_Age of Transition (concluded).--The School of Montpellier: Raimond
Lulli, 1235-1315. John of Gaddesden, 1305--(?). Arnold of Villanova,
12341313. Establishment of Various Universities. Gerard of Cremona,
1187. William of Salicet, 1280. Lanfranc, 1315. Mondino, 1275-1327.
Guy de Chauliac, 1300-1370. Age of Renovation, 1400 to Present
Time.--Erudite Period, including Fifteenth and Sixteenth Centuries.
Thomas Linacre, 1461-1524. Sylvius, 1478-1555. Vesalius, 1514-1564.
Columbus, 1490-1559. Eustachius, 1500-1574. Fallopius, 1523-1562.
Fabricius ab Aquapendente, 1537-1619. Fabricius Hildanus, 1560-1634._
Although{086} I have taken up so much time with an account of the
school of Salernum, a few words must be devoted to the school of
Montpellier, which was second in time and in importance among the great
influences in the culture of western Europe. There was a time when to
have studied there lent a special halo of glory, for, being near the
sea, and in the vicinity of thermal baths, even so early as A.D. 1153 it
was famous as a school of medicine; moreover, those who presided over
it did not lapse unconditionally into mediæval philosophy, with its
bewildering subtleties. It is said to have been founded A.D. 738, but
first mention of it as a source of medical education occurs in 1137,
when Bishop Adelbert II, of Mayence, visited the city to listen to its
medical teachers. A faculty of philosophy was added in 1242, and one of
law in 1298. Within the walls of the city sojourned both Christians and
Jews, the latter being subject directly to the civil authorities, and
particularly esteemed as translators. One of the most famous of the sons
of Israel was Profatius Judicus, who became a rector of the faculty.
Prior to 1370, when the university became subject to the kings of
France, it was under the control of the Pope; and then, as now, the
school of medicine was the chief ornament of this ancient seat of
learning.
One of the most illustrious and famous pupils of Montpellier{087} was
that religious mystic and alchemistic visionary, Raimond Lull, or Lulli,
a would-be transmuter of metals and seeker for the philosopher's stone.
Born in 1234, at the age of thirty he began to see visions, and was
thereby roused from an atheistic tendency to soon become wonderfully
pious; ultimately he entered the order of Minorites, studied Arabic,
and appeared as a missionary in Africa, seeking to convert the
Saracens--who, however, declined the honor, and finally (in 1315)
rewarded his zeal by stoning him to death. Beside works on alchemy and
theology, he wrote on medical subjects, and, like all great minds of the
period, passed among the common people as a sorcerer in league with the
devil. Nevertheless, he was a notable figure in his age and country.
Quite celebrated became the compendium of Gilbert of England (1290),
which contained the same speculative nonsense, the same polypharmacy,
and the same superstition as other works of that time; what little it
contained of value was taken largely from other writers. While this
Gilbert, often known as Gilbertus Anglicus, was not the first English
writer on practical medicine, he was the earliest whose works have been
preserved.
Still more famous was John Gaddesden, physician-in-ordinary to the King
of England, professor in Merton College, Oxford, who wrote the famous
treatise known as _Rosa Anglica_, which appeared between 1305 and 1315.
This treatise was characterized by mysticism and disgusting therapeutic
measures, and tainted by medical avarice, superstition, and charlatanry.
Gaddesden was, perhaps, the first to formally recommend the "laying
on of hands" by the king for the cure of scrofula (first performed by
Edward the Confessor--1042-1056), whence comes the ancient name for
this disease,--i.e., "king's evil." *
*A special "Service of Healing" was used in the English
Church under Henry VIII, 1484-1509.
Arnold{088} de Villeneuve (1234-1313) studied seven years at
Montpellier, twenty years at Paris, visited all the universities in
Italy, then went to Spain to levy on the Arabian authors. He wrote on
medicine, theology and especially on chemistry--in which art he obtained
great renown both as an author and teacher. To him is due the discovery
of spirit of wine, oil of turpentine, aromatic waters, besides several
preparations of less note, and the introduction of chemical compounds
into therapeutics. His was a very stirring life, for he traveled
extensively; he became a teacher at Bologna, and physician to Peter III,
of Arragon. Shortly before his demise he went to Paris, having fallen
under the ban because of a declaration that papal bulls, far from being
sacredly inspired, were human works, and that acts of charity were
dearer to God than hecatombs, etc. He finally perished by shipwreck, but
the spirit of fanaticism followed him after death, for his volumes were
condemned by the Inquisition, because they commended experiments rather
than mere speculations. In spite of his general honesty in accordance
with the spirit of the times he inculcated deceit in medicine, and
one of his declarations is: "If thou canst not find anything in the
examination of the renal secretion, declare that an obstruction of the
liver exists. Particularly use the word 'obstruction,' since it is
not understood, and it is of great importance that people should not
understand what thou say est." He was one of the first to administer
brandy, which he regarded as the elixir of life--whence the modern _Eau
de Vie_.
Connected with this school, also, or well known as having studied there,
were many men whose names became more or less famous--among them John
Arden, who settled in London about the middle of the fourteenth century;
Vinario, a contemporary of Guy de Cliauliac, and the well-known surgeon
and anatomist Henri de Mondeville, who was a teacher of Guy de Chauliac.
But an idea of the doctrines prevalent in the medical literature of this
part of the{089} world, at this time, may be had from the fact that most
writers chose titles for their works after the style of ballad singers:
for instance, those describing the plague and venereal diseases were
called _Flowers and Lilies of Medicine_; the _Rosa Anglica_ of John
Gaddesden was another example. Matters had arrived at such a pass,
indeed, that men of science no longer hesitated to confess superstition
and mingle it openly with deceit, to oppose the interests of the most
needy, and to extort from their fellow-creatures fees in proportion to
their supposed ability to pay.
In the time of Charlemagne each cathedral possessed a school in which
were taught arithmetic, theology, singing, and sometimes medicine;
the Episcopal College had medical teachers who gave advice and dressed
wounds at the doors of the Church of Notre Dame, Paris; but when the
medical profession had been divorced from the sacerdotal by councils and
popes, many of these cathedral schools closed. In order to preserve the
jurisdiction which they for a long time had exercised over the learned
professions, many were erected into universities, and thus the clergy
gave instruction in philosophy, theology, and later in medicine. During
the thirteenth century arose many of the great universities in Europe,
notably those of Bologna, Padua, and Naples, in Italy; of Paris,
Montpellier, and Toulouse, in France; of Valencia and Tortosa, in Spain;
of Oxford, in England. Pope Innocent III by papal bull guaranteed
that the professors and students at Paris should be exempt from all
excommunications save those which emanated directly from the Holy See;
French sovereigns conferred many privileges upon the universities, and
soon the members of the University of Paris formed practically a second
city, with its own laws, customs, police, citizens, and magistrates.
Still, however, all science belonged to the clergy, and its teachers,
though removed from the cloister, were none the less Roman Catholic; so
that the popes reigned over the people through the parish clergy,
and over{090} the latter by the clerical teachers and professors.
Nevertheless, in all candor it must be acknowledged that these studious
men, thus associated together for mutual instruction and emulation
in learning, contributed, in a large measure, to elevate Christian
civilization above all others, though several generations were required
to secure the results calculated to make men celebrated; hence the
early periods of the universities developed very few names. Many were
conspicuous by their love of instruction, but not by originality
of research. Men undertook expensive and wearisome voyages without
encouragement or hope of reward, simply to obtain some rare manuscript
or to hear some renowned professor; and they appeal to us of the
nineteenth century by their devotion, if not by the results of their
work.
Among the somewhat scattered and more or less eminent men of this
period was Gerard, of Cremona in Lombardy, a man of great purity and
studiousness, who arduously pursued all that Latin authors could teach
him, and, not being able to procure in Italy certain manuscripts which
dated from the time of Ptolemy, determined to go to Toledo in search of
an Arabian translation. At this time he was unacquainted with Arabic,
but soon mastered it, and--armed with this powerful resource, which
no other physician had possessed since the time of Constantine the
African--he could not see so many Arabic works devoted to all branches
of science as were gathered at the Spanish University without a desire
to translate and transmit the same to his own country; hence he gave the
remainder of his life to this work. He rendered into Latin the treatises
of Hippocrates and Galen, of Serapion, and of all the famous Arabian
authors from the time of Phazes, including the _Canon_ of Avicenna and
the work on surgery by Albucassis. He died at the age of seventy-three,
in 1187, at Cremona, and left all his books to the monastery of St.
Lucy, within whose walls he was buried.
William{091} of Salicet, born at Plaisance in the first years of the
thirteenth century, became a professor in the University of Bologna,
and later at Verona. He wrote extensively on medicine, and earned a
reputation as a surgeon that preserves his fame to the present day.
It is claimed that his status in medical literature depends, in large
measure, upon the fact that he was, perhaps, the first to refuse slavish
obedience to preceding authors, preferring, instead, to draw upon the
results of personal study and experience. He died in 1280.
Lanfranc, or Lanfranchi (according to whether one prefers his French or
Italian name), studied under William of Salicet. Of his early life very
little is known, save that he practiced surgery in Milan at the time
of the great dissension between the Guelphs and Ghibellines, and, for
attaching himself to the weaker party, was exiled and forced to seek an
asylum in France; he resided in Lyons for several years, and here wrote
a work on minor surgery; in 1295 he went to Paris on the invitation of
the faculty of medicine, opened a course on surgery which met with great
success, and then published a second and larger treatise on the subject.
It is said of him by Malgaigne that, less from his fault perhaps than
that of his age, after his death (about 1315) surgery began to decline.
From the time of Brunus, who practiced in Padua in 1250, the barbers
had done the scarifying and bleeding. After the time of Lanfranchi there
were others who applied leeches and often cauteries, and even the women
meddled with surgery and in all operations competed with the barbers;
the lay surgeons held themselves rivals to the clergy. Lanfranchi
inherited from his old master, William, an aversion for them all, and
often had to contend with uneducated and incompetent laymen. Clerical
surgeons regarded operations as beneath their dignity; and Lanfranchi,
who deplored this condition of affairs, confessed he had sometimes
bled with his own hands, but had never operated for ascites, hernia,
cataract, or stone.
John{092} Pitard has descended to fame not as a writer, but as the
founder of the surgical schools of St. Come and St. Damien, which occupy
so eminent a position in the surgical annals of France. In 1306 he was
surgeon to the King of France, Philip le Bel, and the sworn surgeon
of Chatelet. The College of St. Come, in 1311, was only a little
brotherhood of lay-surgeons, who gradually grew in importance as the
result of the obstinate struggles sustained,--on the one hand, against
the faculty of medicine, and, on the other, against the barber-surgeons.
Malgaigne has, with great patience and clearness, shown that the
importance of this body of men has been greatly exaggerated by
historians; he has traced their various turns of fortune from beginning
to end; I shall have occasion to consider them again farther on.
Mondino, sometimes known as Mundinus, born in 1275, became a professor
in the University of Bologna, and died in 1327. He was the author of
a celebrated treatise on anatomy, said to have reached twenty-five
editions, and which was the first of its kind since Galen. This science
had been greatly neglected; in Salernum, for instance, they were, for
a long time, contented with the treatise of Copho on the anatomy of
the hog, and most of the anatomical knowledge of the age was apparently
derived from this source; Mondino resurrected the study and pursued it
with interest and enthusiasm, though under the greatest difficulties.
His works for more than two centuries, along with the writings of Galen
and the Arabic authors, served for anatomical demonstration, although
very incomplete,--as witness the statement:--
"Beneath the veins of the forearm we see many muscles and many large
and strong cords, of which it is not necessary to attempt the anatomy
on such a corpse (i.e., a recent one), but on one dried in the sun for
three years, as I have shown otherwise, in developing the number{093}
and the anatomy of those of the superior and inferior extremity."
On the other hand, he took the opposite course to discover and
demonstrate the nerves, and advised maceration in running water. It
required almost superhuman boldness to substitute demonstrations on the
human cadaver for those upon swine, yet this was done by Mondino; and at
the time the prejudice against dissection was so general that for more
than a century after Mondino--who died in 1327--no one dared, at least
publicly, to emulate his example. It was in the year 1315 that he
publicly dissected the bodies of two women in Bologna. Anatomical study
was further complicated at this time by certain bulls of Pope Boniface
VIII, forbidding evisceration or boiling or cooking any part of the
human body; these deliverances were really aimed, not against scientific
investigation, but at the absurd custom introduced by the crusaders of
cutting up and boiling the bodies of their relatives who died in
infidel countries, in order to send them home for burial in holy ground;
nevertheless, the papal injunction certainly operated to discourage and
prohibit anatomical dissection, since nearly two hundred years later
the University of Tübingen was obliged to apply to Pope Sixtus IV for
permission to authorize dissection.
Guy de Chauliac, born in Gévaudan about 1300. was the most famous
physician and surgeon in Christendom during the Arabic period. He
studied at the cathedral college of Mende, which at that time was
quite celebrated, and was taught medicine at Montpellier under the best
masters of his day. It is probable, also, that he studied in Paris, and
certain that later, in Bologna, he saw dissections made. Dissatisfaction
with the writings of the ancients and the knowledge which he obtained at
the schools stimulated his own powers of observation, and he became,
in every respect, an original student and acquired a degree{094}
of erudition far more extended than that possessed by any of his
contemporaries. He practiced in various places, longest at Lyons; and
finally entered the service of Pope Clement VI, at Avignon, and probably
enjoyed the same honor under Innocent V and Urban V; when the latter was
made pope, in 1362, de Chauliac became his chaplain, or chapel-reader.
In 1363 he published a work on surgery called _The Inventory_, upon
which his fame chiefly rests, though several other volumes emanated from
his pen. None knew better than he how to unite respect for the ancients
with justice toward contemporaries, and he cited a large number of
Greek, Arabian, and Latin authors, some of whom are now utterly unknown.
The sciences, he declared, are "created by successive additions; the
same man cannot lay the foundation and perfect the superstructure. We
are as children carried on the neck of a giant; aided by the labors of
our predecessors we see all that they have seen, and something beside."
In tracing the character of a surgeon he recommends that he be "learned,
expert, ingenious, bold where he is sure, timid when in doubt, avoiding
bad cures and practices, being gracious to the sick, generous and
compassionate, wise in prediction, chaste, sober, pitiful, and merciful;
not covetous nor extortionate, but receiving moderate fees according to
the circumstances of his patients, the character of the case, and his
own dignity."
"Never since Hippocrates," says Malgaigne, "has medicine learned a
language stamped with such nobility and in such few words." Although
a follower of Galen, in anatomy he insisted on the necessity of
dissection, and proposed to make use of the corpses of executed
criminals for this purpose. The drawings made by Henri de Mondeville
were known to him; he divided abscesses into hot and cold, although
among the latter he included oedcma, tympanites, dropsy, scirrhus, and
other conditions. In practice he was more timid, yet more active,{095}
than Lan franchi, who never cut for stone, but left that operation
to the traveling surgeons. De Ghauliac described it as he had seen it
performed; he opened the abdomen for dropsy, did not hesitate to attempt
the radical cure of hernia, and operated for cataract. The plague which
raged during the fourteenth century and depopulated the known world of
one-fourth of its inhabitants, twice appeared in Avignon while Guy de
Chauliac was a resident there--and he acknowledges that nothing but
shame prevented him from fleeing. He remained at his post, visited the
sick, and was himself attacked and left for dead. "In this frightful
position he had sufficient presence of mind to follow the peculiarities
of his case, analyze his own sufferings, and to give a description
of them worthy of Hippocrates" (Renouard). His work soon became the
surgical code of Christendom, and was commented upon and translated into
all tongues, remaining for a long time a classic, and even at this
day it preserves much of its interest as representing the condition of
medical science at the close of the Middle Ages; moreover, its literary
style was much superior to that of any of his contemporaries, all of
whom wrote very barbarous Latin. He died about 1370.
With the death of de Chauliac terminates our interest, not merely in the
Arabian physicians and those who were intimately connected with them,
but in the so-called Arabic Period. It may be added, in passing, that
the followers of Mahomet, like those of Christ, erected by the side of
each of their mosques a school, and often a hospital, endowed with more
or less generosity by caliphs or the wealthy, who hoped to purchase
redemption and eternal happiness by such liberality.
A certain number of religious orders or communities were established
during the Middle Ages to give succor to the deserving sick, the
most widely known being those of St. Mary; St. Lazarus; St. John, of
Jerusalem; and the Daughters{096} of God. To be sure, some, through the
endowment of the opulent, became rich beyond all reason, and
departed from their primitive purposes, and thus not only excited the
covetousness of monarchs, but had even the temerity to resist their
authority. This compelled, every now and again, a suppression of some
order or institution--partly, perhaps, for laxity of morals, and
partly because of their turbulence. Of this period it may be said
that charitable zeal for the sick was never more pronounced; princes,
bishops, and popes gave examples of devotion by dressing with their own
hands the ulcers of lepers--and leprosy was in those days a frightful
disease, having been contracted by the crusaders in the Orient, and
everywhere spread as they returned, being, moreover, favored by the
miserable uncleanliness which was then so common. Ignorance, dread, and
fear rendered this disease worse than usual, and it was confounded
with other maladies less formidable. It has been estimated that in the
fifteenth century Europe harbored no less than nineteen thousand lepers;
and that the disease was a great terror is manifest by the excessive
caution taken against its spread: its victims were forbidden to enter
cities, and on the highway were compelled to stand aside lest they
should taint passers-by with their breath; even a healthy person
convicted of being touched by a leper was banished from society; any
infraction of these rules was punishable by death. It will thus be seen
what depth of genuine humanity it required to have anything to do with
one of these outcasts.
Another institution prevailed widely during these days,--namely, public
baths, which were established in nearly every city and increased to such
an extent that in the fifteenth century the bathers of Paris constituted
a powerful brotherhood, so powerful, in fact, that Jacque Despars,
physician to Charles VII, and one of the most renowned professors of the
faculty, for speaking openly against{097} the abuse of public baths, was
obliged to leave the capital to avoid persecution.
A study of the general history of the Arabic Period reveals that the
Arabs, previously obscure and uncivilized, emerged rapidly from the
demi-savage state, and took the first rank among the polished nations of
the world. During the earliest portion of this period these people were
religious vandals and destructive fanatics, but later embraced with
enthusiasm and persistence a study of the humanities, and endeavored to
repair their early ravages by collecting the _débris_ of the literary
and scientific monuments of Greece; but, though they cultivated medicine
with zeal and success, they added little to the Greek treasures. Later,
Arabia was overrun by hordes from the deserts of Tartary, a people yet
more barbarous and unknown, who established themselves in all parts of
the globe then under Saracenic dominion, and by their brutal despotism
degraded the Arabians to a condition approaching that from which
they had emerged. This seems to have been ever the result of Turkish
conquest.
Meanwhile the Greek nation, which was for so many ages at the head of
civilization, gradually lost its power, virtue, courage, glory, and
independence, and continued to descend, until now it exercises no
influence whatever on the course of events. During the course of the
Arabic Period only one Grecian physician merits mention on account of
his writings, and in these there was nothing-new except what he had
borrowed without credit from the Saracens.
The Empire of the West,--that is the western part of the ancient Roman
Empire,--after subjugation by barbarians from Germany and Scandinavia,
fell under a cloud whose darkness overwhelmed it. Its people, however,
gradually received new life by commingling their blood with that of the
invaders. Later they were able to repulse the Saracens{098} who poured
in upon them from Spain; then they turned their armies against each
other, and wrought mutual havoc and ruin for several centuries. Again,
roused by religious fanaticism, as had been the Mohammedans previously,
they rushed by thousands upon the plains of Asia Minor, Syria, and
Egypt, which had been for centuries occupied by the Arabs; and their
adventures and enterprises, and the new and varied scenes through which
they passed, gave rise among the "Francs" to some taste for poetry
and works of imagination During the twelfth and thirteenth centuries
governments became more stable, liberal institutions were created, the
rust of ignorance gradually disappeared, and by the end of the Arabic
Period there were really apparent brilliant streaks of mentality in the
horizon of the nations of Europe. In this progressive movement the
study of medicine shared. In the thirteenth century it was worthily
represented in Italy, in Paris, and became established in Montpellier.
Notwithstanding, up to this time physicians apparently only knew how to
timidly follow in the track of the Arabians, and approached little, or
not at all, in their studies, the purer lore of the Greeks.
THE AGE OF RENOVATION.
This Age of Renovation (extending from the commencement of the fifteenth
century to the present time, according to Renouard's classification) is
divided into the Erudite Period, comprising the fifteenth and sixteenth
centuries, and the Reform Period, comprising the seventeenth and
eighteenth centuries, and one should add, in fact, the nineteenth. In
general literature this age is known as that of the Renaissance, and is
one of whose beginning a great deal has been written, and so much better
than I can put it in this brief work, that to general sources I should
perhaps refer those who are interested in knowing how and why there came
about such a tremendous{099} change in methods and habits of thought and
in acquirement of knowledge. But it is the history of medicine that at
this time we particularly desire, and our minds must be, in some slight
degree, prepared for the great changes to be recounted by some, with
the conditions which brought about this revolution. It was truly an
awakening in every department of knowledge and along every line of
study; it was as if the minds of men had been dormant and lost their
power of receptivity, and, after a long period of torpor, awakened in a
new atmosphere amid new surroundings; as if there had burst upon them a
sudden appreciation of ability to do things hitherto undreamed of, and
to acquire knowledge such as hitherto had been possessed by none. Once
free from the shackles imposed by authority of the past, these minds
severed their Gothic bonds, and started forth in every direction with
the ardor of youth and the interest of novelty, all engaging in the
general enterprise of erecting from the _débris_ of antique science a
new temple to the mind in which to worship. While some delved among the
records of the past, others sought to bind the past and present, and
others, bolder yet, cut entirely loose from it, rejected all tradition,
and would fain have built this temple with entirely new materials.
Now, what led to this sudden awakening? Was it chance, or the effect
of certain causes which had long been operating'? It has been seen that
hospitals and various institutions, whose foundations were dedicated to
humanity, were erected in all parts of Europe; that gradually there
had come about a better social organization; that there had been a
diminution of conflicts between princes and their vassals, and the
relations between the two were more nearly at an equilibrium. Moreover,
the invention of the compass, which rendered long voyages less dangerous
and more frequent, opened up to trade regions hitherto inaccessible or
unknown, and attracted interest toward commerce as a means of pecuniary
gain. The telescope had been invented, and{100} astronomy was able to
seize upon some of the facts by it revealed, and thereby to make more
interesting calculations concerning the motions of celestial bodies,
and attain a knowledge of our solar system and its laws. Gradually the
microscope shed light upon the hitherto unseen; engraving on copper had
added its power of illustration to the works of the great writers as
they appeared; but above all, that which brought about this condition of
affairs was the discovery of the art of printing. The first attempts
in this direction were made between the years 1435 and 1440, and by
the united efforts of three men, whose names deserve mention so long as
their art persists,--namely, Guttenberg, Faust, and Shoeffer. Thanks
to them, the same information could be multiplied in manifold form
and transmitted to all parts of the civilized globe. In this way
intelligence and reason become triumphant; thenceforward the dominion of
brute force was broken, and knowledge, because capable of dissemination,
became imperishable.
At the commencement of the Erudite Period Arabic literature still
predominated in medicine. Rhazes, Haly-Abbas, and Avicenna were
universally invoked and explained. But a taste for Greek literature
began to prevail in the universities of Italy, and was finally extended
to every part of Europe, especially after the taking of Constantinople
by Mahomet II, Emperor of the Turks, in 1453. This disaster, which at
first bade fair to be a mortal blow to Greek literature and language,
strange to say, served only to hasten their resurrection in the
Occident. Constantinople having been given over to pillage at this time,
most of its learned men escaped, carrying with them all manuscripts that
could be seized; most of these found refuge in Italy, and enlightened
protectors in the allpowerful prince of the house of Medici, in
Florence, in the popes at Rome, and in Alphonso, of Arragon, King of
Naples and Sicily. Everywhere these fugitives spread the knowledge{101}
of the masterpieces of Greek literature and art, and in this way a taste
for books, libraries, and sound erudition was diffused, while the Greek
and Latin classics were hunted up and published with great patience
and ardor; thus the works of the old writers were edited, translated,
commented upon, and everywhere disseminated throughout Europe.
Among those who devoted themselves to the thankless task of editing,
and purifying from interpolations, the works of the classic writers was
Nicholas Léonicenus, born near Vincenza in the year 1428, who studied
medicine at Padua and taught it for more than sixty years at Ferrara.
He possessed great vigor of mind, with purity of manners and serenity of
soul, and was the first to translate directly from Greek into Latin
the aphorisms of Hippocrates and portions of the writings of Galen.
He combated in every way the infatuation of his contemporaries for the
Arabians and their lore, and called attention to many of the errors
of men who, like Pliny the naturalist, had fallen for lack of fully
understanding the Greek authors they compiled. At the ripe age of
ninety-six he died, regretted by all.
Thomas Linacre, of Canterbury, a contemporary of Léonicenus, though
younger (1461-1524), studied first at the University of Oxford, went
to Italy in 1484, and in Florence attracted the attention of Lorenzo de
Medici, who made him the companion of his own children, to whom he gave
the best possible advantages. In due time he returned to England, where
his talents speedily won him high station, and he became physician
to King Henry VIII, and later to Queen Mary. Linacre was the first
Englishman, it is said, who spoke purely the language of the Romans. He
translated several books of Galen that are still esteemed; and caused
the founding of two chairs, one at Oxford, the other at Cambridge,
whose incumbents were charged with the duty of explaining the works of
Hippocrates{102} and Galen. But he is most entitled to the gratitude of
his countrymen for his influence in founding the College of London. To
appreciate properly its importance and his merits, we must remember the
obstacles that had to be surmounted; for at that time bishops alone
had the right to accord, in their own dioceses, permission to practice
medicine, and, consequently, the healing art was abandoned entirely to
monks and illiterate empirics. It was well that Linacre had influence at
court, else he could never have obtained the reform of such overwhelming
abuses; but he triumphed in spite of powerful opposition, and secured
the issue of letters patent which prohibited the practice of medicine by
any one who had not received a degree in one of the two universities in
the kingdom, and been examined by the President of the College of London
assisted by three others. This was the achievement which gave this
learned man the title of "Restorer of Medicine" in England.
Léonicenus and Linacre, who were of the early Erudite Period, also merit
mention not merely because of literary talents, but because they were
the first eminent physicians to embrace the study of Greek classics,
and to propagate the knowledge therein contained. Subsequently others
followed the same course,--too many, in fact, to be enumerated; but it
was easy to follow after such leaders. From the time when men began
to realize the superiority of Greek models over prolix Arabian
commentaries, they were anxious to seek the light at its source, and
applied themselves with avidity to the study of the originals. At this
time copies of Greek authors were few in number and in a deplorable
condition, owing to neglect. To rediscover them, to purify, to eliminate
what was not original, to rearrange, and finally to multiply by the aid
of the printing-press was an extended labor requiring great knowledge,
rare sagacity, and commendable patience. One of the greatest
publications in medical literature belonging to this epoch was a
complete edition of the Hippocratic writings, translated{103} into Latin
by Anuce Foes,--a poor, but learned, practitioner, who lived on the
products of his business as pension physician in the city of Metz,--and
issued from Frankfort-on-the-Main in 1495. To this master-work Foes
consecrated forty years of his life. Another treatise belonging to this
same time, less important, perhaps, from a medical point of view, but
nevertheless showing great erudition, was a treatise on the gymnastics
of the ancients, by _Jerome Mercurial_ is, a work said to be not less
precious to historians than antiquarians. It was by such intense zeal
and hard labor that true erudition was restored in Europe.
Following now some of the special branches of medical learning and their
development, let us look first at anatomy and physiology. I have already
related the salient points of the life and labors of Mondino, of whom
it is said that, about the year 1315, while professor at Bologna,
he dissected the bodies of two women, and shortly after published an
epitome of anatomy illustrated with wood-cuts. Also has been mentioned
the prohibition of anatomical study pronounced by Pope Boniface VIII, in
1300. It was only toward the close of the fifteenth and the early years
of the sixteenth century that this prejudice began to abate; the popes,
who then stood at the head of scientific movements, withdrew their
interdictions, and the universities of Italy gave public dissections.
Achillini, Benedetti, and Jacques Berenger dissected at Bologna, Padua,
and Pavia, previous to the year 1500; soon afterward their example was
generally followed.
Jacques Dubois, whose name was Latinized into Jacobus Sylvius, was born
in 1478, in a village near Amiens; he studied in Paris, where he worked
most industriously at anatomy, which later he was so successful in
teaching. He was the first to arrange all the muscles of the human body,
to determine their functions, and to give names to those of them which
had not yet been so designated. He discovered{104} the valves of the
large veins, and was the first to study the blood-vessels by means of
colored injections. He gave the same careful attention to pharmacy, and
in Paris, before a large class of students, began lectures, on anatomy,
physiology, hygiene, pathology, and therapeutics; these he continued
until the faculty, on account of jealousy, interrupted them. He then,
in 1529, went to Montpellier, but returned two years later to become a
member of the faculty, and once more lectured with the greatest eclat.
Later yet he became a successor to Vidius in the Royal College,--a
position he retained up to his death in 1555. His medical writings were
extensive and marked by great accuracy, while for anatomy he did a great
deal, contributing much to popularize it. He dissected a great number
of animals and as many human cadavers as he could procure, the number,
however, being small. Unfortunately, he subordinated all his own
research to the authority of Galen, being himself among those anatomists
who permitted themselves to be so far misled.
[Illustration: 0125]
The man of genius and courage, who accepted the truth of what his eyes
revealed to him, and who was the true reformer in anatomy, was Andreas
Vesalius, born at Brussels, in 1514, of a family already illustrious
in medicine. He studied at the University of Louvain, where he early
revealed the inclinations of the anatomist, since in his leisure moments
he was wont to amuse himself in dissecting small animals. Near Louvain
was a place where criminals were executed; and Vesalius, having observed
the body of one from which the soft parts had all been cleaned away by
ravenous birds, only the bones and ligaments remaining, detached the
extremities separately, and then carried off the trunk by night, thus
possessing himself of his first skeleton. Attracted by the fame of
Sylvius, lie afterward went to Paris to become his pupil, but, not
content with the lessons of his master, continued to observe for
himself. On the hill Montfauçon, where executions{105} took place, he
disputed with dogs and vultures for the remains of criminals, or by
stealth disinterred bodies from the cemeteries at the greatest personal
risk. So great was his application that his progress became rapid,
and at the age of twenty he gave instruction to fellow-students; at
twenty-two he became Professor of Anatomy at Padua, being appointed
by the Senate of Venice; at twenty-nine he issued his great work on
anatomy, which showed a completeness that left far in the rear all that
had hitherto been published on this subject. The following year he was
called by the Emperor Charles V to the court of Madrid, then the most
brilliant in Europe, where he became the first physictan, and from this
time abandoned his anatomical labors.
[Illustration: 0126]
He was the first who dared to dispute the words of Galen and point
out his errors,--to ascertain that the greater{107} part of Galen's
descriptions, having been made from monkeys, did not correctly represent
human anatomy. This audacity raised a crowd of vehement opponents, the
least reasonable and most fanatic being his old master, Sylvius; but
even these onslaughts could not conceal the truth. The minds of men
generally were ripe for the revolution whose signal-fire was thus
lighted, and no sooner did Vesalius appeal from the decision of Galen
to observation of nature than a crowd of anatomists were ready to follow
his method. He died in 1564.
One who, at Padua, had been first his pupil, then his
co-laborer,--namely, Columbus, born at Cremona in 1490,--succeeded him.
Columbus criticised, in some respects, the statements of his eminent
predecessor, which he could better do, since he is said to have
dissected fourteen bodies every year, as well as to have practiced
venesection. He came so near to discovering the mystery of the
circulation that it is strange how he could have missed it. He even
appreciated the systole and diastole of the heart and the connection
thereof with dilatation and contraction of the arteries. He knew,
also, that the pulmonary veins conducted arterial blood, and that the
pericardium was a shut sac. He even appreciated the lesser circulation,
since he described how the blood left the right side of the heart and
passed into the lungs, and came back through the veins into the left
ventricle; because of this discovery, and in spite of his utter failure
to appreciate the greater circulation, he has been by some regarded as
entitled to the credit which is universally given to Harvey. From his
position as teacher in Padua Columbus was called to Pisa, and from Pisa
to Rome, where he died in 1559.
[Illustration: 0128]
Another of the great anatomists of this period, second only in fame
to Vesalius, was Eustachius, born about the beginning of the sixteenth
century. He became physician to the Duke of Urbino, and in Rome a city
physician and professor of anatomy, continuing to teach in the latter
city until{109} overtaken by his final sickness. He was a defender of
Galen rather than an opponent, and sought to shelter his reputation from
the attacks of Vesalius. In his praise it must be said that, for his
day, he was a great anatomist; his chief discoveries were in the domain
of comparative anatomy. He brought to bear upon his work a knowledge of
embryology which enabled him, for instance, to describe the kidneys and
the teeth much more accurately than would otherwise have been possible;
he noted, also the pathological changes in bodies dissected, and is
brought daily to our minds as we think of the connecting channel between
the pharynx and the middle ear, to which his name has been given.
He died in 1574.
[Illustration: 8129]
Fallopius, born in Modena, in 1523, was professor successively at
Ferrara, Pisa, and Padua. He cultivated anatomy with the greatest ardor,
and, in consequence, his name is also linked with that of Vesalius,
as are those of Herophilus and Erasistratus in the history of ancient
anatomy. His anatomical researches included all parts of the human body,
and his name has been given to the tube through which the ovum enters
the cavity of the uterus. Death overtook him in the year 1562.
Jerome Fabricius, better known as _Fabricius ab Aquapendente_, was born
in the town of the latter name, near the southern end of the Apennines,
in 1537, received his no early{110} education in Padua, and studied
anatomy under Fallopius, whose assistant he also was. After the death
of the latter he succeeded to the professorship of anatomy, and later
built, at his own expense, a large anatomical theater, in which he
lectured and demonstrated to students from all parts of the world.
Toward the end of his life he had accumulated a large number of
specimens, and published extensively on anatomy, embryology, physiology,
and surgery. Though often accredited with discovering the valves of the
veins, he is not entitled to that honor, since Erasistratus, Sylvius,
Vesalius, and others had previously described them, Estiennes had seen
them in the azygos veins, and Canano in other veins. His true claim to
glory rests upon embryological researches, which he was the first to
undertake in a comparative way. In _De Formato Foetu_ he elucidated
the development of the embryo and its membranes by a long list of
observations on lower animals of many species. He was probably the first
to describe the uterine decidua. Fabricius died in 1619.
This Fabricius must not be confused with the almost-as-renowned
Fabricius Hildanus, who was born in Hilden, near Düsseldorf, in 1560.
Under the German name of Wilhelm Fabry he became widely known as a
surgeon, and, after traveling through France, settled in Hilden,
but later moved to Cologne, where he founded an academy. His first
treatise--on gangrene and sphacelus--quickly made him known, and went
through eleven editions. From Cologne he went successively to Genf,
Lausanne, and Polen; returned to Cologne; and finally, after several
other visits, settled in Bern, where he died of gout and asthma (in
1634.). His frequent changes of location were, perhaps, less the result
of instability than a testimony to his reputation, inasmuch as he was
invited from one place to another. He has been, with propriety, named
the "German Paré," since he rendered such great service to German
surgery,{111} and was not only an expert therein, but likewise a
cultivated physician and polished humanitarian; in fact he was ahead
of his time, by many years, in these regards, as is shown by his
recommending amputation in cases of gangrene, and his writings
concerning gunshot wounds. He enjoyed a ripe experience also in
obstetrics, and even instructed his wife in the obstetric art and
praised her ability most highly. His most important contributions
to literature were in the field of surgery, and these passed through
numerous editions, while his opinions and practice are quoted even
to-day.
[Illustration: 8131]
During this epoch many modifications were introduced and improvements
made in the teaching of medicine. Permanent amphitheaters were
established for dissection, and chairs of anatomy created, their
incumbents being paid out of the public treasury. The popes, appear to
have taken the initiative in this respect,{112} which accounts for the
great number of subjects with which Eustachius was supplied, as compared
with Vesalius, who obtained only two or three in a year. Up to this
time _the razor had been the sole instrument of dissection_, but was now
replaced by the scalpel, which remains in use to-day. By the labors of
the few men mentioned anatomy acquired a degree of perfection which it
had never attained under the Greeks. Skillful artists put their
labors upon paper, and plates and descriptions made from anatomical
preparations represented the various parts of the human body with more
fidelity than had been supposed possible. Nerves, tendons, and ligaments
were no longer confused, but traced so far as possible from origin to
ramifications. Ancient errors generally were corrected. It was proven
that there was no bony structure in the tissue of the heart, that the
partition between its cavities was not porous; and attentive examination
of its valves led to the discovery of the lesser circulation by
Columbus. Michael Servetus, whom John Calvin burned at the stake, was
perhaps the first to note this phenomenon. He saw that the blood could
not penetrate directly from the right into the left cavity of the heart,
but that it was necessary for the whole fluid to pass through the lungs,
where it became impregnated with the vital spirit of the atmosphere, and
reached afterward the left auricle; the position of the valves in the
pulmonary arteries and veins clearly confirmed his conjecture. Moreover
the size of the pulmonary arteries was enormous, and disproportionate
to the quantity of blood necessary for the nutrition of the lungs,
which seemed to prove that this was not, as had been believed, the
sole purpose of those vessels. It was about this time that Fabricius ab
Aquapendente pointed out valves in veins in various parts of the body,
and that Columbus and Andreas Cesalpinus explained more fully the
mechanism of the lesser circulation; in fact, the former so closely
approached an appreciation of the{113} purpose of the vascular system
that some have thought he really knew it, but the passages in his
writings thought to sustain this opinion are not at all conclusive. He
seems to have confused the action of the heart during sleep with that
during the waking hours; and although he realized that the blood could
not flow backward through the arteries, that the vena cava was the only
vessel which permitted the entrance of blood into the heart, and though
he spoke of anastomosis between arteries and veins and remarked that if
a band be applied around a limb the veins swell below the ligature, he
contented himself with comparing the motion of the blood with the flux
and reflux of Euripus, as Aristotle had done. It is even thus that
he tortured his mind in trying to reconcile two irreconcilable
theories,--i.e., the opinion of the ancients on the motion of the blood
and recent discoveries in the anatomy of the vascular system.