3. I swear to aid the Faculty in resisting any undertaking against
their honor or ordinances, especially against those so-called doctors
who practice illicitly; and also submit to any punishment inflicted for
a proscribed action.
4. I swear to assist in full robes, at all meetings, when ordered by
the Faculty.
5. I swear to assist at the exercises of the Academy of Medicine
and the school for the space of two years, and sustain any question
assigned me, in medicine or hygiene, by a thesis. Finally, I swear to
be a good citizen, loving peace and order, and observe a decent manner
in discussion on all questions laid down by the Faculty.
This oath was read in Latin by the Dean, and, as enumerated, each
candidate for a degree solemnly answered “I swear” after each article.
Ranged with physicians at this period, although on a lower plane,
came the surgeons and barbers; these had been created under the title
of _mires_ and _meges_, by medical monks, who could not, under the
canons, resort to surgical operations, as it is written _Ecclesia
abhorrhet a sanguine_.
Let us continue their history. When the College of Physicians was added
to the University of Paris, in the twelfth century, it was specified by
the other Faculties of the institution that surgeons formed no portion
of the medical Faculty, and were not entitled to any consideration.
These surgeons kept shops and wandered through the streets with
instrument cases on their backs, seeking clients, and were assisted
in their work by the barbers, who were even more illiterate than the
surgeons; but, thanks to the exertions of Jean Pitard, surgeon to Saint
Louis, these surgeons succeeded in forming a corporation in 1271. Their
meetings were held in the dead-house of the Cordeliers’ church, and
they were allowed the same privileges as the _magistri in physica_.
They were the surgeons wearing a long robe.
It was only at the end of the century that Lanfranc obtained from
Phillip the Beautiful an order to reorganize and bestow degrees for the
exercise of surgical art. The studies were extremely practical; they
required several years’ attendance at the Hotel Dieu or in the service
of some city surgeon, likewise a certain amount of literary education.
Like the doctors, these surgeons were permitted to wear a robe and hat.
They were a great success.
Unfortunately, the barbers of the fourteenth century obtained, in their
turn, an edict from Charles V., who recognized their corporation and
authorized the knights of the razor to practice bleeding, and also all
manner of minor surgery.
The Faculty of Medicine, jealous of the Surgeons’ College, encouraged
the barbers with all their influence. They founded for the face
scrapers a special course in anatomy on condition that the barber
would always acknowledge the physician as superior to the surgeon.
The barbers made this promise, but the time arrived when they thought
themselves stronger than the Faculty of Medicine; this was in 1593;
but this same year, an order passed by Parliament, at the instigation
of the doctors, deprived the barbers of all the power granted them by
Charles V.
The barbers thus had their punishment for defying the Faculty of
Medicine.
The College of Surgeons, relieved from the competition of the barber
surgeons, now claimed the right to become part of the Medical Faculty,
and an ordinance of Francois I. gave them this privilege. Letters
patent were issued that read:
“It is ordained that the before-mentioned, professors, bachelors,
licentiates or masters, be they married or single, shall enjoy all the
privileges, franchises, liberties, immunities and exemptions accorded
to the other medical graduates of the University.”
Notwithstanding this Royal edict and confirmation of privileges
accorded to surgeons by Henri II., Charles IX., and Henri III., the
Faculty of Medicine positively refused to open their doors to their
mortal enemies, the much despised barber-surgeons, as they were termed.
Even Louis XIV. gave up the idea of making the doctors associate
socially with the surgeons; the latter, then, continued to keep shops,
with a sign of three sacrament boxes supported by a golden lily,
and were only allowed the cadavers of malefactors for purposes of
dissection; these bodies were stolen from the Faculty of Medicine.
In the meantime, the regular barber-surgeons renewed their ancient
allegiance to the doctors, who had vainly attempted to substitute
students in their places.
To put an end to the struggle, the College of Surgeons took the
desperate but injurious resolve to admit all barbers to their
institution and recognize their rights to a surgical degree. A year
later, 1660, the Faculty of Medicine demanded that, inasmuch as the
College of Surgeons admitted ignorant barbers to their school, the
right of surgeons to wear a medical robe and hat and bestow degrees be
denied. The Faculty of medicine gained their suit.
As an indispensable adjunct to the doctor at this period, let us now
mention the apothecary and the bath-keeper.
The patron of the apothecaries was Saint Nicholas; they belonged to the
corporation of grocers, where they were represented by three members.
Their central bureau was at the Cloister Saint Opportune.
The inspection of drug stores and apothecary shops in Paris occurred
once a year, and was made by three members elected from the central
bureau and two doctors in medicine. A druggist in Paris served four
years as an apprentice and six years as an under-dispenser; then
the applicant was obliged to pass two examinations, and, finally,
five extra examinations, the latter in the presence of the master
apothecaries and two doctors. Notwithstanding their oath[8] to not
prescribe medicine for the sick and not to sell drugs without a
doctor’s written order, druggists then, as now, had frequent conflicts
with physicians, as the latter are ever jealous of non professional
interference and always asserting supremacy.
However, it is well to say that druggists never violated the rule
relative to strict inspection of all drugs before using such articles.
All medicines were passed at the central bureau before any apothecary
would purchase for dispensing purposes.
As to bath-keepers, they belonged in antique times, as now, more to the
order of empirics; their history dates far back to the period when the
Romans introduced their bathing system into Gaul—a system which was
perpetuated up to as late as the sixteenth century.
The baths constructed by the ancients and destroyed by the barbarians,
reappeared again in the Middle Ages, under the names of vapor baths and
furnace baths. These baths were shops, usually kept by barbers, where
one could be sheared, sweated or leeched by a tonsorial artist. All the
world then took baths—even the monks washed themselves sometimes; in
fact, almost every monastery had its bath-rooms, where the poor could
wash and be bled without pay.
In those days gentlemen bathed before receiving the order of chivalry.
When one gave a ball it was customary and gallant to offer all the
guests, especially the ladies, a free bath. When Louis XI. went out
to sup with his loyal subjects, the honest tradespeople of Paris, he
always found a hot bath at his disposal. Finally, it was considered a
severe penance to forbid a person from bathing, as was done in the case
of Henry IV., who was excommunicated.
Paris had many bath-houses. From early dawn until sunset the streets
were filled, with cryers for bath-houses, who invited all passers-by
to enter. In the time of Charles VI., bath-keepers introduced vapor
baths. Some of these latter were entirely given up to women; others
were reserved for the King and gentlemen of the court. The price of
vapor baths was fixed by Police ordinance at twenty centimes for a
vapor bath and forty centimes for those who washed afterwards. This
price was subject to revision only at the pleasure of the municipal
authorities.
During times of epidemics vapor baths were discontinued. It was for
sanitary reasons, probably, that an order of the Mayor of Paris, named
Delamere, forbade all persons taking vapor baths until after Christmas
eve, “on penalty of a heavy fine.” This same proclamation was repeated
by act of Parliament on December 13th, 1553, “the penalty corporeal
punishment for offending bath-keepers.”
Parisian vapor baths had such wide-spread reputations and success that
an Italian doctor of the sixteenth century by the name of Brixanius,
who arrived in Paris, wrote the following verses:
“Balnea si calidis queras sudantia thermis,
In claris intrabis aqua, ubi corpus inungit,
Callidus, et multo medicamine spargit aliptes’,
Mox ubi membra satis geminis mundata lacertis
Laverit et sparsos crines siccaverit, albo
Marcida subridens componit corpora lecto.”
Already, in the time of Saint Louis, the number of bath-keepers was so
great that they had a trades union; they were almost all barbers, too;
they washed the body, cut hair, trimmed corns and nails, shaved and
leeched.
Bath houses more than multiplied from the twelfth century, imitations
of Oriental customs, due to the crusaders. Baths were run not only by
men, but by old harridans and fast girls. No respectable woman ever
entered a public bath-house; Christine de Pisan bears witness to that
fact in the following lines: “As to public baths and vapor baths, they
should be avoided by honest women except for good cause; they are
expensive and no good comes out of them, for many obvious reasons; no
woman, if she be wise, would trust her honor therein, if she desire to
keep it.”
The establishments known as vapor baths, as early as the time of Saint
Louis, had already degenerated into houses of prostitution. The police,
in defense of public morality, were finally obliged to forbid fast
women and diseased men from frequenting such places.
In Italy, vapor baths were recognized officially and tolerated as
places of public debauchery; this was also the case in Avignon. The
Synodal statutes of the Church of Avignon, in the year 1441, bear an
ordinance drawn by the civil magistrates and applicable to married men
and also to priests and clergy, forbidding access to the vapor baths
on the Troucat Bridge, which were set apart as a place of tolerated
debauchery by the municipal authorities. This ordinance contained a
provision that was very uncommon in the Middle Ages, _i.e._, a fine of
ten marks for a violation of the law during day time and twenty marks
fine for a violation occurring under cover of night.
In 1448 the city council of Avignon again tried its hand at regulating
the vapor baths at the bridge; but the golden days of debauched women
had long before passed away, and the previous century had witnessed the
acme of the courtesans’ fortunes. The sojourn of the Popes at Avignon
had gathered together from all over the Globe a motley collection of
pilgrims and begotten a frightful condition of libertinage; we have
the authority of Petrarch in saying that it even surpassed that of the
Eternal City, and Bishop Guillaume Durand presented the Council of
Vienna with a graphic picture of this social evil.
According to the proclamation of Etienne Boileau, Mayor of Paris in the
reign of Louis IX., barber bath keepers were forbidden to employ women
of bad reputation in their shops in order to carry on under cover,
as in the massage shops of the present day, an infamous commerce, on
penalty of losing their outfit—seats, basins, razors, etc.,—which were
to be sold at public auction for the profit of the public treasury and
the Crown. But we know full well that the Royal Ordinance of 1254,
which had for its object the reformation of public debauchery, was
only applied for the space of two years, and that the new law of 1256
re-established and legalized public prostitution which offered less
objectionable features than clandestine prostitution.
The use of public baths and hydrotherapy lasted until the sixteenth
century. At this epoch, and without any known reason, the public
suddenly discontinued all balneary practices, and this was noticeable
among the aristocratic class as among the common people. A contrary
evil was developed. “Honest women,” says Vernille, “took a pride in
claiming that they never permitted themselves certain ablutions.”
Nevertheless, Marie de Romien, (_Instruction pour les Jeunes Dames_)
in her classical work for the instruction of young women, remarks:
“They should keep clean, if it be only for the satisfaction of their
husbands; it is not necessary to do as some women of my acquaintance,
who have no care to wash until they be foul under their linen. But to
be a beautiful _damoyselle_ one may wash reasonably often in water
which has been previously boiled and scented with fragrants, for
nothing is more certain than that beauty flourishes best in that young
woman who not only looks but smells clean.”
In an opuscle published in 1530, by one called De Drusæ, we observe
that “notwithstanding the natural laws of propriety, women use scents
more than clean water; and they thus only increase the bad smells
they endeavor to disguise. Some use greasy perfumed ointments, others
sponges saturated in fragrants”
“Entre leur cuisses et dessoubz les aisselles,
Pour ne sentir l’espaulle de mouton.”
This horror of water did not last long, however, and at the
commencement of the seventeenth century the false modesty of women
ended with the creation of river baths, such as exist to-day along the
banks of the Seine.
Was this restoration of cleanly habits due to medical advice? This
question cannot be answered, but it may not be out of place to cite
that remarkable passage from the “Essays of Montaigne” on the hygiene
of bathing, which he recommends in certain maladies:
“It is good to bathe in warm water, it softens and relaxes in ports
where it stagnates over sands and stones. Such application of external
heat, however, makes the kidneys leathery and hard and petrifies the
matter within. To those who bathe: it is best to eat little at night
to the end that the waters drank the next morning operate more easily,
meeting with an empty stomach. On the other hand, it is best to eat a
little dinner, in order not to trouble the action of the water, which
is not in perfect accord; nor should the stomach be filled too suddenly
after its other labor; leave the work of digestion to the night, which
is better than the day, when the body and mind are in perpetual
movement and activity.
“I have noted, on the occasion of my voyages, all the famous baths of
Christendom, and for some years past have made use of waters, for as a
general rule I consider bathing healthy and deem it no risk to one’s
physical condition. The custom of ablution, so generally observed at
times past in all nations, is now only practiced in a few as a daily
habit. I cannot imagine why civilized people ever allow their bodies to
become encrusted with dirt and their pores filled with filth.”[9]
If Montaigne made great use of mineral waters, he had in revenge
a formidable dread of physicians and their medicines, a sentiment
he inherited from his father, “who died,” says he, “at the age of
seventy-four years,” and his “grandfather and great-grandfather died at
eighty years without tasting a drop of physic.”
Montaigne has justly criticized medicine in several essays on the
healing art. He knew well the _intividia medicorum_, and it was for
this reason that he remarked that a physician should always treat a
case without a consultant. “There never was a doctor,” says Montaigne,
“who, on accepting the services of a consultant, did not discontinue or
readjust something.” Is not the same criticism deserved at the present
day? How absurd are our medical consultations. The examples Montaigne
gives of disagreements of doctors in consultation as to doctrines are
equally applicable to modern times. The differences of Herophilus,
Erasistratus, and the Æsclepiadæ as to the original causation of
disease were no greater than those of the schools of Broussais and
Pasteur, which have both acquired a universal celebrity in less than
half a century.
Montaigne insisted that medicine owed its existence only to mankind’s
fear of death and pain, an impatience at poor health and a furious and
indiscreet thirst for a speedy cure, but the author of the “Essays”
adds in concluding: “I honor physicians, not following the feeling of
necessity, but for the love of themselves, having seen many honest
doctors who were honorable and well worthy of being loved.”
The reputation for disagreement among doctors so much insisted on by
Montaigne has served as a well-worn text for many other critics.
In _Les Serres_ of Guillaume Bouchet, a contemporary of the author, we
find the same shaft of sarcasm directed at physicians. Where will you
find men in any other profession save that of medicine who envy and
hate each other so heartily? What other profession on earth is given
over to such bitter disagreements? How can common people be expected
to honor and respect experts and savants so-called when the professors
call each other ignoramusses and asses? Call these doctors into a case
and one after the other they will disagree as to the diagnosis as well
as to the method of cure. As Pellisson wrote:
“When an enemy you wish to kill
Don’t call assasins full of vice,
But call two doctors of great skill
To give contrary advice.”
Or in the verses of the original:
“D’un ennemi voulez vous defaire?
Ne cherchez pas d’assasins
Donnez lui deux medecins,
Et qui’ils soient d’avis contrarie.”
This professional jealousy is always more apparent than real. Aside
from the rivalry for public patronage physicians are a very social
class of men, as witness their many festive meetings. We banquet in
honor of St. Luke the physician, and St. Come, after each thesis,
at anniversaries, at the election of the Dean, and on many other
occasions. It is these co-fraternal meetings at which are reinagurated
the old feelings of good-fellowship; our little quarrels only serve
to discipline the medical body and to increase the grandeur of the
Faculty. It is the constant rubbing of surfaces that makes the true
professional metal glitter.
When we hear new doctors, young graduates, swear the Hippocratic oath,
we do not forget that the principal articles of the statute prescribe
the cultivation of friendships, respect for the older members of the
profession, benevolence to the young beginners, and the preservation
of professional decency and kindness. It may be insisted that banquets
are not to be considered as medical assemblages, for there they laugh
long and loud, and drink many a bumper of rich Burgundy; making joyous
discourse; holding to the famous compliment of Moliere:
Salus, honor et argentum
Atque bonum appetitum.
We know to-day many of the truthful precepts of the School of Salerno
and their bearing on the medical records of the middle ages. Then as
now the doctor had the ever increasing ingratitude of the patient (_ad
proccarendam oegrorum ingratitudinem_).
“The disciple of Hippocrates meeteth often treatment rude,
The payment of his trouble is base ingratitude.
When the patient is in grievous pain the time is opportune
For a keen, sharp-witted doctor to make a good fortune.
Let him profit by the sufferer’s aches and gather in the money,
For the ant gets winter provender and the summer bee its honey.”
Our ancient friends had no pity for charlatans, however. They
rightfully abused all medical impostors, as we read in the precepts of
Salerno’s school:
“Il n’est par d’ignorant, de chartatan stupide,
D’histron imposteur, ou de Juif fourbe avide,
De sorciere crasseuse ou de barbier bavard,
De faussiare inpudent, ou de moine cafard,
De marchand de savon, ou de avengle oculiste,
De baigneur imbecile, ou d’absurde alchimiste,
Pas d’heretique impur qui ne se targue, enfin,
Du beau titre, du nom sacre de medecin.”
The investigation of medical science was far from being an honor to
the middle ages. The best of the profession was hidden in the doctoral
sanctuary, enveloped in those mysteries which are never penetrated by
the profane and only known to the initiated.
The recommendations as to the secrets of our art are addressed to all
young doctors in that famous epilogue commencing:
“Gardez surtout, gardez qui’un profane vulgaire
De votre art respecte ne perce le mystere;
Son eclat devoile perdrait sa dignite
D’un mystere connu decroit la majeste,”
Let us invoke God, the Supreme physician, let us demand the
professional banishment of every doctor who reveals a professional
secret.
“Exsul sit medicus physicius secreta revelans.”—Amen!