surprising enough. For instance, in talking about the stars and
describing their course through the firmament, she makes use of a
comparison that is rather startling. She says: "Just as the blood moves
in the veins which causes them to vibrate and pulsate, so the stars
move in the firmament and send out sparks as it were of light like the
vibrations of the veins." This is, of course, not an anticipation of the
discovery of the circulation of the blood, but it shows how close were
men's ideas to some such thought five centuries before Harvey's
discovery. For Hildegarde the brain was the regulator of all the vital
qualities, the centre of life. She connects the nerves in their passage
from the brain and the spinal cord through the body with manifestations
of life. She has a series of chapters with regard to psychology normal
and morbid. She talks about frenzy, insanity, despair, dread, obsession,
anger, idiocy, and innocency. She says very strongly in one place that
"when headache and migraine and vertigo attack a patient simultaneously
they render a man foolish and upset his reason. This makes many people
think that he is possessed of a demon, but that is not true." These are
the exact words of the saint as quoted in Mlle. Lipinska's thesis.
It is no wonder that Mlle. Lipinska thinks St. Hildegarde the most
important medical writer of her time. Reuss, the editor of the edition
of Hildegarde published in Migne's "Patrology," says: "Among all the
saintly religious who have practised medicine or written about it in the
Middle Ages, the most important is without any doubt St. Hildegarde...."
With regard to her book he says: "All those who wish to write the
history of the medical and natural sciences must read this work in which
this religious woman, evidently well grounded in all that was known at
that time in the secrets of nature, discusses and examines carefully
all the knowledge of the time." He adds, "It is certain that St.
Hildegarde knew many things that were unknown to the physicians of her
time."
When such books were read and widely copied, it shows that there was an
interest in practical and scientific medicine among women in Germany
much greater than is usually thought to have existed at this time. Such
writers, though geniuses, and standing above their contemporaries,
usually represent the spirit of their times and make it clear that
definite knowledge of things medical was considered of value. The
convents and monasteries of this time are often thought of by those who
know least about them as little interested in anything except their own
ease and certain superstitious practices. As a matter of fact, they
cared for their estates, and especially for the peasantry on them, they
provided lodging and food for travellers, they took care of the ailing
of their neighborhood, and, besides, occupied themselves with many
phases of the intellectual life. It was a well-known tradition that
country people who lived in the neighborhood of convents and
monasteries, and especially those who had monks and nuns for their
landlords, were much happier and were much better taken care of than the
tenantry of other estates. For this a cultivation of medical knowledge
was necessary in certain, at least, of the members of the religious
orders, and such books as Hildegarde's are the evidence that not only
the knowledge existed, but that it was collected and written down, and
widely disseminated.
Nicaise, in the introduction to his edition of Guy de Chauliac's
"Grande Chirurgie," reviews briefly the history of women in medicine,
and concludes:
"Women continued to practise medicine in Italy for centuries,
and the names of some who attained great renown have been
preserved for us. Their works are still quoted from in the
fifteenth century.
"There was none of them in France who became distinguished,
but women could practise medicine in certain towns at least on
condition of passing an examination before regularly appointed
masters. An edict of 1311, at the same time that it interdicts
unauthorized women from practising surgery, recognizes their
right to practise the art if they have undergone an
examination before the regularly appointed master surgeons of
the corporation of Paris. An edict of King John, April, 1352,
contains the same expressions as the previous edict. Du
Bouley, in his 'History of the University of Paris,' gives
another edict by the same King, also published in the year
1352, as a result of the complaints of the faculties at Paris,
in which there is also question of women physicians. This
responded to the petition: 'Having heard the petition of the
Dean and the Masters of the Faculty of Medicine at the
University of Paris, who declare that there are very many of
both sexes, some of the women with legal title to practise and
some of them merely old pretenders to a knowledge of medicine,
who come to Paris in order to practise, be it enacted,' etc.
(The edict then proceeds to repeat the terms of previous
legislation in this matter.)
"Guy de Chauliac speaks also of women who practised surgery.
They formed the fifth and last class of operators in his time.
He complains that they are accustomed to too great an extent
to give over patients suffering from all kinds of maladies to
the will of Heaven, founding their practice on the maxim 'The
Lord has given as he has pleased; the Lord will take away when
he pleases; may the name of the Lord be blessed.'
"In the sixteenth century, according to Pasquier, the practice
of medicine by women almost entirely disappeared. The number
of women physicians becomes more and more rare in the
following centuries just in proportion as we approach our own
time. Pasquier says that we find a certain number of them
anxious for knowledge and with a special penchant for the
study of the natural sciences and even of medicine, but very
few of them take up practice."
Just how the lack of interest in medical education for women gradually
deepened, until there was almost a negative phase of it, only a few
women in Italy devoting themselves to medicine, is hard to say. It is
one of the mysteries of the vicissitudes of human affairs that ups and
downs of interest in things practical as well as intellectual keep
constantly occurring. The number of discoveries and inventions in
medicine and surgery that we have neglected until they were forgotten,
and then had to make again, is so well illustrated in chapters of this
book, that I need only recall them here in general. It may seem a little
harder to understand that so important a manifestation of interest in
human affairs as the education and licensure of women physicians should
not only cease, but pass entirely out of men's memory, yet such
apparently was the case. It would not be hard to illustrate, as I have
shown in "Cycles of Feminine Education and Influence" in "Education, How
Old the New" (Fordham University Press, 1910), that corresponding ups
and downs of interest may be traced in the history of feminine education
of every kind. In that chapter I have discussed the possible reasons for
these vicissitudes, which have no place here, but I may refer those who
are interested in the subject to that treatment of it.
IX
MONDINO AND THE MEDICAL SCHOOL OF BOLOGNA
The most important contributions to medical science made by the Medical
School of Salerno at the height of its development were in surgery. The
text-books written by men trained in her halls or inspired by her
teachers were to influence many succeeding generations of surgeons for
centuries. Salerno's greatest legacy to Bologna was the group of
distinguished surgical teachers whose text-books we have reviewed in the
chapter, "Great Surgeons of the Medieval Universities." Bologna herself
was to win a place in medical history, however, mainly in connection
with anatomy, and it was in this department that she was to provide
incentive especially for her sister universities of north Italy, though
also for Western Europe generally. The first manual of dissection, that
is, the first handy volume giving explicit directions for the dissection
of human cadavers, was written at Bologna. This was scattered in
thousands of copies in manuscript all over the medical world of the
fourteenth and early fifteenth centuries. Even after the invention of
printing, many editions of it were printed. Down to the sixteenth
century it continued to be the most used text-book of anatomy, as well
as manual of dissection, which students of every university had in hand
when they made their dissection, or wished to prepare for making it, or
desired to review it after the body had been taken away, for with lack
of proper preservative preparation, bodies had to be removed in a
comparatively short time. Probably no man more influenced the medical
teaching of the fourteenth and fifteen centuries than Mundinus, or, as
he was called in the Italian fashion, Mondino, who wrote this manual of
dissection.
_Mundinus quem omnis studentium universitas colit ut deum_ (Mundinus,
whom all the world of students cultivated as a god), is the expression
by which the German scholar who edited, about 1500, the Leipzig edition
of Mundinus' well-known manual, the _Anathomia_, introduces it to his
readers. The expression is well worth noting, because it shows what was
still the reputation of Mundinus in the medical educational world nearly
two centuries after his death.[12]
Until the time of Vesalius, whose influence was exerted about the middle
of the sixteenth century, Mondino was looked up to by all teachers as
the most important contributor to the science of anatomy in European
medicine since the Greeks. He owed his reputation to two things: his
book, of which we have already spoken, and then, the fact that he
reintroduced dissection demonstrations as a regular practice in the
medical schools. His book is really a manual of making anatomical
preparations for demonstration purposes. These demonstrations had to be
hurried, owing to the rapid decomposition of material consequent upon
the lack of preservatives. The various chapters were prepared with the
idea of supplying explicit directions and practical help during the
anatomical demonstrations, so that these might be made as speedily as
possible. The book does not comprise much that was new at that time, but
it is a good compendium of previous knowledge, and contains some
original observations. It was entirely owing to its form as a handy
manual of anatomical knowledge and, besides, because it was an incentive
to the practice of human dissection, that it attained and maintained its
popularity.
Mondino followed Galen, of course, and so did every other teacher in
medicine and its allied sciences, until Vesalius' time. Even Vesalius
permitted himself to be influenced overmuch by Galen at points where we
wonder that he did not make his observations for himself, since,
apparently, they were so obvious. The more we know of Galen, however,
the less surprised are we at his hold over the minds of men. Only those
who are ignorant of Galen's immense knowledge, his practical common
sense, and the frequent marvellous anticipations of what we think most
modern, affect to despise him. His works have never been translated
into any modern language except piecemeal, there is no complete
translation, and one must be ready to delve into some large Latin, if
not Greek, volumes to know what a marvel of medical knowledge he was,
and how wise were the men who followed him closely, though, being human,
there are times when necessarily he failed them.
For those who know even a little at first hand of Galen, it is only what
might be expected, then, that Mondino, trying to break away from the
anatomy of the pig, which had been before this the basis of all
anatomical teaching in the medical schools (Copho's book, used at
Salerno and Bologna before Mondino's was founded on dissections of the
pig), should have clung somewhat too closely to this old Greek teacher
and Greek master. The incentive furnished by Mondino's book helped to
break the tradition of Galen's unquestioned authority. Besides this, the
group of men around Mondino, his master, Taddeo Alderotti, with his
disciples and assistants, form the initial chapter in the history of the
medical school of Bologna, which gradually assumed the place of Salerno
at this time. There is no better way of getting a definite idea of what
was being done in medicine, and how it was being done, than by knowing
some of the details of the life of this group of medical workers.
Mondino di Liucci, or Luzzi, is usually said to have been born about
1275. His first name is a diminutive for Raimondo. It used to be said of
him that, like many of the great men of history, many cities claimed to
be his birthplace. Five were particularly mentioned--Florence, Milan,
Bologna, Forli, and Friuli. There is, however, another Mondino, a
distinguished physician, who was born and lived at Friuli, and it is
because of confusion with him that the claim for Friuli has been set up.
Florence and Milan are considered out of the question. Mondino was
probably born in or near Bologna. The fact that there should have been
this multiple set of claims shows how much was thought of him. Indeed,
his was the best known name in the medical schools of Europe for nearly
two centuries and a half. He seems to have been a particularly brilliant
student, for tradition records that he had obtained his degree of doctor
of medicine when he was scarcely more than twenty. This seems quite out
of the question for us at the present time, but we have taken to pushing
back the time of graduation, and it is not sure whether this is, beyond
peradventure, so beneficial as is usually thought.
That his early graduation did not hamper his intellectual development,
the fact that, in 1306, when he was about thirty-one years of age, he
was offered the professorial chair in anatomy, which he continued to
occupy with such distinction for the next twenty years, would seem to
prove. His public dissections of human bodies, probably the first thus
regularly made, attracted widespread attention, and students came to him
not only from all over Italy, but also from Europe generally. In this,
after all, Mondino was only continuing the tradition of world teaching
that Bologna had acquired under her great surgeons in the preceding
century. (See "Great Surgeons of the Medieval Universities.")
Mondino came from a family that had already distinguished itself in
medicine at Bologna. His uncle was a professor of physic at the
university. His father, Albizzo di Luzzi, seems to have come from
Florence not long after the middle of the thirteenth century, for the
records show that, about 1270, he formed a partnership with one
Bartolommeo Raineri for the establishment of a pharmacy at Bologna.
Later this passed entirely under the control of the Mondino family, and
came to be known as the Spezieria del Mondino. In it were sold, besides
Eastern perfumes, spices, condiments, probably all sorts of toilet
articles, and even rugs and silks and feminine ornaments. The stricter
pharmacy of the earlier times developed into a sort of department store,
something like our own. The Mondini, however, insisted always on the
pharmacy feature as a specialty, and the fact was made patent to the
general public by a sign with the picture of a doctor on it. This drug
shop of the Mondini continued to be maintained as such, according to Dr.
Pilcher, until the beginning of the nineteenth century.[13]
One of the fellow students of Mondino at the University of Bologna had
been Mondeville. He came from distant France to take a course in surgery
with Theodoric, whose high reputation in the olden time, vague with us
half a century ago, is now amply justified by what we know of him from
such ardent students and admirers as Pagel and Nicaise. Not long after
Mondino's death, Guy de Chauliac came from France to reap similar
opportunities to these, which had proved so fruitful for Mondeville. The
more that we learn about this time the more do we find to make it clear
how deeply interested the generation was in education in every form,
artistic, philosophic, but, also, though this is often not realized,
scientific.
The long distances, so much longer in that time than in ours, to which
men were willing, and even anxious, to go, in order to obtain
opportunities for research, and to get in touch with a special master,
the associations with stimulating fellow pupils of other lands, the
scientific correspondences, almost necessarily initiated by such
circumstances, all indicate an enthusiasm for knowledge such as we have
not been accustomed to attribute to this period. On the contrary, we
have been rather inclined to think them neglectful of all education, and
have, above all, listened acquiescently while men deprecated the lack of
interest in things scientific displayed by these generations. Indeed,
many writers have gone out of their way to find a reason for the
supposed lack of interest in science at this time, and have proclaimed
the Church's opposition to scientific education and study as the cause.
At this time Italy was the home of the graduate teaching for all Europe.
The Italian Peninsula continued to be the foster-mother of the higher
education in letters and art, but also, though this is less generally
known, in science, for the next five centuries. Germany has come to be
the place of pilgrimage for those who want higher opportunities in
science than can be afforded in their own country only during the latter
half of the nineteenth century. France occupied it during the first half
of the nineteenth century. Except for short intervals, when political
troubles disturbed Italy, as about the middle of the fourteenth century,
when the removal of the Popes to Avignon brought their influence for
education over to France and a short period at the beginning of the
eighteenth century, when the Netherlands for a time came into
educational prominence, Italy has always been the European Mecca for
advanced students. Practically all our great discoverers in medicine,
until the last century, were either Italians, or else had studied in
Italy. Mondino, Bertrucci, Salicet, Lanfranc, Baverius, Berengarius,
John De Vigo, who first wrote on gun-shot wounds; John of Arcoli, first
to mention gold filling and other anticipations of modern dentistry;
Varolius, Eustachius, Caesalpinus, Columbus, Malpighi, Lancisi, Morgagni,
Spallanzani, Galvani, Volta, were all Italians. Mondeville, Guy de
Chauliac, Linacre, Vesalius, Harvey, Steno, and many others who might be
named, all studied in Italy, and secured their best opportunities to do
their great work there.
It would be amusing, if it were not amazing, to have serious writers of
history in the light of this plain story of graduate teaching of science
in Italy for over five centuries, write about the opposition of the
Church to science during the Medieval and Renaissance periods. It is
particularly surprising to have them talk of Church opposition to the
medical sciences. The universities of the world all had their charters
from the Popes at this time, and were all ruled by ecclesiastics, and
most of the students and practically all of the professors down to the
end of the sixteenth century belonged to the clerical order. The
universities of Italy were all more directly under the control of
ecclesiastical authority than anywhere else, and nearly all of them were
dominated by papal influence. Bologna, while doing much of the best
graduate work in science, especially in medicine, was, in the Papal
States, absolutely under the rule of the Popes. The university was,
practically, a department of the Papal government. The medical school at
the University of Rome itself was for several centuries, at the end of
the Middle Ages, the teaching-place where were assembled the pick of the
great medical investigators, who, having reached distinction by their
discoveries elsewhere, were summoned to Rome in order to add prestige to
the Papal University. All of them became special friends of the Popes,
dedicated their books to them, and evidently looked to them as
beneficent patrons and hearty encouragers of original scientific
research.
While this is so strikingly true of medical science as to make contrary
declarations in the matter utterly ridiculous, and to suggest at once
that there must be some motive for seeing things so different to the
reality, the same story can be told of graduate science in other
departments. It was to Italy that men came for special higher studies
in mathematics and astronomy, in botany, in mineralogy, and in applied
chemistry, so far as it related to the arts of painting, illuminating,
stained-glass making, and the like. No student of science felt that he
had quite exhausted the opportunities for study that were possible for
him until he had been down in Italy for some time. To meet the great
professors in Italy was looked on as sure to be a source of special
incentive in any department of science. This is coming to be generally
recognized just in proportion as our own interest in the arts and
crafts, and in the history of science, leads us to go carefully into the
details of these subjects at first hand. The editors of the "Cambridge
Modern History," in their preface, declared ten years ago that we can no
longer accept with confidence the declaration of any secondary writer on
history. This is particularly true of the medieval period. We must go
back to the writers of those times.
If it seems surprising that the University of Bologna should have come
into such great prominence as an institute for higher education at this
time, it would be well to recall some of the great work that is being
done in this part of Italy in other departments at this time. Cimabue
laid the foundation of modern art towards the end of the thirteenth
century, and during Mondino's life Giotto, his pupil, raised an artistic
structure that is the admiration of all generations of artists since.
Dante's years are almost exactly contemporary with those of Giotto and
of Mondino. If men were doing such wondrous work in literature and in
art, why should not the same generation produce a man who will
accomplish for the practical science of medicine what his friends and
contemporaries had done in other great intellectual departments.
In recent years we have come to think much more of environment as an
influence in human development and accomplishment than was the custom
sometime ago. The broader general environment in Italy, with genius at
work in other departments, was certainly enough to arouse in younger
minds all their powers of original work. The narrower environment at
Bologna itself was quite as stimulating, for a great clinical teacher,
Taddeo Alderotti, had come, in 1260, from Florence to Bologna, to take
up there the practice and teaching of medicine. It was under him that
Mondino was to be trained for his life work.
To understand the place of Mondino, and of the medical school of
Bologna, in his time, and the reputation that came to them as world
teachers of medicine, we must know, first, this great teacher of Mondino
and the atmosphere of progressive medicine that enveloped the university
in the latter half of the thirteenth century. In the chapter on "Great
Surgeons of the Medieval Universities" we call particular attention to
the series of distinguished men, the first four of whom were educated at
Salerno, and who came to Bologna to teach surgery. They were doing the
best surgery in the world, much better than was done in many centuries
after their time; indeed, probably better than at any period down to our
own day. Besides, they seem to have been magnetic teachers who attracted
and inspired pupils. We have the surgical contributions of a series of
men, written at Bologna, that serve to show what fine work was
accomplished. At this time, however, the field of medicine was not
neglected, though we have but a single great historical name in it that
has lived. This was Taddeo Alderotti, a man who lifted the medical
profession as high in the estimation of his fellow citizens at Florence
as the great painters and literary men of his time did their
departments, and who then moved to Bologna, because of the opportunity
to teach afforded him by the university.