During the following four centuries the University of Salerno—for during the thirteenth century it became a university in fact, if not in name—retrograded steadily, until finally the French Government, on November 29, 1811, officially put an end to its existence. The traveler who to-day visits Salerno, in the hope of seeing some remains of the oldest medical school in Europe, will find there only a collection of squalid buildings which serve as dwellings for the poorer classes, a dirty and uncomfortable inn, and shops of nearly the same dimensions as those which once lined the narrow streets of Pompeii. As he gazes, however, at the superb view presented by the Gulf of Salerno he may readily, by an effort of the imagination, reconstruct the picture of the famous “Hippocratic City” as it was when William the Conqueror and other distinguished persons visited it nearly a thousand years ago.
Neuburger, in his review of the career of the Salerno Medical School, sums up its contributions to the science of medicine in about these terms: Those who taught at Salerno were the first physicians in the Christian part of Western Europe who procured for medicine a home in which scientific considerations alone prevailed, where the Church exercised no control whatever, and where all the different branches of the science were favored to an equal degree. They devoted their best energies, by oral teaching and by their writings, to the single object of communicating practical knowledge of the healing art to all who desired to obtain it; and, by the admirable example of their own lives, they furnished a high standard for the guidance of those who wished to reflect honor upon the name of physician.
CHAPTER XXII
EARLY EVIDENCES OF THE INFLUENCE OF THE RENAISSANCE UPON THE PROGRESS OF MEDICINE IN WESTERN EUROPE
In previous chapters we have seen how the Arabs, inspired with an extraordinary zeal for acquiring knowledge of the different sciences, devoted time and money freely, throughout a period of several centuries, to the accomplishment of this purpose. They were fired with ambition to become a great nation, and their studies of the world’s history taught them that the ancient Greeks had accumulated in their literature vast stores of the very knowledge which they were so anxious to acquire. Accordingly all their energies were directed toward converting these stores from the Greek into their own language, the Arabic. This widespread eagerness of the nation, at a given period of its history, to improve itself intellectually is spoken of as the Arabic Renaissance, and, at the time which I am now about to consider, the movement had practically come to a standstill. A short time, however, before this occurred, the physicians of Italy and of the more northerly countries of Western Europe began to show a similar desire to add to their medical literature; and their first step, like that of the Arabs four or five centuries earlier, was directed to the work of translating Arabic medical treatises into debased Latin, which was the language commonly employed by the learned during the Middle Ages. The knowledge which they desired to acquire could not at that time be obtained in any other way, for nobody was acquainted with the Greek language, and, besides, Greek originals had not yet been brought into Western Europe. These first evidences of the Renaissance in that part of the world were not confined to physicians; they were to be found in every walk of life. The development of the movement reminds one of what takes place near the sea coast, where a period of heat and calm is suddenly broken by the appearance of a few gentle puffs of wind, which are quickly succeeded by the full force of a steady and refreshing sea-breeze. In like manner feeble indications of the coming movement appeared in Italy, France, Germany and even England, and these were soon followed by unmistakable evidences that a genuine Renaissance of widespread proportions had begun. It was as if a great awakening had taken place among the nations which had for centuries lain dormant; an awakening which was followed by a desire to lay aside the trivial pursuits in which they had so far been engaged, and to attain those results which were, later on, to excite the wonder and admiration of the world. Such were, for example, the development of the art of printing with movable types; the discovery of America; the production of such clever painters, sculptors, engravers, workers in metal, etc., as Michael Angelo, Raphael, Albrecht Dürer, Benvenuto Cellini, Rembrandt, and literally scores of others of nearly equal merit; the development of a Shakespeare, a Milton and a Dante in the field of literature; the production of a Luther, a man who had the courage to protest against evil practices which had crept into the Christian church. And medicine, as I have already stated, felt the influence of the approaching Renaissance, and responded to it by efforts which had for their object the acquisition of such knowledge as might be furnished by translations from Arabic treatises. Constantinus, the African, of whom mention has been made on a previous page, seems to have been the first person (toward the end of the eleventh century) who did any work of this kind; but his associates in Salerno do not appear to have valued these translations very highly, or else, perhaps, they were not yet prepared to give serious consideration to works which were new to them. In the twelfth century, as will now be seen, the attitude of the physicians of Western Europe underwent a change.
The city of Toledo, in Spain, was richly stocked with the manuscript treasures of Arabic literature at the time (1085 A. D.) when it fell into the hands of the Christians. One of the earliest scholars to engage in the work of translating these treasures into Latin was Gerard of Cremona, in Lombardy, who lived during the twelfth century (1114–1187 A. D.). He spent most of his lifetime in Toledo, “learning and teaching, reading and translating.” (Neuburger.) Among the medical works which he translated from the Arabic the most important are the following: Several of the writings of Hippocrates and Galen; the Breviarium of Serapion; several of the writings of Rhazes and of Isaac Judaeus; the treatise on surgery by Abulcasis; the Canon of Avicenna, etc. This stimulated many others to follow in the footsteps of Gerard of Cremona; and thus, during the thirteenth century, a number of works of importance were translated in addition to those already mentioned. Such, for example, were the “Colliget” of Averroes by Bonacosa, a Jew (1255) of Padua; the “Teïssir” of Avenzoar, and the “Dietetics” of Maimonides by John of Capua, a Jewish convert to Christianity (1262–1278); the “De veribus cordis” of Avicenna by Arnaldus of Villanova (about 1282); the treatise “De simplicibus” of Serapion the Younger, and the “Liber servitoris” of Abulcasis, by Simon Januensis; and many others. This wave of keen interest in the writings of Arabic physicians and in the Arabic versions of Greek medical authors soon reached Languedoc in France, and then passed over from there into Italy. For a long time the Salerno physicians resisted its influence, but they finally yielded to it, as the leaders in the schools of Bologna, Naples, Montpellier and Paris had already done. It was at Palermo, in Sicily, however, that the movement received its greatest impetus. Frederick II., at that time King of Sicily, and a ruler who was most tolerant in religious matters, had at his Court an entire staff of Arabic physicians, philosophers, astrologers and poets; and, in addition, he kept a number of learned Christians and Jews constantly busy translating Arabic works into Latin. The most widely known member of the latter group was Michael Scotus (or Scottus), who at one time had been a teacher in the Medical School of Salerno. Among the books which he translated while he was at Palermo there were several of Aristotle’s treatises, more particularly those which dealt with psychological topics and with natural history. Frederick not only did everything in his power to promote the work of translating, he also took pains to distribute copies of the Latin versions, when completed, among the universities of Western Europe. His son, Manfred, who succeeded him on the throne, seems to have been almost as much interested in the work as his father had been. It was from him, for example, that the University of Paris received a set of the Aristotle volumes in Latin. When Charles I., King of Naples (1265–1285 A. D.), conquered Sicily he manifested considerable interest in continuing the work of his predecessors, particularly as regards treatises relating to medicine. Among the translators whom he employed for this work was Farragut (in Arabic, Faradsch ben Salem), from Girgenti, a small town on the south coast of Sicily, about sixty miles from Palermo. In addition to several treatises of minor importance he translated into Latin the colossal work of Rhazes—the “Continens.” Charles I. kept at his Court not only expert translators, but also skilled illuminators; and it was by them that the celebrated manuscript copy of this work which is to-day in the Bibliothèque Nationale at Paris, was illustrated with miniatures, three of which are portraits of Farragut. This particular copy of the “Continens” was completed in 1282 A. D. Not a few of the translations made during this period, it should be stated, are now very difficult to understand. In the first, place, the Latin in which they are written is of the barbaric type (neo-Latin), something quite different from that employed by Cicero, Tacitus and other Roman authors of the classical period; and, in the next, it is not infrequently evident that the translator himself did not clearly apprehend the meaning of the original Arabic text. Despite all these drawbacks, however, the placing of Latin versions of Arabic writings within the reach of European physicians accomplished much good. Even the imperfections to which reference has just been made probably served to increase the eagerness of these men to gain access to the real sources of Arabic learning—viz., the writings in the original Greek. To anticipate a little, I may say here that this object was not attained until after the lapse of about two more centuries—that is, not until the scholars of Western Europe had learned to read the Greek, and had also brought out from their hiding places in churches and monasteries of the East the needed originals. At that period of the world’s history centuries corresponded to decades as modern events are recorded.
One may gain some idea of the extent to which these Latin translations of Arabic original treatises and of Arabic versions of Greek medical works influenced the physicians of Western Europe, by consulting one of the important medical treatises of the fourteenth century—that, for example, of Guy de Chauliac (written 1363 A. D.). Edouard Nicaise, the accomplished editor of this and several other mediaeval medical treatises, has printed in his preface Joubert’s table showing just how often Guy quotes each one of about four score earlier authors, and from this analysis it appears that Abulcasis was quoted 175 times, Aristotle 62 times, Avicenna 661 times, Galen 890 times, Haly Abbas 149 times, Mesué 61 times, Hippocrates 120 times, and Rhazes 161 times; or, to state the facts somewhat differently, the quotations from treatises introduced into Western Europe by the Arabs represent, in the present instance, 70 per cent of all the quotations (2279 of a total of 3243) made by this author. Another equally strong piece of evidence is that afforded by Vincent de Beauvais’ encyclopaedia,—a work published in Paris toward the middle of the thirteenth century,—in which the parts relating to medicine appear to have been taken very largely from treatises written by Arabic authors. (See statement on page 270.) There can therefore be no reasonable doubt that the Arabs played a most important part in the renaissance of medical learning which began a century or two earlier, which already in the thirteenth century had made great progress, and which very soon—as time is reckoned in the calendar of all important world movements—was to culminate in that still greater renaissance called “modern medicine.”
During the later portion of the Middle Ages (thirteenth and fourteenth centuries) there were four universities which possessed medical schools of considerable importance—viz., those of Bologna and Padua in Italy, and those of Montpellier and Paris in France. All of these seats of learning, like the famous school at Salerno, developed so gradually and from such modest beginnings that it is scarcely possible to assign to any of them a date of origin. Medicine was taught at several other places—as, for instance, at Oxford, England; at Naples, Vicenza, Siena, Rome, Florence, Ferrara, Pisa and Pavia, in Italy; at Salamanca and Lerida, in Spain; at Prague, in Bohemia; at Cologne, in Germany; at Vienna, in Austria, etc. But the part which these smaller schools played in the work of advancing our knowledge of medicine was certainly of far less importance than that which fell to the lot of the four institutions just mentioned.
The University of Montpellier, if not the oldest of the four schools mentioned, was apparently the first to attain some degree of celebrity. It is known, for example, that the Archbishop of Lyons, who was suffering at the time from some malady which the physicians of that city were not able to cure, visited Montpellier 1153 A. D. in the belief that he might there obtain the desired relief. John of Salisbury, who lived during the latter half of the twelfth century and who was considered one of the greatest scholars of his time, declared that those who wished to acquire a satisfactory knowledge of medicine, found that Salerno and Montpellier were the only places where the desired instruction might be obtained. Gilles de Corbeil (mentioned in the last chapter), Von der Aue, and other eminent men of the same period spoke in equally favorable terms of the merits of Montpellier. The celebrated monk, Caesarius of Heisterbach, calls the university of that city “the headquarters of medical wisdom”; but at the same time he expresses regret that the physicians of that school not only do not believe in miraculous cures, but speak of them ironically. It was one of the characteristics of the institution that the teachers, both the medical and the philosophical, were, at a very early period, allowed great freedom of thought and speech; but, as time went on, this liberty became very much curtailed. During the thirteenth and fourteenth centuries there were, it appears, many Jews among the students at Montpellier, not merely in the department of medicine, but also in the other departments of the university.
The medical schools of Salerno and Montpellier seemed, at this early period (thirteenth century), to possess more individuality than did the similar organizations at Bologna, Padua and Paris; for limited periods of time each of them in turn enjoyed a certain amount of fame by reason of the fact that some teacher or writer of special distinction happened then to be officially connected with the school. In other words, it was the fame of the man and not of the school, that induced students to visit Bologna or Padua, or Paris, during the thirteenth and fourteenth centuries. At a somewhat later period (fifteenth and sixteenth centuries) all three of these institutions stood out prominently before the world as celebrated medical schools, with distinctive characteristics. To be invited to occupy a chair in one of these institutions conferred honorable distinction upon the incumbent selected, and when I reach that period, farther on in this history, I shall describe each one of the more important schools separately. In dealing with the earlier epoch, however, it seems best to devote our attention more particularly to individual physicians than to the schools with which they may happen to be connected.
Among the physicians belonging to the latter half of the thirteenth and the first quarter of the fourteenth century there is one whose proper place in the history of medicine is by no means easy to determine, and who yet played a part of no small importance. This man was Pietro d’Abano, or Petrus Aponensis, who was born at Abano, a small village near Padua, 1250 A. D. Very little is known about his early youth, but from this little we are warranted in drawing the conclusion that his father, a notary, must have taken great pains to afford him every possible educational advantage. He gave his son, for example, the opportunity of studying Greek in Constantinople,—a thing of rare occurrence in those early days,—and allowed him to remain there until he had so far mastered the language that he was able to translate the “Problemata” of Aristotle from the original text. Then, upon his return home from Constantinople, he was sent to Paris for the purpose of perfecting his knowledge of philosophy, mathematics and medicine. After this thorough training for his life work, Pietro d’Abano began teaching philosophy in Padua, and almost immediately he gained such success that people spoke of him as “the great Lombard.” However, like most of the men of that time who became conspicuous through their intellectual attainments, Pietro d’Abano was soon accused by the Dominicans of being a heretic and of cultivating the magician’s art. He was able to parry this blow by making a journey to Rome and obtaining from Pope Boniface VIII. a decree of absolution. About the same time he began writing his two great works—the “Conciliator” and the “Commentaries on Aristotle’s Problemata.” He did not begin to teach medicine at the University of Padua until 1306, when he was already fifty-six years of age. But his lectures, reflecting as they did the depth and extent of his learning and the keenness of his powers of analysis, were a source of great astonishment to his contemporaries. It is reported by Neuburger, for example, that Gentile da Foligno, one of the most distinguished professors in the Medical School of Padua, happening to pass near the auditorium while Pietro d’Abano was delivering his lecture, listened for a short time and then exclaimed: “Salve o santo tempio”—“Hail to this time which has brought forth such wonders!” With the increase of Pietro’s fame came also a decided increase in the bitterness of the persecution carried on against him by his ecclesiastical foes, largely due perhaps to his open and courageous defense of the Averroism which they so much hated. There is very little doubt that he would have been burned at the stake about this time if the friendly disposition of the Popes and the mighty influence possessed by the city of Padua had not shielded him from this danger. In 1314 the newly founded school of Treviso invited Pietro d’Abano to occupy the Chair of Medicine and Physics, and he accepted; but he was taken ill and died during the following year. Shortly before the occurrence of this event he was placed on trial for heresy by the Inquisition, and the proceedings were continued even after his death. Indeed, according to one account of this famous trial, not only was the charge sustained, but the prescribed penalty was inflicted either upon the disinterred corpse or upon an effigy of the condemned man. One century later, the city of Padua erected a permanent memorial in Pietro d’Abano’s honor.