The century of Columbus

by James J. Walsh

[Footnote 35: Translation by Hare, London, 1891.]

The influences that were at work to lift medical education to a higher plane in practical efficiency may be judged from such expressions as those of Rabelais, who, in his letter on education in "Gargantua," suggests as preparatory studies for medicine, Greek and Latin with even a little Hebrew, for the sake of the Holy Scriptures, and natural science, especially zoology, botany and mineralogy, and "then carefully go over again the books of the Greek, Arabian and Latin physicians, not despising the Talmudists and Cabalists; and by frequent dissections acquire perfect knowledge of the outer world, the microcosm, which is man." He himself has shown in a number of passages that he had taken his own advice and even in his famous description of the anatomy of Lent in which his comparisons were formerly thought more or less fanciful, "they are extraordinarily apt and vivid and show deep knowledge of anatomy," while his descriptions of wounds show a competent familiarity with surgical anatomy. This might very well be expected, for Rabelais invented two surgical instruments, one for the reduction of fractures of the thigh bone and the other for operating in cases of strangulated hernia. He has at least one passage in which it is clear that he knew much more about the circulation of the blood than is usually supposed to have [{383}] been known in his time and which demonstrates that there had been a gradual accumulation of knowledge on this subject before Harvey's time. (See chapter on Biological Sciences.)

The interest in medicine can be best realized from the large number of medical books that were printed almost immediately after the discovery of printing. After theology medicine was the subject most occupying the attention of printers. During Columbus' Century a whole series of the classics of medicine was reprinted and made available for wide reading. The patience and scholarship required for this can only be properly appreciated by those who know the labor of reading the crabbed handwriting of the old manuscripts and collating them and the time required to elucidate erroneous readings that had crept in through the negligence of copyists. The world owes an immense debt to the Renaissance for this work. To a great extent these books have been neglected for the last two centuries and we are only now coming to realize how much the scholarly interest of that time meant for subsequent generations. Many of these books are now being republished to the great benefit of medicine. Not only were Hippocrates and Galen and Celsus and the other classics republished, but also the writers of the intermediate time, Aëtius, Alexander of Tralles, the great Arabian writers and then the important contributors to medicine and surgery in the later Middle Ages. The value of the debt thus owed is growing in estimation every year.

The publication of medical books, even during the score of years immediately after printing began to be employed, shows the intense interest in the subject. The first medical publication was a purgation calendar, that is, a list of the days of the year on which purgations should be practised. This was printed by Gutenberg, 1457. Heinrich von Pfolspeundt's "Treatise on Surgery" was printed in 1460; in 1470 medical treatises by Valescus de Tarenta, Jacopo de Dondis and Matthaeus Sylvaticus were printed. In 1471 treatises by Mesnë and Nicolaus Salernitanus were put in type. In 1472 the old "Regimen Sanitatis" was printed and Bellegardo's monograph on "Pediatrics." In 1473 Simon of Genoa's "Medical Dictionary" was set up and in 1476 William of Salicet's "Cyrurgia" was given [{384}] to the press. In 1478 the first edition of Celsus was printed, and the first printed edition of Mondino's "Anathomia" was ready for sale. In 1479 came the first edition of "Avicenna." In spite of the great losses of books that have taken place in the course of time because of fire, water, use and other enemies, we still possess many medical books printed practically in every year of the first quarter of a century after the discovery of printing. Unfortunately the neglect of these old classics during the eighteenth and early nineteenth centuries did more than all the other inimical elements put together in reducing the number of medical incunabula that we might have had.

The first great medical teacher of Columbus' period was Nicholas Leonicenus, born in 1428, who studied medicine at Padua, lived for some ninety-six years and was professor of medicine at Ferrara for over sixty years. He translated the "Aphorisms" of Hippocrates and some of Galen's works into Latin, and occupied himself with the application of the principles laid down in these great classics in his practice, and above all, in his teaching. He made it the business of his life to oppose the Arabian over-medication and especially the use of many drugs on general principles, and he insisted on natural modes of cure, diet, water, exercise, fresh air and the correction of any morbid habits that might have been formed. Probably more than anyone else he influenced the medicine of the first half of Columbus' Century and his work has come to be well recognized in recent years with the growth of interest in the history of medicine.

After him, one of the most important of the physicians of the time was Thomas Linacre, who, after studying some ten years in Italy, returned to England to become the attending physician to Henry VIII. His translations of Galen's works attracted wide attention and Erasmus, Linacre's friend, once declared that after Linacre's translation Galen now spoke much better Latin than he had Greek before. Linacre was a type of the learned physicians of the time and was one of the greatest scholars of the period. That scholarship did not make men impractical, Linacre's organization of the College of Physicians of England is abundant evidence. He found the practice of medicine on his return to England sadly degenerate, [{385}] because there was no competent authority to maintain proper standards of medical education and prosecute those who attempted to practise medicine without any proper training and sometimes, indeed, without any knowledge of the subject. Through the charter from the King, at first for London and subsequently for England, the duty of caring for the protection of the public against the illegal practice of medicine was committed to the Royal College of Physicians. Linacre organized and endowed it, and it continues to exist and exert an excellent influence over medical practice in England under its original charter down to the present time.

Another of the distinguished contributors to medical practice at this time was John Caius, who also translated some of Galen's works and especially the "De Medendi Methodo," his edition containing a series of annotations from his teacher Montanus, and from his own observations on patients. He is deservedly best known for his little book on the Sweating Sickness, in which he exhibited his power of observation and his ability to describe what he saw. Gesner, the great European biologist of the time, who was on terms of intimate relation by correspondence with Caius and knew his work on plants and animals very well, styled him, in the preface to his "Icones Animalium," "a man of consummate erudition, fidelity and diligence as well as judgment," and in an epistle to Queen Elizabeth bestows upon him the eulogium of "the most learned physician of his age." Caius has the merit of introducing the regular practice of dissection into the English teaching of medicine. As Linacre had done, Caius too, as he grew older, used the money which he had accumulated as Royal physician and in the lucrative practice of medicine in London for academic foundations. Linacre founded chairs in Greek and medicine at Oxford and Cambridge, as well as the College of Physicians, and Caius, after having been the first president of Linacre's Royal College, founded Caius College at Cambridge, where he died in 1572. His last year of life had been disturbed by the looting of his rooms of a number of pious articles connected with the old Church to which he faithfully adhered, and Mr. Andrew Lang suggests that only Dr. Caius' timely, though untimely, death (he was but 63 years of age) prevented [{386}] him from sharing the fate of the pious articles associated with the old faith which he had cherished as faithfully as the tenets of that faith itself.

One of the important teachers of medicine at this time was Giovanni de Monte, according to the custom of the time known by the Latinized name of Montanus. He was distinguished for his application of the humanities to medicine and his direct translations of Greek medical books into Latin, so as to avoid the errors which had come from the roundabout translation in the previous times of Greek into Arabian and then into Latin. To him, almost more than any other, is due the reputation that the medical school of Padua obtained at this time, for he gave a series of clinical lectures on the patients in the Hospital of St. Francis which were written down. They show how thorough were his observations and how suggestive his teaching. No wonder that he had pupils from all over Europe. His pupils thought of him as the Americans did of Louis during the early part of the nineteenth century. Many Germans went to hear him. It was a Polish student who reported some of his lectures and Dr. John Caius was, as we have said, one of his most ardent students. Montanus insisted on making careful inspections of the dead bodies in order to control his diagnosis, and the teaching at Padua under him was thoroughly practical and such as we are likely to think of as modern.

TITIAN, PARACELSUS