The religious feelings, and particularly the impression that the defectives were under the special patronage of the patron saint of the village, not only kept them from being abused or taken advantage of in any way, but made them an object of special care. They were given various simple tasks to perform, and the public spirit of the community cared for them. It was only with the development of modern sophistication that the tendency to take advantage of social defectives came and special government regulations had to be made and inspectors appointed. This system of caring for these defective children, however, was eminently satisfactory. Other villages took up the work, especially in the Low Countries and in France. The village and colony system of caring for the insane, which we are now developing with so much satisfaction, was entirely anticipated under the most favourable circumstances, and with religious sanctions, during the Middle Ages. Not a few of the defectives, when they grew up, came to be attached in various humble occupations to monastic establishments. Here they were out of the current of the busy life around them, and were cared for particularly. They were not overworked but asked to do what they could, and given their board and clothes and the sympathetic attention of the religious. There are many more of such cases at the present time than are at all appreciated. They emphasize how much of this fraternal care there must have been in the Middle Ages.
Between the village system of caring for defectives, and the germ of the colony idea in their recognition of the value of the country or small town as a dwelling-place for those suffering from backwardness of mind or chronic bodily ills that disturb mentality, and the “open-door system” for the insane, as practised at Bedlam and other places, the Middle Ages anticipated some of the best features of what is most modern in our care for mental patients. Their use of severe pain as a corrective for the psychoneuroses, even when they thought of them in connection with diabolic possession, is another striking instance of their very practical way of dealing with these patients in a manner likely to do them most good. We have had to make our own developments in these matters, however, before we could appreciate the true value of what they were doing in the Middle Ages.
APPENDIX I
Law of the Emperor Frederick II. (1194-1250) regulating the practice of Medicine.[18]
“While we are bent on making regulations for the common weal of our loyal subjects we keep ever under our observation the health of the individual. In consideration of the serious damage and the irreparable suffering which may occur as a consequence of the inexperience of physicians, we decree that in future no one who claims the title of physician shall exercise the art of healing or dare to treat the ailing, except such as have beforehand in our University of Salerno passed a public examination under a regular teacher of medicine and been given a certificate, not only by the professor of medicine, but also by one of our civil officials, which declares his trustworthiness of character and sufficiency of knowledge. This document must be presented to us, or in our absence from the kingdom, to the person who remains behind in our stead in the kingdom, and must be followed by the obtaining of a licence to practise medicine either from us or from our representative aforesaid. Violation of this law is to be punished by confiscation of goods and a year in prison for all those who in future dare to practise medicine without such permission from our authority.
“Since the students cannot be expected to learn medical science unless they have previously been grounded in logic, we further decree that no one be permitted to take up the study of medical science without beforehand having devoted at least three full years to the study of logic.[19] After three years devoted to these studies he (the student) may, if he will, proceed to the study of medicine, provided always that during the prescribed time he devotes himself also to surgery, which is a part of medicine. After this, and not before, will he be given the licence to practise, provided he has passed an examination, in legal form, as well as obtained a certificate from his teacher as to his studies in the preceding time. After having spent five years in study he shall not practise medicine until he has during a full year devoted himself to medical practice with advice and under the direction of an experienced physician. In the medical schools the professors shall during these five years devote themselves to the recognized books, both those of Hippocrates as well as those of Galen, and shall teach not only theoretic but also practical medicine.
“We also decree as a measure intended for the furtherance of public health that no surgeon shall be allowed to practise, unless he has a written certificate, which he must present to the professor in the medical faculty, stating that he has spent at least a year at that part of medicine which is necessary as a guide to the practice of surgery, and that, above all, he has learned the anatomy of the human body at the medical school, and is fully equipped in this department of medicine, without which neither operations of any kind can be undertaken with success nor fractures be properly treated.
“In every province of our kingdom which is under our legal authority, we decree that two prudent and trustworthy men, whose names must be sent to our court, shall be appointed and bound by formal oath, under whose inspection electuaries and syrups and other medicines be prepared according to law and be sold only after such inspection. In Salerno in particular we decree that this inspectorship shall be limited to those who have taken their degree as masters in physic.