bowls were provided, but usually the student had to resort to the public lavatory in the hall.

Along with these hardships consider the amusements of this period, which were for the greater part conspicuous by their absence. Statutes concerning amusements were often more stringent than those concerning crime or vice. These were essentially military times, and tournaments, hunting, and hawking, which were enjoyed by the upper social classes, were considered too expensive and distracting for university students, and were consequently forbidden. "Mortification of the flesh" was the cry of those days, as even now among some religious fanatics. Even playing with a ball or bat was at times forbidden, along with other "insolent games." A statute of the sixteenth century speaks of tennis and fives as among "indecent games" whose introduction would create scandal in and against the college. Games of chance and playing for money were also forbidden; nevertheless, they were more or less practised. Even chess enjoyed a bad reputation among the mediæval moralists, and was characterized by a certain bishop of Winchester as a "noxious, inordinate, and unhonest game." Dancing was rather a favorite amusement, but was repressed as far as possible, since the celebrated William of Wykeham found it necessary to prohibit dancing and jumping in the chapel. Apparently, then, in those days a good student amused himself little, if at all, and had to find his relaxation in the frequent interruptions caused by church holidays. At St. Andrew's, in Scotland, however, two days' holiday was allowed at carnival time expressly for cock-fighting. On the evenings of festival days entertainments were occasionally provided by strolling players, jesters, or mountebanks, who were largely patronized by students.

Altogether, it is not strange that students in those days fell into dissolute habits, many having to be expelled or punished. We can even understand how some of them actually turned highwaymen and waylaid their more peaceful brothers as they approached the universities with money for the ensuing season. In the archives of the University of Leipzig there are standard forms of proclamation against even such boyish follies as pea-shooting, destruction of trees and crops, throwing water out of the window upon passers-by, shouting at night, wearing of disguises, interfering with a hangman in the execution of his duty, or attending exhibitions of wrestling, boxing, and the like.

Evidently, then, university life had its exceedingly wild side. One needs only to recall the history of the famous Latin Quarter in Paris to be convinced of this. This was the students' quarter in the old city of Paris as extended by Philip Augustus across the river. Paris then was surrounded by a cordon of monasteries, whose abbots exercised jurisdiction over their surrounding districts. Just to the west of the student quarter stood the great Abbey of St. Germain. Between the monks of this monastery and the students there were frequent conflicts, and it is recorded that in 1278, for instance, a pitched battle occurred between the monks, under their provost, on one side, and the unarmed and defenceless boys and masters, on the other, during which many were badly wounded, and some mortally. The matter was finally carried to court, and the monks were required to perform certain penances and to pay certain fines. Their brutality, however, was not effectually suppressed. In 1304 the Provost of Paris hanged and gibbetted a student, and was punished therefor by the king; while the subsequent history of Paris is one of constant conflict between students and the clerical orders. On the other hand, the clerical tonsure in which the Parisian scholar clothed himself enabled him to indulge in all kinds of crime, without fear of that summary execution which would have been his fate had he been merely an ordinary beggar.

Bibulousness was another striking characteristic of mediæval university life. In those days they knew not tea nor coffee nor tobacco, but spirituous liquors in some form were far from unknown to them. No important event of life could be transacted without its drinking accompaniment. At all exercises, public or private, wine was freely provided, and many of the feasts and festivals which began with mass were concluded with a drunken orgie.

You have observed that so far I have made frequent mention of clerical matters. In truth, in northern Europe the Church included practically all the learned professions, including the civil servants of the government, the physicians, architects, secular lawyers, diplomatists, and secretaries, who were all ecclesiastics. It is true that in order to be a "clerk" it was not really necessary to take even minor orders, but it was so easy for a king or bishop to reward his physician, his lawyer, or his secretary by a monastic office rather than by a large salary, that the average student, at least in the larger places, looked to holy orders as his eventual destination. How much of insincerity and hypocrisy there were among those reverend gentlemen thus constituted you may imagine better than I can picture. The Reformation, as well as the increasing corruption of the monastic orders, brought about changes which were not rapid, but which became almost complete, and led finally to the partial restoration of the ancient dignity of the early Church.

Without pursuing this part of the subject further, it may be imagined what a general alteration and reformation in all branches of study, as well as in the general intellectual life of the people, the founding of the universities accomplished. For the greater part designed for the confirmation of the faith, they often brought about a reaction against it. Like the other integral portions of the university, the medical departments of nearly all the mediæval institutions came into existence through voluntary associations of physicians and would-be teachers. For a long time medicine was included under the general head of philosophy, whose standard-bearers were Aristotle and the Arabians. At Tübingen, in 1481, the medical student's days were divided about as follows: In the morning he studied Galen's _Ars Medici_, and in the afternoon Avicenna on _Fever_. During the second year, in the forenoon he studied Avicenna's _Anatomy and Physiology_, and in the afternoon the ninth book of Rhazes on _Local Pathology_. The forenoons of his third year were spent with the _Aphorisms_ of Hippocrates, and in the afternoon he studied Galen. If any text-book on surgery at all were used it was usually that of Avicenna. Some time was also given to the writings of some of the other Arabian physicians. At that time any man who had studied medicine for three years and attained the age of twenty-one might assume the rôle of teacher if he saw fit, being compelled only, at first, to lecture upon the preparatory branches. He was at that time called a _baccalaureus_. After three years' further study he became a _magister_ or _doctor_, although for the latter title a still further course of study was usually prescribed. The courses of medical instruction were quite stereotyped in form, and were carefully watched over by the Church. Nevertheless, it came about that the study of medicine once more was taken up by thinkers, although, unfortunately, not logical thinkers, whereas previously it had been almost entirely confined within the ranks of the clerics or clergy. The most celebrated of all these mediæval philosophers in science and medicine was Albert von Bollstaedt, usually known as Albertus Magnus, who died in 1280. His works which remain to us fill twenty-one quarto volumes, in which he discussed both anatomical and physiological questions. It is exceedingly illustrative of the foolishly speculative vein in which many of these discussions were carried on, that they seriously discussed such questions as whether the removal of the rib from Adam's side, out of which Eve was formed, really caused Adam severe pain, and whether at the judgment day that loss of rib would be compensated by the insertion of another. Those were the days, also, when it was seriously discussed whether Adam or Eve ever had a navel. In spite of such follies, however, Albertus Magnus left an impression upon scholarship in science, in a general way, which long outlasted him.

These were the days when the students organized themselves into so-called "nations," whence arose that conspicuous features of German university life of today of so-called students' Corps. These nations--each composed, for the main part, of men of one nationality--had their own meeting-places, their own property, etc. One of the principal means of instruction in those days was disputations, or, as we would say, debates, held between students, often of different nations, in which they were expected to prove their knowledge and mental alertness. When it is recalled that universities were larger--i. e., better attended--in those days than now, it will be seen to what an extent these nations were developed. Oxford, in 1340, is said to have had no less than 14,000 students; Paris about the same time had 12,000; and Bologna had some 10,000 students, the majority of whom were studying law.

The title of doctor came into vogue about the twelfth century. At first it was confined to teachers proper, and was bestowed upon the learned--i. e., those who had almost solely studied internal medicine, and who were required to take an oath to maintain the methods which had been taught them. For the title of doctor certain fees were paid, partly in money and partly in merchandise. The so-called presents consisted of gloves, clothes, hats, caps, etc. At Salernum it cost about $60 to graduate in this way, while at Paris the cost was sometimes as high as $1,000, and this at a time when money had much more purchasing value than it has to-day. It was then, as now, a peculiar feature of the English universities that but little systematic instruction in medical science was given. Just as the majority of English students at present study in London rather than at one of the great universities, so in those days did they go to Paris or Montpellier.

This will be perhaps as good a place as any to emphasize the fact that the clergy, having so long monopolized all learning and teaching, and having, at the same time, an abhorrence for the shedding of blood, which indeed had been prohibited by many papal bulls and royal edicts, permitted the practice of the operative part of medicine--i. e., surgery--to fall into the hands of the most illiterate and incompetent men. Inasmuch as the Church prohibited the wearing of beards, and as many of the religious orders also shaved their heads, there were attached to every monastery and to every religious order a number of barbers, whose duty was to take care of the clergy in these respects. Thus into their hands was gradually committed the performance of any minor operation which involved the letting of blood, and from this, as a beginning, it came about that no really educated man concerned himself with the operations of surgery, but left them entirely to the illiterate servants of the Church. This is really the reason that the barbers for many centuries did nearly all the surgery, and why, at the same time, surgery fell into such general and wide-spread disrepute. From this it was only revived about one hundred years ago. Did time permit, this would be a most appropriate place to digress from the subject of this paper and rehearse to you the various stages in the evolution of the surgeon from the barber; but time does not permit it, and it constitutes a chapter in history by itself, which must be relegated to some other occasion. (See p. 296).

It was about the beginning of the fifteenth century that the better class of physicians began to belong to the laity, and were called "physici" in contrast to the "clerici." Later they were known as "doctores." Until the fourteenth century most of them studied in Italian or French universities, the Germans even being compelled to go to these foreign institutions. In Paris they were required to take an oath that they would not join the surgeons. This regulation was founded as much upon spite and envy as upon any other motive. Many of the clerical physicians belonged to the lower class, and were so ignorant that even the Church itself was forced to declare many of their successes miracles. Although monks and the clergy in general had been frequently forbidden to practice medicine, the decrees to this effect were quite generally disregarded, except in the matter of surgical operations. In the ranks of the higher clergy it must be said that well-educated physicians were occasionally found. There is, for instance, the record of a certain bishop of Basel, who was deputed to seek from Pope Clement V. an archbishopric for another person, but finding the Pope seriously ill, cured him, and received for himself in return the electorate of Mayence, which was perhaps one of the largest honorariums ever given to a physician.

These were the days when magic, mingled with mystery, played no small rôle in the practice of medicine, and when disgusting and curious remedies were quite in vogue. Superstition and ignorance everywhere played a most prominent part. For instance, it was, in those days, an excellent remedy to creep under the coffin of a saint. When a person was poisoned it was considered wise to hang him up by the feet and perhaps to gouge out one of his eyes, in order that the poison might run out. It should be noted that putting out the eyes was frightfully common in the Middle Ages, mainly as a matter of punishment. It is said, for instance, that the Emperor Basil II. on one occasion put out the eyes of 15,000 Bulgarians, leaving one eye to one of every thousand, in order that he might lead his more unfortunate fellow-sufferers back to their ruler, who, it is said, at the sight of this outrage swooned and died in two days. It is said, too, that this is the reason why the Emperor Albrecht was one-eyed.

What the revival of learning could thus and did accomplish under these conditions as above portrayed may be readily appreciated. The restoration of Greek literature, the revival of anatomy, the habit of independent observation--all told materially in this renaissance of medicine. The Italian universities became the objective point of all who desired a thorough medical education. The students chose the lecturers and officers of the university and had a large voice in the construction of the curriculum. The officers of their selection negotiated with those of the State, at least until the close of the sixteenth century.

In spite of this general renaissance of medical learning and the impetus felt by the inspired few during the sixteenth century, it must be said that the general condition of medical science and of those who practised it was not greatly improved. The superstition of the common people and the timidity and indolence of all concerned were about as marked as they have ever been in the history of human error, and the practice of medicine was at least a century behind the applied knowledge of the other arts and sciences. At that time the best physicians and doctors were to be found in the Italian universities, the French coming next, and, last of all, the German. The Italian universities were the Mecca sought by those who desired the best education of the day, and of all the Italian medical faculties those of Bologna, Pisa, and Padua ranked highest.

Those were the days, also, of the travelling scholars--a very marked feature of mediæval life. They migrated from one of the Latin schools to another, and from one famous teacher to another, sometimes travelling alone, at other times in groups or bands, and practising often the worst barbarities while _en route_, supporting themselves by begging and stealing. On their marches they stole almost everything which was not tightly fastened down, and prepared their food even in the open fields. The result was that most of them fell into dissolute habits of life. A somewhat better class of vagrant students sang hymns before doors and received food as pay. Some earned money singing in the churches. They apparently both drank more beer and at less cost than at present. At that time the cost of beer was about one cent for a large glass.

The younger students were called "schutzen," and, like apprentices in trades, were obliged to perform the most menial duties. The older students were known as the "bacchanten," and each bacchant was honored in proportion to the number of "schutzen" who waited upon him. When, however, this bacchant himself reached the university he was compelled to lay aside his rough clothing and rude manners and take an oath to behave himself.

Not only the students, however, wandered from place to place, but even the professors of the sixteenth century were nomadic, wandering from one university to another; for example, Vesalius, the great teacher of anatomy, taught in Padua, in Pisa, in Louvain, in Basel, in Augsburg, and in Spain. These habits may be partly accounted for by the fact that the students elected at least some of their teachers, and the professors who failed of re-election certainly may be considered to have had a motive for moving on. Salaries were certainly not large in those days. Melanchthon, the great theologian, received during his first eight years a salary of $43 per annum, and by strict economy was able during this period to buy his wife a new dress. During his later years his salary attained the sum of $170, which would be equivalent to $750 to-day. When Vesalius died his salary was $1,000 per annum, to which certain fees were added. It is not strange, therefore, that many of the professors pursued reputable occupations during their odd hours or that they took students to board. We hear to-day of frequent illustrations of the pursuit of knowledge under difficulty, but certainly during the ages to which I have referred the ardent student, were he undergraduate or professor, put up with an amount of hardship, meagre fare, and trouble of all kinds which would stagger most of the young men of to-day.

Men were human then as now, and the universities were not above disputes and quarrels, which sometimes became very bitter and dishonorable, but were the indirect instrument of good, since they led in not a few instances to the founding of other universities. Thus, about the beginning of the sixteenth century, Pistorius and Pollich were both teachers in Leipzig, but holding antagonistic views regarding the nature of syphilis, became so embittered that they could not bear each other's presence, and each resolved to seek another home. The former influenced the elector to select Frankfort-on-the-Oder as the site of a new university, while the latter was the means of founding another at Wittenberg.

It is pretty hard to keep away from the relation of the barber to the anatomist and surgeon when discussing this subject. In another place I have dealt with the evolution of the surgeon from the barber, (See page 296) and have endeavored to show that the principal factor which operated to keep back the progress of surgery during the eighteen centuries previous to the last was the influence of the Church, which opposed the study of anatomy and degraded the practice of surgery. In the times to which I am referring now, an operation which caused the shedding of blood was considered beneath the dignity of an educated physician, and, in some circles, was regarded even as disreputable. It was, therefore, left to the only class of men who were supposed to know how to handle a knife or sharp instrument, i. e., the barbers. When operations were done in universities papal indulgences were often required, and these cost money, since in those days the Pope gave nothing for nothing. Public dissection required also papal indulgences, although in Strasburg, in 1517, permission to dissect the body of an executed criminal was granted by the magistrates in spite of papal prohibition.

The ceremonies attending demonstrations of this kind were both fantastic and amusing. A corpse was ordinarily regarded as disreputable, and had first to be made reputable by reading a decree to that effect from the chief magistrate or lord of the land, and then, by order of the University, stamping the body with the seal of the corporation. It was carried upon the cover of the box in which it had been transported into the anatomical hall, which cover, upon which it rested through the ceremonies, was taken back afterward to the executioner, who remained at some distance with his vehicle. If the corpse was that of one who had been beheaded, the head during the performance of these solemn ceremonies lay between its legs. After the completion of the ceremonies the occasion was graced with music by the city fifers, trumpeters, etc., or an entertainment was given by itinerant actors (Baas).

In time, however, this folly was given up, and by the latter half of the sixteenth century public anatomical theatres were established. The most celebrated was built by Fabricus ab Aquapendente, in Padua. It was so high, however, and so dark that dissections even in broad daylight could only be made visible by torchlight.