The Council of Chalcedon placed such clergy as lived in establishments where orphans, the aged, and infirm were received and cared for under the authority of the Bishops, and makes use of the expression that this regulation was according to ancient custom.
In the time of the Council of Chalcedon a hospital (ξενοδοχεῖον) seems to have been a common adjunct of a church.[532] Originally appropriated to the reception of strangers, its use was afterwards extended to the relief of the poor and also of the sick, as at Alexandria, where, in A.D. 399, we read that “the priest Isidore being four-score years old, was at that time governor of the hospital.”[533]
In connection with the story of Hypatia at Alexandria, we learn that the Parabolani was the name given to the clergy of the lowest order, who were appointed to attend to the sick, particularly in contagious disorders, from which circumstance, says Fleury,[534] their name was derived, because it signifies persons who expose themselves.
Moschion Diorthortes (about the 6th cent.) was a specialist in diseases of women. He wrote a manual for midwives based on the work of Soranus. His description of the uterus is similar to the treatise of that physician. He refutes the opinion of the ancients on the situation of male infants on the right, and of females on the left. He has well indicated the signs of imminent abortion. He made a great number of observations on the physical education of children which must have been of great importance to his time. He justly explained the reason for the cessation of the catamenia after severe diseases: the system cannot afford the waste. He anticipated the modern discovery that sterility is a disease common to women and men. He adhered to the principles of the Methodical school, and the doctrines of strictum and laxum.[535]
Paulus Ægineta, one of the most famous of the Greek writers on medicine, was born in the island of Ægina, probably in the latter half of the seventh century after Christ. He was an Iatrosophist, and a Periodeutes, or one who travelled about in the exercise of his profession. He wrote several books on medicine, of which one has come down to us, called De re Medica Libri Septem, or “Synopsis of Medicine in seven books.” Dr. Adams, in his translation of this famous work for the Sydenham Society, gives us the original introduction to the treatises of this physician, who informs us that:—
“In the first book you will find everything that relates to hygiene, and to the preservation from, and correction of, distempers peculiar to the various ages, seasons, temperaments, and so forth; also the powers and use of the different articles of food, as is set forth in the chapter of contents. In the second is explained the whole doctrine of fevers, an account of certain matters relating to them being premised, such as excrementitious discharges, critical days, and other appearances, and concluding with certain symptoms which are the concomitants of fevers. The third book relates to topical affections, beginning from the crown of the head, and descending down to the nails of the feet. The fourth book treats of those complaints which are external and exposed to view, and are not limited to one part of the body, but affect various parts. Also, of intestinal worms and dracunculi. The fifth treats of the wounds and bites of venomous animals; also of the distemper called hydrophobia, and of persons bitten by dogs which are mad, and by those which are not mad; and also of persons bitten by men. Afterwards it treats of deleterious substances, and of the preservatives from them. In the sixth book is contained everything relating to surgery, both what relates to the fleshy parts, such as the extraction of weapons, and to the bones, which comprehends fractures and dislocations. In the seventh is contained an account of the properties of all medicines, first of the simple, then of the compound, particularly of those which I have mentioned in the preceding six books, and more especially the greater, and as it were, celebrated preparations; for I did not think it proper to treat of all these articles promiscuously, lest it should occasion confusion, but so that any person looking for one or more of the distinguished preparations might easily find it. Towards the end are certain things connected with the composition of medicines, and of those articles which may be substituted for one another, the whole concluding with an account of weights and measures.”
The most valuable and interesting part of this work is the sixth book. The whole treatise is chiefly a compilation from the great physicians who preceded Paulus, but the sixth book contains some original matter.
This great Byzantine physician must have possessed considerable skill in surgery. His famous treatise on midwifery is now lost; it procured for him amongst the Arabs the title of “the Obstetrician,” and entitles him to be called the first of the teachers of the accoucheur’s art. Celebrated equally in the Arabian and Western schools, he exercised an enormous influence in the development of the medical arts. Throughout the Middle Ages he maintained his great popularity, and his surgical teaching was the basis of that of Abulcasis, which afforded to Europe in the Middle Ages her best surgical knowledge. He was the first writer who took notice of the cathartic properties of rhubarb.[536]
After the time of Paulus of Ægina the art of surgery slept for five hundred years; imitators of the ancient masters and compilers of their works alone remained to prove that it was still alive, but no progress was made. The religious orders employed the best methods they knew for the relief of physical suffering, but naturally it was not their work to perfect the healing art. In the Middle Ages, when so much of the medical and surgical practice was in the hands of the monks, particularly of the Benedictine order, many abuses crept in; and at last the practice of surgery by the clergy was forbidden in 1163 by the Council of Tours.
The office of royal physician in the Frankish court in the sixth century was not unattended with risk. When Austrigildis, wife of King Guntram, died of the pestilence in the year 580, she expressed in her last moments a pious desire that her doctors, Nicolaus and Donatus, should be put to death for not having saved her; and her husband, feeling it incumbent upon him to carry out her wishes, had them duly executed.[537]