Read Ebook: Medicine in the Middle Ages Extracts from Le Moyen Age Medical by Dr. Edmond Dupouy; translated by T. C. Minor by Dupouy Edmond Minor Thomas C Thomas Chalmers Translator

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Physicians were not obliged by the magistrates to determine the nature of rapes on women; all gynecological questions were remanded to midwives. In truth, among all the physicians of antiquity only Hippocrates discussed uterine complaints and AEtius studied obstetrics. It was only in the sixteenth century that midwifery took its place among the medical sciences, thanks to Rhodion, Ambroise Par?, Reif, Rousset, and Guillemeau. Shortly before this time, that is to say, in the fifteenth century, Jacques de Foril published his "Commentaires" on generation, his ideas being derived from Avicenna; his notions, however, were absurd, being wholly based on astrological considerations. He pretended that an infant is not viable in the eighth month, because in the first month the pregnant woman is protected by Jupiter, from whom comes life; and in the seventh month by the moon, which favorizes life by its humidity and light; while in the eighth month or reign of Saturn, who eats children, the influence is hostile. But on the ninth month the benevolent influence of Jupiter is again experienced, and for this reason the infant is more apt to be alive at this period of gestation.

To the scholastic philosophy of the Middle Ages we must attribute the prejudice that, the human body being in direct connection with the universe, especially the planets, it was impossible for physical change to occur without the influence of the constellations. Thus astrology came to be considered as an essential part of medicine. This belief in the influence of the stars came from the Orient, and was carried through Europe after the crusades.

As to the treatise on "Diseases of Women," attributed to Trotula, a midwife of the school of Salerno, it is only a formulary of receipts for the use of women--baths in the sea-sands under a hot sun to thin ladies suffering from overfat; signs by which a good wet-nurse may be recognized: a method of kneading the head, the nose, and the limbs of new-born children before placing them in swaddling clothes; the use of virgin wine mixed with honey as a remedy for removing the wrinkles of old age.

Hugo de Lucgnes, in fractures of the bone, employed a powder composed of ginger and cannella, which he used in connection with the "Lord's Prayer," in the meantime also invoking the aid of the Trinity. He treated hernia by cauterization, and leprosy by inunctions of mercurial ointment.

If therapeutics made only slight progress in the thirteenth century, we cannot say as much for other branches of the medical and natural sciences.

Arnauld de Villeneuve, physician, chemist and astrologer, particularly distinguished himself by discovering sulphuric, nitric and hydrochloric acids, and also made the first essence of turpentine.

Lanfranc attracted large numbers of students to the College of Saint Come, and exhibited his skill as an anatomist and surgeon. In one of his publications he gives a very remarkable description of chancres and other venereal symptoms.

Albert the Great and Roger Bacon also belonged to the thirteenth century.

His writings were encyclopedic, their principal merit being commentaries on the works of Aristotle, of whom but little was known at that period; he studied also the Latin translations of the Arabian school, and reviewed Avicenna and Averrhoes, adding to such works some original observations.

Albert the Great, or Albertus Magnus, the name posterity has bestowed on this genius, was also much occupied with alchemy, and passed for a magician. He was considered a sorcerer by many, as he was said to evoke the spirits of the departed, and produced wonderful phenomena.

It was more than a century after these two great men died that medical science commenced its upward flight.

Some years later the prejudice against human dissection disappeared in France, and anatomy was allowed to be taught by the Faculties of Paris and Montpellier. Henri de Hermondaville, Pierre de Cerlata, and Nicholas Bertrucci were particularly distinguished anatomists during the fourteenth century, and traced the scientific path followed by Vesalius, Fallopius, Eustachius, Fabrica de Aguapendente, Sylvius, Plater, Varola de Torre, Charles Etienne, Ingrassias, and Arantius in the sixteenth century.

From this time dates the escape of medicine from ecclesiastical authority.

In 1452, Cardinal d'Estouteville, charged by the Pope with the reorganization of the University of Paris, obtained a revocation of the order obliging celibacy, claiming it to be "impious and senseless" in the case of doctors.

Above the dean, however, was the first Physician to the King, who was a high officer of the crown, having the same rights and privileges as the nobility, securing on his appointment the title of Count with hereditary transmission of same to his family; he was also a Councillor of State and wore the costume and decorations of this order. When he came to the faculty meetings he was received by the dean and bachelors, for he was also grand master of hygiene and legal medicine in the realm; he named all the salaried medical appointments, notably those of experts in medical jurisprudence.

The degree of Bachelor had existed since the foundation of the University of Paris. The Bacchalauri, or Bachalarrii, were always students for the doctoral title. After numerous other tests, they signed the following obligation:

This oath was read in Latin by the Dean, and, as enumerated, each candidate for a degree solemnly answered "I swear" after each article.

It was only at the end of the century that Lanfranc obtained from Phillip the Beautiful an order to reorganize and bestow degrees for the exercise of surgical art. The studies were extremely practical; they required several years' attendance at the Hotel Dieu or in the service of some city surgeon, likewise a certain amount of literary education. Like the doctors, these surgeons were permitted to wear a robe and hat. They were a great success.

The barbers thus had their punishment for defying the Faculty of Medicine.

"It is ordained that the before-mentioned, professors, bachelors, licentiates or masters, be they married or single, shall enjoy all the privileges, franchises, liberties, immunities and exemptions accorded to the other medical graduates of the University."

To put an end to the struggle, the College of Surgeons took the desperate but injurious resolve to admit all barbers to their institution and recognize their rights to a surgical degree. A year later, 1660, the Faculty of Medicine demanded that, inasmuch as the College of Surgeons admitted ignorant barbers to their school, the right of surgeons to wear a medical robe and hat and bestow degrees be denied. The Faculty of medicine gained their suit.

As an indispensable adjunct to the doctor at this period, let us now mention the apothecary and the bath-keeper.

The patron of the apothecaries was Saint Nicholas; they belonged to the corporation of grocers, where they were represented by three members. Their central bureau was at the Cloister Saint Opportune.

The inspection of drug stores and apothecary shops in Paris occurred once a year, and was made by three members elected from the central bureau and two doctors in medicine. A druggist in Paris served four years as an apprentice and six years as an under-dispenser; then the applicant was obliged to pass two examinations, and, finally, five extra examinations, the latter in the presence of the master apothecaries and two doctors. Notwithstanding their oath to not prescribe medicine for the sick and not to sell drugs without a doctor's written order, druggists then, as now, had frequent conflicts with physicians, as the latter are ever jealous of non professional interference and always asserting supremacy.

However, it is well to say that druggists never violated the rule relative to strict inspection of all drugs before using such articles. All medicines were passed at the central bureau before any apothecary would purchase for dispensing purposes.

As to bath-keepers, they belonged in antique times, as now, more to the order of empirics; their history dates far back to the period when the Romans introduced their bathing system into Gaul--a system which was perpetuated up to as late as the sixteenth century.

The baths constructed by the ancients and destroyed by the barbarians, reappeared again in the Middle Ages, under the names of vapor baths and furnace baths. These baths were shops, usually kept by barbers, where one could be sheared, sweated or leeched by a tonsorial artist. All the world then took baths--even the monks washed themselves sometimes; in fact, almost every monastery had its bath-rooms, where the poor could wash and be bled without pay.

During times of epidemics vapor baths were discontinued. It was for sanitary reasons, probably, that an order of the Mayor of Paris, named Delamere, forbade all persons taking vapor baths until after Christmas eve, "on penalty of a heavy fine." This same proclamation was repeated by act of Parliament on December 13th, 1553, "the penalty corporeal punishment for offending bath-keepers."

Parisian vapor baths had such wide-spread reputations and success that an Italian doctor of the sixteenth century by the name of Brixanius, who arrived in Paris, wrote the following verses:

"Balnea si calidis queras sudantia thermis, In claris intrabis aqua, ubi corpus inungit, Callidus, et multo medicamine spargit aliptes', Mox ubi membra satis geminis mundata lacertis Laverit et sparsos crines siccaverit, albo Marcida subridens componit corpora lecto."

Already, in the time of Saint Louis, the number of bath-keepers was so great that they had a trades union; they were almost all barbers, too; they washed the body, cut hair, trimmed corns and nails, shaved and leeched.

Bath houses more than multiplied from the twelfth century, imitations of Oriental customs, due to the crusaders. Baths were run not only by men, but by old harridans and fast girls. No respectable woman ever entered a public bath-house; Christine de Pisan bears witness to that fact in the following lines: "As to public baths and vapor baths, they should be avoided by honest women except for good cause; they are expensive and no good comes out of them, for many obvious reasons; no woman, if she be wise, would trust her honor therein, if she desire to keep it."

The establishments known as vapor baths, as early as the time of Saint Louis, had already degenerated into houses of prostitution. The police, in defense of public morality, were finally obliged to forbid fast women and diseased men from frequenting such places.

In 1448 the city council of Avignon again tried its hand at regulating the vapor baths at the bridge; but the golden days of debauched women had long before passed away, and the previous century had witnessed the acme of the courtesans' fortunes. The sojourn of the Popes at Avignon had gathered together from all over the Globe a motley collection of pilgrims and begotten a frightful condition of libertinage; we have the authority of Petrarch in saying that it even surpassed that of the Eternal City, and Bishop Guillaume Durand presented the Council of Vienna with a graphic picture of this social evil.

In an opuscle published in 1530, by one called De Drusae, we observe that "notwithstanding the natural laws of propriety, women use scents more than clean water; and they thus only increase the bad smells they endeavor to disguise. Some use greasy perfumed ointments, others sponges saturated in fragrants"

"Entre leur cuisses et dessoubz les aisselles, Pour ne sentir l'espaulle de mouton."

This horror of water did not last long, however, and at the commencement of the seventeenth century the false modesty of women ended with the creation of river baths, such as exist to-day along the banks of the Seine.

Was this restoration of cleanly habits due to medical advice? This question cannot be answered, but it may not be out of place to cite that remarkable passage from the "Essays of Montaigne" on the hygiene of bathing, which he recommends in certain maladies:

"It is good to bathe in warm water, it softens and relaxes in ports where it stagnates over sands and stones. Such application of external heat, however, makes the kidneys leathery and hard and petrifies the matter within. To those who bathe: it is best to eat little at night to the end that the waters drank the next morning operate more easily, meeting with an empty stomach. On the other hand, it is best to eat a little dinner, in order not to trouble the action of the water, which is not in perfect accord; nor should the stomach be filled too suddenly after its other labor; leave the work of digestion to the night, which is better than the day, when the body and mind are in perpetual movement and activity.

"I have noted, on the occasion of my voyages, all the famous baths of Christendom, and for some years past have made use of waters, for as a general rule I consider bathing healthy and deem it no risk to one's physical condition. The custom of ablution, so generally observed at times past in all nations, is now only practiced in a few as a daily habit. I cannot imagine why civilized people ever allow their bodies to become encrusted with dirt and their pores filled with filth."

If Montaigne made great use of mineral waters, he had in revenge a formidable dread of physicians and their medicines, a sentiment he inherited from his father, "who died," says he, "at the age of seventy-four years," and his "grandfather and great-grandfather died at eighty years without tasting a drop of physic."

Montaigne insisted that medicine owed its existence only to mankind's fear of death and pain, an impatience at poor health and a furious and indiscreet thirst for a speedy cure, but the author of the "Essays" adds in concluding: "I honor physicians, not following the feeling of necessity, but for the love of themselves, having seen many honest doctors who were honorable and well worthy of being loved."

The reputation for disagreement among doctors so much insisted on by Montaigne has served as a well-worn text for many other critics.

"When an enemy you wish to kill Don't call assasins full of vice, But call two doctors of great skill To give contrary advice."

Or in the verses of the original:

"D'un ennemi voulez vous defaire? Ne cherchez pas d'assasins Donnez lui deux medecins, Et qui'ils soient d'avis contrarie."

This professional jealousy is always more apparent than real. Aside from the rivalry for public patronage physicians are a very social class of men, as witness their many festive meetings. We banquet in honor of St. Luke the physician, and St. Come, after each thesis, at anniversaries, at the election of the Dean, and on many other occasions. It is these co-fraternal meetings at which are reinagurated the old feelings of good-fellowship; our little quarrels only serve to discipline the medical body and to increase the grandeur of the Faculty. It is the constant rubbing of surfaces that makes the true professional metal glitter.

When we hear new doctors, young graduates, swear the Hippocratic oath, we do not forget that the principal articles of the statute prescribe the cultivation of friendships, respect for the older members of the profession, benevolence to the young beginners, and the preservation of professional decency and kindness. It may be insisted that banquets are not to be considered as medical assemblages, for there they laugh long and loud, and drink many a bumper of rich Burgundy; making joyous discourse; holding to the famous compliment of Moliere:

Salus, honor et argentum Atque bonum appetitum.

We know to-day many of the truthful precepts of the School of Salerno and their bearing on the medical records of the middle ages. Then as now the doctor had the ever increasing ingratitude of the patient .

"The disciple of Hippocrates meeteth often treatment rude, The payment of his trouble is base ingratitude. When the patient is in grievous pain the time is opportune For a keen, sharp-witted doctor to make a good fortune. Let him profit by the sufferer's aches and gather in the money, For the ant gets winter provender and the summer bee its honey."

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