FOOTNOTES:

[1] "Medicinisches aus der Aeltesten Kirchen Geschichte." Leipzig, 1892.

[2] Foulis, London and Edinburgh, 1910.

[3] My attention was called to the interesting story of the Jewish physicians of the Middle Ages and their scientific accomplishment while writing the article on Joseph Hyrtl for the Catholic Encyclopedia. His "Das Arabische und Hebräische in der Anatomie" (Wien, 1879) has some interestingly suggestive material on these important chapters of the history of medicine. (I owe my opportunity to consult it to the courtesy of the Surgeon-General's library.) Biographic material has been obtained from Carmoly's "History of the Jewish Physicians," translated by Dr. Dunbar for the Maryland Medical and Surgical Journal, some extra copies of which were printed by John Murphy and Co., Baltimore, about the middle of the nineteenth century. Baas and Haeser's Histories of Medicine and Puschmann and Pagel's "Handbook" provided additional material, and I have found Landau's "Geschichte der Jüdischen Aerzte" (Berlin, 1895) of great service.

[4] Of course there are many absurd things recommended in the Talmud. We cannot remind ourselves too often, however, that there have been absurd things at all times in medicine, and especially in therapeutics. It is curious how often some of these absurdities have repeated themselves. We are liable to think it very queer that men should have presumed, or somehow jumped to the conclusion, that portions of animals might possess wonderful virtue for the healing of diseases of the corresponding special parts of man. We ourselves, however, within a little more than a decade, had a phase of opotherapy—how much less absurd it seems under that high-sounding Greek term—that was apparently very learned in its scientific aspects yet quite as absurd as many phases of old-time therapy, as we look at it. We administered cardin for heart disease and nephrin for kidney trouble, cerebrin for insanity (save the mark!), and even prostate tissue for prostatism—and with reported good results! How many of us realize now that in this we were only repeating the absurdities, so often made fun of in old medicine, with regard to animal tissue and excrement therapeutics? The Talmud has many conclusions with regard to the symptoms of patients drawn from dreams; as, for instance, it is said to be a certain sign of sanguineous plethora when one dreams of the comb of a cock. One phase of our psycho-analysis in the modern time, however, has taken us back to an interpretation of dreams different of course from this, yet analogous enough to be quite striking.

[5] "Maimonides," by David Yellin and Israel Abrahams, Philadelphia, 1903.

[6] "Das Arabische und Hebräische in der Anatomie," Dr. Joseph Hyrtl, Wien, 1879.

[7] "Anat. Antiq. Rariores," Vienna, 1835.

[8] It seems hard to understand how so useful an auxiliary to the surgeon as the ligature,—it seems indispensable to us,—could possibly be allowed to go out of use and even be forgotten. It will not be difficult, however, for anyone who recalls the conditions that obtained in old-time surgery. The ligature is a most satisfying immediate resource in stopping bleeding from an artery, but a septic ligature inevitably causes suppuration and almost inevitably leads to secondary hemorrhage. In the old days of septic surgery secondary hemorrhage was the surgeon's greatest and most dreaded bane. Some time from the fifth to the ninth day a septic ligature came away under conditions such that inflammatory disturbance had prevented sealing of the vessel. If the vessel was large, then the hemorrhage was fast and furious and the patient died in a few minutes. After a surgeon had had a few deaths of this kind he dreaded the ligature. He abandoned its use and took kindly to such methods as the actual cautery, red-hot knives for amputations, and the like, that would sear the surfaces of tissues and the blood-vessels, and not give rise to secondary hemorrhage. A little later, however, someone not familiar with secondary risks would reinvent the ligature. If he were cleanly in his methods and, above all, if he were doing his work in a new hospital, the ligature worked very well for a while. If not, it soon fell into innocuous desuetude again.

[9] Puschmann: "Handbuch der Geschichte der Medizin," Vol. I, page 652.

[10] The first dentist who filled teeth with amalgam in New York, some eighty years ago, had to flee for his life, because of a hue and cry set up that he was poisoning his patients with mercury.

[11] "Storia de la Scuola di Salerno."

[12] It is probably interesting to note that the word universitas as used here has no reference to our word university, but refers to the whole world of students as it were. In the Middle Ages universities were called studia generalia, general studies—that is, places where everything could be studied and where everyone from any part of the world could study. Our use of the word university in the special modern sense of the term comes from the formal mode of address to the faculty of a university when Popes or rulers sent them authoritative documents. Such documents began with the expression Universitas vestra, all of you (in the old-time English, as preserved in the Irish expression, "the whole of ye"), referring to all the members of the faculty. The transfer to our term and signification university was not difficult.

[13] Physicians wore a particular garb consisting of a cloak and often a mask, supposed to protect them from infections at this time, so that it was not difficult to make a characteristic picture as a sign for a pharmacy. These symbolic signs were much commoner and very necessary when people generally were not able to read. It is from that period that we have the mortar and pestle as also the colored lights in the windows of the drug stores, and the many-colored barber-pole. Also the big boot, key, watch, hat, bonnet, and the like, the last symbolic sign invention apparently being the wooden Indian for the tobacco store.

[14] The Medical Library and Historical Journal, Brooklyn, December, 1906.

[15] Taddeo, who was born in 1215, according to our usually accepted traditions in the matter, would have been seventy-five years of age when Mondino as a youth of scarcely more than fifteen went to the University. It might seem that so old a man would have very little influence over the young man. Taddeo, however, had, as we have said, a very strenuous old age. Everything in life had come to him late. He was well past thirty before he began to study philosophy and medicine, having been a seller of candles from necessity because of poverty in his younger years. His great success in practice came when he was past forty. He first began to teach when he was forty-five, and he was nearly fifty-five before he began to write. According to tradition he married when he was nearly eighty—whether for the first or second time is not said—and while this might be considered, and would in some cases be, an indication of weakness of character (it would probably depend on whether he married or was married), it seems in his case to have indicated a vigor of body and character which shows very clearly how great was the possibility of his influence as a teacher having been maintained even up to this late time of life, and thus influencing a pupil who is to represent the most potent influence at the beginning of the next century.

[16] Medical Library and Historical Journal, 1906.

[17] Pilcher (loc. cit.) tells of her tomb. I venture to change his translation of the inscription in certain unimportant particulars. He says:

"We know the very place where she was buried in front of the Madonna delle Lettre in the Church of San Pietro e Marcellino of the Hospital of Santa Maria de Mareto, where her associate, Agenio, mourning and inconsolable, placed a tablet with this inscription:

D . O . M .
Vrceo . Contenti
Alexandrae . Galinae . Pvellae . Persicetanae
Penicillo . Egregiae . Ad . Anatomen . Exhibendam
Et . Insignissimi . Medici . Mundini . Lucii
Paucis . Comparandae . Discipulae . Cineres
Carnis . Hic . Expectant . Resurrectionem
Vixit . Ann . XIX . Obiit . Studio . Absunta
Die XXVI Martii . A . S . MCCCXXVI
Otto . Agenius . Lustrulanus . Ob . Eam . Demptam
Sui . Potiori . Parte . Spoliatus . Sodali . Eximiae
Ac . De . Se . Optime . Meritae . Inconsolabilis . M . P .

This inscription may be translated as follows:

In this urn enclosed
The ashes of the body of
Alexandra Giliani, a maiden of Periceto;
Skilful with her brush in anatomical demonstrations
And a disciple equalled by few,
Of the most noted physician, Mundinus of Luzzi,
Await the resurrection.
She lived 19 years: she died consumed by her labors
March 26, in the year of grace 1326.
Otto Agenius Lustrulanus, by her taking away
Deprived of his better part, his excellent companion,
Deserving of the best,
Has erected this tablet."

[18] This is so striking that I quote their actual words from Gurlt, p. 704: "Multoties fit percussio in anteriori parte cranei et craneum in parte frangitur contraria."

[19] "Historical Relations of Medicine and Surgery Down to the Sixteenth Century," London, 1904.

[20] Of course, for any extended knowledge of Mondeville, a modern reader must turn to Nicaise's translation of his "Chirurgia," which, with an introduction and a biography, was published at Paris in 1893. Nicaise's publication of this and of Guy de Chauliac's treatise has worked a revolution in medical history and, above all, has made these old authors available for those who hesitate to take up a work written entirely in Latin.

[21] In the very first book containing some account of human anatomy, a German volume by Conradus Mengenberger, called "Puch der Natur," the date of printing of which is about 1478,—that is, less than ten years after the printing of the very first book, the "Biblia pauperum," which appeared in 1470,—there are, according to Haller in his "Bibliotheca Anatomica," a series of illustrations. This is the first illustrated medical work ever published.

[22] Fordham University Press, New York, 1908.

[23] Fordham University Press, New York, 1908.

[24] See picture of the hospital ward at Tonnerre, in "The Thirteenth Greatest of Centuries," 3rd edit., New York, 1911.

[25] "The Historical Relations of Medicine and Surgery," by T. Clifford Allbutt, M.A., M.D. London: Macmillan & Co., Ltd., 1905.

[26] The beginning of the manuscript copy in the "Bibliothèque Nationale" is extremely interesting as an example of the English of the period, and alongside of it it seems worth while to quote the closing sentence as Nicaise reproduces them:

"In godes name here bygyneth the inventarie of gadryng to gedre medecyne in the partye of cyrurgie compilede and fulfilled in the zere (yere?) of our Loord 1363 by Guide de Cauliaco cirurgene and doctor of physik in the fulclere studye of Mountpylerz.

"On page 191, verso.—Here endeth the cyrurgie of Maistre Guyd' de Cauliaco dottoure of phisik."

The University of Cambridge copy has the title in the colophon. It runs as follows: "Ye inventorye of Guydo de Caulhiaco Doctor of Phisyk and Cirurgien in Ye Universitie of Mount Pessulanee of Montpeleres." The fly-leaf contains the words, "Jesu Christ save ye soule of mich." It is rather interesting to note how much closer to modern English is this copy, made probably not much more than half a century later than the first one and, above all, how much more nearly the spelling has come. At this time, however, and, indeed, for more than a century later, spelling had no fixed rule, and a man might spell the same word quite differently even on the same page. The difference between doctor spelled thus in the early edition, and doctours in the later one, probably means nothing more than personal peculiarities of the original translator or copyist.

[27] In Nicaise this last word is written crapte. I have ventured to suggest crafte, since a misreading between the two letters would be so easy. In the same way I have suggested tentatively a changing of the z in the title of the Bibliothèque Nationale copy to y, making the word yere instead of zere.

[28] "A History of Dentistry from the Most Ancient Times Until the End of the Eighteenth Century," by Dr. Vincenzo Guerini, editor of the Italian Review L'Odonto-Stomatologia, Philadelphia and New York, Lea and Febriger, 1909.

[29] The first printed edition of Arculanus is that of Venice, 1542, bearing the Latin title, "Joannis Arculani Commentaria in Nonum Librum Rasis," etc.

[30] It is curious to trace how old are the traditions on which some of these old stories, that must now be rejected, are founded. I have come upon the story with regard to Basil Valentine and the antimony and the monks in an old French medical encyclopedia of biography, published in the seventeenth century, and at that time there was no doubt at all expressed as to its truth. How much older than this it may be I do not know, though it is probable that it comes from the sixteenth century, when the kakoëthes scribendi attacked many people because of the facility of printing, and when most of the good stories that have so worried the modern dry-as-dust historian in his researches for their correction became a part of the body of supposed historical tradition. It is probably French in origin because in that language antimoine is a tempting bait for that pseudo-philology which has so often led to false derivations.

[31] There is in the New York Academy of Medicine a thick 24mo volume in which three of the classics of older medicine are bound together. They are Kerckringius's "Commentary on the Triumphal Chariot of Antimony," published at Amsterdam, 1671; Steno's "Dissertation on the Anatomy of the Brain," published in Leyden in 1671, and Father Kircher's "Scrutinium Physico Contagiosae Luis quae dicitur Pestis" (Physico-medical Discussions of the Contagious Disease which is called Pest). This was published at Leipzig in 1659. Just how the three works came to be bound together is hard to say. Very probably they belonged to some old-time scholar, though there is nothing about the books to tell anything of the story. The fact that all three of the authors were ecclesiastics of the Catholic Church, Valentine a Monk, Steno a Bishop, and Kircher a Jesuit, would seem to be one common bond and perhaps a reason for the binding of these rather disparate treatises together. In that case it is probable that the book came from an old monastic library dispersed after the suppression of the order by some government. It seems not unlikely that the volume belonged at some time to an old Jesuit library, for they have suffered the most in that way. That these three classics of medicine should have been republished in handy volume editions within practically ten years shows an interest in medical literature that has not existed again until our own time, for during the eighteenth and early nineteenth centuries there was almost utter neglect of them.

[32] Paper read before the first meeting of the American Guild of St. Luke.

[33] Published by Putnams, New York, 1909.

[34] Dublin, 1882.

[35] The material for this chapter was gathered for a paper read before the Medical Improvement Society of Boston in the spring of 1911. In nearly its present form it was published in The Popular Science Monthly for May, 1911, and thanks are returned to the editor of that magazine for permission to reprint it here. The additions that have been made refer particularly to the estimation of Aristotle in the Middle Ages.

[36] New York, Putnam, 1908.

[37] "De Cœlo et Mundo," 1, tr. iv., x.

INDEX

Other Books by Dr. Walsh