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.

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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 practic?, 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 in327telligible 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 medicin?; 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 medicin?,—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.

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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.

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besides ?sculapius, 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 20s., whereof 6s. 8d. was to go to our lady’s box, 6s. 8d. to the chancellor, or in his absence, to the commissary, and 6.s. 8d. 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 was330 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 subject799 i am indebted for the information concerning it, says that331 “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 says801 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:332 “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.”