Old-Time Makers of Medicine / The Story of The Students And Teachers of the Sciences Related to Medicine During the Middle Ages

by James J. Walsh

MEDIEVAL SURGERY

Even this brief account of the surgeons who taught and studied at the medieval universities demonstrates what fine work they did. It is surely not too much to say that the chapter on university education mainly concerned with them is one of the most interesting in the whole history of the universities. Their story alone is quite enough to refute most of the prevalent impressions and patronizing expressions with regard to medieval education. Their careers serve to show how interested were the men of many nations in the development of an extremely important application of science for the benefit of suffering humanity. Their work utterly contradicts the idea so frequently emphasized that the great students of the Middle Ages were lacking in practicalness. Besides, they make very clear that we have been prone to judge the Middle Ages too much from its speculative philosophies. It has been the custom to say that speculation ruled men's minds and prevented them from making observations, developing science, or applying scientific principles. There was much speculation during the Middle Ages, but probably not any more in proportion than exists at the present day. We were either not acquainted with, or failed to appreciate properly, until comparatively recent years, the other side of medieval accomplishment. Our ignorance led us into misunderstanding of what these generations really did. It was our own fault, because during the Renaissance practically all of these books were edited and printed under the direction of the great scholars of the time in fine editions, but during the eighteenth century nearly all interest was lost in them, and we are only now beginning to get back a certain amount of the precious knowledge that they had in the Renaissance period of this other side of medieval life. We have learned so much about surgery because distinguished scholars devoted themselves to this phase of the history of science. Doubtless there are many other phases of the history of science which suffered the same fate of neglect and with regard to which the future will bring us equally startling revelations. For this reason this marvellous chapter in the history of surgery is a warning as well as a startling record of a marvellous epoch of human progress.

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XI
GUY DE CHAULIAC

One of the most interesting characters in the history of medieval medicine, and undoubtedly the most important and significant of these Old-Time Makers of Medicine, is Guy de Chauliac. Most of the false notions so commonly accepted with regard to the Middle Ages at once disappear after a careful study of his career. The idea of the careful application of scientific principles in a great practical way is far removed from the ordinary notion of medieval procedure. Some observations we may concede that they did make, but we are inclined to think that these were not regularly ordered and the lessons of them not drawn so as to make them valuable as experiences. Great art men may have had, but science and, above all, applied science, is a later development of humanity. Particularly is this supposed to be true with regard to the science and practice of surgery, which is assumed to be of comparatively recent origin. Nothing could well be less true, and if the thoroughly practical development of surgery may be taken as a symbol of how capable men were of applying science and scientific principles, then it is comparatively easy to show that the men of the later Middle Ages were occupied very much as have been our recent generations with science and its practical applications.

The immediate evidence of the value of old-time surgery is to be found in the fact that Guy de Chauliac, who is commonly spoken of in the history of medicine as the Father of Modern Surgery, lived his seventy-odd years of life during the fourteenth century and accomplished the best of his work, therefore, some five centuries before surgery in our modern sense of the term is supposed to have developed. A glance at his career, however, will show how old are most of the important developments of surgery, as also in what a thoroughly scientific temper of mind this subject was approached more than a century before the close of the Middle Ages. The life of this French surgeon, indeed, who was a cleric and occupied the position of chamberlain and physician-in-ordinary to three of the Avignon Popes, is not only a contradiction of many of the traditions as to the backwardness of our medieval forbears in medicine, that are readily accepted by many presumably educated people, but it is the best possible antidote for that insistent misunderstanding of the Middle Ages which attributes profound ignorance of science, almost complete failure of observation, and an absolute lack of initiative in applications of science to the men of those times.

Guy de Chauliac's life is modern in nearly every phase. He was educated in a little town of the south of France, made his medical studies at Montpellier, and then went on a journey of hundreds of miles into Italy, in order to make his post-graduate studies. Italy occupied the place in science at that time that Germany has taken during the nineteenth century. A young man who wanted to get into touch with the great masters in medicine naturally went down into the Peninsula. Traditions as to the attitude of the Church to science notwithstanding, Italy where education was more completely under the influence of the Popes and ecclesiastics than in any other country in Europe, continued to be the home of post-graduate work in science for the next four centuries. Almost needless to say, the journey to Italy was more difficult of accomplishment and involved more expense and time than would even the voyage from America to Europe in our time. Chauliac realized, however, that both time and expense would be well rewarded, and his ardor for the rounding out of his education was amply recompensed by the event. Nor have we any reason for thinking that what he did was very rare, much less unique, in his time. Many a student from France, Germany, and England made the long journey to Italy for post-graduate opportunities during the later Middle Ages.

Even this post-graduate experience in Italy did not satisfy Chauliac, however, for, after having studied several years with the most distinguished Italian teachers of anatomy and surgery, he spent some time in Paris, apparently so as to be sure that he would be acquainted with the best that was being done in his specialty in every part of the world. He then settled down to his own life work, carrying his Italian and French masters' teachings well beyond the point where he received them, and after years of personal experience he gathered together his masters' ideas, tested by his own observations, into his "Chirurgia Magna," a great text-book of surgery which sums up the whole subject succinctly, yet completely, for succeeding generations. When we talk about what he accomplished for surgery, we are not dependent on traditions nor vague information gleaned from contemporaries and successors, who might perhaps have been so much impressed by his personality as to be made over-enthusiastic in their critical judgment of him. We know the man in his surgical works, and they have continued to be classics in surgery ever since. It is an honorable distinction for the medicine of the later fourteenth, the fifteenth, and sixteenth centuries that Guy de Chauliac's book was the most read volume of the time in medicine. Evidently the career of such a man is of import, not alone to physicians, but to all who are interested in the history of education.

Chauliac derives his name from the little town of Chauliac in the diocese of Mende, almost in the centre of what is now the department of Lozère. The records of births and deaths were not considered so important in the fourteenth century as they are now, and so we are not sure of either in the case of Chauliac. It is usually considered that he was born some time during the last decade of the thirteenth century, probably toward the end of it, and that he died about 1370. Of his early education we know nothing, but it must have been reasonably efficient, since it gave him a good working knowledge of Latin, which was the universal language of science and especially of medicine at that time; and though his own style, as must be expected, is no better than that of his contemporaries, he knew how to express his thoughts clearly in straightforward Latin, with only such a mixture of foreign terms as his studies suggested and the exigencies of a new development of science almost required. Later in life he seems to have known Arabic very well, for he is evidently familiar with Arabian books and does not depend merely on translations of them.

Pagel, in the first volume of Puschmann's "Handbook of the History of Medicine," says, on the authority of Nicaise and others, that Chauliac received his early education from the village clergyman. His parents were poor, and but for ecclesiastical interest in him it would have been difficult for him to obtain his education. The Church supplied at that time to a great extent for the foundations and scholarships, home and travelling, of our day, and Chauliac was amongst the favored ones. How well he deserved the favor his subsequent career shows, as it completely justifies the judgment of his patrons. He went first to Toulouse, as we know from his affectionate mention of one of his teachers there. Toulouse was more famous for law, however, than for medicine, and after a time Chauliac sought Montpellier to complete his medical studies.

For English-speaking people an added interest in Guy de Chauliac will be the fact that one of his teachers at Montpellier was Bernard Gordon, very probably a Scotchman, who taught for some thirty-five years at this famous university in the south of France, and died near the end of the first quarter of the fourteenth century. One of Chauliac's fellow-students at Montpellier was John of Gaddesden, the first English Royal Physician by official appointment of whom we have any account. John is mentioned by Chaucer in his "Doctor of Physic," and is usually looked upon as one of the fathers of English medicine. Chauliac did not think much of him, though his reason for his dislike of him will probably be somewhat startling to those who assume that the men of the Middle Ages always clung servilely to authority. Chauliac's objection to Gaddesden's book is that he merely repeats his masters and does not dare to think for himself. It is not hard to understand that such an independent thinker as Chauliac should have been utterly dissatisfied with a book that did not go beyond the forefathers in medicine that the author quotes. This is the explanation of his well-known expression, "Last of all arose the scentless rose of England ['Rosa Angliæ' was the name of John of Gaddesden's book], in which, on its being sent to me, I hoped to find the odor of sweet originality, but instead of that I encountered only the fictions of Hispanus, of Gilbert, and of Theodoric."

The presence of a Scotch professor and an English fellow-student, afterwards a royal physician, at Montpellier, at the beginning of the fourteenth century, shows how much more cosmopolitan was university life in those times than we are prone to think, and what attraction a great university medical school possessed even for men from long distances.

After receiving his degree of Doctor of Medicine at Montpellier Chauliac went, as we have said, to Bologna. Here he attracted the attention and received the special instruction of Bertruccio, who was attracting students from all over Europe at this time and was making some excellent demonstrations in anatomy, employing human dissections very freely. Chauliac tells of the methods that Bertruccio used in order that bodies might be in as good condition as possible for demonstration purposes, and mentions the fact that he saw him do many dissections in different ways.

In Roth's life of Vesalius, which is usually considered one of our most authoritative medical historical works not only with regard to the details of Vesalius' life, but also in all that concerns anatomy about that time and for some centuries before, there is a passage quoted from Chauliac himself which shows how freely dissection was practised at the Italian universities in the fourteenth century. This passage deserves to be quoted at some length because there are even serious historians who still cite a Bull of Pope Boniface VIII, issued in 1300, forbidding the boiling and dismembering of bodies in order to transport them to long distances for burial in their own country, as being, either rightly or wrongly, interpreted as a prohibition of dissection and, therefore, preventing the development of anatomy. In the notes to his history of dissection during this period in Bologna Roth says: "Without doubt the passage in Guy de Chauliac which tells of having frequently seen dissections, must be considered as referring to Bologna. This passage runs as follows: 'My master Bertruccius conducted the dissection very often after the following manner: the dead body having been placed upon a bench, he used to make four lessons on it. In the first the nutritional portions were treated, because they are so likely to become putrefied. In the second, he demonstrated the spiritual members; in the third, the animate members; in the fourth, the extremities.'" (Roth, "Andreas Vesalius." Basel, 1896.)

Bertruccio's master, Mondino, is hailed in the history of medicine as the father of dissection. His book on dissection was for the next three centuries in the hands of nearly every medical scholar in Europe who was trying to do good work in anatomy. It was not displaced until Vesalius came, the father of modern anatomy, who revolutionized the science in the Renaissance time. Mondino had devoted himself to the subject with unfailing ardor and enthusiasm, and from everywhere in Europe the students came to receive inspiration in his dissecting-room. Within a few years such was the enthusiasm for dissection aroused by him in Bologna that there were many legal prosecutions for body-snatching, the consequence doubtless of a regulation of the Medical Department of the University of Bologna, that if the students brought a body to any of their teachers he was bound to dissect it for them. Bertruccio, Mondino's disciple and successor, continued this great work, and now Chauliac, the third in the tradition, was to carry the Bolognese methods back to France, and his position as chamberlain to the Pope was to give them a wide vogue throughout the world. The great French surgeon's attitude toward anatomy and dissection can be judged from his famous expression that "the surgeon ignorant of anatomy carves the human body as a blind man carves wood." The whole subject of dissection at this time has been fully discussed in the first three chapters of my "Popes and Science," where those who are interested in the matter may follow it to their satisfaction.[23]

After his Bologna experience Chauliac went to Paris. Evidently his indefatigable desire to know all that there was to be known would not be satisfied until he had spent some time at the great French university where Lanfranc, after having studied under William of Salicet in Italy, had gone to establish that tradition of French surgery which, carried on so well by Mondeville his great successor, was to maintain Frenchmen as the leading surgeons of the world until the nineteenth century (Pagel). Lanfranc, himself an Italian, had been exiled from his native country, apparently because of political troubles, but was welcomed at Paris because the faculty realized that they needed the inspiration of the Italian medical movement in surgery for the establishment of a good school of surgery in connection with the university. The teaching so well begun by Lanfranc was magnificently continued by Mondeville and Arnold of Villanova and their disciples. Chauliac was fortunate enough to come under the influence of Petrus de Argentaria, who was worthily maintaining the tradition of practical teaching in anatomy and surgery so well founded by his great predecessors of the thirteenth century. After this grand tour Chauliac was himself prepared to do work of the highest order, for he had been in touch with all that was best in the medicine and surgery of his time.

Like many another distinguished member of his profession, Chauliac did not settle down in the scene of his ultimate labors at once, but was something of a wanderer. His own words are, "Et per multa tempora operatus fui in multis partibus." Perhaps out of gratitude to the clerical patrons of his native town to whom he owed so much, or because of the obligations he considered that he owed them for his education, he practised first in his native diocese of Mende; thence he removed to Lyons, where we know that he lived for several years, for in 1344 he took part as a canon in a chapter that met in the Church of St. Just in that city. Just when he was called to Avignon we do not know, though when the black death ravaged that city in 1348 he was the body-physician of Pope Clement VI, for he is spoken of in a Papal document as "venerabilis et circumspectus vir, dominus Guido de Cauliaco, canonicus et præpositus ecclesiæ Sancti Justi Lugduni, medicusque domini Nostri Papæ." All the rest of his life was passed in the Papal capital, which Avignon was for some seventy years of the fourteenth century. He served as chamberlain-physician to three Popes, Clement VI, Innocent VI, and Urban V. We do not know the exact date of his death, but when Pope Urban V went to Rome in 1367, Chauliac was putting the finishing touches on his "Chirurgia Magna," which, as he tells us, was undertaken as a solatium senectutis—a solace in old age. When Urban returned to Avignon for a time in 1370 Chauliac was dead. His life work is summed up for us in this great treatise on surgery, full of anticipations in surgical procedures that we are prone to think much more modern.

Nicaise has emphasized the principles which guided Guy de Chauliac in the choice and interpretation of his authorities by a quotation from Guy himself, which is so different in its tone from what is usually supposed to have been the attitude of mind of the men of science of the time that it would be well for all those who want to understand the Middle Ages better to have it near them. Speaking of the surgeons of his own and immediately preceding generations, Guy says: "One thing particularly is a source of annoyance to me in what these surgeons have written, and it is that they follow one another like so many cranes. For one always says what the other says. I do not know whether it is from fear or from love that they do not deign to listen except to such things as they are accustomed to and as have been proved by authorities. They have to my mind understood very badly Aristotle's second book of metaphysics where he shows that these two things, fear and love, are the greatest obstacles on the road to the knowledge of the truth. Let them give up such friendships and fears. 'Because while Socrates or Plato may be a friend, truth is a greater friend.' Truth is a holy thing and worthy to be honored above everything else. Let them follow the doctrine of Galen, which is entirely made up of experience and reason, and in which one investigates things and despises words."

After all, this is what great authorities in medicine have always insisted on. Once every hundred years or so one finds a really great observer who makes new observations and wakes the world up. He is surprised that men should not have used their powers of observation for themselves, but should have been following old-time masters. His contemporaries often refuse to listen to him at first. His observations, however, eventually make their way. We blame the Middle Ages for following authority, but what have we been always doing but following authority, except for the geniuses who come and lift us out of the rut and illuminate a new portion of the realm of medicine. After they have come, however, and done their work, their disciples proceed to see with their eyes and to think that they are making observations for themselves when they are merely following authority. When the next master in medicine comes along his discovery is neglected because men have not found it in the old books, and usually he has to suffer for daring to have opinions of his own. The fact of the matter is that at any time there is only a very limited number of men who think for themselves. The rest think other people's thoughts and think they are thinking and doing things. As for observation, John Ruskin once said, "Nothing is harder than to see something and tell it simply as you saw it." This is as true in science as in art, and only genius succeeds in doing it well.

Chauliac's book is confessedly a compilation. He has taken the good wherever he found it, though he adds, modestly enough, that his work also contains whatever his own measure of intelligence enabled him to find useful (quæ juxta modicitatem mei ingenii utilia reputavi). Indeed it is the critical judgment displayed by Chauliac in selecting from his predecessors that best illustrates at once the practical character of his intellect and his discerning spirit. What the men of his time are said to have lacked is the critical faculty. They were encyclopedic in intellect and gathered all kinds of information without discrimination, is a very common criticism of medieval writers. No one can say this of Chauliac, however, and, above all, he was no respecter of authority, merely for the sake of authority. His criticism of John of Gaddesden's book shows that the blind following of those who had gone before was his special bête noir. His bitterest reproach for many of his predecessors was that "they follow one another like cranes, whether for love or fear, I cannot say."

Chauliac's right to the title of father of surgery will perhaps be best appreciated from the brief account of his recommendations as to the value of surgical intervention for conditions in the three most important cavities of the body, the skull, the thorax, and the abdomen. These cavities have usually been the dread of surgeons. Chauliac not only used the trephine, but laid down very exact indications for its application. Expectant treatment was to be the rule in wounds of the head, yet when necessary, interference was counselled as of great value. His prognosis of brain injuries was much better than that of his predecessors. He says that he had seen injuries of the brain followed by some loss of brain substance, yet with complete recovery of the patient. In one case that he notes a considerable amount of brain substance was lost, yet the patient recovered with only a slight defect of memory, and even this disappeared after a time. He lays down exact indications for the opening of the thorax, that noli me tangere of surgeons at all times, even our own, and points out the relations of the ribs and the diaphragm, so as to show just where the opening should be made in order to remove fluid of any kind.

In abdominal conditions, however, Chauliac's anticipation of modern views is most surprising. He recognized that wounds of the intestines were surely fatal unless leakage could be prevented. Accordingly he suggested the opening of the abdomen and the sewing up of such intestinal wounds as could be located. He describes a method of suture for these cases and seems, like many another abdominal surgeon, even to have invented a special needleholder.

To most people it would seem absolutely out of the question that such surgical procedures could be practised in the fourteenth century. We have the definite record of them, however, in a text-book that was the most read volume on the subject for several centuries. Most of the surprise with regard to these operations will vanish when it is recalled that in Italy during the thirteenth century, as we have already seen, methods of anæsthesia by means of opium and mandragora were in common use, having been invented in the twelfth century and perfected by Ugo da Lucca, and Chauliac must not only have known but must have frequently employed various methods of anæsthesia.

In discussing amputations he has described in general certain methods of anæsthesia in use in his time, and especially the method by means of inhalation. It would not seem to us in the modern time that this method would be very successful, but there is an enthusiastic accord of authorities attesting that operations were done at this time with the help of this inhalant without the infliction of pain. Chauliac says:

"Some prescribe medicaments which send the patient to sleep, so that the incision may not be felt, such as opium, the juice of the morel, hyoscyamus, mandrake, ivy, hemlock, lettuce. A new sponge is soaked by them in these juices and left to dry in the sun; and when they have need of it they put this sponge into warm water and then hold it under the nostrils of the patient until he goes to sleep. Then they perform the operation."

Many people might be prone to think that the hospitals of Chauliac's time would not be suitable for such surgical work as he describes. It is, however, only another amusing assumption of this self-complacent age of ours to think that we were the first who ever made hospitals worthy of the name and of the great humanitarian purpose they subserve. As a matter of fact, the old-time hospitals were even better than ours or, as a rule, better than any we had until the present generation. In "The Popes and Science," in the chapter on "The Foundation of City Hospitals," I call attention to the fact that architects of the present day go back to the hospitals of the Middle Ages in order to find the models for hospitals for the modern times. Mr. Arthur Dillon, a well-known New York architect, writing of a hospital built at Tonnerre in France, toward the end of the thirteenth century (1292), says:

"It was an admirable hospital in every way, and it is doubtful if we to-day surpass it. It was isolated; the ward was separated from the other buildings; it had the advantage we so often lose of being but one story high, and more space was given to each patient than we can now afford.

"The ventilation by the great windows and ventilators in the ceiling was excellent; it was cheerfully lighted; and the arrangement of the gallery shielded the patients from dazzling light and from draughts from the windows and afforded an easy means of supervision, while the division by the roofless low partitions isolated the sick and obviated the depression that comes from sight of others in pain.

"It was, moreover, in great contrast to the cheerless white wards of to-day. The vaulted ceiling was very beautiful; the woodwork was richly carved, and the great windows over the altars were filled with colored glass. Altogether it was one of the best examples of the best period of Gothic Architecture."[24]

The fine hospital thus described was but one of many. Virchow, in his article on hospitals quoted in the same chapter, called attention to the fact that in the thirteenth and fourteenth centuries every town of five thousand or more inhabitants had its hospital, founded on the model of the great Santo Spirito Hospital in Rome, and all of them did good work. The surgeons of Guy de Chauliac's time would indeed find hospitals wherever they might be called in consultation, even in small towns. They were more numerous in proportion to population than our own and, as a rule, at least as well organized as ours were until the last few years.

It is no wonder that with such a good hospital organization excellent surgery was accomplished. Hernia was Chauliac's specialty, and in it his surgical judgment is admirable. Mondeville before his time did not hesitate to say that many operations for hernia were done not for the benefit of the patient, but for the benefit of the surgeon,—a very striking anticipation of remarks that one sometimes hears even at the present time. Chauliac discussed operations for hernia very conservatively. His rule was that a truss should be worn, and no operation attempted unless the patient's life was endangered by the hernia. It is to him that we owe the invention of a well-developed method of taxis, or manipulation of a hernia, to bring about its reduction, which was in use until the end of the nineteenth century. He suggested that trusses could not be made according to rule, but must be adapted to each individual case. He invented several forms of truss himself, and in general it may be said that his manipulative skill and his power to apply his mechanical principles to his work are the most characteristic of his qualities. This is particularly noteworthy in his chapters on fractures and dislocations, in which he suggests various methods of reduction and realizes very practically the mechanical difficulties that were to be encountered in the correction of the deformities due to these pathological conditions. In a word, we have a picture of the skilled surgeon of the modern time in this treatise of a fourteenth-century teacher of surgery.

Chauliac discusses six different operations for the radical cure of hernia. As Gurlt points out, he criticises them from the same standpoint as that of recent surgeons. The object of radical operations for hernia is to produce a strong, firm tissue support over the ring through which the cord passes, so that the intestines cannot descend through it. It is rather interesting to find that the surgeons of this time tried to obliterate the canal by means of the cautery, or inflammation producing agents, arsenic and the like, a practice that recalls some methods still used more or less irregularly. They also used gold wire, which was to be left in the tissues and is supposed to protect and strengthen the closure of the ring. At this time all these operations for the radical cure of hernia involved the sacrifice of the testicle because the old surgeons wanted to obliterate the ring completely, and thought this the easiest way. Chauliac discusses the operation in this respect and says that he has seen many cases in which men possessed of but one testicle have procreated, and this is a case where the lesser of two evils is to be chosen.

Of course Guy de Chauliac would not have been able to operate so freely on hernia and suggest, following his own experience, methods of treatment of penetrating wounds of the abdomen only that he had learned the lessons of antiseptic surgery which had been gradually developed among the great surgeons of Italy during the preceding century. The use of the stronger wines as a dressing together with insistence on the most absolute cleanliness of the surgeon before the operation, and careful details of cleanliness during the operation, made possible the performance of many methods of surgical intervention that would otherwise surely have been fatal. Probably nothing is harder to understand than that after these practical discoveries men should have lost sight of their significance, and after having carefully studied the viscous exudation which produces healthy natural union, should have come to the thought of the necessity for the formation of laudable pus before union might be expected. The mystery is really no greater than that of many another similar incident in human history, but it strikes us more forcibly because the discovery and gradual development of antiseptic surgery in our own time has meant so much for us. Already even in Chauliac's practice, however, some of the finer elements of the technique that made surgery antiseptic to a marked degree, if not positively aseptic in many cases, were not being emphasized as they were by his predecessors, and there was a beginning of surgical meddlesomeness reasserting itself.

It must not be thought, however, that it was only with the coarse applications of surgery that Chauliac concerned himself. He was very much interested in the surgical treatment of eye diseases and wrote a monograph on cataract, in which he gathers what was known before his time and discusses it in the light of his own experience. The writing of such a book is not so surprising at this time if we recall that in the preceding century the famous Pope John XXI, who had been a physician before he became Pope, and under the name of Peter of Spain was looked up to as one of the distinguished scientists of his time, had written a book on eye diseases that has recently been the subject of much attention.

Pope John had much to say of cataract, dividing it into traumatic and spontaneous, and suggesting the needling of cataract, a gold needle being used for the purpose. Chauliac's method of treating cataract was by depression. His care in the selection of patients may be appreciated from his treatment of John of Luxembourg, King of Bavaria, blind from cataract, who consulted Chauliac in 1336 while on a visit to Avignon with the King of France. Chauliac refused to operate, however, and put off the King with dietary regulations.

In the chapter on John of Arcoli and Medieval Dentistry we call attention to the fact that Chauliac discussed dental surgery briefly, yet with such practical detail as to show very clearly how much more was known about this specialty in his time than we have had any idea of until recent years. He recognized the dentists as specialists, calls them dentatores, but thinks that they should operate under the direction of a physician—hence the physician should know much about teeth and especially about their preservation. He enumerates instruments that dentists should have and shows very clearly that the specialty had reached a high state of development. A typical example of Chauliac's common sense and dependence on observation and not tradition is to be found in what he has to say with regard to methods of removing the teeth without the use of extracting instruments. It is characteristic of his method of dealing with traditional remedies, even though of long standing, that he brushes them aside with some impatience if they have not proved themselves in his experience.

"The ancients mention many medicaments, which draw out the teeth without iron instruments or which make them more easy to draw out; such as the milky juice of the tithymal with pyrethrum, the roots of the mulberry and caper, citrine arsenic, aqua fortis, the fat of forest frogs. But these remedies promise much and accomplish but little—mais ils donnent beaucoup de promesses, et peu, d'opérations."

It is no wonder that Chauliac has been enthusiastically praised. Nicaise has devoutly gathered many of these praises into a sheaf of eulogies at the end of his biography of the great French surgeon. He tells us that Fallopius compared him to Hippocrates. John Calvo of Valencia, who translated the "Great Surgery" into Spanish, looks upon him as the first law-giver of surgery. Freind, the great English physician, in 1725 called him the Prince of Surgeons. Ackermann said that Guy de Chauliac's text-book will take the place of all that has been written on the subject down to his time, so that even if all the other works had been lost his would replace them. Dezimeris, commenting on this, says that "if one should take this appreciation literally, this surgeon of the fourteenth century would be the first and, up to the present time, the only author who ever merited such an eulogy." "At least," he adds, "we cannot refuse him the distinction of having made a work infinitely superior to all those which appeared up to this time and even for a long time afterwards. Posterity rendered him this justice, for he was for three centuries the classic par excellence. He rendered the study easy and profitable, and all the foreign nations the tributaries of our country." Peyrihle considered Guy's "Surgery" as the most valuable and complete work of all those of the same kind that had been published since Hippocrates and added that the reading of it was still useful in his time in 1784. Bégin, in his work on Ambroise Paré, says "that Guy has written an immortal book to which are attached the destinies of French surgeons." Malgaigne, in his "History of Surgery," does not hesitate to say, "I do not fear to say that, Hippocrates alone excepted, there is not a single treatise on surgery,—Greek, Latin, or Arabic,—which I place above, or even on the same level with, this magnificent work, 'The Surgery of Guy de Chauliac.'" Daremberg said, "Guy seems to us a surgeon above all erudite, yet expert and without ever being rash. He knows, above all, how to choose what is best in everything." Verneuil, in his "Conférence sur Les Chirurgiens Érudits," says, "The services rendered by the 'Great Surgery' were immense; by it there commenced for France an era of splendor. It is with justice, then, that posterity has decreed to Guy de Chauliac the title of Father of French surgery."

The more one reads of Chauliac's work the less is one surprised at the estimation in which he has been held wherever known. It would not be hard to add a further sheaf of compliments to those collected by Nicaise. Modern writers on the history of medicine have all been enthusiastic in their admiration of him, just in proportion to the thoroughness of their acquaintance with him. Portal, in his "History of Anatomy and Surgery," says, "Finally, it may be averred that Guy de Chauliac said nearly everything which modern surgeons say, and that his work is of infinite price but unfortunately too little read, too little pondered." Malgaigne declares Chauliac's "Chirurgia Magna" to be "a masterpiece of learned and luminous writing." Professor Clifford Allbutt, the Regius Professor of Physic at the University of Cambridge, says of Chauliac's treatise: "This great work I have studied carefully and not without prejudice; yet I cannot wonder that Fallopius compared the author to Hippocrates or that John Freind calls him the Prince of Surgeons. It is rich, aphoristic, orderly, and precise."[25]

If to this account of his professional career it be added that Chauliac's personality is, if possible, more interesting than his surgical accomplishment, some idea of the significance of the life of the great father of modern surgery will be realized. We have already quoted the distinguished words of praise accorded him by Pope Clement VI. That they were well deserved, Chauliac's conduct during the black death which ravaged Avignon in 1348, shortly after his arrival in the Papal City, would have been sufficient of itself to attest. The occurrence of the plague in a city usually gave rise to an exhibition of the most arrant cowardice, and all who could, fled. In many of the European cities the physicians joined the fugitives, and the ailing were left to care for themselves. With a few notable exceptions, this was the case at Avignon, but Guy was among those who remained faithful to his duty and took on himself the self-sacrificing labor of caring for the sick, doubly harassing because so many of his brother physicians were absent. He denounces their conduct as shameful, yet does not boast of his own courage, but on the contrary says that he was in constant fear of the disease. Toward the end of the epidemic he was attacked by the plague and for a time his life was despaired of. Fortunately he recovered, to become the most influential among his colleagues, the most highly admired of the physicians of his generation, and the close personal friend of all the high ecclesiastics, who had witnessed his magnificent display of courage and of helpfulness for the plague-stricken during the epidemic. He wrote a very clear account of the epidemic, which leaves no doubt that it was true bubonic plague.

After this fine example, Chauliac's advice to brother physicians in the specialty of surgery carried added weight. In the Introductory chapter of his "Chirurgia Magna" he said:

"The surgeon should be learned, skilled, ingenious, and of good morals. Be bold in things that are sure, cautious in dangers; avoid evil cures and practices; be gracious to the sick, obliging to his colleagues, wise in his predictions. Be chaste, sober, pitiful, and merciful; not covetous nor extortionate of money; but let the recompense be moderate, according to the work, the means of the sick, the character of the issue or event, and its dignity."

No wonder that Malgaigne says of him, "Never since Hippocrates has medicine heard such language filled with so much nobility and so full of matter in so few words."

Chauliac was in every way worthy of his great contemporaries and the period in which his lot was cast. Ordinarily we are not apt to think of the early fourteenth century as an especially productive period in human history, but such it is. Dante's Divine Comedy was entirely written during Chauliac's life. Petrarch was born within a few years of Chauliac himself; Boccaccio in Italy, and Chaucer in England, wrote while Chauliac was still alive. Giotto did his great painting, and his pupils were laying the deep, firm foundations of modern art. Many of the great cathedrals were being finished. Most of the universities were in the first flush of their success as moulders of the human mind. There are few centuries in history that can show the existence of so many men whose work was to have an enduring influence for all the after time as this upon which Chauliac's career shed so bright a light. The preceding century had seen the origin of the universities and the rise of such supremely great men as Albertus Magnus, Roger Bacon, Thomas Aquinas, and the other famous scholars of the early days of the mendicant orders, and had made the intellectual mould of university training in which men's minds for seven centuries were to be formed, so that Chauliac, instead of being an unusual phenomenon is only a fitting expression of the interest of this time in everything, including the physical sciences and, above all, medicine and surgery.

For some people it may be a source of surprise that Chauliac should have had the intellectual training to enable him to accomplish such judicious work in his specialty. Many people will be apt to assume that he accomplished what he did in spite of his training, genius succeeding even in an unfavorable environment, and notwithstanding educational disadvantages. Those who would be satisfied with any such explanation, however, know nothing of the educational opportunities provided in the period of which Chauliac was the fruit. He is a typical university man of the beginning of the fourteenth century, and the universities must be given due credit for him. It is ordinarily assumed that the universities paid very little attention to science and that scientists would find practically nothing to satisfy in their curricula. Professor Huxley in his address on "Universities, Actual and Ideal," delivered as the Rectorial Address at Aberdeen University in 1874, declared that they were probably educating in the real sense of the word better than we do now. (See quotation in "The Medical School at Salerno.")

In the light of Chauliac's life it is indeed amusing to read the excursions of certain historians into the relationship of the Popes and the Church to science during the Middle Ages. Chauliac is typically representative of medieval science, a man who gave due weight to authority, yet tried everything by his own experience, and who sums up in himself such wonderful advance in surgery that during the last twenty years the students of the history of medicine have been more interested in him than in anyone who comes during the intervening six centuries. Chauliac, however, instead of meeting with any opposition, encountered encouragement, liberal patronage, generous interest, and even enjoyed the intimate friendship of the highest ecclesiastics and the Popes of his time. In every way his life may be taken as a type of what we have come to know about the Middle Ages, when we know them as we should, in the lives of the men who counted for most in them, and do not accept merely the broad generalizations which are always likely to be deceptive and which in the past have led men into the most absurd and ridiculous notions with regard to a wonderful period in human history.

That Guy de Chauliac was no narrow specialist is abundantly evident from his book, for while the "Great Surgery" treats of the science and art of surgery as its principal subject, there are remarks about nearly everything else relating to medicine, and most of them show a deep interest, a thorough familiarity, and an excellent judgment. Besides we have certain expressions with regard to intellectual matters generally which serve to show Guy as a profound thinker, who thoroughly appreciated just how accumulations of knowledge came to men and how far each generation or member of a generation should go and yet how limited must, after all, be the knowledge obtained by any one person. With regard to books, for instance, he said, "for everyone cannot have all the books, and even if he did have them it would be too tiresome to read them all and completely, and it would require a godlike memory to retain them all." He realized, however, that each generation, provided it took the opportunities offered it, was able to see a little bit farther than its predecessor, and the figure that he employs to express this is rather striking. "Sciences," he said, "are made by additions. It is quite impossible that the man who begins a science should finish it. We are like infants, clinging to the neck of a giant; for we can see all the giant sees and a little more."

One of the most interesting features of the history of Guy de Chauliac is the bibliography of his works which has been written by Nicaise. This is admirably complete, labored over with the devotion that characterized Nicaise's attitude of unstinted admiration for the subject. Altogether he has some sixty pages of a quarto volume with regard to the various editions of Guy's works.

The first manuscript edition of Guy de Chauliac was issued in 1363, the first printed edition in 1478. Even in the fourteenth century Guy's great work was translated into all the languages generally used in Europe. Nicaise succeeded in placing 34 complete manuscripts of the "Great Surgery": 22 of these are in Latin, 4 are in French, 3 are in English, 2 only in Provençal, though that was the language spoken in the region where much of Chauliac's life was passed, and one each in Italian, in Low Dutch, and in Hebrew. Of the English manuscripts, one is number twenty-five English of the Bibliothèque Nationale, Paris; a second is number 3666 English of the Sloane collection in the British Museum, and a third is in the Library of the University of Cambridge.[26]

Paulin Paris, probably one of the best of recent authorities on the age and significance of old manuscripts, says in the third volume of his "Manuscrits Français," page 346, "This manuscript [of Guy de Chauliac's "Great Surgery">[ was made, if not during the life, then certainly very shortly after the death of the author. It is one of the oldest that can be cited, and the fact that an English translation was made so near to the time of the original composition of the book attests the great reputation enjoyed by Guy de Chauliac at this time, and which posterity has fully confirmed."

The Sloane copy in the British Museum contains some medical recipes at the end by Francis Verney. It was probably written in the fifteenth century. Its title is:

"The inventorie or the collectorie in cirurgicale parte of medicine compiled and complete in the yere of our Lord 1363, with some additions of other doctours, necessary to the foresaid arte or crapte (crafte?)."[27]

What we find in the period of manuscripts, however, is as nothing compared to the prestige of Guy de Chauliac's work, once the age of printing began. Nicaise was able to find sixty different printed editions of the "Great Surgery." Nine others that are mentioned by authors have disappeared and apparently no copies of them are in existence. Besides there are sixty editions of portions of the work, of compendiums of it and commentaries on it. Altogether 129 editions are extant. Of these there are sixteen Latin editions, forty-three French, five Italian, four Low Dutch, five Catalan, and one English. Fourteen appeared in the fifteenth century, thirty-eight in the sixteenth century, and seventeen in the seventeenth century. The fourteen editions belonging to the incunabula of printing, issued, that is, before the end of the fifteenth century, show what lively interest there was in the French surgeon of the preceding century, since printing presses at this precious time were occupied only with the books that were considered indispensable for scholars. The first edition of the "Great Surgery" was printed in 1478 at Lyons. Printing had only been introduced there five years before. This first edition, primus primarius or editio princeps, was a French translation by Nicholas Panis. In 1480 an Italian edition was printed at Venice. The first Latin edition was printed also in Venice in 1490.

It would be only natural to expect that the successors of Guy de Chauliac, and especially those who had come personally in contact with him, would take advantage of his thorough work to make still further advances in surgery. As matter of fact, decadence in surgery is noted immediately after his death. Three men taught at the University of Montpellier at the end of the fourteenth and the beginning of the fifteenth century, John de Tornamira, Valesco de Taranta, and John Faucon. They cannot be compared, Gurlt says, with Guy de Chauliac, though they were physicians of reputation in their time. Faucon made a compendium of Guy's work for students. Somehow there seemed to be the impression that surgery had now reached a point of development beyond which it could not advance. Unfortunate political conditions, wars, the withdrawal of the Popes from Avignon to Rome, and other disturbances, distracted men's minds, and surgery deteriorated to a considerable extent, until the new spirit at the time of the Renaissance came to inject fresh life into it.

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XII
MEDIEVAL DENTISTRY—GIOVANNI OF ARCOLI

If there is one phase of our present-day medicine and surgery that most of us are likely to be quite sure is of very recent development it is dentistry. Probably most people would declare at once that they had every reason to think that the science and art of dentistry, as we have it now, developed for the first time in the world's history during the last generation or two. It is extremely interesting to realize then, in the light of this almost universal persuasion, founded to a great extent on the conviction that man is in process of evolution and that as a consequence we must surely be doing things now that men never did before, to find that dentistry, both as an art and science, is old; that it has developed at a number of times in the world's history, and that as fortunately for history its work was done mainly in indestructible materials, the teeth themselves and metal prosthetic apparatus, we have actual specimens of what was accomplished at a number of periods in the olden times. Surprising as it will seem to those who hear of it for the first time, dentistry reached high perfection even in what we know as ancient history. It is rather easy to trace scientific and craftsmanlike interest in it during the medieval period and in the magnificent development of surgery that came just at the end of the Middle Ages, dentistry shared to such degree that some of the text-books of the writers on surgery of this time furnish abundant evidence of anticipations of many of the supposedly most modern developments of dentistry.

There are a number of historical traditions with regard to dentistry and the treatment of the teeth in Egypt that can be traced back to good authorities in Egyptology of a generation or more ago, but it is rather hard to confirm the accounts we have by actual specimens; either none were found or for some reason those actually discovered are now not readily available for study. Among the Phenicians however, though we have good reasons to think that they learned their arts and crafts from the Egyptians, there is convincing evidence of a high development of dentistry. M. Ernest Renan, during an exploring expedition in Phenicia, found in the old necropolis at Sidon a set of teeth wired together, two of which were artificial. It was a striking example of bridgework, very well done, and may now be seen in the Louvre. It would be more than a little surprising, from what we know of the lack of inventiveness on the part of the Phenicians and their tendency to acquire their arts by imitation, if they had reached such a climax of invention by themselves. Since they adapted and adopted most of their arts and crafts from Egypt, with which they were in close commercial relations, it has been argued with some plausibility that the Egyptians may have had many modes of dental prosthesis, but removed all artificial teeth and dental appliances from the mouth of corpses before embalming them, in preparation for the next world, because there was some religious objection to such human handiwork being left in place for the hereafter, as they hoped for it.

There is a well-authenticated tradition of intimate intercourse in a commercial way between the old Etruscans who inhabited the Italian hill country and the Phenicians, so that it is no surprise to find that the oldest of Etruscan tombs contain some fine examples of bridgework. An improvement has come over Phenician work however, and bands of gold instead of wire are used for holding artificial teeth in place. Guerini, whose "History of Dentistry" is the standard work on the subject, on a commission from the Italian government, carefully studied these specimens of Etruscan dental work in the museums of Italy, and has made some interesting observations on them. In one specimen, which is especially notable, two incisor teeth are replaced by a single tooth from a calf. This was grooved in such a way as to make it seem like two separate teeth. Guerini suggests a very interesting and quite unexpected source for this. While examining the specimen he wondered where the old Etruscan dentist had obtained a calf's tooth without a trace of wear on it. He came to the conclusion that he must have cut into the gums of a young calf before the permanent tooth was erupted in order to get this structure absolutely unworn for his purpose. A number of examples of bridgework have been found in the old Etruscan tombs. The dates of their construction are probably not later than 500 b.c., and some of them are perhaps earlier than 700 b.c.

The Etruscans affected the old Romans in the matter of dentistry, so that it is easy to understand the passage in the "Laws of the Twelve Tables," issued about 450 b.c., which, while forbidding the burial of gold with corpses, made a special exception for such gold as was fastened to the teeth. Gold was rare at Rome, and care was exercised not to allow any unnecessary decrease of the visible supply almost in the same way as governments now protect their gold reserves. It may seem like comparing little things with great, but the underlying principle is the same. Hence this special law and its quite natural exception.

In Pope Julius' Museum in Rome there is a specimen of a gold cap made of two plates of gold riveted together and also riveted to bands of metal which were fastened around the neighboring teeth in order to hold the cap in place. This is from later Republican times at Rome. At the end of the Republic and the beginning of the Empire there appear to have been many forms of dental appliances. Martial says that the reason why one lady's teeth—whose name he does not conceal—are white and another's—name also given—were dark, was that the first one bought hers and the second still had her own. In another satiric poem he describes an elderly woman as so much frightened that when she ran away her teeth fell out, while her friends lost their false hair. Fillings of many kinds were used, dentrifices of nearly every kind were invented, and dentistry evidently reached a high stage of development, though we have nowhere a special name for dentist, and the work seems to have been done by physicians, who took this as a specialty.

While in the Middle Ages there was, owing to conditions, a loss of much of this knowledge of antiquity with regard to dentistry, or an obscuration of it, it never disappeared completely, and whenever men have written seriously about medicine, above all about surgery in relation to the face and the mouth, the teeth have come in for their share of scientific and practical consideration. Aëtius, the first important Christian writer on medicine and surgery, discusses, as we have seen in the sketch of him, the nutrition of the teeth, their nerves, "which came from the third pair and entered the teeth by a small hole existing at the end of the root," and other interesting details of anatomy and physiology. He knows much about the hygiene of the teeth, discusses extraction and the cure of fistula and other details. Paul of Ægina in the next century has much more, and while they both quote mainly from older authors there seems no doubt that they themselves had made not a few observations and had practical experience.

It was from these men that the Arabian physicians and surgeons obtained their traditions of medicine, and so it is not surprising to find that they discuss dental diseases and their treatment rationally and in considerable detail. Abulcasis particularly has much that is of significance and interest. We have pictures of two score of dental instruments that were used by them. The Arabs not only treated and filled carious teeth and even replaced those that were lost, but they also corrected deformities of the mouth and of the dental arches. Orthodontia is sometimes said to be of much later origin and to begin many centuries after Abulcasis' time, yet no one who knows of his work can speak of Orthodontia as an invention after him. In this, however, as in most of the departments of medicine and surgery, the Arabs were merely imitators, though probably they expanded somewhat the practical knowledge that had come to them.

When the great revival in surgery came in the twelfth and thirteenth centuries it is not surprising that there should also have been an important renewal of interest in dentistry. A detailed review of this would take us too far afield, but at least something may be said of two or three of the great representative surgical writers who touched on this specialty.

About the middle of the fourteenth century that prince of surgeons, and model of surgical writers, Guy de Chauliac, wrote his great text-book of surgery, "Le Grande Chirurgie." An extremely interesting feature of this work is to be found in the chapters that treat of diseases of the teeth. These are not very comprehensive, and are evidently not so much the result of his experience, as the fruit of his reading, yet they contain many practical valuable ideas that are supposed to be ever so much later than the middle of the fourteenth century. His anatomy and physiology at least are not without many errors. His rules for the preservation of the teeth show that the ordinary causes of dental decay were well recognized even as early as this. Emphasis was laid on not taking foods too hot or too cold, and above all not to follow either hot or cold food by something very different from it in temperature. The breaking of hard things with the teeth was recognized as one of the most frequent causes of such deterioration of the enamel as gives opportunity for the development of decay. The eating of sweets, and especially the sticky sweets—preserves and the like—was recognized as an important source of caries. The teeth were supposed to be cleaned frequently, and not to be cleaned too roughly, for this would do more harm than good. We find these rules repeated by succeeding writers on general surgery, who touch upon dentistry, or at least the care of the teeth, and they were not original with Guy de Chauliac, but part of the tradition of surgery.

As noted by Guerini in his "History of Dentistry," the translation of which was published under the auspices of the National Dental Association of the United States of America,[28] Chauliac recognized the dentists as specialists. Besides, it should be added, as is evident from his enumeration of the surgical instruments which he declares necessary for them, they were not as we might easily think in the modern time mere tooth pullers, but at least the best among them treated teeth as far as their limited knowledge and means at command enabled them to do so, and these means were much more elaborate than we have been led to think, and much more detailed than we have reason to know that they were at certain subsequent periods.

In fact, though Guy de Chauliac frankly confesses that he touches on the subject of dentistry only in order to complete his presentation of the subject of surgery and not because he has anything of his own to say with regard to the subject, there is much that is of present-day interest in his brief paragraphs. He observes that operations on the teeth are special and belong to the dentatores, or dentists, to whom doctors had given them over. He considers, however, that the operations in the mouth should be performed under the direction of a physician. It is in order to give physicians the general principles with which they may be able to judge of the advisability or necessity for dental operations that his short chapters are written. If their advice is to be of value, physicians should know the various methods of treatment suitable for dental diseases, including mouth washes, gargles, masticatories, anointments, rubbings, fumigations, cauterizations, fillings, filings, and the various manual operations. He says that the dentator must be provided with the appropriate instruments, among which he names scrapers, rasps, straight and curved spatumina, elevators, simple and with two branches, toothed tenacula, and many different forms of probes and canulas. He should also have small scalpels, tooth trephines, and files.

Chauliac is particularly emphatic in his insistence on not permitting alimentary materials to remain in cavities, and suggests that if cavities between the teeth tend to retain food material they should even be filed in such a way as to prevent these accumulations. His directions for cleansing the teeth were rather detailed. His favorite treatment for wounds was wine, and he knew that he succeeded by means of it in securing union by first intention. It is not surprising, then, to find that he recommends rinsing of the mouth with wine as a precaution against dental decay. A vinous decoction of wild mint and of pepper he considered particularly beneficial, though he thought that dentifrices, either powder or liquid, should also be used. He seems to recommend the powder dentifrices as more efficacious. His favorite prescription for a tooth powder, while more elaborate, resembles to such an extent, at least some, if not indeed most of those, that are used at the present time, that it seems worth while giving his directions for it. He took equal parts of cuttle bone, small white sea-shells, pumice stone, burnt stag's horn, nitre, alum, rock salt, burnt roots of iris, aristolochia, and reeds. All of these substances should be carefully reduced to powder and then mixed. His favorite liquid dentifrice contained the following ingredients,—half a pound each of sal ammoniac and rock salt, and a quarter of a pound of sacharin alum. All these were to be reduced to powder and placed in a glass alembic and dissolved. The teeth should be rubbed with it, using a little scarlet cloth for the purpose. Just why this particular color of cleansing cloth was recommended is not quite clear.

He recognized, however, that cleansing of the teeth properly often became impossible by any scrubbing method, no matter what the dentifrice used, because of the presence of what we call tartar and what he called hardened limosity or limyness (limosité endurcie). When that condition is present he suggests the use of rasps and spatumina and other instrumental means of removing the tartar.

Evidently he did not believe in the removal of the teeth unless this was absolutely necessary and no other method of treatment would avail to save the patient from continuous distress. He summarizes the authorities with regard to the extraction of teeth and the removal of dental fragments and roots. He evidently knew of the many methods suggested before his time of removing teeth without recourse to instrumental extraction. There were a number of applications to the gums that were claimed by older authors to remove the teeth without the need of metal instruments. We might expect that Chauliac would detect the fallacy with regard to these and expose it. He says that while much is claimed for these methods he has never seen them work in practice and he distrusts them entirely.

The most interesting phase of what Guy de Chauliac has to say with regard to dentistry is of course to be found in his paragraphs on the artificial replacement of lost teeth and the subject of dental prosthesis generally. When teeth become loose he advises that they be fastened to the healthy ones with a gold chain. Guerini suggests that he evidently means a gold wire. If the teeth fall out they may be replaced by the teeth of another person or with artificial teeth made from oxbone, which may be fixed in place by a fine metal ligature. He says that such teeth may be serviceable for a long while. This is a rather curt way of treating so large a subject as dental prosthesis, but it contains a lot of suggestive material. He was quoting mainly the Arabian authors, and especially Abulcasis and Ali Abbas and Rhazes, and these of course, as we have said, mentioned many methods of artificially replacing teeth as also of transplantation and of treatment of the deformities of the dental arches.

On the whole, however, it must be confessed that we have here in the middle of the fourteenth century a rather surprising anticipation of the knowledge of a special department of medicine which is usually considered to be distinctly modern, and indeed as having only attracted attention seriously in comparatively recent times.

After Guy de Chauliac the next important contributor to dentistry is Giovanni of Arcoli, often better known by his Latin name, Johannes Arculanus, who was a professor of medicine and surgery at Bologna and afterwards at Padua, just before and after the middle of the fifteenth century, and who died in 1484. He is famous principally for being the first we know who mentions the filling of teeth with gold.

It might possibly be suggested that coming at this time Arculanus should rather be reckoned as a Maker of Medicine in the Renaissance than as belonging to the Middle Ages and its influences. His education, however, was entirely completed before the earliest date at which the Renaissance movement is usually said to begin, that is with the fall of Constantinople in 1452, and he was dead before the other date, that of the discovery of America in 1492, which the Germans have in recent years come to set down as the end of the Middle Ages. Besides, what he has to say about dentistry occurs in typical medieval form. It is found in a commentary on Rhazes, written just about the middle of the fifteenth century. In the later true Renaissance such a commentary would have been on a Greek author. In his commentary Arculanus touches on most of the features of medicine and surgery from the standpoint of his own experience as well as from what he knows of the writings of his predecessors and contemporaries. With the rest he has a series of chapters on diseases of the teeth. Guerini in his "History of Dentistry" says that "this subject [dentistry] is treated rather fully, and with great accuracy." Even some short references to it will, I think, demonstrate this rather readily.[29]

Arculanus is particularly full in his directions for the preservation of the teeth. We are rather prone to think that prophylaxis is comparatively a modern idea, and that most of the principles of conservation of human tissues and the prevention of deterioration and disease are distinctly modern. It needs only a little consideration of Arculanus' instruction in the matter of the teeth, however, to undo any such false impression. For obvious reasons I prefer to quote Guerini's summation of this medieval student of dentistry's rules for dental hygiene:

"For the preservation of teeth—considered by him, quite rightly, a matter of great importance—Giovanni of Arcoli repeats the various counsels given on the subject by preceding writers, but he gives them as ten distinct canons or rules, creating in this way a kind of decalogue of dental hygiene. These rules are: (1) It is necessary to guard against the corruption of food and drink within the stomach; therefore, easily corruptible food—milk, salt fish, etc.—must not be partaken of, and after meals all excessive movement, running exercises, bathing, coitus, and other causes that impair the digestion, must also be avoided. (2) Everything must be avoided that may provoke vomiting. (3) Sweet and viscous food—such as dried figs, preserves made with honey, etc.—must not be partaken of. (4) Hard things must not be broken with the teeth. (5) All food, drink, and other substances that set the teeth on edge must be avoided. (6) Food that is too hot or too cold must be avoided, and especially the rapid succession of hot and cold, and vice versa. (7) Leeks must not be eaten, as such a food, by its own nature, is injurious to the teeth. (8) The teeth must be cleaned at once, after every meal, from the particles of food left in them; and for this purpose thin pieces of wood should be used, somewhat broad at the ends, but not sharp-pointed or edged; and preference should be given to small cypress twigs, to the wood of aloes, or pine, rosemary, or juniper and similar sorts of wood which are rather bitter and styptic; care must, however, be taken not to search too long in the dental interstices and not to injure the gums or shake the teeth. (9) After this it is necessary to rinse the mouth by using by preference a vinous decoction of sage, or one of cinnamon, mastich, gallia, moschata, cubeb, juniper seeds, root of cyperus, and rosemary leaves. (10) The teeth must be rubbed with suitable dentrifices before going to bed, or else in the morning before breakfast. Although Avicenna recommended various oils for this purpose, Giovanni of Arcoli appears very hostile to oleaginous frictions, because he considers them very injurious to the stomach. He observes, besides, that whilst moderate frictions of brief duration are helpful to the teeth, strengthen the gums, prevent the formation of tartar, and sweeten the breath, too rough or too prolonged rubbing is, on the contrary, harmful to the teeth, and makes them liable to many diseases."

All this is so modern in many ways that we might expect a detailed exact knowledge of the anatomy of the teeth and even something of their embryology from Arculanus. It must not be forgotten, however, that coming as he does before the Renaissance, the medical sciences in the true sense of the word are as yet unborn. Men are accumulating information for practical purposes but not for the classification and co-ordination that was to make possible the scientific development of their knowledge.

Giovanni of Arcoli's acquaintance with the anatomy of the teeth was rather sadly lacking. He does not know even with certainty the number of roots that the teeth have. This has been attributed to the fact that he obtained most of his information from books, and had not the time to verify descriptions that he had found. It has been argued from this that he was himself probably not a practical dentist, and turned to that specialty only as a portion of his work as a general surgeon, and that consequently he was not sufficiently interested to verify his statements. His chapters on dentistry would seem to bear out this conclusion to some extent, though the very fact that one who was himself not specially interested in dental surgery should have succeeded in gathering together so much that anticipates modern ideas in dentistry, is of itself a proof of how much knowledge of the subject there was available for a serious student of that time. The anatomy of the teeth continued to be rather vague until about the middle of the next century when Eustachius, whose investigations of the anatomy of the head have deservedly brought him fame and the attachment of his name to the Eustachian canal, wrote his "Libellus de Dentibus—Manual of the Teeth," which is quite full, accurate, and detailed. Very little has been added to the microscopic anatomy of the teeth since Eustachius' time. He had the advantage, of course, of being intimately in contact with the great group of Renaissance anatomists,—Vesalius, Columbus, Varolius, Fallopius, and the others, the great fathers of anatomy. Besides, his position as Papal Physician and Professor of Anatomy at the Papal Medical School at Rome gave him opportunities for original investigation, such as were not easily obtained elsewhere.

Arculanus can scarcely be blamed, therefore, for not having anticipated the Renaissance, and we must take him as merely the culmination of medieval knowledge with regard to anatomy and surgery. Medieval medical men did not have the time nor apparently the incentive to make formal medical science, though it must not be forgotten, as has been said, that they did use the knowledge they obtained by their own and others' observation to excellent advantage for the practical benefit of ailing humanity. The sciences related to medicine are conscious developments that follow the evolution of practical medicine, nor must it be forgotten that far from always serving as an auxiliary to applied medical science, often indeed in the history of medicine scientific pursuits have led men away into side issues from which they had to be brought back by some genius medical observer. As might be expected, then, it is with regard to the practical treatment and general consideration of ailments of the teeth that Giovanni of Arcoli is most interesting. In this some of his chapters contain a marvellous series of surprises.

Arculanus was probably born towards the end of the fourteenth century. The date of his death is variously placed as either 1460 or 1484, with the probability in favor of the former. From 1412 to 1427 he was professor at Bologna, where in accordance with the non-specializing tendencies of the time he did not occupy a single chair but several in succession. He seems first to have taught Logic, then Moral Philosophy, and finally Medicine. His reputation in medicine drew many students to the university, and his fame spread all over Italy. The rival University of Padua then secured him, and he seems to have been for some twenty years there. Later apparently he accepted a professor's chair at Ferrara, where the D'Estes were trying to bring their university into prominence. It was at Ferrara that he died. He was a man of wide reading, of extensive experience, both of men and medicine, and one of the scholars of his time. His works are, as we have said, mainly excerpts from earlier writers and particularly the Arabians, but they contain enough of hints drawn from his own observation and experience to make his work of great value.

While, as Gurlt remarks in his "History of Surgery," Arculanus' name is one of those scarcely known—he is usually considered just one of many obscure writers of the end of the Middle Ages—his writings deserve a better fate. They contain much that is interesting and a great deal that must have been of the highest practical value to his contemporaries. They attracted wide attention in his own and immediately succeeding generations. The proof of this is that they exist in a large number of manuscript copies. Just as soon as printing was introduced his books appeared in edition after edition. His "Practica" was printed in no less than seven editions in Venice. Three of them appeared before the end of the fifteenth century, which places them among the incunabula of printing.

Probably nothing in the history of human intellectual interest is more striking than the excellent judgment displayed by the editors who selected the works to be printed at this time. Very few of them were trivial or insignificant. Fewer still were idle speculations, and most of them were almost of classical import for literature and science. Four editions of this work were printed in Venice in the sixteenth century, one of them as late as 1560, when the work done by such men as Vesalius, Columbus, Eustachius, and Fallopius would seem to have made Arculanus out of date. The dates of the various editions are Venice, 1483, 1493, 1497, 1504, 1542, 1557, and 1560. Besides there was an edition printed at Basel in 1540.

Arculanus is said to have re-introduced the use of the seton, that is the method of producing intense counter-irritation by the introduction of some foreign body into an incision in the skin. We owe to him, too, according to Pagel in the chapters on medieval medicine in Puschmann's "Handbook of the History of Medicine," an excellent description of alcoholic insanity.

His directions for the treatment of conditions in the mouth and nose apart from the teeth are quite as explicit and practical, and in many ways quite as great an anticipation of some of our modern notions as what he has to say with regard to the teeth. For instance, in the treatment of polyps he says that they should be incised and cauterized. Soft polyps should be drawn out with a toothed tenaculum as far as can be without risk of breaking them off. The incision should be made at the root so that nothing or just as little as possible of the pathological structure be allowed to remain. It should be cut off with a fine scissors, or with a narrow file just small enough to permit its ingress into the nostrils, or with a scalpel without cutting edges on the sides, but only at its extremity, and this cutting edge should be broad and well sharpened. If there is danger of hemorrhage, or if there is fear of it, the instruments with which dissection is made should be fired (igniantur), that is, heated at least to a dull redness. Afterwards the stump, if any remains, should be touched with a hot iron or else with cauterizing agents so that as far as possible it should be obliterated.

After the operation a pledget of cotton dipped in the green ointment described by Rhazes should be placed in the nose. This pledget should have a string fastened to it, hanging from the nose in order that it may be easily removed. At times it may be necessary to touch the root of the polyp with a stylet on which cotton has been placed that has been dipped in aqua fortis (nitric acid). It is important that this cauterizing fluid should be rather strong so that after a certain number of touches a rather firm eschar is produced. In all these manipulations in the nose Arculanus recommends that the nose should be held well open by means of a nasal speculum. Pictures of all these instruments occur in his extant works, and indeed this constitutes one of their most interesting and valuable features. They are to be seen in Gurlt's "History of Surgery."

In some cases he had seen the polyp was so difficult to get at or was situated so far back in the nose that it could not be reached by means of a tenaculum or scissors, or even the special knife devised for that purpose. For these patients Arculanus describes an operation that is to be found in the older writers on surgery, Paul of Ægina (Æginetus), Avicenna, and some of the other Arabian surgeons. For this three horse-tail hairs are twisted together and knotted in three or four places, and one end is passed through the nostrils and out through the mouth. The ends of this are then pulled on backward and forward after the fashion of a saw. Arculanus remarks evidently with the air of a man who has tried it and not been satisfied that this operation is quite uncertain, and seems to depend a great deal on chance, and much reliance must not be placed on it. Arculanus suggests a substitute method by which latent polyps or occult polyps as he calls them may be removed.

There is scarcely an important disease for which Arculanus has not some interesting suggestions, and the more one reads of him the more is one surprised to find how many things that we might think of as coming into the purview of medicine long after his time or at least as having been neglected from the time of the Greeks almost down to our own time are here treated explicitly, definitely, and with excellent practical suggestions. He has a good deal to say with regard to the treatment of angina, which he calls synanche, or synanchia, or cynanche, or angina. Parasynanche is a synonymous term, but refers to a milder synanche. He distinguished four forms of it. In one called canine angina, because the patient's tongue hangs out of his mouth, somewhat the same as from an overheated dog in the summer time, while at the same time the mouth is held open and he draws his breath pantingly, Arculanus suggests an unfavorable prognosis, and would seem to refer to those cases of Ludwig's angina in which there is involvement of the tongue and in which our prognosis continues to be of the very worst even to our own day. At times the angina causes such swelling in the throat that the breathing is interfered with completely. For this Arculanus' master, Rhazes, advised tracheotomy. Arculanus himself, however, apparently hesitated about that.

It is not surprising, then, to find that Arculanus is very explicit in his treatment of affections of the uvula. He divides its affections into apostema, ulcus, putredo sive corrosio, et casus. Apostema was abscess, ulcus any rather deep erosion, putredo a gangrenous condition, and casus the fall of the uvula. This is the notorious falling of the soft palate which has always been in popular medical literature at least. Arculanus describes it as a preternatural elongation of the uvula which sometimes goes to such an extent as to make it resemble the tail of a mouse. For shorter elongations he suggests the cautery; for longer, excision followed by the cautery so that the greater portion of the extending part may be cut off. If people fear the knife he suggests following Rhazes, the application of an astringent powder directly to the part by blowing through a tube. His directions for the removal of the uvula are very definite. Seat the patient upon a stool in a bright light while an assistant holds the head; after the tongue has been firmly depressed by means of a speculum let the assistant hold this speculum in place. With the left hand then insert an instrument, a stilus, by which the uvula is pulled forward, and then remove the end of it by means of a heated knife or some other process of cauterization. The mouth should afterwards be washed out with fresh milk.

The application of a cauterizing solution by means of a cotton swab wrapped round the end of a sound may be of service in patients who refuse the actual cautery. To be successful the application must be firmly made and must be frequently repeated.

After this it is not surprising to find that Arculanus has very practical chapters on all the other ordinary surgical affections. Empyema is treated very thoroughly, liver abscess, ascites, which he warns must be emptied slowly, ileus especially when it reaches stercoraceous vomiting, and the various difficulties of urination, he divides them into dysuria, ischuria, and stranguria, are all discussed in quite modern fashion. He gives seven causes for difficulty of urination. One, some injury of the bladder; two, some lesion of the urethra; three, some pathological condition in the power to make the bladder contract; four, some injury of the muscle of the neck of the bladder; five, some pathological condition of the urine; six, some kidney trouble, and seven, some pathological condition of the general system. He takes up each one of these and discusses the various phases, causes, disposition, and predispositions that bring them about. One thing these men of the Middle Ages could do, they reasoned logically, they ordered what they had to say well, and they wrote it out straightforwardly.

That Arculanus' work with regard to dentistry was no mere chance and not solely theoretic can be understood very well from his predecessors, and that it formed a link in a continuous tradition which was well preserved we may judge from what is to be found in the writings of his great successor, Giovanni or John de Vigo, who is considered one of the great surgeons of the early Renaissance, and to whom we owe what is probably the earliest treatise on "Gun-shot Wounds." John of Vigo was a Papal physician and surgeon, generally considered one of the most distinguished members of the medical profession of his time. Two features of his writing on dental diseases deserve mention. He insists that abscesses of the gums shall be treated as other abscesses by being encouraged to come to maturity and then being opened. If they do not close promptly, an irritant Egyptian ointment containing verdigris and alum among other things should be applied to them. In the cure of old fistulous tracts near the teeth he employs not only this Egyptian ointment but also arsenic and corrosive sublimate. What he has to say with regard to the filling of the teeth is, however, most important. He says it with extreme brevity, but with the manner of a man thoroughly accustomed to doing it. "By means of a drill or file the putrefied or corroded part of the tooth should be completely removed. The cavity left should then be filled with gold leaf." It is evident that the members of the Papal court, the Cardinals and the Pope himself, had the advantage of rather good dentistry at John de Vigo's hands even as early as the beginning of the sixteenth century.

John de Vigo, however, is not medieval. He lived on into the sixteenth century and was influenced deeply by the Renaissance. He counts among the makers of modern medicine and surgery, as his authorship of the treatise on gun-shot wounds makes clear. He comes in a period that will be treated of in a later volume of this series on "Our Forefathers in Medicine."

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XIII
CUSANUS AND THE FIRST SUGGESTION OF LABORATORY METHODS IN MEDICINE

As illustrating how, as we know more about the details of medical history, the beginnings of medical science and medical practice are pushed back farther and farther, a discussion in the Berliner klinische Wochenschrift a dozen years ago is of interest. Professor Ernest von Leyden, in sketching the history of the taking of the pulse as an important aid in diagnostics, said that John Floyer was usually referred to as the man who introduced the practice of determining the pulse rate by means of the watch. His work was done about the beginning of the eighteenth century. Professor von Leyden suggested, however, that William Harvey, the English physiologist, to whom is usually attributed the discovery of the circulation of the blood, had emphasized the value of the pulse in medical diagnosis, and also suggested the use of the watch in counting the pulse. Professor Carl Binz, of the University of Bonn, commenting on these remarks of Professor von Leyden, called attention to the fact that more than a century before the birth of either of these men, even the earlier, to whom the careful measurement of the pulse rate is thus attributed as a discovery, a distinguished German churchman, who died shortly after the middle of the fifteenth century, had suggested a method of accurate estimation of the pulse that deserves a place in medical history.

This suggestion is so much in accord with modern demands for greater accuracy in diagnosis that it seems not inappropriate to talk of it as the first definite attempt at laboratory methods in the department of medicine. The maker of the suggestion, curiously enough, was not a practising physician, but a mathematician and scholar, Cardinal Nicholas of Cusa, who is known in history as Cusanus from the Latin name of the town Cues on the Moselle River, some twenty-five miles south of Trèves, where he was born. His family name, Nicholas Krebs, has been entirely lost sight of in the name derived from his native town, which is the only reason why most of the world knows anything about that town. Cardinal Cusanus suggested that in various forms of disease and at various times of life, as in childhood, boyhood, manhood, and old age, the pulse was very different. It would be extremely valuable to have some method of accurately estimating, measuring, and recording these differences for medical purposes. At that time watches had not yet been invented, and it would have been very difficult to have estimated the time by the clocks, for almost the only clocks in existence were those in the towers of the cathedrals and of the public buildings. The first watches, Nuremberg eggs, as they were called, were not made by Peter Henlein until well on into the next century. The only method of measuring time with any accuracy in private houses was the clepsydra or water-clock, which measured the time intervals by the flow of a definite amount of water. Cardinal Cusanus suggested then that the water-clock should be employed for estimating the pulse frequency. His idea was that the amount of water which flowed while a hundred beats of the pulse were counted, should be weighed, and this weight compared with that of the average weight of water which flowed while a hundred beats of the normal pulse of a number of individuals of the same age and constitution were being counted.

This was a very single and a very ingenious suggestion. We have no means of knowing now whether it was adopted to any extent or not. It may seem rather surprising that a cardinal should have been the one to make such a suggestion. Cusanus, however, was very much interested in mathematics and in the natural sciences, and we have many wonderful suggestions from his pen. He was the first, for instance, to suggest, more than a century before Copernicus, that the earth was not the centre of the universe, and that it would not be absolutely at rest or, as he said, devoid of all motion. His words are: "Terra igitur, quæ centrum esse nequit, motu omni carere non potest." He described very clearly how the earth moved round its own axis, and then he added, what cannot fail to be a surprising declaration for those in the modern times who think such an idea of much later origin, that he considered that the earth itself cannot be fixed, but moves as do the other stars in the heavens. The expression is so astonishing at that time in the world's history that it seems worth the while to give it in its original form, so that it may be seen clearly that it is not any subsequent far-fetched interpretation of his opinion, but the actual words themselves, that convey this idea. He said: "Consideravi quod terra ista non potest esse fixa, sed movetur ut aliæ stellæ."

How clearly Cusanus anticipated another phase of our modern views may be judged from what he has to say in "De Docta Ignorantia" with regard to the constitution of the sun. It is all the more surprising that he should by some form of intuition reach such a conclusion, for the ordinary sources of information with regard to the sun would not suggest such an expression except to a genius, whose intuition outran by far the knowledge of his time. The Cardinal said: "To a spectator on the surface of the sun the splendor which appears to us would be invisible, since it contains, as it were, an earth for its central mass, with a circumferential envelope of light and heat, and between the two an atmosphere of water and clouds and of ambient air." After reading that bit of precious astronomical science announced nearly five centuries ago, it is easy to understand how Copernicus could have anticipated other phases of our knowledge, as he did in his declarations that the figure of the earth is not a sphere, but is somewhat irregular, and that the orbit of the earth is not circular.

Cusanus was an extremely practical man, and was constantly looking for and devising methods of applying practical principles of science to ordinary life. As we shall see in discussing his suggestion for the estimation of the pulse rate later on, he made many other similar suggestions for diagnostic purposes in medicine, and set forth other applications of mathematics and mechanics to his generation.

Many of Cusanus' books have curiously modern names. He wrote, for instance, a series of mathematical treatises, in Latin of course, on "Geometric Transmutations," on "Arithmetical Complements," on "Mathematical Complements," on "Mathematical Perfection," and on "The Correction of the Calendar." In his time the calendar was in error by more than nine days, and Cusanus was one of those who aroused sufficient interest in the subject, so that in the next century the correction was actually made by the great Jesuit mathematician, Father Clavius. Perhaps the work of Cusanus that is best known is that "On Learned Ignorance—De Docta Ignorantia," in which the Cardinal points out how many things that educated people think they know are entirely wrong. It reminds one very much of Josh Billings's remark that it is not so much the ignorance of mankind that makes them ridiculous, as the knowing so many things that ain't so. It is from this work that the astronomical quotations which we have made are taken. The book that is of special interest to physicians is his dialogue "On Static Experiments," which he wrote in 1450, and which contains the following passages:

"Since the weight of the blood and the urine of a healthy and of a diseased man, of a young man and an old man, of a German and an African, is different for each individual, why would it not be a great benefit to the physician to have all of these various differences classified? For I think that a physician would make a truer judgment from the weight of the urine viewed in connection with its color than he could make from its color alone, which might be fallacious. So, also, weight might be used as a means of identifying the roots, the stems, the leaves, the fruits, the seeds, and the juice of plants if the various weights of all the plants were properly noted, together with their variety, according to locality. In this way the physician would appreciate their nature better by means of their weight than if he judged them by their taste alone. He might know, then, from a comparison of the weights of the plants and their various parts when compared with the weight of the blood and the urine, how to make an application and a dosage of drugs from the concordances and differences of the medicaments, and even might be able to make an excellent prognosis in the same way. Thus, from static experiments, he would approach by a more precise knowledge to every kind of information.

"Do you not think if you would permit the water from the narrow opening of a clepsydra [water-clock] to flow into a basin for as long as was necessary to count the pulse a hundred times in a healthy young man, and then do the same thing for an ailing young man, that there would be a noticeable difference between the weights of the water that would flow during the period? From the weight of the water, therefore, one would arrive at a better knowledge of the differences in the pulse of the young and the old, the healthy and the unhealthy, and so, also, as to information with regard to various diseases, since there would be one weight and, therefore, one pulse in one disease, and another weight and another pulse in another disease. In this way a better judgment of the differences in the pulse could be obtained than from the touch of the vein, just as more can be known from the urine about its weight than from its color alone.

"Just in the same way would it not be possible to make a more accurate judgment with regard to the breathing, if the inspirations and expirations were studied according to the weight of the water that passed during a certain interval? If, while water was flowing from a clepsydra, one were to count a hundred expirations in a boy, and then in an old man, of course, there would not be the same amount of water at the end of the enumeration. Then this same thing might be done for other ages and states of the body. As a consequence, when the physician once knew what the weight of water that represented the number of expirations of a healthy boy or youth, and then of an individual of the same age ill of some infirmity or other, there is no doubt that, by this observation, he will come to a knowledge of the health or illness and something about the case, and, perhaps, also with more certainty would be able to choose the remedy and the dose required. If he found in a healthy young man apparently the same weight as in an old and decrepit individual, he might readily be brought to the conclusion that the young man would surely die, and in this way have some evidence for his prognosis in the case. Besides, if in fevers, in the same way, careful studies were made of the differences in the weight of water for pulse and respiration in the warm and the cold paroxysms, would it not be possible thus to know the disease better and, perhaps, also get a more efficacious remedy?"

As will be seen from this passage, Cusanus had many more ideas than merely the accurate estimation of the pulse frequency when he suggested the use of the water-clock. Evidently the thought had come to him that the specific gravity of the substances, that is, their weight in comparison to the weight of water, might be valuable information. Before his time, physicians had depended only on the color and the taste of the urine for diagnostic purposes. He proposed that they should weigh it, and even suggested that they should weigh, also, the blood, I suppose in case of venesection, for comparison's sake. He also thought that the comparative weight of various roots, stems, leaves, juices of plants might give hints for the therapeutic uses of these substances. This is the sort of idea that we are apt to think of as typically modern. Specific gravities and atomic weights have been more than once supposed to represent laws in therapeutics, which so far, however, we have not succeeded in finding, but it is interesting to realize that it is nearly five hundred years since the first thought in this line was clearly expressed by a distinguished thinker and scientific writer.

There are many interesting expressions in Cusanus' writings which contradict most of the impressions commonly entertained with regard to the scholars of the Middle Ages. It is usually assumed that they did not think seriously, but speculatively, that they feared to think for themselves, neglected the study of nature around them, considered authority the important source of knowledge, and were as far as possible from the standpoint of modern scientific students and investigators. Here is a passage from Nicholas, on knowing and thinking, that might well have been written by a great intellectual man at any time in the world's history, and that could only emanate from a profound scholar at any time.

"To know and to think, to see the truth with the eye of the mind, is always a joy. The older a man grows the greater is the pleasure which it affords him, and the more he devotes himself to the search after truth, the stronger grows his desire of possessing it. As love is the life of the heart, so is the endeavor after knowledge and truth the life of the mind. In the midst of the movements of time, of the daily work of life, of its perplexities and contradictions, we should lift our gaze fearlessly to the clear vault of heaven, and seek ever to obtain a firmer grasp of and a keener insight into the origin of all goodness and beauty, the capacities of our own hearts and minds, the intellectual fruits of mankind throughout the centuries, and the wondrous works of nature around us; at the same time remembering always that in humility alone lies true greatness, and that knowledge and wisdom are alone profitable in so far as our lives are governed by them."

The career of Nicholas of Cusa is interesting, because it sums up so many movements, and, above all, educational currents in the fifteenth century. He was born in the first year of the century, and lived to be sixty-four. He was the son of a wine grower, and attracted the attention of his teachers because of his intellectual qualities. In spite of comparatively straitened circumstances, then, he was afforded the best opportunities of the time for education. He went first to the school of the Brethren of the Common Life at Deventer, the intellectual cradle of so many of the scholars of this century. Such men as Erasmus, Conrad Mutianus, Johann Sintheim, Hermann von dem Busche, whom Strauss calls "the missionary of human wisdom," and the teacher of most of these, Alexander Hegius, who has been termed the schoolmaster of Germany, with Nicholas of Cusa and Rudolph Agricola and others, who might readily be mentioned, are the fruits of the teaching of these schools of the Brethren of the Common Life, in one of which Thomas à Kempis, the author of "The Imitation of Christ," was, for seventy years out of his long life of ninety, a teacher.

Cusanus succeeded so well at school that he was later sent to the University of Heidelberg, and subsequently to Padua, where he took up the study of Roman law, receiving his doctorate at the age of twenty-three. This series of educational opportunities will be surprising only to those who do not know educational realities at the beginning of the fifteenth century. There has never been a time when a serious seeker after knowledge could find more inspiration. On his return to Germany, Father Krebs became canon of the cathedral in Coblenz. This gave him a modest income, and leisure for intellectual work which was eagerly employed. He was scarcely more than thirty when he was chosen as a delegate to the Council at Basel. After this he was made Archdeacon of the Cathedral of Lüttich, and from this time his rise in ecclesiastical preferment was rapid. He had attracted so much attention at the Council of Basel that he was chosen as a legate of the Pope for the bringing about certain reforms in Germany. Subsequently he was sent on ecclesiastical missions to the Netherlands, and even to Constantinople. At the early age of forty he was made a Cardinal. After this he was always considered as one of the most important consultors of the Papacy in all matters relating to Germany. During the last twenty-five years of his life in all the relations of the Holy See to Germany, appeal was constantly made to the wisdom, the experience, and the thoroughly conservative, yet foreseeing, judgment of this son of the people, whose education had lifted him up to be one of the leaders of men in Europe.

It was during this time that he wrote most of his books on mathematics, which have earned for him a prominent place in Cantor's "History of Mathematics," about a score of pages being devoted to his work. Much of his thinking was done while riding on horseback or in the rude vehicles of the day on the missions to which he was sent as Papal Legate. He is said to have worked out the formula for the cycloid curve while watching the path described by flies that had lighted on the wheels of his carriage, and were carried forward and around by them. His scientific books, though they included such startling anticipations of Copernicus' doctrines as we have already quoted (Copernicus did not publish the first sketch of his theory for more than a quarter of a century after Cusanus' death), far from disturbing his ecclesiastical advancement or injuring his career as a churchman, seem actually to have been considered as additional reasons for considering him worthy of confidence and consultation.

As the result of his careful studies of conditions in Germany, he realized very clearly how much of unfortunate influence the political status of the German people, with their many petty rulers and the hampering of development consequent upon the trivial rivalries, the constant bickerings, and the inordinate jealousies of these numerous princelings, had upon his native country. Accordingly, towards the end of his life he sketched what he thought would be the ideal political status for the German people. As in everything that he wrote, he went straight to the heart of the matter and, without mincing words, stated just exactly what he thought ought to be done. Considering that this scheme of Cusanus for the prosperity and right government of the German people was not accomplished until more than four centuries after his death, it is interesting, indeed, to realize how this clergyman of the middle of the fifteenth century should have come to any such thought. Nothing, however, makes it clearer than this, that it is not time that fosters thinking, but that great men at any time come to great thoughts. Cusanus wrote:

"The law and the kingdom should be placed under the protection of a single ruler or authority. The small separate governments of princes and counts consume a disproportionately large amount of revenue without furnishing any real security. For this reason we must have a single government, and for its support we must have a definite amount of the income from taxes and revenues yearly set aside by a representative parliament and before this parliament (reichstag) must be given every year a definite account of the money that was spent during the preceding year."

Cusanus' life and work stand, then, as a type of the accomplishment, the opportunities, the power of thought, the practical scholarship, the mathematical accuracy, the fine scientific foresight of a scholar of the fifteenth century. For us, in medicine, it is interesting indeed to realize that it is from a man of this kind that a great new departure in medicine with regard to the employment of exact methods of diagnosis had its first suggestion in modern times. The origin of that suggestion is typical. It has practically always been true that it was not the man who had exhausted, or thought that he had done so, all previous medical knowledge, who made advances in medicine for us. It has nearly always been a young man early in his career, and at a time when, as yet, his mind was not overloaded with the medical theories of his own time. Cusanus was probably not more than thirty when he made the suggestion which represents the first practical hint for the use of laboratory methods in modern medicine. It came out of his thoughtful consideration of medical problems rather than from a store of garnered information as to what others thought. It is a lesson in the precious value of breadth of education and serious training of mind for real progress at all times.

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XIV
BASIL VALENTINE, LAST OF THE ALCHEMISTS, FIRST OF THE CHEMISTS

"Fieri enim potest ut operator erret et a via regia deflectat, sed ut erret natura quando recte tractatur fieri non potest."

"For it is quite possible that the physician should err and be turned aside from the straight (royal) road, but that nature when she is rightly treated should err is quite impossible."

This is one of the preliminary maxims of a treatise on medicine written by a physician born not later than the first half of the fifteenth century, and who may have lived even somewhat earlier. We are so prone to think of the men of that time as utterly dependent on authority, not daring to follow their own observation, suspecting nature, and almost sure to be convinced that only by going counter to her could success in the treatment of disease be obtained, that it is a surprise to most people to find how completely the attitude of mind, that is supposed to be so typically modern in this regard, was anticipated full four centuries ago. There are other expressions of this same great physician and medical writer, Basil Valentine, which serve to show how faithfully he strove with the lights that he had to work out the treatment of patients, just as we do now, by trying to find out nature's way, so as to imitate her beneficent processes and purposes. It is quite clear that he is but one of many faithful, patient observers and experimenters—true scientists in the best sense of the word—who lived in all the centuries of the Middle Ages.

Speculations and experiments with regard to the elixir of life, the philosopher's stone, and the transmutation of metals, are presumed to have filled up all the serious interests of the alchemists, supposed to be almost the only scientists of those days. As a matter of fact, however, men were making original observations of profound significance, and these were considered so valuable by their contemporaries that, though printing had not yet been invented, even the immense labor involved in the manifold copying of large folio volumes by the slow hand process did not suffice to deter them from multiplying the writings of these men so numerously that they were preserved in many copies for future generations, until the printing press came to perpetuate them.

Of this there is abundant evidence in the preceding pages as regards medicine, and, above all, surgery, while a summary of accomplishments of workers in other departments will be found in Appendix II, "Science at the Medieval Universities."

At the beginning of the twentieth century, with some of the supposed foundations of modern chemistry crumbling to pieces under the influence of the peculiarly active light thrown upon our nineteenth century chemical theories by the discovery of radium, and our observations on radio-active elements generally, there is a reawakening of interest in some of the old-time chemical observers, whose work used to be laughed at as so unscientific, or, at most, but a caricature of real science, and whose theory of the transmutation of elements into one another was considered so absurd. It is interesting in the light of this to recall that the idea that the elementary substances were essentially distinct from each other, and that it would be impossible under any circumstances to convert one element into another, belongs entirely to the nineteenth century. Even so deeply scientific a mind as that of Newton, in the preceding century, could not bring itself to acknowledge the tradition, that came to be accepted subsequent to his time, of the absurdity of metallic transformation. On the contrary, he believed quite formally in transmutation as a basic chemical principle, and declared that it might be expected to occur at any time. He had seen specimens of gold ores in connection with metallic copper, and concluded that this was a manifestation of the natural transformation of one of these yellow metals into the other.

With the discovery that radium transforms itself into helium, and that, indeed, all the so-called radioactivities of the heavy metals are probably due to a natural transmutation process constantly at work, the ideas of the older chemists cease entirely to be a subject for amusement. The physical chemists of the present day are very ready to admit that the old teaching of the absolute independence of something over seventy elements is no longer tenable, except as a working hypothesis. The doctrine of "matter and form," taught for so many centuries by the scholastic philosophers, which proclaimed that all matter is composed of two principles, an underlying material substratum, and a dynamic or informing principle, has now more acknowledged verisimilitude, or lies at least closer to the generally accepted ideas of the most progressive scientists, than it has at any time for the last two or three centuries. Not only the great physicists, but also the great chemists, are speculating along lines that suggest the existence of but one form of matter, modified according to the energies that it possesses under a varying physical and chemical environment. This is, after all, only a restatement in modern times of the teaching of St. Thomas of Aquin, in the thirteenth century.

It is not surprising, then, that there should be a reawakening of interest in the lives of some of the men, who, dominated by some of the earlier scholastic ideas, by the tradition of the possibility of finding the philosopher's stone, which would transmute the baser metals into the precious metals, devoted themselves with quite as much zeal as any modern chemist to the observation of chemical phenomena. One of the most interesting of these—indeed, he might well be said to be the greatest of the alchemists—is the man whose only name that we know is that which appears on a series of manuscripts written in the High German dialect of the end of the fifteenth and the beginning of the sixteenth century. That name is Basil Valentine, and the writer, according to the best historical traditions, was a Benedictine monk. The name Basil Valentine may only have been a pseudonym, for it has been impossible to trace it among the records of the monasteries of the time. That the writer was a monk, however, there seems to be no room for doubt, for his writings give abundant evidence of it, and, besides, in printed form they began to have their vogue at a time when there was little likelihood of their being attributed to a monastic source, unless an indubitable tradition connected them with some monastery.

This Basil Valentine (to accept the only name we have) did so much for the science of the composition of substances that he eminently deserves the designation that has been given him of the last of the alchemists and the first of the chemists. There is practically a universal recognition of the fact now that he deserves also the title of the Founder of Pharmaceutical Chemistry, not only because of the value of the observations contained in his writings, but also because of the fact that they proved so suggestive to certain scientific geniuses during the century succeeding Valentine's life. Almost more than to have added to the precious heritage of knowledge for mankind, it is a boon for a scientific observer to have awakened the spirit of observation in others, and to be the founder of a new school of thought. This Basil Valentine undoubtedly did, and, in the Renaissance, the incentive from his writings for such men as Paracelsus is easy to appreciate.

Besides, his work furnishes evidence that the investigating spirit was abroad just when it is usually supposed not to have been, for the Thuringian monk surely did not do all his investigation alone, but must have owed, as well as given, many a suggestion to his contemporaries.

Some ten years ago, when Sir Michael Foster, professor of physiology in the University of Cambridge, England, was invited to deliver the Lane Lectures at the Cooper Medical College in San Francisco, he took for his subject "The History of Physiology." In the course of his lecture on "The Rise of Chemical Physiology" he began with the name of Basil Valentine, who first attracted men's attention to the many chemical substances around them that might be used in the treatment of disease, and said of him:

"He was one of the alchemists, but in addition to his inquiries into the properties of metals and his search for the philosopher's stone, he busied himself with the nature of drugs, vegetable and mineral, and with their action as remedies for disease. He was no anatomist, no physiologist, but rather what nowadays we should call a pharmacologist. He did not care for the problem of the body, all he sought to understand was how the constituents of the soil and of plants might be treated so as to be available for healing the sick and how they produced their effects. We apparently owe to him the introduction of many chemical substances, for instance of hydrochloric acid, which he prepared from oil and vitriol of salt, and of many vegetable drugs. And he was apparently the author of certain conceptions which, as we shall see, played an important part in the development of chemistry and of physiology. To him, it seems, we owe the idea of the three 'elements,' as they were and have been called, replacing the old idea of the ancients of the four elements—earth, air, fire, and water. It must be remembered, however, that both in the ancient and the new idea the word 'element' was not intended to mean that which it means to us now, a fundamental unit of matter, but a general quality or property of matter. The three elements of Valentine were: (1) sulphur, or that which is combustible, which is changed or destroyed, or which at all events disappears during burning or combustion; (2) mercury, that which temporarily disappears during burning or combustion, which is dissociated in the burning from the body burnt, but which may be recovered, that is to say, that which is volatile, and (3) salt, that which is fixed, the residue or ash which remains after burning."

It is a little bit hard in our time for most people to understand just how such a development of thoroughly scientific chemical notions, with investigations for their practical application, should have come before the end of the Middle Ages. This difficulty of understanding, however, we are coming to realize in recent years, is entirely due to our ignorance of the period. We have known little or nothing about the science of the Middle Ages, because it was hidden away in rare old books, in rather difficult Latin, not easy to get at, and still less easy to understand always, and we have been prone to conclude that since we knew nothing about it, there must have been nothing. Just inasmuch as we have learned something definite about the medieval scholars, our admiration has increased. Professor Clifford Allbutt, the Regius Professor of Medicine at the University of Cambridge, in his Harveian Oration, delivered before the Royal College of Physicians in 1900, on "Science and Medieval Thought" (London, 1901), declared that "the schoolmen, in digging for treasure, cultivated the field of knowledge even for Galileo and Harvey, for Newton and Darwin." He might have added that they had laid foundations in all our modern sciences, in chemistry quite as well as in astronomy, physiology, and the medical sciences, in mathematics and botany.

In chemistry the advances made during the thirteenth, fourteenth, and fifteenth centuries were, perhaps, even more noteworthy than those in any other department of science. Albertus Magnus, who taught at Paris, wrote no less than sixteen treatises on chemical subjects, and, notwithstanding the fact that he was a theologian as well as a scientist, and that his printed works fill some fifteen folio volumes, he somehow found the time to make many observations for himself, and performed numberless experiments in order to clear up doubts. The larger histories of chemistry accord him his proper place, and hail him as a great founder in chemistry, and a pioneer in original investigation.

Even St. Thomas of Aquin, much as he was occupied with theology and philosophy, found some time to devote to chemical questions. After all, this is only what might have been expected of the favorite pupil of Albertus Magnus. Three treatises on chemical subjects from Aquinas' pen have been preserved for us, and it is to him that we are said to owe the use, in the Western world at least, of the word amalgam, which he first employed in describing various chemical methods of metallic combination with mercury that were discovered in the search for the genuine transmutation of metals.

Albertus Magnus' other great scientific pupil, Roger Bacon, the English Franciscan friar, followed more closely in the scientific ways of his great master, devoting himself almost entirely to the physical sciences. Altogether he wrote some eighteen treatises on chemical subjects. For a long time it was considered that he was the inventor of gunpowder, though this is now known to have been introduced into Europe by the Arabs. Roger Bacon studied gunpowder and various other explosive combinations in considerable detail, and it is for this reason that he obtained the undeserved reputation of being an original discoverer in this line. How well he realized how much might be accomplished by means of the energy stored up in explosives, can, perhaps, be best appreciated from the fact that he suggested that boats would go along the rivers and across seas without either sails or oars, and that carriages would go along the streets without horse or man power. He considered that man would eventually invent a method of harnessing these explosive mixtures, and of utilizing their energies for his purposes without danger. It is curiously interesting to find, as we begin the twentieth century, and gasolene is so commonly used for the driving of automobiles and motor boats, and is being introduced even into heavier transportation as the most available source of energy for suburban traffic, at least, that this generation should only be fulfilling the idea of the old Franciscan friar of the thirteenth century, who prophesied that in explosives there was the secret of eventually manageable energy for transportation purposes.

Succeeding centuries were not as fruitful in great scientists as the thirteenth, and yet, in the second half of the thirteenth, there was a Pope, John XXI, who had been a physician and professor of medicine before his election to the Papacy, three of whose scientific treatises—one on the transmutation of metals, which he considers an impossibility, at least as far as the manufacture of gold and silver was concerned; a treatise on diseases of the eyes, to which good authorities have not hesitated to give lavish praise for its practical value, considering the conditions in which it was written; and, finally, his treatise on the preservation of the health, written when he was himself over eighty years of age—are all considered by good authorities as worthy of the best scientific spirit of the time.

During the fourteenth century, Arnold of Villanova, the inventor of nitric acid, and the two Hollanduses, kept up the tradition of original investigation in chemistry. Altogether there are some dozen treatises from these three men on chemical subjects. The Hollanduses particularly did their work in a spirit of thoroughly frank, original investigation. They were more interested in minerals than in any other class of substances, but did not waste much time on the question of transmutation of metals. Professor Thompson, the professor of chemistry at Edinburgh, said, in his "History of Chemistry," many years ago, that the Hollanduses give very clear descriptions of their processes of treating minerals in investigating their composition, and these serve to show that their knowledge was by no means entirely theoretical, or acquired only from books.

It is not surprising, then, to have a great investigating pharmacologist come along sometime about the beginning of the fifteenth century, when, according to the best authorities, Basil Valentine was born. From traditions he seems to have had a rather long life, and his years run nearly parallel with his century. His career is a typical example of the personally obscure and intellectually brilliant lives which the old monks lived. Probably in nothing have recent generations been more deceived in historical matters than in their estimation of the intellectual attainments and accomplishment of the old monks. The more that we know of them, not from second-hand authorities, but from their own books and from what they accomplished in art and architecture, in agriculture, in science of all kinds, the more do we realize what busy men they were, and appreciate what genius they often brought to the solution of great problems. We have had much negative pseudo-information brought together with the definite purpose of discrediting monasticism, and now that positive information is gradually being accumulated, it is almost a shock to find how different are the realities of the story of the intellectual life during the Middle Ages from what many writers had pictured them.

To those who may be surprised that a man who did great things in medicine should have lived during the fifteenth century, it may be well to recall the names and a little of the accomplishment of the men of this period, who were Basil Valentine's contemporaries, at least in the sense that some portion of their lives and influence was coeval with his. Before the end of this century Columbus had discovered America, and by no happy accident, for many men of his generation did correspondingly great work. Cardinal Nicholas of Cusa had developed mathematics and applied mathematical ideas to the heavens, so that he could announce the conclusion that the earth was a star, like the other stars, and moved in the heavens as they do. Contemporary with Cusanus was Regiomontanus, who has been proclaimed the father of modern astronomy, and a distinguished mathematician. Toscanelli, the Florentine astronomer, whose years run almost parallel with those of the fifteenth century, did fine scholarly work, which deeply influenced Columbus and the great navigators of the time. The universities in Italy were attracting students from all over Europe, and such men as Linacre and Dr. Caius went down there from England. Raphael was but a young man at the end of the century, but he had done some noteworthy painting before it closed. Leonardo da Vinci was born just about the middle of the century, and did some marvellous work before the end of that century. Michael Angelo was only twenty-five at the close of the century, but he, too, did fine work, even at this early age. Among the other great Italian painters of this century are Fra Angelico, Perugino, Raphael's master, Pinturicchio, Signorelli, the pupil of his uncle, Vasari, almost as distinguished, Botticelli, Titian, and very many others, who would have been famous leaders in art in any other but this supremely great period.

It was not only in Italy, however, that there was a wonderful outburst of genius at this time, for Germany also saw the rise of a number of great men during this period. Jacob Wimpheling, the "Schoolmaster of Germany," as he has been called, whose educational work did much to determine the character of German education for two centuries, was born in 1450. Rudolph Agricola, who influenced the intellectual Europe of this time deeply, was born in 1443. Erasmus, one of the greatest of scholars, of teachers, and of controversialists, was born in 1467. Johann Reuchlin, the great linguist, who, next to Erasmus, is the most important character in the German Renaissance, was born in 1455. Then there was Sebastian Brant, the author of "The Ship of Fools," and Alexander Hegius, both of this same period. The most influential of them all, Thomas à Kempis, who died in 1471, and whose little book, "The Following of Christ," has influenced every generation deeply ever since, was probably a close contemporary of Basil Valentine. When one knows what European, and especially German scholars, were accomplishing at this time, no room is left for surprise that Basil Valentine should have lived and done work in medicine at this period that was to influence deeply the after history of medicine.

Most of what Basil Valentine did was accomplished in the first half of the fifteenth century. Coming, as he did, before the invention of printing, when the spirit of tradition was more rife and dominating than it has been since, it is almost needless to say that there are many curious legends associated with his name. Two centuries before his time, Roger Bacon, doing his work in England, had succeeded in attracting so much attention even from the common people, because of his wonderful scientific discoveries, that his name became a byword, and many strange magical feats were attributed to him. Friar Bacon was the great wizard, even in the plays of the Elizabethan period. A number of the same sort of myths attached themselves to the Benedictine monk of the fifteenth century. He was proclaimed in popular story to have been a wonderful magician. Even his manuscript, it was said, had not been published directly, but had been hidden in a pillar in the church attached to his monastery, and had been discovered there after the splitting open of the pillar by a bolt of lightning from heaven. It is the extension of this tradition that has sometimes led to the assumption that Valentine lived in an earlier century, some even going so far as to say that he, too, like Roger Bacon, was a product of the thirteenth century. It seems reasonably possible, however, to separate the traditional from what is actual in his existence, and thus to obtain some idea at least of his work, if not of the details of his life. The internal evidence from his works enables the historian of science to place his writing within half a century of the discovery of America.

One of the myths that have gathered around the name of Basil Valentine, because it has become a commonplace in philology, has probably made him more generally known than any of his actual discoveries. In one of the most popular of the old-fashioned text-books of chemistry in use about half a century ago, in the chapter on antimony, there was a story that students, if I may judge from my own experience, never forgot. It was said that Basil Valentine, a monk of the Middle Ages, was the discoverer of this substance. After having experimented with it in a number of ways, he threw some of it out of his laboratory one day when the swine of the monastery, finding it, proceeded to gobble it up, together with some other refuse. Just when they were finishing it, the monk discovered what they were doing. He feared the worst from it, but took the occasion to observe the effect upon the swine very carefully. He found that, after a preliminary period of digestive disturbance, these swine developed an enormous appetite, and became fatter than any of the others. This seemed a rather desirable result, and Basil Valentine, ever on the search for the practical, thought that he might use the remedy to good purpose on the members of the community. Some of the monks in the monastery were of rather frail health and delicate constitution, and most of them were rather thin, and he thought that the putting on of a little fat, provided it could be accomplished without infringement of the rule, might be a good thing for them. Accordingly, he administered, surreptitiously, some of the salts of antimony, with which he was experimenting, in the food served to these monks. The result, however, was not so favorable as in the case of the hogs. Indeed, according to one, though less authentic, version of the story, some of the poor monks, the unconscious subjects of the experiment, perished as the result of the ingestion of the antimonial compounds. According to the better version, they suffered only the usual unpleasant consequences of taking antimony, which are, however, quite enough for a fitting climax to the story. Basil Valentine called the new substance which he had discovered antimony, that is, opposed to monks. It might be good for hogs, but it was a form of monks' bane, as it were.[30]

Unfortunately for most of the good stories of history, modern criticism has nearly always failed to find any authentic basis for them, and they have had to go the way of the legends of Washington's hatchet and Tell's apple. We are sorry to say that that seems to be true also of this particular story. Antimony, the word, is very probably derived from certain dialectic forms of the Greek word for the metal, and the name is no more derived from anti and monachus than it is from anti and monos (opposed to single existence), another fictitious derivation that has been suggested, and one whose etymological value is supposed to consist in the fact that antimony is practically never found alone in nature.

Notwithstanding the apparent cloud of unfounded traditions that are associated with his name, there can be no doubt at all of the fact that Valentinus—to give him the Latin name by which he is commonly designated in foreign literatures—was one of the great geniuses, who, working in obscurity, make precious steps into the unknown that enable humanity after them to see things more clearly than ever before. There are definite historical grounds for placing Basil Valentine as the first of the series of careful observers who differentiated chemistry from the old alchemy and applied its precious treasures of information to the uses of medicine. It is said to have been because of the study of Basil Valentine's work that Paracelsus broke away from the Galenic traditions, so supreme in medicine up to his time, and began our modern pharmaceutics. Following Paracelsus came Van Helmont, the father of modern medical chemistry, and these three did more than any others to enlarge the scope of medication and to make observation rather than authority the most important criterion of truth in medicine. Indeed, the work of this trio of men of the fifteenth and sixteenth centuries—the Renaissance in medicine as in art—dominated medical treatment, or at least the department of pharmaceutics, down almost to our own day, and their influence is still felt in drug-giving.

While we do not know the absolute data of either the birth or the death of Basil Valentine and are not sure of the exact period even in which he lived and did his work, we are sure that a great original observer about the time of the invention of printing studied mercury and sulphur and various salts of the metals, and above all introduced antimony to the notice of the scientific world, and especially to the favor of practitioners of medicine. His book, "The Triumphal Chariot of Antimony," is full of conclusions not quite justified by his premises nor by his observations. There is no doubt, however, that the observational method which he employed furnished an immense amount of knowledge, and formed the basis of the method of investigation by which the chemical side of medicine was to develop during the next two or three centuries. Great harm was done by the abuse of antimony, but then great harm is done by the abuse of anything, no matter how good it may be. For a time it came to be the most important drug in medicine and was only replaced by venesection.

The fact of the matter is that doctors were looking for effects from their drugs, and antimony is, above all things, effective. Patients, too, wished to see the effect of the medicines they took. They do so even yet, and when antimony was administered there was no doubt about its working.

The most interesting of Basil Valentine's books, and the one which has had the most enduring influence, is undoubtedly "The Triumphal Chariot of Antimony."[31] It has been translated and has had a wide vogue in every language of modern Europe. Its recommendation of antimony had such an effect upon medical practice that it continued to be the most important drug in the pharmacopœia down almost to the middle of the nineteenth century. If any proof were needed that Basil Valentine or that the author of the books that go under the name was a monk it would be found in the introduction to this volume, which not only states that fact very clearly, but also in doing so makes use of language that shows the writer to have been deeply imbued with the old monastic spirit. I quote the first paragraph of this introduction because it emphasizes this. The quotation is taken from the English translation of the work as published in London in 1678. Curiously enough, seeing the obscurity surrounding Valentine himself, we do not know for sure who made the translation. The translator apologizes somewhat for the deeply religious spirit of the book, but considers that he was not justified in eliminating any of this. The paragraph is left in the quaint, old-fashioned form so eminently suited to the thoughts of the old master, and the spelling and use of capitals is not changed.

"Basil Valentine: His Triumphant Chariot of Antimony.—Since I, Basil Valentine, by Religious Vows am bound to live according to the order of St. Benedict and that requires another manner of Spirit of Holiness than the common state of Mortals exercised in the profane business of this World; I thought it my duty before all things, in the beginning of this little book, to declare what is necessary to be known by the pious Spagyrist [old-time name for medical chemist], inflamed with an ardent desire of this Art, as what he ought to do, and whereunto to direct his striving, that he may lay such foundations of the whole matter as may be stable; lest his Building, shaken with the Winds, happen to fall, and the whole Edifice to be involved in shameful Ruine which otherwise being founded on more firm and solid principles, might have continued for a long series of time. Which Admonition I judged was, is and always will be a necessary part of my religious Office; especially since we must all die, and no one of us which are now, whether high or low, shall long be seen among the number of men. For it concerns me to recommend these Meditations of Mortality to Posterity, leaving them behind me, not only that honor may be given to the Divine Majesty, but also that men may obey him sincerely in all things.

"In this my meditation I found that there were five principal heads, chiefly to be considered by the wise and prudent spectators of our Wisdom and Art. The first of which is Invocation of God. The second, Contemplation of Nature. The third, True Preparation. The fourth, the Way of Using. The fifth, Utility and Fruit. For he who regards not these, shall never obtain place among true Chymists, or fill up the number of perfect Spagyrists. Therefore, touching these five heads, we shall here following treat and so far declare them, as that the general Work may be brought to light and perfected by an intent and studious Operator."

This book, though the title might seem to indicate it, is not devoted entirely to the study of antimony, but contains many important additions to the chemistry of the time. For instance, Basil Valentine explains in this work how what he calls the spirit of salt might be obtained. He succeeded in manufacturing this material by treating common salt with oil of vitriol and heat. From the description of the uses to which he put the end product of his chemical manipulation, it is evident that under the name of spirit of salt he is describing what we now know as hydrochloric acid. This is said to be the first definite mention of it in the history of science, and the method suggested for its preparation is not very different from that employed even at the present time. He also suggests in his volume how alcohol may be obtained in high strengths. He distilled the spirit obtained from wine over carbonate of potassium, and thus succeeded in depriving it of a great proportion of its water. We have said that he was deeply interested in the philosopher's stone. Naturally this turned his attention to the study of metals, and so it is not surprising to find that he succeeded in formulating a method by which metallic copper could be obtained. The material used for the purpose was copper pyrites, which was changed to an impure sulphate of copper by the action of oil of vitriol and moist air. The sulphate of copper occurred in solution, and the copper could be precipitated from it by plunging an iron bar into it. Basil Valentine recognized the presence of this peculiar yellow metal, and studied some of its qualities. He does not seem to have been quite sure, however, whether the phenomenon that he witnessed was not really a transmutation of at least some of the iron into copper as a consequence of the other chemicals present. There are some observations on chemical physiology, and especially with regard to respiration, in the book on antimony which show their author to have anticipated the true explanation of the theory of respiration. He states that animals breathe because air is needed to support their life, and that all the animals exhibit the phenomenon of respiration. He even insists that the fishes, though living in water, breathe air, and he adduces in support of this idea the fact that whenever a river is entirely frozen the fishes die. The reason for this being, according to this old-time physiological chemist, not that the fishes are frozen to death, but that they are not able to obtain air in the ice as they did in the water, and consequently perish.

There are many testimonials to the practical character of all his knowledge and his desire to apply it for the benefit of humanity. The old monk could not repress the expression of his impatience with physicians who gave to patients for "diseases of which they knew little, remedies of which they knew less." For him it was an unpardonable sin for a physician not to have faithfully studied the various mixtures that he prescribed for his patients, and not to know not only their appearance and taste and effect, but also the limits of their application. Considering that at the present time it is a frequent source of complaint that physicians often prescribe remedies with even whose physical appearance they are not familiar and whose composition is often quite unknown to them, this complaint of the old-time chemist alchemist will be all the more interesting for the modern physician. It is evident that when Basil Valentine allows his ire to get the better of him it is because of his indignation over the quacks who were abusing medicine and patients in his time, as they have ever since. There is a curious bit of aspersion on mere book learning in the passage that has a distinctly modern ring, and one feels the truth of Russell Lowell's expression that to read a classic, no matter how antique, is like reading a commentary on the morning paper, so up-to-date does genius ever remain:

"And whensoever I shall have occasion to contend in the School with such a Doctor, who knows not how himself to prepare his own medicines, but commits that business to another, I am sure I shall obtain the Palm from him; For indeed that good man knows not what medicines he prescribes to the sick; whether the color of them be white, black, gray, or blew (sic), he cannot tell; nor doth this wretched man know whether the medicine he gives be dry or hot, cold or humid; but he only knows that he found it so written in his books, and then pretends to knowledge or as it were Possession by Prescription of a very long time; yet he desires to further information. Here again let it be lawful to exclaim, Good God, to what a state is the matter brought! what Goodness of Minde is in these men! what care do they take of the sick! Wo, wo to them! in the day of Judgement they will find the fruit of their Ignorance and Rashness, then they will see him whom they pierced, when they neglected their Neighbor, sought after money and nothing else; whereas were they cordial in their profession, they would spend Nights and Days in Labour that they might become more learned in their Art, whence more certain health would accrew to the sick with their estimation and greater glory to themselves. But since Labour is tedious to them they commit the matter to chance, and being secure of their Honour, and content with their Fame, they (like Brawlers) defend themselves with a certain garrulity, without any respect had to Confidence or Truth."

Perhaps one of the reasons why Valentine's book has been of such enduring interest is that it is written in an eminently human vein and out of a lively imagination. It is full of figures relating to many other things besides chemistry, which serve to show how deeply this investigating observer was attentive to all the problems of life around him. For instance, when he wants to describe the affinity that exists between many substances in chemistry, and which makes it impossible for them not to be attracted to one another, he takes a figure from the attractions that he sees exist among men and women. It is curious to find affinities discussed in our modern sense so long ago. There are some paragraphs with regard to the influence of the passion of love that one might think rather a quotation from an old-time sermon than from a great ground-breaking book in the science of chemistry.

"Love leaves nothing entire or sound in man; it impedes his sleep, he cannot rest either day or night; it takes off his appetite that he hath no disposition either to meat or drink by reason of the continual torments of his heart and mind. It deprives him of all Providence, hence he neglects his affairs, vocation, and business. He minds neither study, labor, nor prayer; casts away all thoughts of anything but the body beloved; this is his study, this his most vain occupation. If to lovers the success be not answerable to their wish, or so soon and prosperously as they desire, how many melancholies henceforth arise, with griefs and sadness, with which they pine away and wax so lean as they have scarcely any flesh cleaving to the bones. Yea, at last they lose the life itself, as may be proved by many examples! for such men (which is an horrible thing to think of) slight and neglect all perils and detriments, both of the body and life, and of the soul and eternal salvation."

It is evident that human nature is not different in our sophisticated twentieth century from that which this observant old monk saw around him in the fifteenth. He continues:

"How many testimonies of this violence which is in love, are daily found? for it not only inflames the younger sort, but it so far exaggerates some persons far gone in years as through the burning heat thereof, they are almost mad. Natural diseases are for the most part governed by the complexion of man and therefore invade some more fiercely, others more gently; but Love, without distinction of poor or rich, young or old, seizeth all, and having seized so blinds them as forgetting all rules of reason, they neither see nor hear any snare."

But then the old monk thinks that he has said enough about this rather foreign subject, and apologizes for his digression in another paragraph that should remove any lingering doubt there might be with regard to the genuineness of his monastic character. At the end of the passage he makes the application in a very few words. The personal element in his confession is so naïve and so simply straightforward that instead of seeming to be the result of conceit, which would surely have repelled the reader, it rather attracts and enhances his kindly feeling for its author. The paragraph would remind one in certain ways of that personal element that was to become more popular in literature after Montaigne in the next century made it rather the fashion.

"But of these enough; for it becomes not a religious man to insist too long upon these cogitations, or to give place to such a flame in his heart. Hitherto (without boasting I speak it) I have throughout the whole course of my life kept myself safe and free from it, and I pray and invoke God to vouchsafe me his Grace that I may keep holy and inviolate the faith which I have sworn, and live contented with my spiritual spouse, the Holy Catholick Church. For no other reason have I alleged these than that I might express the love with which all tinctures ought to be moved towards metals, if ever they be admitted by them into true friendship, and by love, which permeates the inmost parts, be converted into a better state."

The application of the figure at the end of his long digression is characteristic of the period in which he wrote, as also to a considerable extent of the German literary methods of the time.

In this volume on the use of antimony there are in most of the editions certain biographical notes which have sometimes been accepted as authentic, but oftener rejected. According to these, Basil Valentine was born in a town in Alsace, on the southern bank of the Rhine. As a consequence of this, there are several towns that have laid claim to being his birthplace. M. Jean Reynaud, the distinguished French philosophical writer of the first half of the nineteenth century, once said that Basil Valentine, like Ossian and Homer, had many towns claim him years after his death. He also suggested that, like those old poets, it was possible that the writings sometimes attributed to Basil Valentine were really the work not of one man, but of several individuals. There are, however, many objections to this theory, the most forcible of which is the internal evidence derived from the books themselves showing similarities of style and method of treating subjects too great for us to admit non-identity in the writers. M. Reynaud lived at a time when it was all the fashion to suggest that old works that had come down to us, like the Iliad and the Odyssey, and even such national epics as the Cid and the Arthur Legends and the Nibelungenlied were to be attributed to several writers rather than to one. We have passed that period of criticism, however, and have reverted to the idea of single authorship for these works, and the same conclusion has been generally come to with regard to the writings attributed to Basil Valentine.

Other biographic details contained in "The Triumphal Chariot of Antimony" are undoubtedly more correct. According to them Basil Valentine travelled in England and Holland on missions for his order, and went through France and Spain on a pilgrimage to St. James of Compostella.

Besides this work, there is a number of other books of Basil Valentine's, printed during the first half of the sixteenth century, that are well known and copies of which may be found in most of the important libraries. The United States Surgeon General's Library at Washington contains not a few of the works on medical subjects, and the New York Academy of Medicine Library has some valuable editions of certain of his works. Some of his other well-known books, each of which is a good-sized octavo volume, bear the following descriptive titles (I give them in English, though as they are usually found, they are in Latin, sixteenth-century translations of the original German): "The World in Miniature: or, The Mystery of the World and of Human Medical Science," published at Mayburg, 1609; "The Chemical Apocalypse: or, The Manifestation of Artificial Chemical Compounds," published in Erfurt in 1624; "A Chemico-Philosophic Treatise Concerning Things Natural and Preternatural, Especially Relating to the Metals and the Minerals," published at Frankfurt in 1676; "Haliography: or, The Science of Salts: A Treatise on the Preparation, Use, and Chemical Properties of All the Mineral, Animal, and Vegetable Salts," published at Bologna in 1644; "The Twelve Keys of Philosophy," Leipsic, 1630. These are of interest to the chemist and physicist rather than to the physician, and it is as a Maker of Medicine that we are concerned with Valentine here.

The great attention aroused in Basil Valentine's work at the Renaissance period can be best realized from the number of manuscript copies and their wide distribution. His books were not all printed at one place, but, on the contrary, in different portions of Europe. The original edition of "The Triumphal Chariot of Antimony" was published in Leipsic in the early part of the sixteenth century. The first editions of the other books, however, appeared at places so distant from Leipsic as Amsterdam and Bologna, while various cities of Germany, as Erfurt and Frankfurt, claim the original editions of still other works. Many of the manuscript copies still exist in various libraries in Europe; and while there is no doubt that some unimportant additions to the supposed works of Basil Valentine have come from the attribution to him of scientific treatises of other German writers, the style and the method of the principal works mentioned is entirely too similar not to have been the fruit of a single mind and that possessed of a distinct investigating genius, setting it far above any of its contemporaries in scientific speculation and observation.

The most interesting feature of all of Basil Valentine's writings that are extant is the distinctive tendency to make his observations of special practical utility. His studies in antimony were made mainly with the idea of showing how that substance might be used in medicine. He did not neglect to point out other possible uses, however, and knew the secret of the employment of antimony in order to give sharpness and definition to the impression produced by metal types. It would seem as though he was the first scientist who discussed this subject, and there is even some question of whether printers and typefounders did not derive their ideas in this matter from our chemist.

Interested though he was in the transmutation of metals, he never failed to try to find and suggest some medicinal use for all of the substances that he investigated. His was no greedy search for gold and no cumulation of investigations with the idea of benefiting only himself. Mankind was always in his mind, and perhaps there is no better demonstration of his fulfilment of the character of the monk than this constant solicitude to benefit others by every bit of investigation that he carried out. For him, with medieval nobleness of spirit, "the first part of every work must be the invocation of God, and the last, though no less important than the first, must be the utility and fruit for mankind that can be derived from it."

The career of the last of the Makers of Medicine in the Middle Ages may be summed up briefly in a few sentences that show how thoroughly this old Benedictine was possessed of the spirit of modern science. He believed in observation as the most important source of medical knowledge. He valued clinical experience far above book information. He insisted on personal acquaintanceship on the part of the physician with the drugs he used, and thought nothing more unworthy of a practitioner of medicine,—indeed he sets it down as almost criminal—than to give remedies of whose composition he was not well aware and whose effect he did not thoroughly understand. He thought that nature was the most important aid to the physician, much more important than drugs, though he was the first to realize the significance of chemical affinities, and he seems to have understood rather well how individual often were the effects obtained from drugs. He was a patient student, a faithful observer, a writer who did not begrudge time and care to the composition of large books on medicine, yet withal he was no dry-as-dust scholar, but eminently human in his sympathies with ailing humanity, and a strenuous upholder of the dignity of the profession to which he belonged. Scarcely more can be said of anyone in the history of medicine, at least so far as good intentions go; though many accomplished more, none deserve more honor than the Thuringian monk whom we know as Basil Valentine.

There are many other of these old-time Makers of Medicine of whom nearly the same thing can be said. Basil Valentine is only one of a number of men who worked faithfully and did much both for medical science and professional life during the thousand years from the fall of Rome to the fall of Constantinople, when, according to what used to be commonly accepted opinion, men were not animated by the spirit of research and of fine incentive to do good to men that we are so likely to think of as belonging exclusively to more modern times. A man whom he greatly influenced, Paracelsus, took up the tradition of scientific investigation where Basil Valentine had left it. His work, though more successfully revolutionary, was not done in such a fine spirit of sympathy with humanity nor with that simplicity of life and purity of intention that characterized the old monk's work. Paracelsus' birth in the year of the discovery of America places him among the makers of the foundations of our modern medicine, and he will be treated of in a volume on "The Forefathers in Medicine."

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APPENDIX I
ST. LUKE THE PHYSICIAN[32]

In the midst of what has been called the "higher criticism" of the Bible in recent times, one of the long accepted traditions that has been most strenuously assailed and, indeed, in the minds of many scholars, seemed, for a time at least, quite discredited, was that St. Luke the Evangelist, the author of the Third Gospel and the Acts of the Apostles, was a physician. Distinguished authorities in early Christian apologetics have declared that the pillars of primitive Christian history are the genuine Epistles of St. Paul, the writings of St. Luke, and the history of Eusebius. It is quite easy to understand, then, that the attack upon the authenticity of the writings usually assigned to St. Luke, which in many minds seemed successful, has been considered of great importance. In the very recent time there has been a decided reaction in this matter. This has come, not so much from Roman Catholics, who have always clung to the traditional view, and whose great Biblical students have been foremost in the support of the previously accepted opinion, but from some of the most strenuous of the German higher critics, who now appreciate that destructive, so-called higher criticism went too far, and that the traditional view not only can be maintained, but is the only opinion that will adequately respond to all the new facts that have been found, and all the recently gathered information with regard to the relations of events in the olden time.

By far the most important contribution to the discussion in recent years came not long since from the pen of Professor Adolph Harnack, the professor of church history in the University of Berlin. Professor Harnack's name is usually cited as that of one of the most destructive of the higher critics. His recent book, however, "Luke the Physician,"[33] is an entire submission to the old-fashioned viewpoint that the writer of the Third Gospel and of the Acts of the Apostles was a Greek fellow-worker of St. Paul, who had been in company for years with Mark and Philip and James, and who had previously been a physician, and was evidently well versed in all the medical lore of that time. Harnack does not merely concede the old position. As might be expected, his rediscussion of the subject clinches the arguments for the traditional view, and makes it impossible ever to call it in question again. It is easy to understand how important are such admissions when we recall how much this traditional view has been assailed, and how those who have held it have been accused of old-fogyism and lack of scholarship, and unwarranted clinging to antiquated notions just because they thought they were of faith, and how, lacking in true scholarship, seriously hampering genuine investigation, such conservatism has been declared to be.

The question of Luke's having been a physician is an extremely valuable one, and no one in our time is better fitted by early training and long years of study to elucidate it than Professor Harnack. He began his excursions into historical writing years ago, as I understand, as an historian of early Christian medicine. Some of his works on medical conditions just before and after Christ are quoted confidently by the distinguished German medical historians. From this department he graduated into the field of the higher criticism. He is eminently in a position, therefore, to state the case with regard to St. Luke fully, and to indicate absolutely the conclusions that should be drawn from the premises of fact, writings, and traditions that we have. He does so in a very striking way. Perhaps no better example of his thoroughly lucid and eminently logical mode of argumentation is to be found than the paragraph in which he states the question. It might well be recommended as an example of terse forcefulness and logical sequence that deserves the emulation of all those who want to write on medical subjects. If we had more of these characteristic qualities of Harnack's style, our medical literature, so called, would not need to occupy so many pages of print as it does—yet would say more. Here it is:

St. Luke, according to St. Paul, was a physician. When a physician writes a historical work it does not necessarily follow that his profession shows itself in his writing; yet it is only natural for one to look for traces of the author's medical profession in such a work. These traces may be of different kinds: 1, The whole character of the narrative may be determined by points of view, aims, and ideals which are more or less medical (disease and its treatment); 2, marked preference may be shown for stories concerning the healing of diseases, which stories may be given in great number and detail; 3, the language may be colored by the language of physicians (medical technical terms, metaphors of medical character, etc.). All these three groups of characteristic signs are found, as we shall see, in the historical work which bears the name of St. Luke. Here, however, it may be objected that the subject matter itself is responsible for these traits, so that their evidence is not decisive for the medical calling of the author. Jesus appeared as a great physician and healer. All the evangelists say this of Him; hence it is not surprising that one of them has set this phase of His ministry in the foreground, and has regarded it as the most important. Our evangelist need not therefore have been a physician, especially if he were a Greek, seeing that in those days Greeks with religious interests were disposed to regard religion mainly under the category of healing and salvation. This is true, yet such a combination of characteristic signs will compel us to believe that the author was a physician if, 4, the description of the particular cases of disease shows distinct traces of medical diagnosis and scientific knowledge; 5, if the language, even where questions of medicine or of healing are not touched upon, is colored by medical phraseology; and, 6, if in those passages where the author speaks as an eye-witness medical traits are especially and prominently apparent. These three kinds of tokens are also found in the historical work of our author. It is accordingly proved that it proceeds from the pen of a physician.

The importance of the concession that Luke was a physician should be properly appreciated. His whole gospel is written from that standpoint. For him the Saviour was the healer, the good physician who went about curing the ills of the body, while ministering to people's souls. He has more accounts of miracles of healing than any of the other Evangelists. He has taken certain of the stories of the other Evangelists who were eye-witnesses, and when they were told in naïve and popular language that obscured the real condition that was present, he has retold the story from the physician's standpoint, and thus the miracle becomes clearer than ever. In one case, where Mark has a slur on physicians, Luke eliminates it. In a number of cases the correction of Mark's popular language in the description of ailments is made in terms that could not have been used except by one thoroughly versed in the Greek medical terminology of the times. As a matter of fact, there seems to be no doubt now that Luke had been, before he became an Evangelist, a practising physician in Malta of considerable experience. His testimony, then, to the miracles is particularly valuable as almost a medical eye-witness.

In medical science, St. Luke's time was by no means barren of knowledge. The Alexandrian school of medicine had done some fine work in its time. It was the first university medical school in the world's history, and there dissection was first practised regularly and publicly for the sake of anatomy, and even the vivisection of criminals who were supplied by the Ptolemei for human physiology, was a part of the school curriculum. A number of important discoveries in brain anatomy are attributed to Herophilus, after whom the torcular herophili within the skull is named, and who invented the term calamus scriptorius for certain appearances in the fourth ventricle. His colleague, Erasistratus, the co-founder of this school at Alexandria, did work in pathological anatomy, and laid the foundation for serious study there. For three centuries there is some good worker, at or in connection with Alexandria, whose name is preserved for us in the history of medicine. Other Greek schools of medicine in the East, as, for instance, that of Pergamos, also did excellent work. Galen is the great representative of this school, and he came in the century after St. Luke. A physician educated in Greek medicine at that time, then, would be in an excellent position to judge critically of the miracles of healing of the Christ, and it would seem to have been providential that Luke was called for this purpose.

The evidence for his membership of our profession will doubtless be interesting to all physicians. Some of the distinctive passages in which Luke's familiarity with medical terms to such an extent that to express his meaning he found himself compelled to use them, will appeal at once to these, for whom such terms are part of everyday speech. The use of the word hydropikos, which is not to be met with anywhere else in the New Testament, nor in the non-medical Greek literature of that time, though the word is of frequent occurrence as a designation for a person suffering from dropsy (and always, as in Luke, the adjective for the substantive), in Hippocrates, Dioscorides, and Galen is a typical example.

Where such vague terms as paralyzed occur Luke does not use the familiar word, but the medical term that meant stricken with paralysis, indicating not any inability to use the limbs, but such a one as was due to a stroke of apoplexy. We who, as physicians, have heard of so many cures of paralysis from our friends, the Eddyites, are prone to ask, as the first question, what sort of a paralysis it was. Luke made inquiries from men who were eye-witnesses, and then has described the scene with such details as convinced him as a physician of the reality of the miracle, and his description was meant to carry conviction to the minds of others.

Occasionally St. Luke uses words which only a physician would be likely to know at all. That is to say, even a man reasonably familiar with medical terminology and medical literature would not be likely to know them unless he had been technically trained. One of these is the word sphudron, a word which is only medical, and is not to be found even in such large Greek lexicons of ordinary words as that of Passow. Sphudron is the anatomical term of the Græco-Alexandrian school for the condyles of the femur. Galen and other medical authors use it, and Luke, in giving the details of the story of the lame man cured, in the third chapter of the Acts, seventh verse, selects it because it exactly expresses the meaning he wished to convey. In this story there are a number of added medical details. These are all evidently arranged so as to give the full medical significance to the miracle. For instance, the man had been lame from birth, literally from the womb of his mother. At this time he was forty years of age, an age at which the spontaneous cure of such an ailment or, indeed, any cure of it, could scarcely be expected, if, during the preceding time, there had been no improvement.

In the story of the cure of Saul's blindness Luke says in the Acts that his blindness fell from him like scales. The figure is a typically medical one. The word for fall that is used is, as was pointed out by Hobart ("Medical Language of St. Luke," Dublin, 1882), exactly the term that is used for the falling of scales from the body. The term for scales is the specific designation of the particles that fall from the body during certain skin diseases or after certain of the infectious fevers, as in scarlet fever. Hippocrates and Galen have used it in many places. It is distinctively a medical word. In the story of the vision of St. Peter, told also in the Acts, the word ecstasis, from which we derive our word ecstasy, is used. This is the only word St. Luke uses for vision and he alone uses it. This term is of constant employment in a technical sense in the medical writers of St. Luke's time and before it. When the other evangelists talk of lame people they use the popular term. This might mean anything or nothing for a physician. Luke uses one of the terms that is employed by physicians when they wish to indicate that for some definite reason there is inability to walk.

In the story of the Good Samaritan there are some interesting details that indicate medical interest on the part of the writer. It is Luke's characteristic story and a typical medical instance. He employs certain words in it that are used only by medical writers. The use of oil and wine in the treatment of the wounds of the stranger traveller was at one time said to indicate that it could not have been a physician who wrote the story, since the ancients used oil for external applications in such cases but not wine. More careful search of the old masters of medicine, however, has shown that they used oil and wine not only internally but externally. Hippocrates, for instance, has a number of recommendations of this combination for wounds. It is rather interesting to realize this, and especially the wine in addition to the oil, because wine contains enough alcohol to be rather satisfactorily antiseptic. There seems no doubt that wounds that had been bathed in wine and then had oil poured over them would be likely to do better than those which were treated in other ways. The wine would cleanse and at least inhibit bacterial growth. The subsequent covering with oil would serve to protect the wound to some degree from external contamination.

Sometimes there is an application of medical terms to something extraneous from medicine that makes the phrase employed quite amusing. For instance, when Luke wants to explain how they strengthened the vessel in which they were to sail he describes the process by the term which was used in medical Greek to mean the splinting of a part or at least the binding of it up in such a way as to enable it to be used. The word was quite a puzzle to the commentators until it was pointed out that it was the familiar medical term, and then it was easy to understand. Occasionally this use of a medical term gives a strikingly accurate significance to Luke's diction. For instance, where other evangelists talk of the Lord looking at a patient or turning to them, Luke uses the expression that was technically employed for a physician's examination of his patient, as if the Lord carefully looked over the ailing people to see their physical needs, and then proceeded to cure them. Manifestly in Luke's mind the most interesting phase of the Lord's life was His exhibition of curative powers, and the Saviour was for him the divine healer, the God physician of bodies as well as of souls.

There are many little incidents which he relates that emphasize this. For instance, where St. Mark talks about the healing of the man with a withered hand, St. Luke adds the characteristic medical note that it was the right hand. When he tells of the cutting off of the ear of the servant of the high priest in the Garden of Olives St. Luke takes the story from St. Mark, but adds the information that would appeal to a physician that it was the right ear. Moreover, though all four evangelists record the cutting off of the ear, only St. Luke adds the information that the Lord healed it again. It is as if he were defending the kindly feelings of the Divine Physician and as if it would have been inexcusable had He not exerted His miraculous powers of healing on this occasion. It is St. Luke, too, who has constantly distinguished between natural illnesses and cases of possession. This careful distinction alone would point to the author of the third gospel and the Acts as surely a physician. As it is it confirms beyond all doubt the claim that the writer of these portions of the New Testament was a physician thoroughly familiar with all the medical writings of the time and probably a physician who had practised for a long time.

Certain miracles of healing are related only by St. Luke as if he realized better than any of the other evangelists the evidential value that such instances would have for future generations as to the divinity of the personage who worked them. The beautiful story of the raising from death of the son of the widow of Nain is probably one of the oftenest quoted passages from St. Luke. It is a charming bit of literature. While it suggests the writer physician it makes one almost sure that the other tradition according to which St. Luke was also a painter must be true. The scene is as picturesque as it can be. The Lord and His Apostles and the multitudes coming to the gate of the little city just as in the evening sun the funeral cortège with the widow burying her only son came out of it. The approach of the Lord to the weeping mother, His command to the dead son to arise, and the simple words, "and he gave him back to his mother," constitute as charming a scene as a painter ever tried to visualize. Besides this, Luke alone has the story of the man suffering with dropsy and the woman suffering from weakness. The intensely picturesque quality of many of these scenes that he describes so vividly would indeed seem to place beyond all doubt the old tradition that he was an artist as well as a physician.

It is interesting to realize that it is to Luke alone that we owe the account of the well-known message sent by Christ Himself to John the Baptist when John sent his disciples to inquire as to His mission. After describing His ministry He said: "Go and relate to John what you have heard and seen: the blind see, the lame walk, the deaf hear, the lepers are made clean, the dead rise again, to the poor the Gospel is preached." To no one more than to a physician would that description of His mission appeal as surely divine.

To those who care to follow the subject still further, and above all, to read opinions given before the reversal of the verdict of the higher criticism on the Lucan writings, indeed before ever that trial was brought, there is much in "Horæ Lucanæ—A Biography of St. Luke," by Henry Samuel Baynes (Longmans, 1870), that will surely be of interest. He has some interesting quotations which show how thoroughly previous centuries realized all the force of modern arguments. For instance, the following paragraph from Dr. Nathaniel Robinson, a Scotch physician of the eighteenth century, will illustrate this. Dr. Robinson said:

It is manifest from his Gospel, that Luke was both an acute observer, and had even given professional attention to all our Saviour's miracles of healing. Originally, among the Egyptians, divinity and physic were united in the same order of men, so that the priest had the care of souls, and was also the physician. It was much the same under the Jewish economy. But after physic came to be studied by the Greeks, they separated the two professions. That a physician should write the history of our Saviour's life was appropriate, as there were divers mysterious things to be noticed, concerning which his education enabled him to form a becoming judgment.

It is even interesting to realize that St. Luke's tendency to use medical terms has been of definite value in determining the question whether both the third gospel and the Acts of the Apostles are by the same man. They have been attributed to St. Luke traditionally, but in the higher criticism some doubt has been thrown on this and an elaborate hypothesis of dual authorship set up. It has been asserted that it is very improbable on extrinsic grounds that they were both written by one hand and certain intrinsic evidence, changes in the mode of narration, especially the use of the first personal pronoun in the plural in certain passages, has been pointed to as making against single authorship. This tendency to deny old-time traditions of authorship with regard to many classical writings was a marked characteristic of the early part of the nineteenth century, but the close of the century saw practically all of these denials discredited. The nineteenth century ushered in studies of Homer, with the separatist school perfectly confident in their assertion that the Iliad and the Odyssey were not by the same person, and even that the Iliad itself was the work of several hands.

At the beginning of the twentieth century we are quite as sure that both the Iliad and Odyssey were written by the same person and that the separatists were hurried into a contrary decision not a little by the feeling of the sensation that such a contradiction of previously accepted ideas would create. This is a determining factor in many a supposed novel discovery, that it is hard always to discount sufficiently. A thing may be right even though it is old, and most new discoveries, it must not be forgotten, that is, most of those announced with a great blare of trumpets, do not maintain themselves. The simple argument that the separatists would have to find another poet equal to Homer to write the other poem has done more than anything else to bring their opinion into disrepute. It is much easier to explain certain discrepancies, differences of style, and of treatment of subjects, as well as other minor variants, than to supply another great poet. Most of the works of our older literatures have gone through a similar trial during the over-hasty superficially critical nineteenth century. The Nibelungenlied has been attributed to two or three writers instead of one. The Cid, the national epic of Spain, and the Arthur Legends, the first British epic, have been at least supposed to be amenable to the same sort of criticism. In every case, scholars have gone back to the older traditional view of a single author. The phases of literary and historic criticism with regard to Luke's writings are, then, only a repetition of what all our great national classics have gone through from supercilious scholarship during the past hundred years.

It is not surprising, then, that there should be dual or even triple ascriptions of authorship for various portions of the Scriptures, and Luke's writings have on this score suffered as much or more even than others, with the possible exception of Moses. It is now definitely settled, however, that the similarities of style between the Acts and the third gospel are too great for them to have come from two different minds. This is especially true, as pointed out by Harnack, in all that regards the use of medical terms. The writer of the Acts and the writer of the third gospel knew Greek from the standpoint of the physician of that time. Each used terms that we find nowhere else in Greek literature except among medical writers. What is thus true for one critical attack on Luke's reputation is also true in another phase of recent higher criticism. It has been said that certain portions of the Acts which are called the "we" portions because the narration changes in them from the third to the first person were to be attributed to another writer than the one who wrote the narrative portions. Here, once more, the test of the medical words employed has decided the case for Luke's sole authorship. It is evidently an excellent thing to be able to use medical terms properly if one wants to be recognized with certainty later on in history for just what one's business was. It has certainly saved the situation for St. Luke, though there may be some doubt as to the real force of objections thus easily overthrown.

It is rather interesting to realize that many scholars of the present generation had allowed themselves to be led away by the German higher criticism from the old tradition with regard to Luke as a physician and now will doubtless be led back to former views by the leader of German biblical critics. It shows how much more distant things may influence certain people than those nearer home—how the hills are green far away. Harnack confesses that the best book ever written on the subject of Luke as a physician, the one that has proved of most value to him, and that he still recommends everyone to read, was originally written in English. It is Hobart's "Medical Language of St. Luke,"[34] written more than a quarter of a century before Harnack. The Germans generally had rather despised what the English were doing in the matter of biblical criticism, and above all in philology. Yet now the acknowledged coryphæus of them all, Harnack, not only admits the superiority of an old-time English book, but confesses that it is the best statement of the subject up to the present time, including his own. He constantly quotes from it, and it is evident that it has been the foundation of all of his arguments. It is not the first time that men have fetched from afar what they might have got just as well or better at home.

Harnack has made complete the demonstration, then, that the third gospel and the Acts were written by St. Luke, who had been a practising physician. In spite of this, however, he finds many objections to the Luke narratives and considers that they add very little that is valuable to the contemporary evidence that we have with regard to Christ. He impairs with one hand the value of what he has so lavishly yielded with the other. He finds inconsistencies and discrepancies in the narrative that for him destroy their value as testimony. A lawyer would probably say that this is that very human element in the writings which demonstrates their authenticity and adds to their value as evidence, because it shows clearly the lack of any attempt to do anything more than tell a direct story as it had come to the narrator. No special effort was made to avoid critical objections founded on details. It was the general impression that was looked for.

Sir William Ramsay, in his "Luke the Physician and Other Studies in the History of Religion" (New York: Armstrong and Sons, 1908), has answered Harnack from the side of the professional critic with much force. He appreciates thoroughly the value of Professor Harnack's book, and above all the reactionary tendency away from nihilistic so-called higher criticism which characterized so much of German writing on biblical themes in the nineteenth century. He says (p. 7): "This [book of Harnack's] alone carries Lukan criticism a long step forwards, and sets it on a new and higher plane. Never has the unity and character of the book been demonstrated so convincingly and conclusively. The step is made and the plane is reached by the method which is practised in other departments of literary criticism, viz., by dispassionate investigation of the work and by discarding fashionable a priori theories."

The distinguished English traveller and writer on biblical subjects points out, however, that in detail many of Harnack's objections to the Lukan narratives are due to insufficient consideration of the circumstances in which they were written and the comparative significance of the details criticised. He says, "Harnack lays much stress on the fact that inconsistencies and inexactnesses occur all through Acts. Some of these are undeniable; and I have argued that they are to be regarded in the same light as similar phenomena in the poem of Lucretius and in other ancient classical writers, viz., as proofs that the work never received the final form which Luke intended to give it, but was still incomplete when he died. The evident need for a third book to complete the work, together with those blemishes in expression, form the proof."

Ramsay's placing of Harnack's writing in general is interesting in this connection. (P. 8) "Professor Harnack stands on the border between the nineteenth and twentieth century. His book shows that he is to a certain degree sensitive of and obedient to the new spirit; but he is only partially so. The nineteenth century critical method was false, and is already antiquated....

"The first century could find nothing real and true that was not accompanied by the marvellous and the 'supernatural.' The nineteenth century could find nothing real and true that was. Which view was right and which was wrong? Was either complete? Of these two questions, the second alone is profitable at the present. Both views were right—in a certain way of contemplating; both views were wrong—in a certain way. Neither was complete. At present, as we are struggling to throw off the fetters which impeded thought in the nineteenth century, it is most important to free ourselves from its prejudices and narrowness."

He adds (pp. 26 and 27): "There are clear signs of the unfinished state in which this chapter was left by Luke; but some of the German scholar's criticisms show that he has not a right idea of the simplicity of life and equipment that evidently characterized the jailer's house and the prison. The details which he blames as inexact and inconsistent are sometimes most instructive about the circumstances of this provincial town and Roman colonia.

"But it is never safe to lay much stress on small points of inexactness or inconsistency in any author. One finds such faults even in the works of modern scholarship if one examines them in the microscopic fashion in which Luke is studied here. I think I can find them in the author [Harnack] himself. His point of view sometimes varies in a puzzling way."

As a matter of fact, Harnack, as pointed out by Ramsay, was evidently working himself more and more out of the old conclusion as to the lack of authenticity of the Lucan writings into an opinion ever more and more favorable to Luke. For instance, in a notice of his own book, published in the Theologische Literaturzeitung, "he speaks far more favorably about the trustworthiness and credibility of Luke, as being generally in a position to acquire and transmit reliable information, and as having proved himself able to take advantage of his position. Harnack was gradually working his way to a new plane of thought. His later opinion is more favorable."

Ramsay also points out that Professor Giffert, one of our American biblical critics, had felt compelled by the geographical and historical evidence to abandon in part the older unfavorable criticism of Luke and to admit that the Acts is more trustworthy than previous critics allowed. Above all, "he saw that it was a living piece of literature written by one author." In a word, Luke is being vindicated in every regard.

Some of the supposed inaccuracies of Luke vanish when careful investigation is made. Some of his natural history details, for instance, have been impugned and the story of the viper that "fastened" itself upon St. Paul in Malta has been cited as an example of a story that would not have been told in that way by a man who knew medicine and the related sciences in Luke's time. Because the passage illustrates a number of phases of the discussion with regard to Luke's language I make a rather long quotation from Ramsay:

Take as a specimen with which to finish off this paper the passage Acts xxviii, 9 et seq., which is very fully discussed by Harnack twice. He argues that the true meaning of the passage was not understood until medical language was compared, when it was shown that the Greek word by which the act of the viper to Paul's hand is described, implies "bit" and not merely "fastened upon." But it is a well-assured fact that the viper, a poisonous snake, only strikes, fixes the poison fangs on the flesh for a moment, and withdraws its head instantly. Its action could never be what is attributed by Luke the eye witness to this Maltese viper; that it hung from Paul's hand and was shaken off into the fire by him. On the other hand, constrictors, which have no poison fangs, cling in the way described, but as a rule do not bite. Are we, then, to understand in spite of the medical style and the authority of Professor Blass (who translates "momordit" in his edition), that the viper fastened upon the apostle's hand? Then, the very name viper is a difficulty. Was Luke mistaken about the kind of snake which he saw? A trained medical man in ancient times was usually a good authority about serpents, to which great respect was paid in ancient medicine and custom.

Mere verbal study is here utterly at fault. We can make no progress without turning to the realities and facts of Maltese natural history. A correspondent obligingly informed me some years ago that Mr. Bryan Hook, of Farnham, Surrey (who, my correspondent assures me, is a thoroughly good naturalist), had found in Malta a small snake, Coronella austriaca, which is rare in England, but common in many parts of Europe. It is a constrictor, without poison fangs, which would cling to the hand or arm as Luke describes. It is similar in size to the viper, and so like in markings and general appearance that Mr. Hook, when he caught his specimen, thought he was killing a viper.

My friend, Prof. J. W. H. Trail, of Aberdeen, whom I consulted, replied that Coronella lævis or austriaca, is known in Sicily and the adjoining islands; but he can find no evidence of its existence in Malta. It is known to be rather irritable, and to fix its small teeth so firmly into the human skin as to need a little force to pull it off, though the teeth are too short to do any real injury to the skin. Coronella is at a glance very much like a viper; and in the flames it would not be closely examined. While it is not reported as found in Malta except by Mr. Hook, two species are known there belonging to the same family and having similar habits (leopardinus and zamenis (or coluber) gemonensis). The coloring of Coronella leopardinus would be the most likely to suggest a viper.

The observations justify Luke entirely. We have here a snake so closely resembling a viper as to be taken for one by a good naturalist until he had caught and examined a specimen. It clings, and yet it also bites without doing harm. That the Maltese rustics should mistake this harmless snake for a venomous one is not strange. Many uneducated people have the idea that all snakes are poisonous in varying degrees, just as the vulgar often firmly believe that toads are poisonous. Every detail as related by Luke is natural, and in accordance with the facts of the country.

In a word, then, the whole question as to Luke's authority as a writer, as an eye-witness of many things, and as the relator of many others with regard to which he had obtained the testimony of eye-witnesses is fully vindicated. Twenty years ago many scholars were prone to doubt this whole question. Ten years ago most of them were convinced that the Luke traditions were not justified by recent investigation. Now we have come back once more to the complete acceptance of the old traditions.

Perhaps the most unfortunate characteristic of much nineteenth-century criticism in all departments, even those strictly scientific, was the marked tendency to reject previous opinions for new ones. Somehow men felt themselves so far ahead of old-time writers and thinkers that they concluded they must hold opinions different from their ancestors. In nearly every case the new ideas that they evolved by supposedly newer methods are not standing the test of time and further study. There had been a continuous belief in men's minds, having its basis very probably on a passage in one of St. Peter's Epistles, that the earth would dissolve by fire. This was openly contradicted all during the nineteenth century and the time when the earth would freeze up definitely calculated by our mathematicians. Now after having studied radioactivity and learned from the physicist that the earth is heating up and will eventually get too hot for life, we calmly go back to the old Petrine declaration. Some of the most distinguished of the German biologists of the present day, such men as Driesch and others, calmly tell us that the edifice erected by Darwin will have to come down because of newly discovered evidence, and indeed some of them go so far as to declare that Darwinism was a crude hypothesis very superficial in its philosophical aspects and therefore acceptable to a great many people who, because it was easy to understand and was very different from what our fathers had believed, hastened to accept it. Nothing shows the necessity for being conservative in the matter of new views in science or ethics or religion more than the curious transition state in which we are with regard to many opinions at the present time, with a distinct tendency toward reaction to older views that a few years ago were thought quite untenable. We are rather proud of the advance that we are supposed to be making along many lines in science and scholarship, and yet over and over again, after years of work, we prove to have been following a wrong lead and must come back to where we started. This has been the way of man from the beginning and doubtless will continue. The present generation are having this curious regression that follows supposed progress strongly emphasized for them.

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APPENDIX II
SCIENCE AT THE MEDIEVAL UNIVERSITIES[35]

With the growth of interest in science and in nature study in our own day, one of the expressions that is probably oftenest heard is surprise that the men of preceding generations and especially university men did not occupy themselves more with the world around them and with the phenomena that are so tempting to curiosity. Science is usually supposed to be comparatively new and nature study only a few generations old. Men are supposed to have been so much interested in book knowledge and in speculations and theories of many kinds, that they neglected the realities of life around them while spinning fine webs of theory. Previous generations, of course, have indulged in theory, but then our own generation is not entirely free from that amusing occupation. Nothing could well be less true, however, than that the men of preceding generations were not interested in science even in the sense of physical science, or that nature study is new, or that men were not curious and did not try to find out all they could about the phenomena of the world around them.

The medieval universities and the school-men who taught in them have been particularly blamed for their failure to occupy themselves with realities instead of with speculation. We are coming to recognize their wonderful zeal for education, the large numbers of students they attracted, the enthusiasm of their students, since they made so many handwritten copies of the books of their masters, the devotion of the teachers themselves, who wrote at much greater length than do our professors even now and on the most abstruse subjects, so that it is all the more surprising to think they should have neglected science. The thought of our generation in the matter, however, is founded entirely on an assumption. Those who know anything about the writers of the Middle Ages at first hand are not likely to think of them as neglectful of science even in our sense of the term. Those who know them at second hand are, however, very sure in the matter.

The assumption is due to the neglect of history that came in the seventeenth and eighteenth centuries. We have many other similar assumptions because of the neglect of many phases of mental development and applied science at this time. For instance, most of us are very proud of our modern hospital development and think of this as a great humanitarian evolution of applied medical science. We are very likely to think that this is the first time in the world's history that the building of hospitals has been brought to such a climax of development, and that the houses for the ailing in the olden time were mere refuges, prone to become death traps and at most makeshifts for the solution of the problem of the care of the ailing poor. This is true for the hospitals of the seventeenth and eighteenth centuries, but it is not true at all for the hospitals of the thirteenth and fourteenth and fifteenth centuries. Miss Nutting and Miss Dock in their "History of Nursing"[36] have called attention to the fact that the lowest period in hospital development is during the eighteenth and early nineteenth centuries. Hospitals were little better than prisons, they had narrow windows, were ill provided with light and air and hygienic arrangements, and in general were all that we should imagine old-time hospitals to be. The hospitals of the earlier time, however, had fine high ceilings, large windows, abundant light and air, excellent arrangements for the privacy of patients, and in general were as worthy of the architects of the earlier times as the municipal buildings, the cathedrals, the castles, the university buildings, and every other form of construction that the late medieval centuries devoted themselves to.

The trouble with those who assume that there was no study of science and practically no attention to nature study in the Middle Ages is that they know nothing at all at first hand about the works of the men who wrote in the medieval period. They have accepted declarations with regard to the absolute dependence of the scholastics on authority, their almost divine worship of Aristotle, their utter readiness to accept authoritative assertions provided they came with the stamp of a mighty name, and then their complete lack of attention to observation and above all to experiment. Nothing could well be more ridiculous than this ignorant assumption of knowledge with regard to the great teachers at the medieval universities. Just as soon as there is definite knowledge of what these great teachers wrote and taught, not only does the previous mood of blame for them for not paying much more attention to science and nature at once disappear, but it gives place to the heartiest admiration for the work of these great thinkers. It is easy to appreciate, then, what Professor Saintsbury said in a recent volume on the thirteenth century:

And there have even been in these latter days some graceless ones who have asked whether the science of the nineteenth century after an equal interval will be of any more positive value—whether it will not have even less comparative interest than that which appertains to the scholasticism of the thirteenth.

Three men were the great teachers in the medieval universities at their prime. They have been read and studied with interest ever since. They wrote huge tomes, but men have pored over them in every generation. They were Albertus Magnus, the teacher of the other two, Thomas Aquinas and Roger Bacon. All three of them were together at the University of Paris shortly after the middle of the thirteenth century. Anyone who wants to know anything about the attitude of mind of the medieval universities, their professors and students, and of all the intellectual world of the time towards science and observation and experiment, should read the books of these men. Any other mode of getting at any knowledge of the real significance of the science of this time is mere pretence. These constitute the documents behind any scientific history of the development of science at this time.

It is extremely interesting to see the attitude of these men with regard to authority. In Albert's tenth book (of his "Summa"), in which he catalogues and describes all the trees, plants, and herbs known in his time, he observes: "All that is here set down is the result of our own experience, or has been borrowed from authors whom we know to have written what their personal experience has confirmed; for in these matters experience alone can be of certainty." In his impressive Latin phrase "experimentum solum certificat in talibus." With regard to the study of nature in general he was quite as emphatic. He was a theologian as well as a scientist, yet in his treatise on "The Heavens and the Earth" he declared that "in studying nature we have not to inquire how God the Creator may, as He freely wills, use His creatures to work miracles and thereby show forth His power. We have rather to inquire what nature with its immanent causes can naturally bring to pass."[37]

Just as striking quotations on this subject might be made from Roger Bacon. Indeed, Bacon was quite impatient with the scholars around him who talked over-much, did not observe enough, depended to excess on authority, and in general did as mediocre scholars always do, made much fuss on second-hand information—plus some filmy speculations of their own. Friar Bacon, however, had one great pupil whose work he thoroughly appreciated because it exhibited the opposite qualities. This was Petrus—we have come to know him as Peregrinus—whose observations on magnetism have excited so much attention in recent years with the republications of his epistle on the subject. It is really a monograph on magnetism written in the thirteenth century. Roger Bacon's opinion of it and of its author furnishes us the best possible index of his attitude of mind towards observation and experiment in science.

I know of only one person who deserves praise for his work in experimental philosophy for he does not care for the discourses of men and their wordy warfare, but quietly and diligently pursues the works of wisdom. Therefore what others grope after blindly, as bats in the evening twilight, this man contemplates in their brilliancy because he is a master of experiment. Hence, he knows all of natural science whether pertaining to medicine and alchemy, or to matters celestial or terrestrial. He has worked diligently in the smelting of ores as also in the working of minerals; he is thoroughly acquainted with all sorts of arms and implements used in military service and in hunting, besides which he is skilled in agriculture and in the measurement of lands. It is impossible to write a useful or correct treatise in experimental philosophy without mentioning this man's name. Moreover, he pursues knowledge for its own sake; for if he wished to obtain royal favor, he could easily find sovereigns who would honor and enrich him.

Similar expressions might readily be quoted from Thomas Aquinas, but his works are so easy to secure and his whole attitude of mind so well known, that it scarcely seems worth while taking space to do so. Aquinas is still studied very faithfully in many universities, and within the last few years one of his great text-books of philosophy has been replaced in the curriculum of Oxford University, in which it occupied a prominent position in the long ago, as a work that may be offered for examination in the department of philosophy. It is with regard to him particularly that there has been the greatest revulsion of feeling in recent years and a recognition of the fact that here was a great thinker familiar with all that was known in the physical sciences, and who had this knowledge constantly in his mind when he drew his conclusions with regard to philosophical and theological questions.

It used to be the fashion to make little of the medieval scholars for the high estimation in which they held Aristotle. Occasionally even yet one hears narrowly educated men, I am sorry to say much more frequently scientific specialists than others, talk deprecatingly of this ardent devotion to Aristotle. No one who knows anything about Aristotle ever indulges in such an exhibition of ignorance of the realities of the history of philosophy and science. To know Aristotle well is to think of him as probably possessed of the greatest human mind that ever existed. We do not need to go back to the Middle Ages to be confirmed in that opinion. Modern scientists who know their science well, but who also know Aristotle well, and who are ardent worshippers at his shrine, are not hard to find. Romanes, the great English biologist of the end of the nineteenth century, said: "It appears to me that there can be no question that Aristotle stands forth not only as the greatest figure in antiquity but as the greatest intellect that has ever appeared upon this earth."

Before Romanes, George H. Lewes, in his interesting monograph in the history of thought, "Aristotle, a Chapter in the History of Science," is quite as complimentary to the great Greek thinker. We may say that Lewes was by no means partial to Aristotle. Anything but inclined to accept authority as of value in philosophy, he had been rendered impatient by the fact that so much of the history of philosophy was dominated by Aristotle, and it was only that the panegyric was forced from him by careful study of all that the Stagirite wrote that he said: "History gazed on him with wonder. His intellect was piercing and comprehensive; his attainments surpassed those of every philosopher; his influence has been excelled only by the founders of religion ... his vast and active intelligence for twenty centuries held the world in awe."

Professor Osborn, whose scholarly study of the theory of evolution down the ages "From the Greeks to Darwin" rather startled the world of science by showing not only how old was a theory of evolution, but how frequently it had been stated and how many of them anticipated phases of our own thought in the matter, pays a high compliment to the great Greek scientist. He says: "Aristotle clearly states and rejects a theory of the origin of adaptive structures in animals altogether similar to that of Darwin." He then quotes certain passages from Aristotle's "Physics," and says: "These passages seem to contain absolute evidence that Aristotle had substantially the modern conception of the evolution of life, from a primordial, soft mass of living matter to the most perfect forms, and that even in these he believed that evolution was incomplete for they were progressing to higher forms."

Modern French scientists are particularly laudatory in their estimation of Aristotle. The group of biologists, Buffon, Cuvier, St. Hilaire, and others who called world attention to French science and its attainments about a century ago, are all of them on record in highest praise of Aristotle. Cuvier said: "I cannot read his work without being ravished with astonishment. It is impossible to conceive how a single man was able to collect and compare the multitude of facts implied in the rules and aphorisms contained in this book."

It is possible, however, to get opinions ardently laudatory of Aristotle from the serious students of any nation, provided only they know their Aristotle. Sir William Hamilton, the Scotch philosopher, said:

"Aristotle's seal is upon all the sciences, his speculations have determined those of all subsequent thinkers." Hegel, the German philosophic writer, is not less outspoken in his praise: "Aristotle penetrated the whole universe of things and subjected them to intelligence." Kant, who is often said to have influenced our modern thinking more than any other in recent generations, has his compliment for Aristotle. It relates particularly to that branch of philosophy with which Kant had most occupied himself. The Koenigsberg philosopher said: "Logic since Aristotle, like Geometry since Euclid, is a finished science."

I do not want to tire you or I could quote many other authorities who proclaim Aristotle the genius of the race. They would include poets like Dante and Goethe, scholars like Cicero and Anthon, literary men like Lessing and Reich and many others. The scholars of the Middle Ages, far from condemnation for their devotion to Aristotle, deserve the highest praise for it. If they had done nothing else but appreciate Aristotle as our greatest modern scholars have done, that of itself would proclaim their profound scholarship.

The medieval writers are often said to have been uncritical in their judgment, but in their lofty estimation of Aristotle they displayed the finest possible critical judgment. On the contrary, the generations who made much of the opportunity to minimize medieval scholarship because of its worship at the shrine of Aristotle, must themselves fall under the suspicion at least of either not knowing Aristotle or of not thinking deeply about the subjects with regard to which he wrote. For in all the world's history the rule has been that whenever men have thought deeply about a subject and know what Aristotle has written with regard to that subject, they have the liveliest admiration for the great Greek thinker. This is true for philosophy, logic, metaphysics, politics, ethics, dramatics, but it is also quite as true for physical science. He lacked our knowledge, though not nearly to the degree that is usually thought, and he had a marvellous accumulation of information, but he had a breadth of view and a thoroughness of appreciation with a power of penetration that make his opinions worth while knowing even on scientific subjects in our enlightened age.

As for the supposed swearing by Aristotle, in the sense of literally accepting his opinions without daring to examine them critically, which is so constantly asserted to have been the habit of the medieval scholars and teachers, it is extremely difficult in the light of the expressions which we have from them, to understand how this false impression arose. Aristotle they thoroughly respected. They constantly referred to his works, but so has every thinking generation ever since. Whenever he had made a declaration they would not accept the contradiction of it without a good reason, but whenever they had good reasons, Aristotle's opinion was at once rejected without compunction. Albertus Magnus, for instance, said: "Whoever believes that Aristotle was a God must also believe that he never erred, but if we believe that Aristotle was a man, then doubtless he was liable to err just as we are." A number of direct contradictions of Aristotle we have from Albert. A well-known one is that with regard to Aristotle's assertion that lunar rainbows appeared only twice in fifty years. Albert declared that he himself had seen two in a single year.

Indeed, it seems very clear that the whole trend of thought among the great teachers of the time was away from the acceptance of scientific conclusions on authority unless there was good evidence for them available. They were quite as impatient as the scientists of our time with the constant putting forward of Aristotle as if that settled a scientific question. Roger Bacon wanted the Pope to forbid the study of Aristotle because his works were leading men astray from the study of science, his authority being looked upon as so great that men did not think for themselves but accepted his assertions. Smaller men are always prone to do this, and indeed it constitutes one of the difficulties in the way of advance in scientific knowledge at all times, as Roger Bacon himself pointed out.

These are the sort of expressions that are to be expected from Friar Bacon from what we know of other parts of his work. His "Opus Tertium" was written at the request of Pope Clement IV, because the Pope had heard many interesting accounts of what the great thirteenth-century teacher and experimenter was doing at the University of Oxford, and wished to learn for himself the details of his work. Bacon starts out with the principle that there are four grounds of human ignorance. These are, "first, trust in inadequate authority; second, that force of custom which leads men to accept without properly questioning what has been accepted before their time; third, the placing of confidence in the assertions of the inexperienced; and fourth, the hiding of one's own ignorance behind the parade of superficial knowledge, so that we are afraid to say I do not know." Professor Henry Morley, a careful student of Bacon's writings, said with regard to these expressions of Bacon:

No part of that ground has yet been cut away from beneath the feet of students, although six centuries have passed. We still make sheep-walks of second, third and fourth, and fiftieth hand references to authority; still we are the slaves of habit, still we are found following too frequently the untaught crowd, still we flinch from the righteous and wholesome phrase "I do not know" and acquiesce actively in the opinion of others that we know what we appear to know.

In his "Opus Majus" Bacon had previously given abundant evidence of his respect for the experimental method. There is a section of this work which bears the title "Scientia Experimentalis." In this Bacon affirms that "without experiment nothing can be adequately known. An argument may prove the correctness of a theory, but does not give the certitude necessary to remove all doubt, nor will the mind repose in the clear view of truth unless it finds its way by means of experiment." To this he later added in his "Opus Tertium": "The strongest argument proves nothing so long as the conclusions are not verified by experience. Experimental science is the queen of sciences, and the goal of all speculation."

It is no wonder that Dr. Whewell, in his "History of the Inductive Sciences," should have been unstinted in his praise of Roger Bacon's work and writings. In a well-known passage he says of the "Opus Majus":

Roger Bacon's "Opus Majus" is the encyclopedia and "Novum Organon" of the thirteenth century, a work equally wonderful with regard to its wonderful scheme and to the special treatises by which the outlines of the plans are filled up. The professed object of the work is to urge the necessity of a reform in the mode of philosophizing, to set forth the reasons why knowledge had not made greater progress, to draw back attention to the sources of knowledge which had been unwisely neglected, to discover other sources which were yet almost untouched, and to animate men in the undertaking of a prospect of the vast advantages which it offered. In the development of this plan all the leading portions of science are expanded in the most complete shape which they had at that time assumed; and improvements of a very wide and striking kind are proposed in some of the principal branches of study. Even if the work had no leading purposes it would have been highly valuable as a treasure of the most solid knowledge and soundest speculations of the time; even if it had contained no such details it would have been a work most remarkable for its general views and scope.

As a matter of fact the universities of the Middle Ages, far from neglecting science, were really scientific universities. Because the universities of the early nineteenth century occupied themselves almost exclusively with languages and especially formed students' minds by means of classical studies, men in our time seem to be prone to think that such linguistic studies formed the main portion of the curriculum of the universities in all the old times and particularly in the Middle Ages. The study of the classic languages, however, came into university life only after the Renaissance. Before that the undergraduates of the universities had occupied themselves almost entirely with science. It was quite as much trouble to introduce linguistic studies into the old universities in the Renaissance time to replace science, as it was to secure room for science by pushing out the classics in the modern time. Indeed the two revolutions in education are strikingly similar when studied in detail. Men who had been brought up on science before the Renaissance were quite sure that that formed the best possible means of developing the mind. In the early nineteenth century men who had been formed on the classics were quite as sure that science could not replace them with any success.

There is no pretence that this view of the medieval universities is a new idea in the history of education. Those who have known the old universities at first hand by the study of the actual books of their professors and by familiarity with their courses of study, have not been inclined to make the mistake of thinking that the medieval university neglected science. Professor Huxley in his "Inaugural Address as Rector of Aberdeen University" some thirty years ago stated very definitely his recognition of medieval devotion to science. His words are well worth remembering by all those who are accustomed to think of our time as the first in which the study of science was taken up seriously in our universities. Professor Huxley said:

The scholars of the medieval universities seem to have studied grammar, logic, and rhetoric; arithmetic and geometry; astronomy, theology, and music. Thus their work, however imperfect and faulty, judged by modern lights, it may have been, brought them face to face with all the leading aspects of the many-sided mind of man. For these studies did really contain, at any rate in embryo, sometimes it may be in caricature, what we now call philosophy, mathematical and physical science, and art. And I doubt if the curriculum of any modern university shows so clear and generous a comprehension of what is meant by culture, as this old Trivium and Quadrivium does.

It would be entirely a mistake, however, to think that these great writers and teachers who influenced the medieval universities so deeply and whose works were the text-books of the universities for centuries after, only had the principles of physical and experimental science and did not practically apply them. As a matter of fact their works are full of observation. Once more, the presumption that they wrote only nonsense with regard to science comes from those who do not know their writings at all, while great scientists who have taken the pains to study their works are enthusiastic in praise. Humboldt, for instance, says of Albertus Magnus, after reading some of his works with care:

Albertus Magnus is equally active and influential in promoting the study of natural science and of the Aristotelian philosophy. His works contain some exceedingly acute remarks on the organic structure and physiology of plants. One of his works bearing the title of "Liber Cosmographicus De Natura Locorum" is a species of physical geography. I have found in it considerations on the dependence of temperature concurrently on latitude and elevation and on the effect of different angles of the sun's rays in heating the ground which have excited my surprise.

It is with regard to physical geography of course that Humboldt is himself a distinguished authority.

Humboldt's expression that he found some exceedingly acute remarks on the organic structure and physiology of plants in Albert the Great's writings will prove a great surprise to many people. Meyer, the German historian of botany, however, has re-echoed Humboldt's praise with emphasis. The extraordinary erudition and originality of Albert's treatise on plants drew from Meyer the comment:

No botanist who lived before Albert can be compared with him unless Theophrastus, with whom he was not acquainted; and after him none has painted nature in such living colors or studied it so profoundly until the time of Conrad Gessner and Cæsalpino.

These men, it may be remarked, come three centuries after Albert's time. A ready idea of Albert's contributions to physical science can be obtained from his life by Sighart, which has been translated into English by Dixon and was published in London in 1870. Pagel, in Puschmann's "History of Medicine," already referred to, gives a list of the books written by Albert on scientific matters with some comments which are eminently suggestive, and furnish solid basis for the remark that I have made, that men's minds were occupied with nearly the same problems in science in the thirteenth century as we are now, while the conclusions they came to were not very different from ours, though reached so long before us.

This catalogue of Albertus Magnus' works shows very well his own interest and that of his generation in physical science of all kinds. There were eight treatises on Aristotle's physics and on the underlying principles of natural philosophy and of energy and of movement; four treatises concerning the heavens and the earth, one on physical geography which also contains, according to Pagel, numerous suggestions on ethnography and physiology. There are two treatises on generation and corruption, six books on meteors, five books on minerals, three books on the soul, two books on the intellect, a treatise on nutritives, and then a treatise on the senses and another on the memory and on the imagination. All the phases of the biological sciences were especially favorite subjects of his study. There is a treatise on the motion of animals, a treatise in six books on vegetables and plants, a treatise on breathing things, a treatise on sleep and waking, a treatise on youth and old age, and a treatise on life and death. His treatise on minerals contains, according to Pagel, a description of ninety-five different kinds of precious stones. Albert's volumes on plants were reproduced with Meyer, the German botanist, as editor (Berlin, 1867). All of Albert's books are available in modern editions.

Pagel says of Albertus that

His profound scholarship, his boundless industry, the almost incontrollable impulse of his mind after universality of knowledge, the many-sidedness of his literary productivity, and finally the almost universal recognition which he received from his contemporaries and succeeding generations, stamp him as one of the most imposing characters and one of the most wonderful phenomena of the Middle Ages.

In another passage Pagel has said:

While Albert was a Churchman and an ardent devotee of Aristotle, in matters of natural phenomena he was relatively unprejudiced and presented an open mind. He thought that he must follow Hippocrates and Galen, rather than Aristotle and Augustine, in medicine and in the natural sciences. We must concede it a special subject of praise for Albert that he distinguished very strictly between natural and supernatural phenomena. The former he considered as entirely the object of the investigation of nature. The latter he handed over to the realm of metaphysics.

Roger Bacon is, however, the one of these three great teachers who shows us how thoroughly practical was the scientific knowledge of the universities and how much it led to important useful discoveries in applied science and to anticipations of what is most novel even in our present-day sciences. Some of these indeed are so startling, that only that we know them not by tradition but from his works, where they may be readily found without any doubt of their authenticity, we should be sure to think that they must be the result of later commentators' ideas. Bacon was very much interested in astronomy, and not only suggested the correction of the calendar, but also a method by which it could be kept from wandering away from the actual date thereafter. He discovered many of the properties of lenses and is said to have invented spectacles and announced very emphatically that light did not travel instantaneously but moved with a definite velocity. He is sometimes said to have invented gunpowder, but of course he did not, though he studied this substance in various forms very carefully and drew a number of conclusions in his observations. He was sure that some time or other man would learn to control the energies exhibited by explosives and that then he would be able to accomplish many things that seemed quite impossible under present conditions.

He said, for instance:

Art can construct instruments of navigation, such that the largest vessels governed by a single man will traverse rivers and seas more rapidly than if they were filled with oarsmen. One may also make carriages which without the aid of any animal will run with remarkable swiftness.

In these days when the automobile is with us and when the principal source of energy for motor purposes is derived from explosives of various kinds, this expression of Roger Bacon represents a prophecy marvellously surprising in its fulfilment. It is no wonder that the book whence it comes bears the title "De Secretis Artis et Naturæ." Roger Bacon even went to the extent, however, of declaring that man would some time be able to fly. He was even sure that with sufficient pains he could himself construct a flying machine. He did not expect to use explosives for his motor power, however, but thought that a windlass properly arranged, worked by hand, might enable a man to make sufficient movement to carry himself aloft or at least to support himself in the air, if there were enough surface to enable him to use his lifting power to advantage. He was in intimate relations by letter with many other distinguished inventors and investigators besides Peregrinus and was a source of incentive and encouragement to them all.

The more one knows of Aquinas the more surprise there is at his anticipation of many modern scientific ideas. At the conclusion of a course on cosmology delivered at the University of Paris he said that "nothing at all would ever be reduced to nothingness" (nihil omnino in nihilum redigetur). He was teaching the doctrine that man could not destroy matter and God would not annihilate it. In other words, he was teaching the indestructibility of matter even more emphatically than we do. He saw the many changes that take place in material substances around us, but he taught that these were only changes of form and not substantial changes and that the same amount of matter always remained in the world. At the same time he was teaching that the forms in matter by which he meant the combinations of energies which distinguish the various kinds of matter are not destroyed. In other words, he was anticipating not vaguely, but very clearly and definitely, the conservation of energy. His teaching with regard to the composition of matter was very like that now held by physicists. He declared that matter was composed of two principles, prime matter and form. By forma he meant the dynamic element in matter, while by materia prima he meant the underlying substratum of material, the same in every substance, but differentiated by the dynamics of matter.

It used to be the custom to make fun of these medieval scientists for believing in the transmutation of metals. It may be said that all three of these greatest teachers did not hold the doctrine of the transmutation of metals in the exaggerated way in which it appealed to many of their contemporaries. The theory of matter and form, however, gave a philosophical basis for the idea that one kind of matter might be changed into another. We no longer think that notion absurd. Sir William Ramsay has actually succeeded in changing one element into another and radium and helium are seen changing into each other, until now we are quite ready to think of transmutation placidly. The Philosopher's Stone used to seem a great absurdity until our recent experience with radium, which is to some extent at least the philosopher's stone, since it brings about the change of certain supposed elements into others. A distinguished American chemist said not long ago that he would like to extract all the silver from a large body of lead ore in which it occurs so commonly, and then come back after twenty years and look for further traces of silver, for he felt sure that they would be found and that lead ore is probably always producing silver in small quantities and copper ore is producing gold.

Most people will be inclined to ask where the fruits of this undergraduate teaching of science are to be found. They are inclined to presume that science was a closed book to the men and women of that time. It is not hard, however, to point the effect of the scientific training in the writings of the times. Dante is a typical university man of the period. He was at several Italian universities, was at Paris and perhaps at Oxford. His writings are full of science. Professor Kühns, of Wesleyan, in his book "The Treatment of Nature in Dante," has pointed out how much Dante knows of science and of nature. Few of the poets not only of his own but of any time have known more. There are only one or two writers of poetry in our time who go with so much confidence to nature and the scientific interpretation of her for figures for their poetry. The astronomy, the botany, the zoölogy of Albertus Magnus and Thomas Aquinas, Dante knew very well and used confidently for figurative purposes. Anyone who is inclined to think nature study a new idea in the world forgets, or has never known, his Dante. The birds and the bees, the flowers, the leaves, the varied aspects of clouds and sea, the phenomena of phosphorescence, the intimate habits of bird and beast and the ways of the plants, as well as all the appearances of the heavens, Dante knew very well and in a detail that is quite surprising when we recall how little nature study is supposed to have attracted the men of his time. Only that his readers appreciated it all, Dante would surely not have used his scientific erudition so constantly.

So much for the undergraduate department of the universities of the Middle Ages, and the view is absolutely fair, for these were the men to whom the students flocked by thousands. They were teaching science, not literature. They were discussing physics as well as metaphysics, psychology in its phenomena as well as philosophy, observation and experiment as well as logic, the ethical sciences, economics, practically all the scientific ideas that were needed in their generation—and that generation saw the rise of the universities, the finishing of the cathedrals, the building of magnificent town halls and castles and beautiful municipal buildings of many kinds, including hospitals, the development of the Hansa League in commerce, and of wonderful manufacturers of all the textiles, the arts and crafts, as well as the most beautiful book-making and art and literature. We could be quite sure that the men who solved all the other problems so well could not have been absurd only in their treatment of science. Anyone who reads their books will be quite sure of that.

While most people might be ready, then, to confess that possibly Huxley was not mistaken with regard to the undergraduate department of the universities, most of them would feel sure that at least the graduate departments were sadly deficient in accomplishment. Once more this is entirely an assumption. The facts are all against any such idea.

There were three graduate departments in most of the universities—theology, law, and medicine. While physical scientists are usually not cognizant of it apparently, theology is a science, a department of knowledge developed scientifically, and most of these medieval universities did more for its scientific development than the schools of any other period. Quite as much may be said for philosophy, for there are many who hesitate to attribute any scientific quality to modern developments in the matter. As for law, this is the great period of the foundation of scientific law development; the English common law was formulated by Bracton, the deep foundations of basic French and Spanish law were laid, and canon law acquired a definite scientific character which it was always to retain. All this was accomplished almost entirely by the professors in the law departments of the universities.

It was in medicine, however, where most people would be quite sure without any more ado that nothing worth while talking about was being done, that the great triumphs of graduate teaching at the medieval universities were secured. Here more than anywhere else is there room for supreme surprise at the quite unheard-of anticipations of our modern medicine and, stranger still, as it may seem, of our modern surgery.

The law regulating the practice of medicine in the Two Sicilies about the middle of the thirteenth century shows us the high standard of medical education. Students were required to have three years of preliminary study at the university, four years in the medical department, and then practise for a year with a physician before they were allowed to practise for themselves. If they wanted to practise surgery, an extra year in the study of anatomy was required. I published the text of this law, which was issued by the Emperor Frederick II about 1241, in the Journal of the American Medical Association three years ago. It also regulated the practice of pharmacy. Drugs were manufactured under the inspection of the government and there was a heavy penalty for substitution, or for the sale of old inert drugs, or improperly prepared pharmaceutical materials. If the government inspector violated his obligations as to the oversight of drug preparations the penalty was death. Nor was this law of the Emperor Frederick an exception. We have the charters of a number of medical schools issued by the Popes during the next century, all of which require seven years or more of university study, four of them in the medical department, before the doctor's degree could be obtained. When new medical schools were founded they had to have professors from certain well-recognized schools on their staff at the beginning in order to assure proper standards of teaching, and all examinations were conducted under oath-bound secrecy and with the heaviest obligations on professors to be assured of the knowledge of students before allowing them to pass.

It might be easy to think, and many people are prone to do so, that in spite of the long years of study required there was really very little to study in medicine at that time. Those who think so should read Professor Clifford Allbutt's address on the "Historical Relations of Medicine and Surgery" delivered at the World's Fair at St. Louis in 1904. He has dwelt more on surgery than on medicine, but he makes it very clear that he considers that the thinking professors of medicine of the later Middle Ages were doing quite as serious work in their way as any that has been done since. They were carefully studying cases and writing case histories, they were teaching at the bedside, they were making valuable observations, and they were using the means at their command to the best advantage. Of course there are many absurdities in their therapeutics, but then we must not forget there have always been many absurdities in therapeutics and that we are not free from them in our day. Professor Richet, at the University of Paris, said not long ago: "The therapeutics of any generation is quite absurd to the second succeeding generation." We shall not blame the medieval generations for having accepted remedies that afterwards proved inert, for every generation has done that, even our own.

Their study of medicine was not without lasting accomplishment, however. They laid down the indications and the dosage for opium. They used iron with success, they tried out many of the bitter tonics among the herbal medicines, and they used laxatives and purgatives to good advantage. Down at Montpellier, Gilbert, the Englishman, suggested red light for smallpox because it shortened the fever, lessened the lesions, and made the disfigurement much less. Finsen was given the Nobel prize partly for re-discovery of this. They segregated erysipelas and so prevented its spread. They recognized the contagiousness of leprosy, and though it was probably as widespread as tuberculosis is at the present time, they succeeded not only in controlling but in eventually obliterating it throughout Europe.

It was in surgery, however, that the greatest triumphs of teaching of the medieval universities were secured. Most people are inclined to think that surgery developed only in our day. The great surgeons of the thirteenth and fourteenth centuries, however, anticipated most of our teaching. They investigated the causes of the failure of healing by first intention, recognized the danger of wounds of the neck, differentiated the venereal diseases, described rabies, and knew much of blood poisoning, and operated very skilfully. We have their text-books of surgery and they are a never-ending source of surprise. They operated on the brain, on the thorax, on the abdominal cavity, and did not hesitate to do most of the operations that modern surgeons do. They operated for hernia by the radical cure, though Mondeville suggested that more people were operated on for hernia for the benefit of the doctor's pocket than for the benefit of the patient. Guy de Chauliac declared that in wounds of the intestines patients would die unless the intestinal lacerations were sewed up, and he described the method of suture and invented a needle holder. We have many wonderful instruments from these early days preserved in pictures at least, that show us how much modern advance is merely re-invention.

They understood the principles of aseptic surgery very well. They declared that it was not necessary "that pus should be generated in wounds." Professor Clifford Allbutt says:

They washed the wound with wine, scrupulously removing every foreign particle; then they brought the edges together, not allowing wine or anything else to remain within—dry adhesive surfaces were their desire. Nature, they said, produces the means of union in a viscous exudation, or natural balm, as it was afterwards called by Paracelsus, Paré, and Wurtz. In older wounds they did their best to obtain union by cleansing, desiccation, and refreshing of the edges. Upon the outer surface they laid only lint steeped in wine. Powders they regarded as too desiccating, for powder shuts in decomposing matters; wine after washing, purifying, and drying the raw surfaces evaporates.

Almost needless to say these are exactly the principles of aseptic surgery. The wine was the best antiseptic that they could use and we still use alcohol in certain cases. It would seem to many quite impossible that such operations as are described could have been done without anæsthetics, but they were not done without anæsthetics. There were two or three different forms of anæsthesia used during the thirteenth and fourteenth centuries. One method employed by Ugo da Lucca consisted of the use of an inhalant. We do not know what the material employed was. There are definite records, however, of its rather frequent employment.

What a different picture of science at the medieval universities all this makes from what we have been accustomed to hear and read with regard to them. It is difficult to understand where the old false impressions came from. The picture of university work that recent historical research has given us shows us professors and students busy with science in every department, making magnificent advances, many of which were afterwards forgotten, or at least allowed to lapse into desuetude.

The positive assertions with regard to old-time ignorance were all made in the course of religious controversy. In English-speaking countries particularly it became a definite purpose to represent the old Church as very much opposed to education of all kinds and above all to scientific education. There is not a trace of that to be found anywhere, but there were many documents that were appealed to to confirm the protestant view. There was a Papal bull, for instance, said to forbid dissection. When read it proves to forbid the cutting up of bodies to carry them to a distance for burial, an abuse which caused the spread of disease, and was properly prohibited. The Church prohibition was international and therefore effective. At the time the bull was issued there were twenty medical schools doing dissection in Italy and they continued to practise it quite undisturbed during succeeding centuries. The Papal physicians were among the greatest dissectors. Dissections were done at Rome and the cardinals attended them. Bologna at the height of its fame was in the Papal States. All this has been ignored and the supposed bull against anatomy emphasized as representing the keynote of medical and surgical history. Then there was a Papal decree forbidding the making of gold and silver. This was said to forbid chemistry or alchemy and so prevent scientific progress. The history of the medical schools of the time shows that it did no such thing. The great alchemists of the time doing really scientific work were all clergymen, many of them very prominent ecclesiastics.

Just in the same way there were said to be decrees of the Church councils forbidding the practice of surgery. President White says in his "Warfare of Science with Theology in Christendom," that, as a consequence of these, surgery was in dishonor until the Emperor Wenceslaus, at the beginning of the fifteenth century, ordered that it should be restored to estimation. As a matter of fact, during the two centuries immediately preceding the first years of the fifteenth century, surgery developed very wonderfully, and we have probably the most successful period in all the history of surgery except possibly our own. The decrees forbade monks to practise surgery because it led to certain abuses. Those who found these decrees and wanted to believe that they prevented all surgical development simply quoted them and assumed there was no surgery. The history of surgery at this time is one of the most wonderful chapters in human progress.

The more we know of the Middle Ages the more do we realize how much they accomplished in every department of intellectual effort. Their development of the arts and crafts has never been equalled in the modern time. They made very great literature, marvellous architecture, sculpture that rivals the Greeks', painting that is still the model for our artists, surpassing illuminations; everything that they touched became so beautiful as to be a model for all the after time. They accomplished as much in education as they did in all the other arts, their universities had more students than any that have existed down to our own time, and they were enthusiastic students and their professors were ardent teachers, writers, observers, investigators. While we have been accustomed to think of them as neglecting science, their minds were occupied entirely with science. They succeeded in anticipating much more of our modern thought, and even scientific progress, than we have had any idea until comparatively recent years. The work of the later Middle Ages in mathematics is particularly strong, and was the incentive for many succeeding generations. Roger Bacon insisted that, without mathematics, there was no possibility of real advance in physical science. They had the right ideas in every way. While they were occupied more with the philosophical and ethical sciences than we are, these were never pursued to the neglect of the physical sciences in the strictest sense of that term.

Is it not time that we should drop the foolish notions that are very commonly held because we know nothing about the Middle Ages—and, therefore, the more easily assume great knowledge—and get back to appreciate the really marvellous details of educational and scientific development which are so interesting and of so much significance at this time?

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APPENDIX III
MEDIEVAL POPULARIZATION OF SCIENCE

The idea of collecting general information from many sources, of bringing it together into an easily available form, so as to save others labor, of writing it out in compendious fashion, so that it could readily pass from hand to hand, is likely to be considered typically modern. As a matter of fact, the Middle Ages furnish us with many examples of the popularization of science, of the writing of compendia of various kinds, of the gathering of information to save others the trouble, and, above all, of the making of what, in the modern time, we would call encyclopedias. Handbooks of various kinds were issued, manuals for students and specialists, and many men of broad scholarship in their time devoted themselves to the task of making the acquisition of knowledge easy for others. This was true not only for history and philosophy and literature, but also for science. It is not hard to find in each century of the Middle Ages some distinguished writer who devoted himself to this purpose, and for the sake of the light that it throws on these scholars, and the desire for information that must have existed very commonly since they were tempted to do the work, it seems worth while to mention here their names, and those of the books they wrote, with something of their significance, though the space will not permit us to give here much more than a brief catalogue raisonné of such works.

Very probably the first who should be mentioned in the list is Boëthius, who flourished in the early part of the sixth century. He owed much of his education to his adoptive father, afterwards his father-in-law, Symmachus, who, with Festus, represented scholarship at the court of the Gothic King, Theodoric of Verona. These three—Festus, Symmachus, and Boëthius—brought such a reputation for knowledge to the court that they are responsible for many of the wonderful legends of Dietrich of Bern, as Theodoric came to be called in the poems of the medieval German poets. The three distinguished and devoted scholars did much to save Greek culture at a time when its extinction was threatened, and Boëthius particularly left a series of writings that are truly encyclopedic in character. There are five books on music, two on arithmetic, one on geometry, translations of Aristotle's treatises on logic, with commentaries; of Porphyry's "Isagoge," with commentaries, and a commentary on Cicero's "Topica." Besides, he wrote several treatises in logic and rhetoric himself, one on the use of the syllogism, and one on topics, and in addition a series of theological works. His great "Consolations of Philosophy" was probably the most read book in the early Middle Ages. It was translated into Anglo-Saxon by King Alfred, into old German by Notker Teutonicus, the German monk of St. Gall, and its influence may be traced in Beowulf, in Chaucer, in High German poetry, in Anglo-Norman and Provençal popular poetry, and also in early Italian verse. Above all, the "Divine Comedy" has many references to it, while the "Convito" would seem to show that it was probably the book that most influenced Dante. Though it is impossible to confirm by documentary evidence the generally accepted idea that Boëthius died a martyr for Christianity, the tradition can be traced so far back, and it has been so generally accepted that this seems surely to have been the case. The fact is interesting, as showing the attitude of scholars towards the Church and of the Church towards scholarship thus early.

The next great name in the tradition should probably be that of Cassiodorus, the Roman writer and statesman, prime minister of Theodoric, who, after a busy political life, retired to his estate at Vivarium, and, in imitation of St. Benedict, who had recently established a monastery at Monte Cassino, founded a monastery there. He is said to have lived to the age of ninety-three. His retirement favored this long life, for, after the death of Theodoric, troublous times came, and civil war, and only his monastic privileges saved him from the storm and stress of the times. He had been interested in literature and the collection of information of many kinds before his retirement, and it is not unlikely that his recognition of the fact that the monastic life offered opportunities for the pursuit of this, under favorable circumstances, led him to take it up.

While still a statesman he wrote a series of works relating to history and politics and public affairs generally. These consisted mainly of chronicles and panegyrics, and twelve books of miscellanies called Variæ. After his retirement to the monastery, a period of ardent devotion to writing begins, and a great number of books were issued. He evidently gathered round him a number of men whom he inspired with his spirit, or, perhaps, selected, because he found that, while they had a taste for a quiet, peaceful spiritual life, they were also devoted to the accumulation and diffusion of knowledge. A series of commentaries on portions of the Scriptures was written, the Jewish antiquities of Josephus translated, and the ecclesiastical histories of Theodoric, Sozomen, and Socrates made available in Latin. Cassiodorus himself is said to have made a compendium of these, called the "Historia Tripartita," which was much used as a manual of history during succeeding centuries. Then there were treatises on grammar, on orthography, and a series of works on mathematics. In all of his writings Cassiodorus shows a special fondness for the symbolism of numbers.

There is a well-grounded tradition that he insisted on the study of the Greek classics of medical literature, especially Hippocrates and Galen, and awakened the interest of the monks in the necessity for making copies of these fathers of medicine. The tradition that he established at Vivarium is also found to have existed at Monte Cassino among the Benedictines, and, doubtless, to this is to be attributed the foundation of the medical school of Salerno, where Benedictine influence was so strong. It is probable, therefore, that to Cassiodorus must be attributed the preservation in as perfect a state as we have them of the old Greek medical writers.

His main idea was, of course, the study of Scriptures, but with just as many helps as possible. He thought that commentators, and historians, not alone Christian, but also Hebrew and Pagan, should be studied to illustrate it, and then the commentaries of the Latin fathers, so that a thoroughly rounded knowledge of it should be obtained. He thus began an "Encyclopedia Biblica," and set a host of workers at its accomplishment.

Every country in Europe shared this movement for the diffusion of information during the early Middle Ages, and the works of men from each of these countries in succeeding centuries has come down to us, preserved in spite of all the vicissitudes to which they were so liable during the centuries before the invention of printing and the easy multiplication of books. To many people it will seem surprising to learn that the next evidence of deep broad interest in knowledge is to be found in the next century in the distant west of Europe, in the Spanish Peninsula. It is a long step from the semi-barbaric splendor of the Gothic court at Verona, to the bishop's palace in Seville in Andalusia. The two cities are separated by what is no inconsiderable distance in our day. In the seventh century they must have seemed almost at the other end of the world from each other. Those who recall what we have insisted on in several portions of the body of this work with regard to the high place Spanish genius won for itself in the Roman Empire, and how much of culture among the Spaniards of that time the occurrence of so many important writers of that nationality must imply, will not be surprised at the distinguished work of a great Christian Spanish writer of the seventh century.

Indeed, it would be only what might be expected for evidences of early awakening of the broadest culture to be found in Spain. The important name in the popularization of science in the seventh century is St. Isidore of Seville. He made a compendium of all the scattered scientific traditions and information of his time with regard to natural phenomena in a sort of encyclopedia of science. This consisted of twenty books—chapters we would call them now—treating almost de omni re scibili et quibusdam aliis (everything knowable and a few other things besides). It is possible that the work may have been written by a number of collaborators under the patronage of the bishop, though there is no sure indication of this to be found either in the volume itself or even contemporary history. All the ordinary scientific subjects are treated. Astronomy, geography, mineralogy, botany, and even man and the animals have each a special chapter. Pouchet, in his "History of the Natural Sciences During the Middle Ages," calls attention to the fact that, in grouping the animals for collective treatment in the different chapters, sometimes the most heterogeneous creatures are brought under a common heading. Among the fishes, for instance, are classed all living things that are found in water. The whale and the dolphin, as well as sponges, and oysters, and crocodiles, and sea serpents, and lobsters, and hippopotamuses, all find a place together, because of the common watery habitation. The early Spanish Churchman would seem to have had an enthusiastic zeal for complete classification that would surely have made him a strenuous modern zoölogist.

The next link in the tradition of encyclopedic work is the Venerable Bede, whose character was more fully honored by the decree on November 13, 1899, by Pope Leo XIII declaring him a Doctor of the Church. Bede was the fruit of that ardent scholarship which had risen in England as a consequence of the introduction of Christianity. It had been fostered by the coming of scholar saints from Ireland, but was, unfortunately, disturbed by the incursions of the Danes. While Bede is known for his greatest work, the "Ecclesiastical History of the English People," which gives an account of Christianity in England from its beginning until his own day, he wrote many other works. His history is the foundation of all our knowledge of early British history, secular as well as religious, and has been praised by historical writers of all ages, who turned to it for help with confidence. He wrote a number of other historical works. Besides, he wrote books on grammar, orthography, the metrical art, on rhetoric, on the nature of things, the seasons, and on the calculation of the seasons. These latter books are distinctly scientific. His contributions to Gregorian Music are now of great value.

After this, Alcuin and the monks, summoned by Charlemagne, take up the tradition of gathering and diffusing information, and the great monasteries of Tours, Fulda, and St. Gall carry it on. Besides these, in the ninth century Monte Cassino comes into prominence as an institution where much was done of what we would now call encyclopedic work. After his retirement from Salerno Constantine Africanus made his translations and commentaries on Arabian medicine, constituting what was really a medical encyclopedia of information not readily available at that time.

After this, of course, the tradition is taken up by the universities, and it is only when, with the thirteenth century, there came the complete development of the university spirit, that encyclopedias reached their modern expression. Three great encyclopedists, Vincent of Beauvais, Thomas of Cantimprato, and Bartholomæus Anglicus, are the most famous. Vincent consulted all the authors sacred and profane that he could lay hold on, and the number was, indeed, prodigious. I have given some account of him in "The Thirteenth Greatest of Centuries" (Catholic Summer School Press, New York, third edition, 1910).

It would be very easy to conclude that these encyclopedias, written by clergymen for the general information of the educated people of the times, contain very little that is scientifically valuable, and probably nothing of serious medical significance. Any such thought is, however, due entirely to unfamiliarity with the contents of these works. They undoubtedly contain absurdities, they are often full of misinformation, they repeat stories on dubious authority, and sometimes on hearsay, but usually the source of their information is stated, and especially where it is dubious, as if they did not care to state marvels without due support. Books of popular information, however, have always had many queer things,—queer, that is, to subsequent generations,—and it is rather amusing to pick up an encyclopedia of a century ago, much less a millennium ago, and see how many absurd things were accepted as true. The first edition of the "Encyclopedia Britannica," issued one hundred and fifty years ago, furnishes an easily available source of the absurdities our more recent forefathers accepted. The men of the Middle Ages, however, were much better observers as a rule, and used much more critical judgment, according to their lights, than we have given them credit for. Often the information that they have to convey is not only valuable, but well digested, thoroughly practical, and sometimes a marvellous anticipation of some of our most modern thoughts. There is one of these encyclopedias which, because it was written in my favorite thirteenth century, I have read with some care. It is simply a development of the work of preceding clerical encyclopedists, and often refers to them. Because it contains some typical examples of the better sorts of information in these works, I have thought it worth while to quote two passages from it. The author is Bartholomæus Anglicus, and the quaint English in which it is couched is quoted from "Medical Lore" (London, 1893). The book is all the more interesting because in a dear old English version, issued about 1540, the spellings of which are among the great curiosities of English orthography, it was often read and consulted by Shakespeare, who evidently quotes from it frequently, for not a little of the quaint scientific lore that he uses for his figures can be traced to expressions used in this book.

The first of the paragraphs that deserves to be quoted, discusses madness, or, as we would call it, lunacy, and sums up the causes, the symptoms, and the treatment quite as well as that has ever been done in the same amount of space:

Madness cometh sometime of passions of the soul, as of business and of great thoughts, of sorrow and of too great study, and of dread: sometime of the biting of a wood hound, or some other venomous beast; sometime of melancholy meats, and sometime of drink of strong wine. And as the causes be diverse, the tokens and signs be diverse. For some cry and leap and hurt and wound themselves and other men, and darken and hide themselves in privy and secret places. The medicine of them is, that they be bound, that they hurt not themselves and other men. And namely, such shall be refreshed, and comforted, and withdrawn from cause and matter of dread and busy thoughts. And they must be gladded with instruments of music, and some deal be occupied.'

The second discusses in almost as thorough a way the result of the bite of a mad dog. The old English word for mad, wood, is constantly used. The causes, the symptoms, and course of the disease, and its possible prevention by early treatment, are all discussed. The old tradition was already in existence that sufferers from rabies or hydrophobia, as it is called, dreaded water, when it is really only because the spasm consequent upon the thought even of swallowing is painful that they turn from it. That tradition has continued to be very commonly accepted even by physicians down to our own day, so that Bartholomew, the Englishman, in the thirteenth century, will not be blamed much for setting it forth for popular information in his time some seven centuries ago. The idea that free bleeding would bring about the removal of the virus is interesting, because we have in recent years insisted in the case of the very similar disease, tetanus, on allowing or deliberately causing wounds in which the tetanus microbe may have gained an entrance, to bleed freely.

The biting of a wood hound is deadly and venomous. And such venom is perilous. For it is long hidden and unknown, and increaseth and multiplieth itself, and is sometimes unknown to the year's end, and then the same day and hour of the biting, it cometh to the head, and breedeth frenzy. They that are bitten of a wood hound have in their sleep dreadful sights, and are fearful, astonied, and wroth without cause. And they dread to be seen of other men, and bark as hounds, and they dread water most of all things, and are afeared thereof full sore and squeamous also. Against the biting of a wood hound wise men and ready use to make the wounds bleed with fire or with iron, that the venom may come out with the blood, that cometh out of the wound.