MONK PHYSICIANS—ITINERANT DOCTORS—SURGERY IN THE MIDDLE AGES.
The treatment prescribed by the monks, who were ready to cure the
body as well as the soul, consisted mainly of holy water, prayer, the
touching of relics, and a number of decoctions of herbs, the properties
of which they were acquainted with. Many of these physician monks
wandered about the country devoting themselves to the wants of the sick.
During the eleventh century hospitals began to spring up in various
parts of the country and over Europe. They seem to have originated
at the time of the crusades. Lacroix says: “The Johannists, and
the brotherhoods of St. Mary and St. Lazarus devoted themselves to
missions of charity in the East; in France, there were the brothers
of St. Antony and of the Holy Ghost; and throughout the world the
heroic chevaliers of St. John of Jerusalem or of the Templars, whose
countless establishments combined the triple character of conventual
church, almshouse, and fortress, and who, attired in a dress both
military and monastic, wore a mantle similar to that seen in the
statues of Æsculapius, as a sign of the double mission—beneficent and
warlike—which they had sworn to fulfil”.
Each of these orders had a special form of treatment, and took charge
of specific diseases. Thus, the Templars paid special attention to
those pilgrim soldiers and travellers particularly troubled with
ophthalmia, scurvy, or those suffering from wounds. The Johannists
professed the cure of epidemical disease and pestilence. The order
of St. Antony looked after those stricken with dysenteries and those
complaints known as St. Anthony’s fire, while the Lazarists treated
leprosy, small-pox, and pustular fevers. The first school of nurses
of which we have record, is one organised by Hildegarde, Abbess of
Rupertsberg, who died 1180. These nuns gave great assistance in
the hospitals. Thus the monks about the twelfth century tended the
bodies as well as the souls, and even accompanied armies on military
expeditions in that capacity.
In the thirteenth century faculties were established at Montpellier,
Salerno, and Paris, by the order of papal bulls, to grant degrees
in medicine. In order to obtain the title of master physician, the
candidate had first to become a clerk, then pass an examination before
masters or doctors selected from the staff of the college by the Bishop
of Maguelonne.
The barbers at this time came to occupy an important position in
medicine, and were promoted to the rank of subordinate surgeons,
chiefly for blood-letting and minor accidents.
In the fourteenth century medicine had rapidly progressed in Europe,
and the celebrated physician and surgeon Lanfranc founded the St.
Cosmo College at Paris, the examinations of which all surgeons were
obliged to pass. A decree was also passed by the King of France in 1352
prohibiting any one who was not an apothecary, student, or mendicant
monk from practising medicine. The king, we find, also exempted
the master barbers from doing duty as watchmen, as “the barbers
being nearly all of them in the habit of practising surgery, great
inconvenience might arise if they were absent from their houses when
sent for during the night”.
In France, the little barbers, as they were called, travelled about
on foot from village to village with a bag containing their drugs
and remedies, while the great barbers, or sworn surgeons, astride
their hacks with tinkling bells to announce their approach, wore long
robes trimmed with fur, and other rich apparel. They were usually
accompanied by an assistant and several servants, who carried their
cases of instruments, which always included scissors, nippers, a probe
or _éprouvette_, razors, lances, and needles. He also carried five
kinds of ointments, _viz._, basilicon, apostles’ ointment, the white
ointment, yellow ointment, and the dialtœa ointment for subduing
local pain.
Guy de Chauliac, who was physician to three successive popes, stated
“he never went out on his visits without taking several clysters and
plain remedies, besides gathering herbs in the field, so as to treat
diseases in a proper manner”.
Even at that early time the credulity of the public became imposed upon
by quacks, and Lacroix tells us of an English surgeon, one Goddesden,
who had two sorts of prescriptions, one for the rich and another for
the poor; he sold at a high price to the barbers a so-called panacea,
which the latter sold at a large profit, and this was simply a mixture
of frogs pounded in a mortar. In one of his books there is a short
chapter on _disagreeable_ diseases, as he terms them, “which work their
own cure, and bring no grist to the doctor’s mill”.
In the fifteenth century the practice of medicine became more and
more influenced and dominated by the occult sciences, and especially
astrology. All mankind was ruled by the stars, and the cause of
various diseases was attributed to the conjunction of certain planets.
“They believed the blood rose during the daytime towards the sun, and
descended into the lower extremities at night; that at the third hour
the bile subsided, so that its acid properties might not be mixed with
the course of the blood; and that at the second hour the atrabilis,
and in the evening the phlegm, subsided.” Such illusions and erroneous
beliefs stopped the progress of science, and threatened to turn a
noble art into mere charlatanry. In this country the surgeons mostly
practised as apothecaries; and we are told that when Henry V. invaded
France in 1415, the only surgeon he had in his camp was one Thomas
Morstede, who was with difficulty induced to accompany the army,
bringing with him twelve assistants.
The sixteenth century saw an effort to throw off some of these errors
which had grown round the art. The invention of printing helped largely
in disseminating knowledge throughout Europe, and the followers of
medicine assumed a higher position.
[Illustration: AN APOTHECARY’S SHOP. FIFTEENTH CENTURY.]
Towards the end of the fifteenth century Tachenius wrote: “There
is no new thing under the sun whatsoever, therefore the followers
of Hippocrates have handed out, and as it were midwifed into the
world, the same was from the beginning though our eyes were not so
clear-sighted as to discern it”. To which Stephen Pasquier replied in
the following rhyme:—
“Some Paracelse of novelty implead,
For which, judged crime, he erst was banished,
So Hippocrates, Chrysippus, and at Rome
Asclepiade, too, were new. They’d all one doom.
They who condemn new things condemn the old,
Or else do both misjudge and are o’er bold.”
During the crusades the surgeons naturally acquired a very large
experience in the treatment of wounds—incised, lacerated, and
contused. Baldwin was severely wounded before Jerusalem, having
received a spear-thrust “through the thigh and the loins”. He fell
fainting from his horse, but the most skilful leeches were summoned,
“by whose art and skill the king and valiant athlete was enabled to
recover from this deadly wound”. Baldwin was also wounded in the foot
before Antioch, and the surgical talent available was baffled by the
injury to such a degree that it was proposed to kill a Saracen after
wounding him in the same part, so as to learn the proper course to
pursue. Baldwin, however, refused to allow this crude attempt at
experimental surgery to be made. There seem to be no medical records of
the second crusade. In the third, the French king, Philippe Auguste,
and our own Cœur de Lion suffered grievously from a disease, the
symptomatology of which included extensive exfoliation of the skin,
shedding of the nails, and loss of the hair. The disease is called
_Arnoldia_ by the chroniclers, and is variously conjectured to have
been leprosy or syphilis. It could hardly have been leprosy, for both
the royal sufferers recovered, Cœur de Lion being killed eight years
later at the siege of Chalus, and Philippe Auguste dying of quartan
ague twenty-four years after Richard. Of the fourth crusade we have no
medical details. In the fifth, St. Louis of France was accompanied by
his private physician Dudon and other leeches; among them was a lady
doctor or _phisicienne_ named Hernandis, who probably attended the
queen in her confinement, which took place at Damietta. The expedition
suffered terribly from scurvy, typhus, and other pestilences. The
part played by water in the diffusion of disease would seem to have
been recognised, though the methods of water examination would hardly
satisfy a modern chemist. A piece of white linen was dipped in the
water to be tested, and then dried; if there were any stains on the
linen the water was condemned, but if not it was pronounced pure.
The addition of four crushed almonds or beans was believed to make
the water of the Nile safe for drinking. The method of disinfection
adopted for the king’s tent was to fumigate it with a mixture of amber,
chick peas, or lupine, which were macerated in wine, and then placed
on live charcoal. In the sixth crusade, which took place twenty-two
years later, vast numbers, including St. Louis himself, fell victims to
ignorance of the elements of sanitation.