THE FOURTEENTH CENTURY.
Revival of Human Anatomy.—Famous Physicians of the Century.—Domestic
Medicine in Chaucer.—Fellowship of the Barbers and Surgeons.—The Black
Death.—The Dancing Mania.—Pharmacy.
REVIVAL OF HUMAN ANATOMY.
Brighter days dawned for medical science after the close of the
thirteenth century, up to which era the Saracenic learning prevailed.
While human dissections were impossible, the sciences of anatomy and
philosophy had made no advance beyond the point at which they were
left by Galen, and as he dissected only animals they were necessarily
left in a very imperfect state. It is not known precisely when human
dissection was revived; probably the school of Salerno, under the
influence of Frederick II., has a right to the honour. In 1308,
however, we find the senate of Venice decreeing that a body should be
dissected annually,[791] and it is known that such dissections took
place at Bologna in 1300. We have, however, nothing very definite on
the subject till a few years later. Italy gave birth to the first great
anatomist of Europe.
The father of modern anatomy was MONDINO, who taught in Bologna about
the year 1315. Under his cultivation “the science first began to rise
from the ashes in which it had been buried.”[792] His demonstrations of
the different parts of the human body at once attracted the notice of
the medical profession of Europe to the school of Bologna. He died in
1325. Though he had a penetrating faculty of observation, he was not
altogether original, as he copied Galen and the Arabians. He divided
the body into three cavities: the upper, containing the animal members;
the lower, the natural members; and the middle, the spiritual members.
His anatomy of the heart is wonderfully accurate, and he came very near
to the discovery of the circulation of the blood.[793] He described
seven pairs of nerves at the base of the brain, and was evidently
acquainted with the anatomy of that organ.
He is said to have had the assistance of a young lady, ALASSANDRA
GILIANI, as prosector. Anatomical demonstrations in those days were,
at the best, very imperfect. The demonstrator did not actually himself
dissect; this was done by a barber-surgeon with a razor, the lecturer
merely standing by and pointing out the objects of interest to the
students with his staff. Nor did the process occupy much time; four
lessons served to explain the mysteries of the human frame: the first
was on the abdomen, the second on the organs of the chest, the third
on the brain, and the fourth on the extremities.[794] The bodies were
buried, or placed in running or boiling water, to soften the tissues
and facilitate their examination. Dissections first took place at
Prague in 1348, Montpellier after 1376, Strasburg, 1517. In Italy,
sometimes, a condemned criminal was first stabbed in prison by the
executioner, and then conveyed at once to the dissecting room, for the
use of the doctors.
The most famous physicians of this period were:—
PETRUS APONO, or PIETRO OF ABANO (1250-1315), a famous physician, who
lived at Abano near Padua, and who had studied medicine and other
sciences at Padua and Paris. He travelled in Greece and other parts,
acquired a knowledge of the Greek language, and was a devoted student
of the works of Averroes. He endeavoured to mediate between the Arabian
and the Greek physicians in their controversies on medicine, and wrote
with that view his work, entitled the _Conciliator differentiarum
philosophorum et precipue medicorum_. He knew enough of physiology to
be aware that the brain is the source of the nerves, and the heart that
of all the blood-vessels. He meddled with astrology, and was accused of
practising magic, of possessing the philosopher’s stone. He was found
guilty on his second trial by the Inquisition; but as he died before
the trial was completed, he was merely burned in effigy.
JACOB DE DONDIS (1298-1359) was a physician, who was a professor at
Padua, and was famous as the author of an herbal with plates containing
descriptions of simple medicines.
ARNOLD OF VILLA NOVA (1235-1312), physician, alchemist, and astrologer,
did much to advance chemical science, and whose work, the _Breviarium
Practicæ_, is not a mere compilation. He advised his pupils, when they
failed to find out what was the matter with their patients, to declare
that there was “some obstruction of the liver,”—a practice much in
vogue even in the present day. He was the first to administer brandy,
which he called the elixir of life (Baas). He discovered the art of
preparing distilled spirits (Thomson).
Collections of medical cases first began to be preserved in an
intelligible form in the thirteenth century; they were called
_consilia_. Those by FULGINEUS (before 1348), by MONTAGNANA (died
1470), and by BAVERIUS DE BAVERIIS, of Imola (about 1450), are said to
be interesting.[795]
GORDONIUS was a Scottish professor at Montpellier, who in 1307 wrote
the _Practica seu Lilium Medicinæ_; it went through several editions,
and was translated into French and Hebrew.
SYLVATICUS (_ob._ 1342) wrote a sort of medical glossary and dictionary.
GILBERTUS ANGLICANUS (about 1290) wrote a compendium of medicine, also
called _Rosa Anglicana_, a work of European reputation, said to contain
good observations on leprosy.
JOHN OF GADDESDEN was an Oxford man and a court physician, who between
1305 and 1317 wrote the _Rosa Anglica seu Practica Medicinæ_,—a work
which, though of little merit, remained popular up to the sixteenth
century. Some of his remedies are very curious. For loss of memory
he prescribed the heart of a nightingale, and he was a firm believer
in the efficacy of the king’s touch for scrofula. For small-pox he
prescribed the following treatment, as soon as the eruption appeared:
“Cause the whole body of your patient to be wrapped in scarlet cloth,
or in any other red cloth, and command everything about the bed to
be made red. This is an excellent cure.” Again, for epilepsy, the
method of cure was as follows: “Because there are many children and
others afflicted with the epilepsy, who cannot take medicines, let the
following experiment be tried, which I have found to be effectual,
whether the patient was a demoniac, a lunatic, or an epileptic. When
the patient and his parents have fasted three days, let them conduct
him to a church. If he be of a proper age, and of his right senses, let
him confess. Then let him hear Mass on Friday, and also on Saturday.
On Sunday let a good and religious priest read over the head of the
patient, in the church, the gospel which is read in September, in the
time of vintage, after the feast of the Holy Cross. After this, let
the priest write the same gospel devoutly, and let the patient wear it
about his neck, and he shall be cured. The gospel is, ‘This kind goeth
not out but by prayer and fasting.’” These quotations are both from the
_Medical Rose_; and as the author was at the head of his profession,
numbered princes amongst his patients, and was extolled by writers of
the time, it doubtless fairly represents the practice of the period.
The medicine of the period embraced the demon theory of disease and the
belief in the efficacy of amulets, or more correctly of characts.
DOMESTIC MEDICINE IN CHAUCER’S TIME.
CHAUCER (1340-1400), in the _Nonnes Preestes Tale_, tells us how in his
time people took care of their health by attention to diet; and how,
when folk were sick, and doctors not handy, nor medicines to be had at
the chemist’s close by, the wise women were able, not only to prescribe
skilfully, but to supply the requisite medicines from their own store
or garden.
“A poure widewe, somdel stoupen in age,
Was whilom dwelling in a narwe cotage
Beside a grove, stonding in a dale.
* * * * *
Hire diete was accordant to hire cote.
Repletion ne made hire never sike;
Attempre diete was all hire physike
And exercise, & hertes suffisance.
The goute let hire nothing for to dance,
No apoplexie shente not hire hed,
No win ne dranke she, neyther white ne red.
‘Now, sire,’ quod she, ‘whan we flee fro the bemes,
For Goddes love, as take som laxatif;
Up peril of my soule, & of my lif,
I conseil you the best, I wol not lie.
That both of coler, & of melancolie
Ye purge you; and for ye shul not tarie,
Though in this toun be non apotecarie,
I shal myself two herbes techen you,
That shal be for your hele, & for your prow;
And in our yerde, the herbes shal I finde,
The which han of hir propretee by kinde
To purgen you benethe, & eke above.
Sire, forgete not this for Goddes love;
Ye ben ful colerike of complexion;
Ware that the Sonne in his ascention
Ne find you not replete of humours hote:
And if it do, I dare wel lay a grote,
That ye shul han a fever tertiane,
Or elles an ague, that may be your bane.
A day or two ye shal han digestives
Of wormes, or ye take your laxatives,
Of laureole, centaurie, & fumetere,
Or elles of ellebor, that groweth there,
Of catapuce, or of gaitre-beries,
Or herbe ive growing in our yerd, that mery is;
Picke hem right as they grow, and ete hem in.’”
Chaucer has indicated for us, in his Prologue to the _Canterbury
Tales_, who were the great medical authors studied by English
physicians of the period.
Besides Æsculapius, whose works certainly could not have reached the
“Doctour of Physicke,” he read Dioscorides, the famous writer on
Materia Medica (A.D. 40-90). Rufus (of Ephesus, about A.D. 50). Old
Hippocras = Hippocrates. Hali = Ali Abbas (died 994). Gallien = Galen.
Serapion; there were two, the elder and the younger. Rasis = Rhazes
(A.D. 850-923). Avicen = Avicenna (died 1170). Averriois = Averroes
(died 1198). Damascene = Janus Damascenus, _alias_ Mesue the elder
(780-857). Constantin = Constantinus Africanus (1018-1085). Bernard
= Bernardus Provincialis (about 1155). Gatisden = John of Gaddesden
(about 1305). Gilbertin = Gilbert of England (about 1290).
“His study was but little on the Bible,” says the poet, who also
intimates that as gold in physic is a cordial, he was partial to fees.
FELLOWSHIP OF BARBERS AND SURGEONS.
On the 10th of September, 1348, says Anthony à Wood,[796] “appeared
before Mr. John Northwode, D.D., Chancellor of the University of
Oxford, John Bradey, Barber, Richard Fell, Barber Surgeon, Thomas
Billye, Waferer, and with them the whole Company and Fellowship of
Barbers within the precincts of Oxford, and intending thenceforward to
join and bind themselves in amity and love, brought with them certain
ordinations and statutes drawn up in writings for the weal of the Craft
of Barbers, desiring the said Chancellor that he would peruse and
correct them, and when he had so done, to put the University seal to
them. Thus the Barbers of Oxford were formed into a Corporation, one of
their ordinations being that no man nor servant of the Craft of Barbers
or Surgery should reveal any _infirmity_ or _secret_ disease they have,
to their customers or patients. Of which, if any one should be found
guilty, then he was to pay 20_s._, whereof 6_s._ 8_d._ was to go to Our
Lady’s box, 6_s._ 8_d._ to the Chancellor, or in his absence, to the
Commissary, and 6._s._ 8_d._ to the Proctors.” The Barbers, Surgeons,
Waferers, and makers of singing bread were all of the same fellowship.
They all continued in one society till the year 1500, when the Cappers
or Knitters of Caps, sometimes called Capper-Hurrers, were united to
them.[797] In 1551 the Barbers and Waferers laid aside their charter
and took one in the name of the City; but Wood says they lived without
any ordination, statutes, or charter till 1675, when they received a
charter from the University.[798]
THE BLACK DEATH.
A great pestilence desolated Asia, Europe, and Africa in the fourteenth
century, which was known as _The Black Death_. Its origin was
oriental, and it was distinguished by boils and tumours of the glands,
accompanied by black spots. Many patients became stupefied and fell
into a deep sleep; they became speechless, their tongues were black,
and their thirst unquenchable. Their sufferings were so terrible that
many in despair committed suicide. Those who waited upon the sick
caught the disease, and in Constantinople many houses were bereft of
their last inhabitant. Guy de Chauliac, the physician (born about
1300), bravely defied the plague when it raged in Avignon for six or
eight weeks, although the form which it there assumed was distinguished
by the pestilential breath of the patients who expectorated blood,
so that the near vicinity of the persons who were sick was certain
death. The courageous de Chauliac, when all his colleagues had fled
the city, boldly and constantly assisted the sufferers. He saw the
plague twice in Avignon—in 1348, and twelve years later. Boccacio, who
was in Florence when it raged in that city, has described it in the
_Decameron_. No medicine brought relief; not only men, but animals
sickened with it and rapidly expired. Boccacio himself saw two hogs,
on the rags of a person who had died of the plague, fall dead, after
staggering a little as if they had been poisoned. Multitudes of other
animals fell victims to the epidemic in the same way. In France many
young and strong persons died as soon as they were struck, as if by
lightning. The plague spread over England with terrible rapidity. It
first broke out in the county of Dorset; advancing to Devonshire and
Somersetshire, it reached Bristol, Gloucester, Oxford, and London. The
annals of contemporaries record the awful fact that throughout the land
only a tenth of the population remained alive. The contagion spread
from England to Norway. Poland and Russia suffered later in a similar
manner, although the disease did not always manifest itself in the same
form in every case. Only two medical descriptions of the disease have
come down to us—one by GUY DE CHAULIAC, the other by RAYMOND CHALIN
DE VINARIO. Chauliac notices the fatal coughing of blood; Vinario in
addition describes fluxes of blood from the bowels, and bleeding at the
nose. What were the causes which produced so dreadful a plague, it is
impossible to discover with certainty.
Dr. Hecker, to whose work on the subject[799] I am indebted for
the information concerning it, says that “mighty revolutions in
the organism of the earth, of which we have credible information,
had preceded it. From China to the Atlantic the foundations of the
earth were shaken, throughout Asia and Europe the atmosphere was in
commotion, and endangered, by its baneful influence, both vegetable and
animal life.”
In 1337, 4,000,000 of people perished by famine in China in the
neighbourhood of Kiang alone. Floods, famines, and earthquakes were
frequent, both in Asia and Europe. In Cyprus a pestiferous wind
spread a poisonous odour before an earthquake shook the island to its
foundations, and many of the inhabitants fell down suddenly and expired
in dreadful agonies after inhaling the noxious gases. German chemists
state that a thick stinking mist advancing from the east spread over
Italy in thousands of places, and vast chasms opened in the earth which
exhaled the most noxious vapours.
THE DANCING MANIA.
In the year 1374 a strange delusion arose in Germany, a convulsion
infuriating the human frame, and afflicting the people for more than
two centuries. It was called the dance of St. John or of St. Vitus, and
those affected by it performed a wild dance while screaming and foaming
with fury. The sight of the afflicted communicated the mania to the
observers, and the demoniacal epidemic soon spread over the whole of
Germany and the neighbouring countries to the north-west.
Bands of men and women went about the streets forming circles hand in
hand, and danced madly for hours together, until they fell in a state
of exhaustion to the ground. They complained, when in this state, of
great oppression, and groaned as if in extreme pain, till they were
tightly bandaged round their waists with cloths, when they speedily
recovered. While dancing they were insensible to external impressions,
but their minds were in a condition of great exaltation, and they
saw in their fancies heavenly beings and visitants from the world of
spirits. At Aix-la Chapelle, at Cologne, and in 1418 at Strasburg, the
“Dancing Plague” infatuated the people by thousands.[800]
Hecker attributes the madness to the recollection of the crimes
committed by the people during the visitation of the Black Plague,
to the previous inundations, the wretched condition of the people of
Western and Southern Germany in consequence of the incessant feuds
of the barons, to hunger, bad food, and the insecurity of the times.
Dancing plagues had often occurred before; in 1237 more than a hundred
children were suddenly seized by it at Erfurt, and several other dates
are given by historians for similar occurrences. Physicians did not
attempt the cure of the malady, but left it to the priests, as it was
considered to be due to demoniacal possession.
Hecker says[801] that Paracelsus in the sixteenth century was the first
physician who made a study of St. Vitus’s dance. The great reformer
of medicine said: “We will not, however, admit that the saints have
power to inflict diseases, and that these ought to be named after them,
although many there are who, in their theology, lay great stress on
this supposition, ascribing them rather to God than to nature, which is
but idle talk. We dislike such nonsensical gossip, as is not supported
by symptoms, but only by faith, a thing which is not human, whereon the
gods themselves set no value.”
PHARMACY.
The drug dealers of the Middle Ages had little or no relationship to
our apothecaries and pharmacists.
The word _apotheca_ meant a store or warehouse, and its proprietor was
the _apothecarius_. From the word _apotheca_ the Italians derive their
_bottéga_, and the French their _boutique_, a shop. The thirteenth and
fourteenth century apothecary, therefore, was altogether a different
person from our own. It is probable that the Arabian physicians about
the time of Avenzoar, in the eleventh century, began to abandon to
druggists the business of compounding their prescriptions; the custom
would then have spread to Spain, Sicily, and South Italy, where the
Saracen possessions lay. This explains how so many Arabic terms became
introduced into chemical nomenclature, such as _alembic_. Persons
who prepared preserves, etc., were called _confectionarii_, and they
made up medicines, and those who kept medicine shops were called
_stationarii_. The physicians at Salerno had the inspection of the
_stationes_.
Beckmann finds no proof that physicians at that time sent their
prescriptions to the _stationes_ to be dispensed. He says: “It appears
rather that the _confectionarii_ prepared medicines from a general set
of prescriptions legally authorized, and that the physicians selected
from these medicines kept ready for use, such as they thought most
proper to be administered to their patients.”[802]