An Epitome of the History of Medicine

by Roswell Park

"Never since Hippocrates," says Malgaigne, "has medicine learned a language stamped with such nobility and in such few words." Although a follower of Galen, in anatomy he insisted on the necessity of dissection, and proposed to make use of the corpses of executed criminals for this purpose. The drawings made by Henri de Mondeville were known to him; he divided abscesses into hot and cold, although among the latter he included oedcma, tympanites, dropsy, scirrhus, and other conditions. In practice he was more timid, yet more active, than Lan franchi, who never cut for stone, but left that operation to the traveling surgeons. De Ghauliac described it as he had seen it performed; he opened the abdomen for dropsy, did not hesitate to attempt the radical cure of hernia, and operated for cataract. The plague which raged during the fourteenth century and depopulated the known world of one-fourth of its inhabitants, twice appeared in Avignon while Guy de Chauliac was a resident there—and he acknowledges that nothing but shame prevented him from fleeing. He remained at his post, visited the sick, and was himself attacked and left for dead. "In this frightful position he had sufficient presence of mind to follow the peculiarities of his case, analyze his own sufferings, and to give a description of them worthy of Hippocrates" (Renouard). His work soon became the surgical code of Christendom, and was commented upon and translated into all tongues, remaining for a long time a classic, and even at this day it preserves much of its interest as representing the condition of medical science at the close of the Middle Ages; moreover, its literary style was much superior to that of any of his contemporaries, all of whom wrote very barbarous Latin. He died about 1370.

With the death of de Chauliac terminates our interest, not merely in the Arabian physicians and those who were intimately connected with them, but in the so-called Arabic Period. It may be added, in passing, that the followers of Mahomet, like those of Christ, erected by the side of each of their mosques a school, and often a hospital, endowed with more or less generosity by caliphs or the wealthy, who hoped to purchase redemption and eternal happiness by such liberality.

A certain number of religious orders or communities were established during the Middle Ages to give succor to the deserving sick, the most widely known being those of St. Mary; St. Lazarus; St. John, of Jerusalem; and the Daughters of God. To be sure, some, through the endowment of the opulent, became rich beyond all reason, and departed from their primitive purposes, and thus not only excited the covetousness of monarchs, but had even the temerity to resist their authority. This compelled, every now and again, a suppression of some order or institution—partly, perhaps, for laxity of morals, and partly because of their turbulence. Of this period it may be said that charitable zeal for the sick was never more pronounced; princes, bishops, and popes gave examples of devotion by dressing with their own hands the ulcers of lepers—and leprosy was in those days a frightful disease, having been contracted by the crusaders in the Orient, and everywhere spread as they returned, being, moreover, favored by the miserable uncleanliness which was then so common. Ignorance, dread, and fear rendered this disease worse than usual, and it was confounded with other maladies less formidable. It has been estimated that in the fifteenth century Europe harbored no less than nineteen thousand lepers; and that the disease was a great terror is manifest by the excessive caution taken against its spread: its victims were forbidden to enter cities, and on the highway were compelled to stand aside lest they should taint passers-by with their breath; even a healthy person convicted of being touched by a leper was banished from society; any infraction of these rules was punishable by death. It will thus be seen what depth of genuine humanity it required to have anything to do with one of these outcasts.

Another institution prevailed widely during these days,—namely, public baths, which were established in nearly every city and increased to such an extent that in the fifteenth century the bathers of Paris constituted a powerful brotherhood, so powerful, in fact, that Jacque Despars, physician to Charles VII, and one of the most renowned professors of the faculty, for speaking openly against the abuse of public baths, was obliged to leave the capital to avoid persecution.

A study of the general history of the Arabic Period reveals that the Arabs, previously obscure and uncivilized, emerged rapidly from the demi-savage state, and took the first rank among the polished nations of the world. During the earliest portion of this period these people were religious vandals and destructive fanatics, but later embraced with enthusiasm and persistence a study of the humanities, and endeavored to repair their early ravages by collecting the débris of the literary and scientific monuments of Greece; but, though they cultivated medicine with zeal and success, they added little to the Greek treasures. Later, Arabia was overrun by hordes from the deserts of Tartary, a people yet more barbarous and unknown, who established themselves in all parts of the globe then under Saracenic dominion, and by their brutal despotism degraded the Arabians to a condition approaching that from which they had emerged. This seems to have been ever the result of Turkish conquest.

Meanwhile the Greek nation, which was for so many ages at the head of civilization, gradually lost its power, virtue, courage, glory, and independence, and continued to descend, until now it exercises no influence whatever on the course of events. During the course of the Arabic Period only one Grecian physician merits mention on account of his writings, and in these there was nothing-new except what he had borrowed without credit from the Saracens.

The Empire of the West,—that is the western part of the ancient Roman Empire,—after subjugation by barbarians from Germany and Scandinavia, fell under a cloud whose darkness overwhelmed it. Its people, however, gradually received new life by commingling their blood with that of the invaders. Later they were able to repulse the Saracens who poured in upon them from Spain; then they turned their armies against each other, and wrought mutual havoc and ruin for several centuries. Again, roused by religious fanaticism, as had been the Mohammedans previously, they rushed by thousands upon the plains of Asia Minor, Syria, and Egypt, which had been for centuries occupied by the Arabs; and their adventures and enterprises, and the new and varied scenes through which they passed, gave rise among the "Francs" to some taste for poetry and works of imagination During the twelfth and thirteenth centuries governments became more stable, liberal institutions were created, the rust of ignorance gradually disappeared, and by the end of the Arabic Period there were really apparent brilliant streaks of mentality in the horizon of the nations of Europe. In this progressive movement the study of medicine shared. In the thirteenth century it was worthily represented in Italy, in Paris, and became established in Montpellier. Notwithstanding, up to this time physicians apparently only knew how to timidly follow in the track of the Arabians, and approached little, or not at all, in their studies, the purer lore of the Greeks.

THE AGE OF RENOVATION.

This Age of Renovation (extending from the commencement of the fifteenth century to the present time, according to Renouard's classification) is divided into the Erudite Period, comprising the fifteenth and sixteenth centuries, and the Reform Period, comprising the seventeenth and eighteenth centuries, and one should add, in fact, the nineteenth. In general literature this age is known as that of the Renaissance, and is one of whose beginning a great deal has been written, and so much better than I can put it in this brief work, that to general sources I should perhaps refer those who are interested in knowing how and why there came about such a tremendous change in methods and habits of thought and in acquirement of knowledge. But it is the history of medicine that at this time we particularly desire, and our minds must be, in some slight degree, prepared for the great changes to be recounted by some, with the conditions which brought about this revolution. It was truly an awakening in every department of knowledge and along every line of study; it was as if the minds of men had been dormant and lost their power of receptivity, and, after a long period of torpor, awakened in a new atmosphere amid new surroundings; as if there had burst upon them a sudden appreciation of ability to do things hitherto undreamed of, and to acquire knowledge such as hitherto had been possessed by none. Once free from the shackles imposed by authority of the past, these minds severed their Gothic bonds, and started forth in every direction with the ardor of youth and the interest of novelty, all engaging in the general enterprise of erecting from the débris of antique science a new temple to the mind in which to worship. While some delved among the records of the past, others sought to bind the past and present, and others, bolder yet, cut entirely loose from it, rejected all tradition, and would fain have built this temple with entirely new materials.

Now, what led to this sudden awakening? Was it chance, or the effect of certain causes which had long been operating'? It has been seen that hospitals and various institutions, whose foundations were dedicated to humanity, were erected in all parts of Europe; that gradually there had come about a better social organization; that there had been a diminution of conflicts between princes and their vassals, and the relations between the two were more nearly at an equilibrium. Moreover, the invention of the compass, which rendered long voyages less dangerous and more frequent, opened up to trade regions hitherto inaccessible or unknown, and attracted interest toward commerce as a means of pecuniary gain. The telescope had been invented, and astronomy was able to seize upon some of the facts by it revealed, and thereby to make more interesting calculations concerning the motions of celestial bodies, and attain a knowledge of our solar system and its laws. Gradually the microscope shed light upon the hitherto unseen; engraving on copper had added its power of illustration to the works of the great writers as they appeared; but above all, that which brought about this condition of affairs was the discovery of the art of printing. The first attempts in this direction were made between the years 1435 and 1440, and by the united efforts of three men, whose names deserve mention so long as their art persists,—namely, Guttenberg, Faust, and Shoeffer. Thanks to them, the same information could be multiplied in manifold form and transmitted to all parts of the civilized globe. In this way intelligence and reason become triumphant; thenceforward the dominion of brute force was broken, and knowledge, because capable of dissemination, became imperishable.