RISE OF THE UNIVERSITIES.
School of Montpellier.—Divorce of Medicine from Surgery.
An important era in the history of medicine in Europe was the rise of
the universities. It is not possible to fix precisely the date of the
foundation of these great centres of learning, but we may sufficiently
for our purpose fix the twelfth century as approximately the period in
which Bologna, Montpellier, Oxford, Cambridge, and Paris were regularly
established.
Cambridge University took its rise in all probability somewhere in the
twelfth century, “originating in an effort on the part of the monks of
Ely to render a position of some military importance also a place of
education.”[727]
The most ancient universities in Europe are said to be those of
Bologna, Oxford, Cambridge, Paris, and Salamanca. The following dates
are approximate: Bologna, 1116; Oxford, 879; Cambridge, twelfth
century; Cordova, 968; Paris, 792, renovated 1200; Palenza, 1209,
removed to Salamanca, 1249. Salamanca was founded 1239; Naples, 1224;
Montpellier, 1289; Rome, 1243; Salerno, 1233.[728]
The University of Bologna was famous as a school of law and letters so
early as the twelfth century. In the next it became distinguished for
its medical teaching. It was in such perfection that its professors
were classed as physicians, surgeons, barber surgeons, and oculists.
But still, anatomy, except in so far as it assisted the surgeon,
was neglected. Roger, Roland, Jamerio, Bruno, and Lanfranc, seemed
alone to have paid much attention to it, and then only to borrow from
Galen.[729] The medical faculty became celebrated after 1280, when
Thaddeus Florentinus was a teacher in it.
The University of Padua was founded 1179.
In 1268 it possessed three teachers of medicine and the same number of
teachers of natural science.
Montpellier was the first great rival of Salerno as a school of
medicine. Its charter dates from 1229.
Medicine was not taught at Paris during the twelfth century. John of
Salisbury, writing in the year 1160, says that those who desired to
study medicine had to go either to Salerno or Montpellier. But, says
Laurie,[730] physicians of eminence are recorded as having taught at
Paris after this date, and the subject was formally lectured upon not
later than 1200. Degrees or licences in physic were granted in 1231.
The University of Naples was founded in 1224, by the Emperor Frederick
II. Originally all the faculties were represented, but in 1231 medicine
was forbidden, as by Imperial decree it could only be taught at Salerno.
The University of Prague was founded in 1348 by Charles IV. of Bohemia,
as a complete university from the outset.
SCHOOL OF MONTPELLIER.
The origin of the medical school of Montpellier is obscure. Probably
it originated in the tenth century, and there is little doubt that
the Jews of Spain were concerned in its foundation. The Arabs found
firm friends in the Jewish people of Spain, their monotheism proving
a bond of union which ensured the sympathy of each, and the school of
Montpellier became the rallying-point of Arabian and Jewish learning.
Europe has rendered too little gratitude for the intellectual blessings
bestowed on her by the Hebrews. A nation of Eastern origin, and having
very extensive relations with Eastern commerce, the Israelites acted
as the medium for transmitting the intellectual and material wealth
of Eastern countries to Western peoples. We owe to them much of our
acquaintance with Saracenic medicine and pharmacy. They translated
for us Arabic books, and they introduced to Western markets the
precious drugs of far-distant Eastern lands. The school of medicine
of Montpellier first became famous in the beginning of the twelfth
century. Averroism prevailed, and a practical empirical spirit
distinguished the school from the dogmatic and scholastic teaching of
other universities. It has been attempted to show that a Jewish doctor
from Narbonne first taught medicine at Montpellier. When Benjamin of
Tudela went to the university in 1160, he says that he found many
Jews amongst the inhabitants. Adalbert, Bishop of Mayence, went to
Montpellier in 1137 to learn medicine from the doctors, “that he might
understand the deeply hidden meaning of things.” In 1153 the Archbishop
of Lyons went there for treatment, and John of Salisbury said that
medicine was to be acquired either at Salerno or Montpellier. Men
called the school the “Fountain of Medical Wisdom,” and it soon rose to
great importance on account of its unlimited freedom in teaching.[731]
Cardinal Conrad made a law that no one should act as a teacher of
medicine in the university who had not been examined in it and received
a licence to teach. In 1230 it was ordered that no one should practise
medicine until he had been examined, and that to the satisfaction of
two masters in medical science chosen as examiners by the bishop. To
engage in practice without the certificate of the examiners and the
bishop was to incur the sentence of excommunication.[732] Surgeons,
however, were not compelled to undergo examination. Medicine flourished
at Montpellier with great independence; it was not merged with the
other faculties, and it was not subjected to clerical influences.[733]
Even Louis XIV. was obliged to withdraw a decree ordering the union of
the medical with the other faculties.[734]
Every student was compelled (1308) to attend medical lectures for at
least five years, and to practise medicine for eight months, before
being allowed to graduate. In 1350 the degree of Magister had to be
taken in addition.[735]
The most brilliant period in the history of the medical school of
Montpellier was that of the thirteenth and fourteenth centuries. Its
fame was sounded throughout the world. From all parts invalids went to
Montpellier to seek its famous physicians. King John of Bohemia, and
the Bishop of Hereford, were of the number.
DIVORCE OF MEDICINE FROM SURGERY.
Surgery became separated from medicine in Alexandria, but it was not
until the middle of the twelfth century that the ecclesiastics were
restrained from undertaking any bloody operations. The universities
rejected surgery under the pretext, “_ecclesia abhorret a sanguine_”
(the church abhors the shedding of blood). It is therefore to this
epoch, as Mr. Cooper says,[736] that we must refer the true separation
of medicine from surgery; the latter was entirely abandoned to the
ignorant laity.
At the Council of Tours, A.D. 1163, the practice of surgery was
denounced as unfit for the hands of priests and men of literature, the
consequence being that the surgeon became little better than a sort
of professional servant to the physician, the latter not only having
the sole privilege of prescribing internal medicines, but even that of
judging and directing when surgical operations should be performed.
Then the subordinate surgeon was only called upon to execute with his
knife, or his hand, duties which the more exalted physician did not
choose to undertake; and, in fact, he visited the patient, did what was
required to be done, and took his leave of the case, altogether under
the orders of his master.[737]
JOHN OF SALISBURY, one of the most learned men of the twelfth century,
gives an account of the state of medicine in that period, which is
very suggestive. “The professors of the theory of medicine are very
communicative; they will tell you all they know, and, perhaps, out
of their great kindness a little more. From them you may learn the
nature of all things, the causes of sickness and of health, how to
banish the one and how to preserve the other; for they can do both at
pleasure. They will describe to you minutely the origin, the beginning,
the progress, and the cure of all diseases. In a word, when I hear
them harangue, I am charmed; I think them not inferior to Mercury or
Æsculapius, and almost persuade myself that they can raise the dead.
There is only one thing that makes me hesitate. Their theories are as
directly opposite to one another as light and darkness. When I reflect
on this, I am a little staggered. Two contradictory propositions cannot
both be true. But what shall I say of the practical physicians? I must
say nothing amiss of them. It pleaseth God, for the punishment of my
sins, to suffer me to fall too frequently into their hands. They must
be soothed, and not exasperated. That I may not be treated roughly in
my next illness, I dare hardly allow myself to think in secret what
others speak aloud.”
In another work, however, the writer delivers himself with greater
freedom. Speaking of newly-fledged medicos, he says: “They soon return
from college, full of flimsy theories, to practise what they have
learned. Galen and Hippocrates are continually in their mouths. They
speak aphorisms on every subject, and make their hearers stare at their
long, unknown, and high-sounding words. The good people believe that
they can do anything, because they pretend to all things. They have
only two maxims which they never violate: never mind the poor, never
refuse money from the rich.”
ROBERT OF GLOUCESTER[738] does not write very highly of the skill
in surgery possessed by the Anglo-Normans. Speaking of the Duke of
Austria, who took King Richard the First prisoner, his verses import
that when “he fell off from his horse and sorely bruised his foot,
his physicians declared that if it was not immediately smitten off, he
would die; but none would undertake the performance of the operation;
till the Duke took a sharp axe, and bid the chamberlain strike it
off, and he smote thrice ere he could do it, putting the Duke to most
horrid torture. And Holinshed tells us that in the time of Henry the
Third there lived one Richard, surnamed Medicus, ‘a most learned
physician, and no less expert in philosophy and mathematics;’ but makes
not the least mention of surgery. Also some authors have attributed
the death of Richard the First (wounded in the shoulder at the Castle
of Chalezun), to the unskilfulness of those who had the care of the
wound, and not from the quarrel’s being poisoned, as others have
insinuated.”[739]
The university title of Doctor was not known in England before the
reign of Henry II.[740]
RICHARD FITZ-NIGEL, Bishop of London, was apothecary to Henry II. Many
bishops and dignitaries of the Church were physicians to kings and
princes.[741] Most of the practitioners of medicine and teachers of
physic were churchmen, either priests or monks.
ST. HILDEGARD (1098-1179), Abbess of Ruppertsberg, near Bingen on
the Rhine, was a famous physician and student of nature, who wrote a
treatise on Materia Medica. Her pharmacy was in advance of her time,
and to this eminent lady physician we are indebted for the attempts to
disguise the nastiness of physic; she enveloped the remedy in flour,
which was then made into pancakes and eaten.[742] Meyer says that her
work entitled _Physica_ “is a treatise on Materia Medica, unmistakably
founded on popular traditions.” Her visions and revelations concerning
physical and medical questions are contained in her work “_Divinorum
operum simplicis hominis liber_.” She was a true reformer within the
Church, and her pure life was singularly devoted and unselfish; she
was, in fact, a Woman Physician, who should be the patron saint of our
lady doctors.