During the twelfth century the school of Salernum, through the personal interest manifested by Emperor Frederick II., acquired a degree of reputation attained by few similar institutions in ancient times. Schools in Paris and England were placed on an advanced standing, the professors being salaried; and about this period the titles of bachelor, licentiate, and master, were granted to the physicians.
During the thirteenth and fourteenth centuries medicine made remarkable progress in France under St. Louis. During the reign of this prince the teaching of medicine and surgery was divided into separate and distinct classes. Medical institutions now became greatly encouraged, and in the leading cities of Europe universities were erected under the auspices of royalty.
Medical instruction experienced an important revolution in the European countries during the fourteenth century. For the first time in Europe anatomy was taught by dissection of the human body. Guy de Chauliac, who lived at the end of this century, wrote a treatise on surgery which served as the basis of European instruction until Ambroise Paré of France published his celebrated work upon the same subject.
The fifteenth century was also one of improvement. The Arabs added a few observations on pathology, especially of the eruptive fevers. Some useful works on pharmacy and materia medica were published during this epoch. During this era the operation was devised for replacing the nose when removed by accident or disease, by using for the purpose a piece of flesh taken from the arm, and applying it by a grafting process. About the middle of this period the internal administration of metallic drugs was introduced. Towards the latter end, the invention of printing tended to assist the progress of medicine. Near the close of this century scurvy was first noticed in Germany. During this period more energy was devoted to postmortem demonstrations and the study of symptoms of diseases.
To Benevieni we owe the commencement of the study of gross pathology and pathological anatomy. Malgaigne remarks of him: “A eulogy which he merits, and which he shared with no other person, and which has not been accorded to him up to this time by the many historians of surgery, who have superficially searched among these precious sources, is that he was the first who had the habit, felt the need, and set the useful example, which he transmitted to his successors, of searching in the cadaver, according to the title of his book, for the concealed causes of disease.” His observations on anatomical heart lesions, gall-stone, and presence of parasites in the body, were original. John Fernel, who has been surnamed “the modern Galen,” divided medicine into physiology, pathology, and therapeutics. The fundamental maxim of therapeutics, that every disease must be combated by contrary remedies, was early laid down by him, and he claimed that anything that cured a disease was contrary to it. Surgery was placed on a high scale during this era, as thorough a course as the time afforded was given, and a rigid examination held at its termination. Ambroise Paré contributed largely toward making this a glorious century. He rose from the lowest walks of life to the highest professional attainments and honors. He was the first to control hemorrhage by tying the bleeding vessels, thus doing away with the former crude and painful method of pouring on hot oil. This procedure proved quite a boon to surgery; as an instance it may be mentioned that prior to the introduction of this method in amputations the bleeding was controlled by means of a hot iron, and this before the days of anæsthesia.
Every age of ancient, mediæval, and modern medicine has had its charlatans, and the more civilization progresses, the more popular these quacks become with certain types of people, particularly those of the middle and lower classes, although no class appears to be exempt. Latent, unscrupulous, and unprincipled, they play upon the credulity of the ignorant.
The central figure of the mediæval charlatans was Paracelsus, who was given to drink and debauchery. He advertised extensively, similar to the charlatans of to-day, and exerted an influence in his time. “The school which he would have founded was nothing but a school of ignorance, dissipation, and boasting—a school of medical dishonesty.”
During the sixteenth century the greatest discoveries took place in anatomy, based upon dissections, the only rational method of ascertaining anatomical knowledge. The lesser circulation of the blood, or that through the lungs, was appreciated.
The officers of the universities were chosen by the students, who assisted in laying out the curriculum. Compare this with the rigid methods of medical instruction now in vogue. The practitioners were of roving habits, which were evidently contracted during their student days, as it was customary for them to go from one school to another, the poor classes defraying expenses by begging and singing.
There was evident improvement in the social and mental status of medical men upon the approach of the seventeenth century, and this period is signalized by the discovery of the circulation of the blood, one of the most important ever made in medicine. Chemistry now assumed the dignified aspect of a science, which fact benefited the progress of medicine.