Though the Salernitan medical school proper was a secular institution, there is no doubt that the Benedictines had great influence in it and had fostered its formation. How close the monks of Monte Cassino were allied to the Popes, everyone knows. The Benedictines considered themselves the special wards of the Papacy, and a number of the Abbots of Monte Cassino, or monks belonging to the community, and of men who had been educated in the monastery, had been raised to the Papacy during the Middle Ages. The origin of modern medical teaching is thus closely associated not only with the Benedictines, but through them with the Popes, without whose encouragement and sanction the work would not have flourished as it did.
In advance of the formal establishment of medical schools, in the modern sense of the word, two Popes were distinguished before their elevation to the Papacy for their attainments in all the sciences, and especially in medicine, one of whom actually founded an important school of thought in medicine, while the other was a professor at Salerno. The first of these is the famous [{227}] Gerbert, who, under the name of Sylvester II., was Pope at the end of the millenium and carried Christianity over what was supposed to be the perilous period of the completion of the first thousand years, when the end of the world was so universally looked for. Gerbert was famous for his attainments in every branch of science, and indeed so many wonderful traditions have collected around his name in this matter that one hesitates to accept most of them. There seems to be no doubt, however, that he was the beloved master of Fulbert of Chartres, who did much for medicine in France at the beginning of the eleventh century and who was the founder of the so-called school of Chartres and himself the teacher of John of Chartres, who became the physician to King Henry I., of France, and of Peter of Chartres and Hildier and Goisbert.
Before the end of the eleventh century Pope Victor III., who had been the Abbot of Monte Cassino, was elected Pope much against his will. He occupied the Papal throne only for about a year and a half. He had been especially recommended by Pope Gregory VII., the famous Hildebrand, as a very suitable successor. Desiderius, as he was called before becoming Pope, was one of the best scholars of his time, and had taught for some years with great distinction at Salerno. It is not known absolutely that he taught medicine, but, as the university of Salerno is usually considered not to have been founded until the middle of the next century, and as before that time the main teaching faculty was that of the medical school and all other teaching was subordinated to it, Desiderius must surely be considered as a teacher at least of medical students. At that time a physician was expected to know something more than merely his [{228}] profession. Mathematics and philosophy were the two favorite subjects to which, besides medicine, they devoted themselves. The presence of the future Pope at Salerno is, moreover, the best possible index of the sympathy between the ecclesiastical authorities and the medical school.
Besides there are definite records of the friendship which existed between Alphanus, Archbishop of Salerno, and Desiderius, while they were both members of the Benedictine Community of Monte Cassino. Alphanus subsequently taught medicine at Salerno, and some of his writings on medicine have been preserved for us. He was the author of a work bearing the title De Quatuor Elementis Corporis Humani, a treatise on the four elements of the human body, which is a compendium of most of the knowledge of anatomy and physiology of the time, though it also contains much more than the information with regard to the merely physical side of man's being. The fact that Alphanus should have been promoted from the professorship in the medical faculty to the Archbishopric of Salerno is only another proof of the entire sympathy which existed between the Church and the professors of medical science at that time.
During the thirteenth century universities were founded in some twenty important cities in Europe, and in connection with most of them a medical school was established. These educational institutions were the result of the initiative of ecclesiastics; their officials all belonged to the clerical body, most of their students were considered as clerics--and indeed this was the one way to secure them against the calls for military service which would otherwise have disturbed the enthusiasm for study--and the Popes were considered the supreme [{229}] authority over all the universities. In spite of this thoroughly ecclesiastical character of the universities and educational institutions, there is not a hint of interference with the teaching of medical science and abundant evidence of its encouragement. Indeed, for anyone who knows the story of the universities of the thirteenth century, it is practically impossible to understand how there could have arisen any tradition of ecclesiastical opposition to education in any form, and there is not a trace of foundation for the stories with regard to ecclesiastical intolerance of science, which are supposed to be supported by certain Papal decrees.
The best possible demonstration of the maintenance of the most amicable relations between churchmen and physicians during the century in which these decrees were issued is also the most interesting fact in the history of medicine during the thirteenth century. It is not generally known that one of the most distinguished physicians of the thirteenth century, one who wrote a book on the special subject of eye diseases that is still a classic, afterwards became Pope under the name of John. He is variously known as John XIX., John XX., or John XXI., according as certain occupants of the Papal throne are considered to be of authority or not. He was educated at Paris, and probably spent some time at Montpelier. Under the name of Peter of Spain, though he was what we should now call a Portuguese, he subsequently taught physic at the University of Sienna. Here he wrote the famous little work on the Diseases of the Eye, which was reviewed by Dr. Petella, physician-in-chief of the Royal Italian Marine, in Janus, the International Archives for the History of Medicine and for Medical Geography in 1898. Petella does not [{230}] hesitate to proclaim him one of the greatest men of his time. Daunou, one of the continuators of the Benedictines' literary history of France, [Footnote 28] says that this Peter of Spain was one of the most notable persons in Europe in his generation.
[Footnote 28: Histoire Litteraire de la France, Vol. XVI. This is the famous work begun by the Benedictines of St. Maur.]
Pope John XXI., before his accession to the Papacy, had certainly accomplished remarkable work in medicine, and of a kind that makes his writings of great interest even at the present day. There is scarcely an important pathological condition of the eye which does not receive some consideration in this little book, and it is a constant source of surprise in reading it to find, with their limited knowledge and lack of instruments, what good diagnosticians the ophthalmologists of the thirteenth century were. Cataract is described, for instance, under the name of "water that descends into the eye," and a distinction is made between cataract from internal and external causes. Hardening of the eye is mentioned and is declared to be very serious in its effects. There seems no doubt that this was glaucoma. Conditions of the lids, particularly, were differentiated and treated by rational measures, some of them quite modern in substance. A curious anticipation of modern therapeutics is the frequent recommendation of extracts of the livers of various fishes for external and internal use, that is a reminder of the present employment of cod-liver oil. The book is acknowledged to be a classic in medicine. The fact that its author should have become Pope later, is the best proof that instead of opposition there was the greatest sympathy between medicine and ecclesiasticism in his time.
With these thoroughly amicable relations between the Church and the medical schools during the thirteenth and preceeding centuries, it will not be so much of a surprise as it might otherwise be, to learn of the foundation of the Medical School of Rome and of the continuation of Papal patronage of it even while the Popes were absent at Avignon. University records do not say much about it during the next two centuries. With the coming of the Renaissance, however, and the entrance of a new spirit into education, the Popes also were touched by the educational time-spirit, and there came a rejuvenation of the University of the City, which now acquired a new name, that of the Sapienza, and became the home of some of the most distinguished teaching in Europe in every department. Early in the sixteenth century the medical department of the Sapienza, or Papal University at Rome, became one of the most noteworthy institutions of Europe because of the work in medicine accomplished there, and had among its faculty the most distinguished investigators in medical science, and especially in that department of medicine--anatomy--which by an unfortunate tradition the Popes are said to have hampered.