(From Chirurgie de Pierre Franco, edited by E. Nicaise, Paris, 1895.)
The State of Medicine and Surgery in Countries Other than Italy and France During the Later Portion of the Middle Ages.—From the account given by Neuburger it appears that the seeds planted by the famous teachers of medicine and surgery in Italy and France during the thirteenth and fourteenth centuries had begun to take root in England and in the Low Countries to the north of France, and were in fact already producing some good fruit in those lands. Thus, for example, there have been handed down to our time the names of four physicians who attained a certain degree of eminence in England during the thirteenth and fourteenth centuries—Gilbertus Anglicus, John of Gaddesden, John Mirfeld and John Arderne.
Gilbertus Anglicus, who was the first English medical writer to secure a certain degree of celebrity among the physicians of continental Europe, wrote a compendium of medicine that was commonly called the “Laurea anglica.” The book contains, along with some good original observations and the records of his own experience, not a few wearisome theoretical discussions; and at the same time it reveals the fact that the author was inclined to favor remedial measures of a superstitious nature. In the last chapter of his compendium, however, he makes the very practical suggestion that distillation may be resorted to when one desires to purify water that is contaminated. Gilbertus, after obtaining his preliminary training in England in the early part of the thirteenth century, visited some of the leading schools on the continent, among others those of Salerno and Montpellier, in which latter city he appears to have practiced medicine for a certain length of time.
John of Gaddesden, who is also spoken of as Johannes Anglicus, was born about 1280 A. D. and died in 1361. He was therefore a contemporary of Guy de Chauliac. He is said to have been a Fellow of Merton College, Oxford, and to have held the positions of Prebendary of St. Paul’s, London, and of private physician to the royal family. He was also the author of a medical treatise which was generally known by the title, “Rosa Anglica” (first printed in 1492). Neuburger speaks of this book as being an imitation of Gourdon’s “Lilium Medicinae,” but of a somewhat inferior grade, and he quotes two or three passages which show that medicine was in a very low stage of development in England at the beginning of the fourteenth century. Gaddesden, for example, advises his confrères to adopt the rule of always securing their honorarium before they undertake the treatment of a sick person. In another part of the book he states that he treated one of the sons of Edward II. for small-pox and secured excellent results, not merely as regards the perfect restoration of his health, but also as regards the complete prevention of any pitting of his face. He attributes this success to the fact that he enveloped the patient in a red cloth and took pains to have every object in the vicinity of the bed draped in red.[71]
John Mirfeld, who lived during the second half of the fourteenth century, completed his medical studies in Oxford, then entered the Monastery of St. Bartholomew’s in London, and devoted himself thenceforward to work in connection with the hospital belonging to that institution. Among the books which he wrote there are a few that deal with matters of interest to the physician. Such, for example, are a glossary which bears the title “Synonyma Bartholomaei,” a work called the “Breviarium Bartholomaei,” and a shorter treatise on prognosis—the “Speculum.” None of these, however, possesses any special importance.
FIG. 13. THE PHYSICIAN, THE SURGEON AND THE PHARMACIST.
Reproduction of a miniature at the head of Guy de Chauliac’s La Grande Chirurgie, edited by E. Nicaise, Paris, 1890.
John Arderne was born in England 1307 A. D., probably obtained his medical training in Montpellier, accompanied the English Army to France in the character of a “Sergeant-Surgion,” and was present at the battle of Crécy (1346 A. D.). During the succeeding twenty-four years he practiced medicine in Wiltshire and Newark, and then settled for the remainder of his life in London. Although his practice included both internal diseases and those which required surgical treatment, the great reputation which he acquired was based chiefly upon his success in the latter field. Most of his writings, it appears, are still in the form of manuscript. They deal chiefly with surgery and are accompanied by drawings of the instruments which he employed. They possess one feature which distinguishes them from the majority of medical writings of the Middle Ages, viz., they abound in reports of cases observed and treated by the author; and, furthermore, the methods of treatment which he recommends are in most instances rational and of a relatively simple nature. The only one of Arderne’s treatises which has been printed is that relating to fistula in ano. It bears the title, “John Arderne—Treatises of Fistula in Ano, Haemorrhoids, and Clysters; from an early fifteenth-century manuscript translation,” and is edited by D’Arcy Power, Early English Text Society, Original Series, 139; London and Oxford, 1910. Arderne, we are told by Neuburger, puts forward two claims: 1, that he succeeded in curing a large number of cases of anal fistula, in proof of which he gives the names of the persons upon whom he operated successfully, many of whom are high up in the social scale; and, 2, that no other surgeon of whom he has any knowledge, either in England or on the continent of Europe, is able to cure the disease.
The three English physicians of whom I have here given very brief accounts, can scarcely be said to compare favorably with those men who, during the same period, brought fame to the medical schools of Bologna, Padua, Montpellier and Paris; and this fact suggests the question, Do these men really represent the best type of physicians who lived in England during the fourteenth century? The great English poet Chaucer, in his “Canterbury Tales” (written at about the same period of time), furnishes us with a portrait of a man who appears to have been well informed with regard to the earlier Greek and Arabian medical authorities as well as with the leading physicians of his own time, and who in addition was clever both in ascertaining the causes and nature of his patients’ maladies and in prescribing for them the proper remedies. As this physician’s name is not mentioned, we cannot be sure that he was not one of the three to whom reference has just been made. By the description given by the poet, who probably was personally acquainted with the man whose portrait he draws, one is tempted to believe that he was a physician of a higher type than any one of the three named above. Chaucer’s account reads as follows:—