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. john304 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

305

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, or306 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 ?sculapius, 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 gloucester738 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 when307 “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.