Part 3

Beside the ostensible object of preventing the practice of medicine by ignorant persons, the foundation of the College effected another equally important reform which may possibly have been foreseen and intended by its founders, although the intention was not avowed. This was nothing else than the liberation of medicine and the medical profession from the control of the Church. The Bishops, it is said, notwithstanding the formal abolition of their privileges, continued to license physicians for 180 years after the foundation of the College, but never since has any ecclesiastical authority controlled the status or the practice of the medical profession in England. This liberty could hardly have been so complete had medicine been as completely as in other countries a department of University teaching. Linacre’s foundation must have the credit of preserving medicine both from the immediate domination of clerics and from future subjection to the leaden rule of orthodoxy, which swayed for several centuries the English Universities. The conditions of the new College and the mode of admission into it were clearly designed, and were calculated to give a very definite stamp to the English physician. He was to be in the first place a man of learning, and in this respect the standard of the College was certainly higher than that of the Universities, as is clear from the history of certain controversies that arose between these authorities. Considering too that it was scarcely possible to obtain in this country the particular kind of learning required, a strong inducement was held out to physicians to study at the Universities of the Continent, especially in Italy. Hence physicians were not only learned but very often travelled persons; and the names of foreigners are found rather frequently in the early rolls of the College. Moreover as the number of physicians practising in London was not large, and the difficulties of obtaining a licence were so considerable, a physician had no doubt a social position very much above that of the surgeon, and perhaps relatively higher than at the present day. It must be admitted also that the standing of an English physician has been made more definite and further removed from any association with trade than in any other European country. We see then pretty clearly what was the ideal that Linacre had framed;—a grave and learned person, well read in Galen, respecting, but not bowing down to, the prestige of the Universities, claiming for his own science a dignity apart from, but not conflicting with, that of theology, looking upon surgeons and apothecaries with charity, but not without a sense of his own superiority.

Such was to be the English Physician, and Linacre succeeded, if such was his object, in moulding a definite type of character which lasted for two centuries at least. But the physician of Linacre’s school is no more;—his epitaph was written nearly a hundred years ago by no less a person than Samuel Johnson. The great lexicographer was asked upon his death-bed for what physician he had sent. “I have sent,” he said, “for Heberden, _ultimum Romanorum_, the last of our learned physicians.”

The further history of the College of Physicians need not be written here; but something must be said of two other foundations also due to the public spirit and far-seeing benevolence of Linacre. These were his readerships at Oxford and Cambridge. In order to provide for the public teaching of medicine in the University and more especially for the reading of the works of Hippocrates and Galen, Linacre shortly before his death transferred to trustees considerable landed estates producing about £30 a year, which it was no doubt intended should be conveyed directly to the Universities for the foundation of Readerships. But the manner in which his purpose was carried out was unsatisfactory, and the subsequent history of the foundations is a melancholy chapter in University annals. The four trustees were Sir Thomas More, Tunstall, Bishop of London, Stokesley, himself afterwards a bishop and a certain Sheriff, a lawyer. For reasons which it is difficult to understand, unless simply negligence and procrastination were responsible, nothing was done with these funds till the reign of Edward VI., when Tunstall, the surviving trustee, transferred part of the estate to Merton College, Oxford, for the foundation of two Readers, and another part to St John’s College, Cambridge, for the establishment of a Readership there. It is quite clear that Linacre intended these to be University and not college foundations. His intention is sufficiently established by a letter addressed to him by the University of Oxford which has been published by Dr Johnson. The University acknowledges “that peculiar affection towards our commonwealth by which you have rendered yourself specially eminent,” and speaks of the splendid lectures “which you have appointed to be read here at your expense as wisely devoted to the study of medicine.” This might seem to refer to a foundation already established, but for the concluding words of the letter, “Lastly, we earnestly and again and again implore you not to abandon the resolution you have undertaken, and that your intentions may never be so many and varied as to divert or overcrowd this project. Let us certainly hope that the restoration of these, as well as all other studies to their pristine dignity may be effected during your life, and if aught in our power can promote this most excellent design, believe us prepared to second your wishes. Farewell, and may you long enjoy life, chief patron of learning!” According to Anthony Wood, Linacre’s foundation was settled in Merton College instead of in the University, on account of the great decay of the University in the reign of Edward VI., and through the persuasion of Dr Reynolds, warden of Merton College. This College was moreover for some reason specially frequented by the students of medicine. The appointment of readers, originally the duty of the trustees, was now transferred to the College. Members of the College had a preference for the appointment; though if none were found properly qualified, a member of another College or Hall might be appointed. The appointment was for three years only. With our present experience of University history, it is easy to see that no system could have been better calculated to reduce Linacre’s great foundation to uselessness and obscurity.

The names of a few of the earlier readers are given by Wood; that of one only, Dr Robert Barnes, emerges from total obscurity. The Readerships soon became sinecures, and their stipends were regarded as nothing more than an agreeable addition to the incomes of two of the Fellows. Among the many similar instances of the misapplication of endowments we shall not easily find a grosser abuse. Twenty years ago, as is well known, the Oxford Commissioners revived the name of the Founder in the present flourishing Linacre Professorship of Anatomy so ably filled, so important in the history of science in Oxford, and provided for its endowment by Merton College, as an equivalent for the income which the College still derives from Linacre’s estates.

At Cambridge the history of the corresponding Readership was even more unfortunate. The appointment was given to St John’s College, and though it was at first provided that the lectures of Linacre’s Reader should be delivered in the Schools of the University, the office soon came to be regarded as nothing more than a college sinecure. Moreover, through bad management of the funds, or chiefly, I believe, through an imprudent exchange of the estate originally settled by Linacre for one which has turned out to be of less value, the income originally intended for the Readership seems to have been lost. But for the sake of other than Cambridge men it ought to be here stated that the present Linacre Reader of Pathology fills with credit a chair most inadequately endowed, and has revived in Cambridge the public teachings of a study perfectly congruous with, though different from that which was intended by the founder. It is impossible to doubt that Linacre looked forward to founding what should essentially be a school of medicine in each University. And it is a strange instance of the irony of fate, that Cambridge at the present day comes far nearer to carrying out the plans of the great scholar than his own University of Oxford, to which he always shewed the loyalty of an affectionate son, and on which he conferred the largest share of his munificent bounty.

In the year 1524 it became evident to Linacre that his health was breaking, and in June of that year he executed his will. He appears to have suffered much from the painful disease, stone in the bladder, which finally carried him off on the 20th October, 1524, at the age, as is supposed, of sixty-four. His death was a great loss to the cause of learning in England, and many passages in the letters of contemporary scholars will shew that it was not less felt in all learned circles throughout Europe. He was buried in the Old Cathedral of St Paul, but for more than thirty years no memorial appears to have marked his grave. This strange neglect was only supplied in the year 1557 by the great physician John Caius, a name memorable in Cambridge annals, who if not personally a pupil of Linacre was in the most complete sense the inheritor of his spirit, and the most perfect type of a physician, such as the founder of our College wished to see. The Latin epitaph, written no doubt by Caius himself, perished in the great fire of London, but has been preserved by Dugdale. After an enumeration of the learned works and public services of Linacre it sketches in a few words a fine character, “Fraudes dolosque mire perosus; fidus amicis; omnibus ordinibus juxta carus.”

It will hardly be necessary to supplement the terse eulogium pronounced by Caius, by any attempt to sum up Linacre’s moral excellences. But it may be worth while to form some estimate of the talents and accomplishments which gave him so high a reputation among his contemporaries. No original writing of Linacre’s has been preserved, except his grammatical works and a few dedications and letters, on the strength of which it would be absurd to hazard any generalization as to his intellectual power. His reputation rested and still rests upon his translations; together with the undefined, but unmistakably strong impression which he produced upon his friends and literary contemporaries. From them we should gather that it was to the multifariousness of Linacre’s attainments as well as his excellence in each, that he owed his renown. To his literary faculty there are many testimonies. His Latin writing was thought to be so good that according to the friendly eulogium of Erasmus, the works of Galen as interpreted by Linacre, spoke better Latin than they had before spoken Greek. Other opinions not less laudatory were expressed both by Erasmus himself in other places and by other scholars not less sensitive in the matter of style. Linacre was not, however, a slavish imitator of any master. Erasmus among others has preserved the tradition of his slight regard for Cicero. He would rather have been thought to write like Quinctilian. The only complaint however which Erasmus makes against his friend is for his excessive elaboration in polishing and correcting his writings, from which it resulted that much of his work was reserved as not sufficiently perfect to be published: and in many cases ultimately lost[14]. It is disappointing to hear that Linacre had translated Aristotle in such a way that Erasmus says ‘_sic Latine legitur Aristoteles ut, licet Atticus, vix in suo sermone parem habeat gratiam_’: and of his other versions ‘_sunt illi permulta in scriniis, magno usui futura studiosis_.’

Beside the excellence of his style, Linacre was famed for his critical judgment, ‘_vir non exacti tantum sed severi judicii_’, says Erasmus, while in Grammar and Rhetoric, as shewn in the curious little fable of Richard Pacey formerly quoted, he was regarded as no less a master. Moreover he was what was called in those days an eminent ‘philosopher,’ that is, profoundly read in the works of the ancient naturalists and philosophers, such as Aristotle, Plato and Pliny.

It is not easy to form any distinct notion of Linacre’s skill in his own profession. Little more was expected of a physician in those days than to apply with proper care the maxims of the books. We do not even know whether in his practice Linacre made more use of the ancient medical classics whom he was endeavouring to rescue from neglect than of the ‘Neoterics’ who were the ruling spirits of the day, and whose doctrines were derived from the Arab physicians or from European schools sprung out of the Arab learning. Some have taken for granted that a man so great in book learning could not be good in practice. But the few notices which remain give no countenance to this assumption. Erasmus commemorates in two or three places his friend’s medical skill. In one he deplores Linacre’s absence, and laments (with curious modernism) that his servant had left the physician’s last prescription at the druggist’s, and begs for another copy. In one instance a record of Linacre’s treatment of Erasmus’s complaint remains, and appears to have been as sensible and practical, as if the physician had known not a word of Greek, and had passed his life as a country apothecary. He is also recorded to have advised his friend William Lily not to consent to an operation for the removal of a tumour of the hip; but the operation undertaken against Linacre’s advice, unfortunately proved fatal.

It was not Linacre’s fortune to contribute anything to the science of medicine, or to any of its collateral sciences. His age was not one of research as now understood. The first original work on medicine produced in England was done by his successor Caius, whose treatise on the sweating sickness published twenty years after Linacre’s death is still esteemed. This and other great epidemics must have passed before the eyes of Linacre, but no record remains to shew us in what light he regarded them. Nor is there any evidence that he appreciated the importance of the revival of Anatomy and Botany; sciences on which the subsequent development of medicine in Europe has so largely been based. Though evidently eagerly desirous to assist in the renovation of medical science, he looked to other means to accomplish this end. What these means were it may be worth while to state somewhat more in detail.

The aim which Linacre and other scholars set before them in translating or publishing the works of Galen can only be understood by a consideration of the state of medical learning and scholarship at the time. The student of medicine in those days, like the student of theology or philosophy, had to derive his knowledge almost entirely from books. There was indeed one school of practical anatomy in Italy, that founded by Mundinus at Bologna in the 14th century, and continued in Linacre’s time by Berengarius Carpus, who is said to have dissected one hundred bodies with his own hand, but in other parts of Europe only a literary knowledge of anatomy was possible. There was no such thing as hospital instruction, and what would be called in modern times Materia Medica was represented only by the empirical knowledge of humble collectors of simples, and by the works of scholars learned only in books who gave descriptions borrowed at second or third hand from the Arabian physicians, or at a still greater distance from Aristotle. Medical learning, thus understood, received like all other learning the stimulus of two great movements, the revival of Greek literature, with the consequent higher estimation of the classical Latin writers, on the one hand, and on the other hand the readier diffusion of books through the invention of printing. How the classical revival affected letters in general, theology and philosophy, is well known. Everywhere men became aware more or less distinctly that there was a new world of knowledge within their reach, but concealed from them by a mass of commentary and compilation, barbarous in language, and corrupt in substance, though professedly founded on the works of those great authors who were little more than names to the mediæval scholars. Gradually the great figures of antiquity became more distinct, as the followers of the new learning tore off the barbarous wrappings which had so long hidden or distorted them. It was in this spirit that the scholars set to work in their great task of restoring antiquity. There were doubtless many other aims, and some of them higher, which animated the more ardent spirits of the Renaissance, but of these we cannot pretend to speak. What alone concerns us here is their resolute endeavour to get at the real Aristotle, Plato or Homer, instead of the reflections and shadows of them which had long been reverenced. It was this spirit which made the printing of the first edition of Homer by Chalcondylas and Demetrius Cretensis in 1488, seem to them, as it has indeed seemed to later generations, an epoch in literature. It was this which in the next generation led Erasmus to devote years of labour to bringing out the Novum Testamentum, and it was in this spirit too, that Linacre the pupil of Chalcondylas and the teacher of Erasmus, standing between the literary and the religious revival, conceived the two great projects of his life, the publication of Aristotle and Galen in a form accessible to the whole learned world. The first scheme indeed he scarcely commenced, of the latter he did but little, though as he says “nihil magis in votis erat.”

To discover the genuine text of an ancient author and make it known may seem to us a useful task, though not among the greatest, but to the scholars of the Renaissance it was a matter of supreme importance. Linacre and his fellow workers doubtless expected that medicine would profit as much by the rediscovery of the Greek medical writings as letters and philosophy had gained from the masterpieces of Greek poetry and speculation; and it was with such hopes that they undertook to revive and make known the works of Galen. Galen, like Aristotle, had been very imperfectly known, even to those who most implicitly acknowledged his authority. With regard to Aristotle Sir Alexander Grant has pointed out that thousands of scholars who considered themselves staunch Aristotelians, knew not a word of the master beyond the two first treatises in the Organon; and in the same way, many who reverenced Galen as the source of all medical knowledge, knew him only through imperfect Latin versions, the compilations of mediæval scholars, or of the Arabians, whose works were chiefly based on Galen, and who had in this case as in that of Aristotle the credit of making a Greek author in large measure known to the modern world.

The works of Avicenna, Mesua and others were the chief medical text-books in Europe before, and even for a long time after, the revival of learning. The Jewish teachers, who had founded schools of surgery in many European cities, (among others in Oxford, before the rise of the University) were versed in Arabian learning, and thus it came to pass that medicine presented itself to the mediæval world in an Arabian dress. From these sources and from the teachers of the school of Salerno, were compiled the manuals of the “Arabistæ” or “Neoterici,” which under such names as Articella, Practica, Lilium Medicinæ, Rosa Anglica were the daily guides of the medical practitioner.

When the Arabian writers fell into disrepute, partly through being condemned as heretical, and partly as being barbarous in style, it was regarded, if one may say so, as a sort of indignity that Medical Science should still be so much beholden to the infidel sages. Those physicians who were also scholars felt this to be a reproach which must be wiped out. This feeling, fantastic as it may seem, was apparently wide-spread through the little world of scholars, and has been expressed by one of them in a manner so strange that I cannot forbear to quote it both for the sake of the grain of truth which it contains, and for its unconscious reflection of the fantastic ideas of the age.

The author Symphorien Champier was a physician of Lyons, a voluminous writer as well as a liberal and wealthy patron of letters. The extract is from a short tract _Symphonia Galeni ad Hippocratem, Cornelii Celsi ad Avicennam, una cum sectis antiquorum medicorum ac recentium_, forming the introduction to a little work on Clysters, _Clysteriorum campi contra Arabum opinionem pro Galeni sententiâ_, etc., which is known in literature as the original of the “Treatise on Clysters, by S. C.”, placed by Rabelais in the catalogue of books forming the library of St Victor.

After lamenting that for so many centuries pure literature, that is Greek and Roman, should have been neglected, and instead the mean ditties (_neniæ_) of certain pretenders should have been cultivated. _Indignum facinus_, says Champier, _(ita me deus amet) nullis bobus, nullisque victimis expiandum_.

Next, passing to the subjects of philosophy and medicine, he represents a war as arising between the Arabians and the Classics, which might have ended disastrously for the latter, but for the interposition of divine providence.

“Jam eo insolentiæ ac temeritatis devenerant Arabi principes, ut nobis medicam artem funditus auferre audacissime conarentur; quandoquidem castra solventes in Græcos ac Latinos omnem belli impetum convertebant, multaque millia processerant, cum deus Opt. Max. (cujus est hominum repente et consilia et animos immutare) ut auguror sanctissimi Lucæ precibus et orationibus flexus, auxiliarios milites demisit, qui obsidione miseros, Hippocratem, Galenum, Dioscoridem, Paulum Aeginetam et nostrum Celsum Cornelium, jam deditionem cogitantes eriperent et liberarent; idque quantâ sit confectum diligentiâ, in confesso est. Hippocrati non pauci auxilio fuere, Galeno ab Arabum principe oppresso strennue [sic] adfuit Vicentinorum dux [Nicolaus Leonicenus], præterea ex Galliâ Copus, ex Angliâ Linacrus, bone deus quo studio, quâ alacritate. Porro Dioscoridi Gallorum virtus et ferocia, Venetorum prudentia, Florentinorum divitiæ opem tulerunt.”

This passage only puts in an extravagant form the same ideas about the value of ancient learning in relation to medicine which we have already quoted from the letters of Leonicenus, and of Aldus.

A more serious scholar than Symphorien Champier, Janus Cornarius, has left a very clear statement of the position which Galen and the ancient medical writers were considered to occupy at this critical epoch in the history of learning.

He says that medicine, like all good arts and disciplines, comes from the Greeks, and is to be learnt from their works alone. As to the Arabs, Avicenna, Rhazes and others, who now-a-days reign in nearly all our schools, and the numerous Italian or French physicians, who have become celebrated by writing so many of the books called ‘_Practica_,’ they are physicians only in name. It were to be wished, he says, that all public schools would acknowledge their errors and repudiate the barbarian physicians, as the Florentine academy had done.

“At vero non penitus desperandum quando nuper adeo una Florentina Academia resipiscendo aliquando etiam aliis spem nobis exhibuit, quæ excusso Arabicæ et barbaræ servitutis medicæ jugo, ex professo se Galenicam appellavit et profligato barbarorum exercitû, unum totum et solum Galenum, ut optimum artis medicæ authorem, in omnibus se sequuturum pollicita est[15].”