[Footnote 27: Janus, Archives International es pour l'histoire de la Medicine et pour la Geographie Medicale, paraissant tous les deux mois. Amsterdam, 1897-1898.]
Petella does not hesitate to say of him that he was "one of the most renowned personages of Europe during the thirteenth century, from the point of view of the triple evolution of his extraordinary mind, which caused him to make his mark in the physical sciences, in the metaphysical sciences, and in the religious world. In him there was an incarnation of the savant of the time, and he must be considered the most perfect encyclopedist of the Middle Ages in their first renascence."
Anyone who reads Dr. Petella's account of this book by Pope John XXI. will be surprised at how much was known about diseases of the eye at the middle of the thirteenth century. For instance, hardening of the eye is spoken of as a very serious affection, so that there seems to be no doubt that the condition now known as glaucoma was recognized and its bad prognosis appreciated. His account of the external anatomy of the eye, eight coats of which he describes, beginning with the [{208}] conjunctiva and ending with the retina, is quite complete. The eye is said to have eight muscles, the levator of the upper eyelid and the sphincter muscle of the eye being counted among them. The other muscles are picturesquely described as reins, that is, guiding ribbons for the eye. Cataract is described as water descending into the eye, and two forms of it are distinguished--one traumatic, due to external causes, and the other due to internal causes. Lachrimal fistula is described and its causes discussed. Various forms of blepharitis are touched upon. Many suggestions are made for the treatment of trichiasis. That a man who was as distinguished in medicine as Peter of Spain should have been elected Pope, is the best possible proof that there was no opposition between science and religion during the thirteenth century.
But to return to the Papal Physicians in our original meaning of the term. Alderotti's successor as physician to the Papal Court was scarcely, if any, less distinguished. This was Simon Januensis, the medical attendant to Pope Nicholas IV., whose pontificate lasted from 1288-1292. Simon did much to make the use of opium more scientific than it had been, and he established definite rules for its administration. Before this the anodyne effects of the drug had been well known, but the difficulty had been to regulate its dosage properly and prevent the use of too large quantities, while at the same time securing the administration of sufficient of the drug to relieve pain. At the beginning there was much prejudice with regard to opium. Indeed, as every physician knows, this prejudice has not entirely died out even in our own day. How much of good, then, Simon was able to accomplish because the prestige of his position as [{209}] Papal Physician helped to break down this prejudice, and how much human suffering he saved as a consequence, it is easy to understand.
Simon is best known in the history of medical science as the author of what was probably the first important dictionary of medicine. This was called the Synonyma Medicinae or Clavis Sanationis, the Key of Health. Steinschneider has declared this book to be one of the most important works in the field of Synonymies. Julius Pagel, in his chapter on Therapeutics in the Middle Ages, in Puschmann's Handbook of the History of Medicine, already quoted, says that this Papal Physician succeeded in solving very happily the problem which he set himself, of gathering together the information that had been collected during past centuries with regard to medical words, and especially those relating to the use of various remedial measures. The industry of the writer may be very well appreciated from the fact that his glossary contains some six thousand articles. Its place in the history of science, as given by Meyer, the German historian of botany, is that for the understanding of the older words in natural science, no better aid than this can be found. He considers it the best work of its kind until Caspar Bauhin's similar volume came to replace it, but that was not until well on in the seventeenth century. Simon was greatly encouraged in this work by Popes Nicholas IV. and Boniface VIII., to both of whom he was body physician and at the same time an intimate friend.
The custom of having for medical attendant one of the leading physicians of the day, if not actually the most prominent medical scientist of the time, which had obtained at Rome during the thirteenth century, was maintained at Avignon during the three-quarters of a [{210}] century in which the Papal See had its seat there. Just who the regular medical attendant of Clement V., the first of the Avignon Popes, was is not very sure. When he became seriously ill toward the end of his life, however, Arnold of Villanova, one of the professors of physic at Paris and probably the most distinguished living physician of the time, was summoned in consultation, and began his journey down to Avignon. This summons attracted widespread attention, which was still further emphasized by the fact that Arnold of Villanova died on the journey. It is not difficult to appreciate even at this distance of time how much weight the summoning of a physician from a long distance to attend His Holiness would have on the minds of the people, and how much it would tend to call their attention to the important medical school from which the great man came. People generally, who heard the facts, would want at least to have in attendance on them, if possible, a physician who had been graduated at the school from which Arnold of Villanova was summoned on his important medical mission. How much this would mean for the encouragement of scientific medicine as it was developing at the University of Paris can scarcely be overestimated.
The distinct tendency of the Popes to keep in touch with the best men in medicine and surgery in their time is well illustrated by the case of Guy de Chauliac. This great French surgeon and professor at the University of Montpelier is hailed by the modern medical world as the Father of Modern Surgery. There is no doubt at all of his intensely modern character as a teacher, nor of his enterprise as a progressive surgeon. Few men have done more for advance in medicine, and his name is [{211}] stamped on a number of original ideas that have never been eclipsed in surgery. After studying anatomy very faithfully, especially by means of dissections, in Italy, where he tells us that his master at Bologna, Bertrucci, made a larger number of dissections scarcely more than thirty years after the supposed Papal decree of prohibition, he returned to Montpelier to become the professor of surgery there, and introduced the Italian methods of investigation into the famous old university.
At this time the Popes were at Avignon, not far distant from Montpelier. From them Guy received every encouragement in his scientific work. He insisted that no one could practice surgery with any hope of success unless he devoted himself to careful dissection of the human body. If we were to believe some of the things that have been said with regard to the Popes forbidding dissection, this should have been enough to keep the French surgeon from the favor of the Popes, but it did not. On the contrary, he was the intimate friend and consultant medical attendant of two of the Avignon Popes, and was the chamberlain to one of them. The good influence of Chauliac on the minds of the Popes is reflected in their interest in the medical department of the University of Montpelier. About this time Pope Urban VI. founded the College of Twelve Physicians at Montpelier. He was an alumnus of the university, and had been appealed to to enlarge the opportunities of his Alma Mater. He did so in the manner just related.
One of the Papal Physicians of the Avignon times was unfortunate. This was the ill-fated Cecco di Ascolo, who was distinguished as a poet and a philosopher as well as a physician. But for his sad end, one might be tempted to say, that he had so many irons in the fire [{212}] that it was scarce to be wondered at that he suffered the fate of many another tender of too many irons, and eventually got his fingers burnt. He was body physician of Pope John XXII. during a good part of the long pontificate of that strenuous old man, who became Pope when over seventy, lived to be ninety, yet accomplished important work in every year of his career. After leaving Avignon Cecco went to Italy and became the Professor of Astrology at Bologna. The term astrology had none of the unfortunate or derisory signification that it has at the present time. It was, as the etymology of the word implies, the science of the stars, though it was cultivated with due reference to the influence of these heavenly bodies on human fate and human constitutions. Hence a physician's interest in it. This continued to be a characteristic of astrology down to the time of Tycho-Brahe, the Danish astronomer, at the beginning of the seventeenth century. Cecco and another distinguished physician of the time, Dino de Garbo, became involved in a public controversy, as the result of which Cecco was denounced to the public authorities as undermining the basis of government and virtually teaching anarchy, though it was called heresy, and as a result of the bitter feud he suffered the penalty of death by fire.
The last of the Papal Physicians connected with the Pontifical Court at Avignon was almost as illustrious as any of his predecessors. He was the well-known Joannes de Tornamira, who was the body physician to Gregory XI. until that Pontiff brought the Papal Court back to Rome. Then Tornamira became the chancellor of the University of Montpelier. He wrote an introduction to the study of medicine, meant for the use of students and young physicians, called a Clarificatorium, which, [{213}] according to Puschmann's History of Medicine, was the most used text-book of medicine during the fourteenth and fifteenth centuries. Besides this he wrote a long and important work On Fevers and the Accidents of Fevers, in which he sums up all the medical knowledge of the time on these subjects.