Old-Time Makers of Medicine Part 9

To understand the place of Mondino, and of the medical school of Bologna, in his time, and the reputation that came to them as world teachers of medicine, we must know, first, this great teacher of Mondino and the atmosphere of progressive medicine that enveloped the university in the latter half of the thirteenth century. In the chapter on "Great Surgeons of the Medieval Universities" we call particular attention to the series of distinguished men, the first four of whom were educated at Salerno, and who came to Bologna to teach surgery. They were doing the best surgery in the world, much better than was done in many centuries after their time; indeed, probably better than at any period down to our own day. Besides, they seem to have been magnetic teachers who attracted and inspired pupils. We have the surgical contributions of a series of men, written at Bologna, that serve to show what fine work was accomplished. At this time, however, the field of medicine was not neglected, though we have but a single great historical name in it that has lived. This was Taddeo Alderotti, a man who lifted the medical profession as high in the estimation of his fellow citizens at Florence as the great painters and literary men of his time did their departments, and who then moved to Bologna, because of the opportunity to teach afforded him by the university.

It is sometimes a little difficult for casual students of the time to understand the marvellous reputation acquired by this medieval physician. It should not be, however, when we recall the enthusiastic reception and procession of welcome accorded to Cimabue's Madonna, and the almost universal acclaim of the greatness of Dante's work, even in his own time. In something of that same spirit Bologna came to appreciate Taddeo, as he is familiarly known, looked upon him as a benefactor of the community, and voted to relieve him of the burden of paying taxes. He came to be considered as a public inst.i.tution, whose presence was a blessing to his fellow citizens, and whose goodness to them should be recognized in this public way. One is not surprised to hear Villani, the well-known contemporary historian, speak of him as the greatest physician in Christendom.

The feelings of the citizens of Bologna, it may well be confessed, were not entirely unselfish, or due solely to the desire to encourage a great scientific genius. Few men of his generation had done more for the city in a material way quite apart from whatever benefits he conferred upon the health of its citizens than Dr. Taddeo. It was he who organized medical teaching in the city on such a plane that it attracted students from all over the world. Bologna had had a great law school before this, founded by Irnerius, to which students had come from all over the world.

With the advent of Taddeo from Florence, and his success as a medical pract.i.tioner, there began to flock to his lectures many students who spread his fame far and wide. The city council could scarcely do less than grant the same privileges to the medical students and teachers of Taddeo's school as they had previously accorded to the faculty of law and its students. The city council recognized quite as clearly as any board of aldermen in the modern time how much, even of material benefit, a great university was to the building up of a city, though their motives were probably much higher than that, and their enlightened policy had its reward in the rapid growth of Bologna until, very probably at the end of the thirteenth century, it had more students than any university of the modern time. The number was not less than fifteen thousand, and may have been twenty thousand.

To this great university success Taddeo and his medical school contributed not a little. The especially attractive feature of his teaching seems to have been its eminent practicalness. He himself had made an immense success of the practice of medicine, and acc.u.mulated a great fortune, so much so that Dante, in his "Paradiso," when he wishes to find a figure that would represent exactly the opposite to what St.

Dominic, the founder of the Dominicans, did for the love of wisdom and humanity, he takes that of Taddeo, who had accomplished so much for personal reputation and wealth.

This might easily lead to the impression that Taddeo's teaching was unscientific, or merely empiric, or that he himself was a narrow-minded maker of money, intent only on his immediate influence, and hampered by exclusive devotion to practical medicine. Nothing could be farther from the truth than any such impression. Taddeo was not only the head of a great medical school, a great teacher whom his students almost worshipped, a physician to whom patients flocked because of his marvellous success, a fine citizen of a great city, whom his fellow citizens honored, but he was a broad-minded scholar, a philosopher, and even an author in branches apart from medicine.

In that older time it was the custom to combine the study of philosophy and medicine. For centuries after that period in Italy it was the custom for men to take both degrees, the doctorate in philosophy and in medicine at the same time. Indeed, most of those whose work has made them famous, down to and including Galvani, did so. Taddeo wrote commentaries on the works of Hippocrates and Galen, but he also translated the ethics of Aristotle, and did much to make the learning of the Arabs easily available for his students. His was a broad, liberal scholarship. Dr. Lewis Pilcher, in his article on "The Mondino Myth,"[14] does not hesitate to say that "to the spirit which, from his professorial chair, Taddeo infused into the teaching and study of medicine undoubtedly is due the high position which for many generations thereafter the school of Bologna continued to maintain as a centre of medical teaching."

Of course, erudition had its revenge, and carried Taddeo too far. The difficult thing in human nature is to stay in the mean and avoid exaggeration. His methods of ill.u.s.trating medical truths from many literary and philosophical sources often caused the kernel of observation to be hidden beneath a blanket of speculation or, at least, to be concealed to a great extent. Even the Germans, who have insisted most on this unfortunate tendency of Taddeo, have been compelled to confess that there is much that is valuable in what he accomplished, and that even his modes of expression were not without a certain vivacity which attracted attention and doubtless added materially to his success as a teacher. Pagel, in Puschmann's "Handbuch," says: "It cannot be denied [this is just after he has quoted a pa.s.sage of Taddeo with regard to dreams] that Taddeo's expressions have a certain liveliness all their own that gives us some idea why he was looked upon as so good a teacher, a teacher who, as we know now, also gave instruction by the bedside of patients." Pagel adds, "Taddeo's greatest merit and his highest significance in medical education consist in the fact that a great many (_zahlreiche_) physicians followed directly in his footsteps and were counted as his pupils. They were all men, as we know them, who as writers and pract.i.tioners of medicine succeeded in going far beyond the level of mediocrity in what they accomplished."

This was the teacher who most influenced young Mondino when he came to the University of Bologna, for it seems not unlikely that as a medical student he was actually the pupil of Taddeo, then in a vigorous old age.

If not, he was at least brought under the direct influence of the teaching tradition created during more than thirty years by that wonderful old man. Knowing what we do of Taddeo it is not surprising that his pupil should have accomplished work that was to influence succeeding generations more than any other of that wonderful thirteenth century. Dr. Pilcher in the article on "The Mondino Myth," so often placed under contribution in this sketch, says that "It needs no great stretch of the imagination to picture somewhat of the effect that contact with such a man as Taddeo di Alderotto[15] might have, in molding the character of his young neighbor and pupil, the chemist's son, who a few years later, by his devotion to the study of human anatomy, was to re-establish the practical pursuit of study on the human cadaver as the common privilege of the skilled physician, and was to engrave his own name deeply on the records of medicine."

Under this worthy compatriot and contemporary of the great Florentines, Mondino was inspired to be the teacher that did so much for Bologna.

Until recent years it has usually been the custom to give too much significance to the work of the men whose names stand out most prominently in the early history of departments of the intellectual life. Mondino's reputation has shared in this exaggerative tendency to some extent, hence the necessity for realizing what was accomplished before his time and the fact that he only stands as the culmination of a progressive period. Carlyle spoke of Dante as the man in whom "ten silent centuries found a voice." The centuries, however, were only silent because the moderns did not know how to listen to their message.

We know now that every country in Europe had a great contributor to literature in the century before Dante. The Cid, the Arthur Legends, the Nibelungen, the Troubadours, naturally led up to Dante. He was only the culmination of a great period of literature. We know now that men had worked in art before Cimabue and Giotto, and had done impressive work that made for the progress of art. These names, however, have come to represent in many minds the sort of solitary phenomena that Dante has seemed sometimes even to scholars.

Because Mondino did such good work in medical teaching it is sometimes declared, even in rather serious histories, that he was the first to accomplish anything in his department, and that before his time there is a blank. Some historians, for instance, have insisted that Mondino was the first to do human dissections, and that he did at most but two or three. Only those who are unacquainted with the magnificent development of surgery that took place during the preceding century, the evidence for which is so abundantly given in modern historians of medicine and especially in Gurlt's great work on the history of surgery, from which we have quoted enough to give a good idea of the extent to which the movement went, are likely to accept any such declaration. There could not have been all that successful surgery without much dissection not only of animals but also of human bodies. The teaching of dissection was not regularly organized until Mondino's time, but it seems very clear that even he must have dissected many more bodies than the number usually attributed to him. Professor Lewis Stephen Pilcher of Brooklyn, who made a special study of Mondino traditions in Bologna itself, and collected some of the early editions of his books, feels so acutely the absurdity of the ordinarily accepted tradition in this matter, that he has written a paper on the subject bearing the suggestive t.i.tle, "The Mondino Myth." He says:[16]

"We are accustomed to think of the practice of dissection as having been re-created by Mondino, and at once fully developed, springing into acceptance. The year 1315 is the generally accepted date for the first public anatomical demonstration upon a human body made by Mondino, and yet it is true that among the laws promulgated by Frederick II, more than seventy-five years before (A.D. 1231), was included a decree that a human body should be dissected at Salernum at least once in five years in the presence of the a.s.sembled physicians and surgeons of the kingdom, and that in the regulations established for admission to the practice of medicine and surgery in the kingdom it was decreed that no surgeon should be admitted to practise unless he should bring testimonials from the masters teaching in the medical faculty, that he was 'learned in the anatomy of human bodies, and had become perfect in that part of medicine without which neither incisions could safely be made nor fractures cured.'

"Salernum was notable in its legalization of the dissection of human bodies before the first public work of Mondino, for, according to a doc.u.ment of the Maggiore Consiglio of Venice of 1308, it appears that there was a college of medicine at Venice which was even then authorized to dissect a body every year. Common experience tells us that the embodiment of such regulations into formal law would occur only after a considerable preceding period of discussion, and in this particular field of clandestine practice. It is too much to ask us to believe that in all this period, from the date of the promulgation of Frederick's decree of 1231 to the first public demonstration by Mondino, at Bologna in 1315, the decree had been a dead letter and no human body had been anatomized. It is true there is not, as far as I am aware, any record of any such work, and commentators and historians of a later date have, without exception, accepted the view that none was done, and thereby heightened the halo a.s.signed to Mondino as the one who ushered in a new era. Such a view seems to me to be incredible. Be that as it may, it is undeniable that at the beginning of the 14th century the idea of dissecting the human body was not a novel one; the importance of a knowledge of the intimate structure of the body had already been appreciated by divers ruling bodies, and specific regulations prescribing its practice had been enacted. It is more reasonable to believe that in the era immediately preceding that of Mondino human bodies were being opened and after a fashion anatomized. All that we know of the work of Mondino suggests that it was not a new enterprise in which he was a pioneer, but rather that he brought to an old practice a new enthusiasm and better methods, which, caught on the rising wave of interest in medical teaching at Bologna, and preserved by his own energy as a writer in the first original systematic treatise written since the time of Galen, created for him in subsequent uncritical times the reputation of being the Restorer of the practice of anatomizing the human body, the first one to demonstrate and teach such knowledge since the time of the Ptolemaic anatomists, Erasistratus and Herophilus.

"The changes have been rung by medical historians upon a casual reference in Mondino's chapter on the uterus to the bodies of two women and one sow which he had dissected, as if these were the first and the only cadavers dissected by him.

The context involves no such construction. He is enforcing a statement that the size of the uterus may vary, and to ill.u.s.trate it remarks that 'a woman whom I anatomized in the month of January last year, viz., 1315 Anno Christi, had a larger uterus than one whom I anatomized in the month of March of the same year.' And further, he says that 'the uterus of a sow which I dissected in 1316 (the year in which he was writing) was a hundred times greater than any I have seen in the human female, for she was pregnant and contained thirteen pigs.' These happen to be the only reference to specific bodies that he makes in his treatise. But it is a far cry to wring out of these references the conclusion that these are the only dissections he made. It is quite true that if we incline to enshroud his work in a cloud of mystery and to figure it as an unprecedented awe-inspiring feature to break down the prejudices of the ages, it is easy to think of him as having timidly profaned the human body by his anatomizing zeal in but one or two instances. His own language, however, throughout his book is that of a man who was familiar with the differing conditions of the organs found in many different bodies; a man who was habitually dissecting."

(Quotations from the work of Mundinus showing his familiarity with dissections. The leaf and line references are to the Dryander edition, Marburg, 1541.)

"I do not consider separately the anatomy of component parts, because their anatomy does not appear clearly in the fresh subject, but rather in those macerated in water." (Leaf 2, lines 8-13.)

"... these differences are more noticeable in the cooked or perfectly dried body, and so you need not be concerned about them, and perhaps I will make an anatomy upon such a one at another time and will write what I shall observe with my own senses, as I have proposed from the beginning." (Leaf 60, lines 14-17.)

"What the members are to which these nerves come cannot well be seen in such a dissection as this, but it should be liquefied with rain water, and this is not contemplated in the present body." (Leaf 60, lines 31-33.)

"After the veins you will note many muscles and many large and strong cords, the complete anatomy of which you will not endeavor to find in such a body but in a body dried in the sun for three years, as I have demonstrated at another time; I also declared completely their number, and wrote the anatomy of the muscles of the arms, hands, and feet in a lecture which I gave over the first, second, third, and fourth subjects."

(Leaf 61, lines 1-7.)

Very probably the best evidence that we have of the comparative frequency at least of dissection at this time is to be found in the records of a trial for body-s.n.a.t.c.hing that occurred in Bologna. The details would remind one very much of what we know of the difficulties with regard to dissection in America a couple of generations ago, when no bodies were provided by law for dissection purposes. In the course of some studies for the history of the New York State Medical Society (New York, 1906) I found that nearly every one of the first half dozen presidents of the New York Academy of Medicine, which is not much more than sixty years old, had had body-s.n.a.t.c.hing experiences when they were younger. Dr. Samuel Francis, the medico-historical writer, tells of a personal expedition across the ferry in the winter time, bringing a body from a Long Island graveyard. In order to avoid the constables on the Long Island side and the police on the New York side, because there had been a number of cases of body-s.n.a.t.c.hing recently and the authorities were on the lookout, the corpse was placed sitting beside the physician who drove the wagon, with a cloak wrapped around it, as if it were a living person specially protected against the cold. Similar experiences were not unusual. The lack of bodies for dissection is sometimes attributed to religious scruples, but they have very little to do with it, as at all times men have refused to allow the bodies of their friends to be treated as anatomical material. This is the natural feeling of abhorrence and not at all religious. It is only when there are many unclaimed bodies of strangers and the poor, as happens in large cities, that there can be an abundance of anatomical material.

The details of this body-s.n.a.t.c.hing case are strangely familiar to those who know the history of similar cases before the middle of the nineteenth century. The case occurred in 1319 in Bologna, just four years after Mondino's public dissections. Four students were involved in the charge of body-s.n.a.t.c.hing, all of them from outside the city of Bologna itself, three from Milan and one from Piacenza. In modern experience, too, as a rule, students from outside of the town where the medical college was situated, were always a little readier than natives to violate graveyards. These four students were accused of having gone at night to the Cemetery of St. Barnabas, outside the gate of San Felice,--suburban graveyards were usually the scene of such exploits,--and to have dug up the body of a certain criminal named Pasino, who had been hanged a few days before. They carried the body to the school in the Parish of San Salvatore, where Alberto Zancari was teaching. The resurrection had been accomplished without witnesses, but there were several witnesses who testified that they recognized the body of Pasino in the school and students occupied with its dissection. If evidence for the zeal of the medical students of that time for dissection were needed, surely we have it in the testimony at this trial. At a time when body-s.n.a.t.c.hing has become a criminal offence usually there have been many repeated occurrences of it before the parties are brought to trial, so that it seems not unlikely that a good many dissections of illegally secured bodies were being done at Bologna at this time.

We know of a regulation of the University in force at this time, which required the teachers at the University to do an anatomy or dissection for students if they secured a body for that purpose. The students seem to have used all sorts of influence, political, monetary, diplomatic, and ecclesiastical, in order to secure the bodies of criminals.

Sometimes when they failed in their purpose they waited until after burial and then took the body without leave. When we recall the awfully deterrent condition in which bodies must have been that were thus provided for dissecting purposes, it is easy to understand that the enthusiasm of the students for dissection must have been at a very high pitch. Certainly it was far higher than at the present day, when, in spite of the fact that our dissecting-rooms have very few of the old-time dangers and unpleasantnesses, dissection is only practised with a.s.siduity if special care is exercised in requiring attendance and superintending the work of the department.

In my book on "The Popes and Science" I have gathered the traditions relating to Mondino's a.s.sistants in the chair of anatomy at Bologna.

They furnish abundant evidence of the fact that dissections, far from being uncommon, must have been not at all infrequent at the north Italian universities at this time. Curiously enough, one of these a.s.sistants was a young woman who, as was not infrequently the custom at this time in the Italian universities, was matriculated as a student at Bologna. She took up first philosophy, and afterwards anatomy, under Mondino. While it is not generally realized, co-education was quite common at the Italian universities of the thirteenth and fourteenth centuries, and at no time since the foundation of the universities has a century pa.s.sed in Italy without distinguished women occupying professors' chairs at some of the Italian universities. This young woman, Alessandra Giliani, of Persiceto, a country district not far from Bologna, took up the study of anatomy with ardor and, strange as it may appear, became especially enthusiastic about dissection. She became so skilful that she was made the prosector of anatomy, that is, one who prepares bodies for demonstration by the professors.

According to the "Cronaca Persicetana," quoted by Medici in his "History of the Anatomical School at Bologna":

"She became most valuable to Mondino because she would cleanse most skilfully the smallest vein, the arteries, all ramifications of the vessels, without lacerating or dividing them, and to prepare them for demonstration she would fill them with various colored liquids, which, after having been driven into the vessels, would harden without destroying the vessels. Again, she would paint these same vessels to their minute branches so perfectly and color them so naturally that, added to the wonderful explanations and teachings of the master, they brought him great fame and credit." The whole pa.s.sage shows a wonderful antic.i.p.ation of our most modern methods--injection, painting, hardening--of making anatomical preparations for cla.s.s and demonstration purposes.

Some of the details of the story have been doubted, but her memorial tablet, erected at the time of her death in the Church of San Pietro e Marcellino of the Hospital of Santa Maria de Mareto, gives all the important facts, and tells the story of the grief of her fiance, who was himself Mondino's other a.s.sistant.[17] This was Otto Agenius, who had made for himself a name as an a.s.sistant to the chair of anatomy in Bologna, and of whom there were great hopes entertained because he had already shown signs of genius as an investigator in anatomy. These hopes were destined to grievous disappointment, however, for Otto died suddenly, before he had reached his thirtieth year. The fact that both these a.s.sistants of Mondino died young and suddenly, would seem to point to the fact that probably dissection wounds in those early days proved even more fatal than they occasionally did a century or more ago, when the proper precautions against them were not so well understood. The death of Mondino's two prosectors in early years would seem to hint at some such unfortunate occurrence.

As regards the evidence of what the young man had accomplished before his untimely death, probably the following quotation, which Medici has taken from one of the old chroniclers, will give the best idea:

"What advantage indeed might not Bologna have had from Otto Agenius l.u.s.trula.n.u.s, whom Mondino had used as an a.s.siduous prosector, if he had not been taken away by a swift and lamentable death before he had completed the sixth l.u.s.trum of his life!"

How well the tradition created by Mondino continued at the university will be best understood from what we know of Guy de Chauliac's visit to the medical school here about the middle of the century. The great French surgeon tells us that he came to Bologna to study anatomy under the direction of Mondino's successor, Bertruccius. When he wrote his preface to his great surgery he recalled this teaching of anatomy at Bologna and said, "It is necessary and useful to every physician to know, first of all, anatomy. For this purpose the study of books is indeed useful, but it is not sufficient to explain those things which can only be appreciated by the senses and which need to be seen in the dead body itself." He advises his students to consult Mundinus' treatise but to demonstrate its details for themselves on the dead body. He relates that he himself had often, _mult.i.toties_, done this, especially under the direction of Bertruccius at Bologna. Curiously enough, as pointed out by Professor Pilcher, Mondino had used this same word _mult.i.totiens_ (the variant spelling makes no difference in the meaning) in speaking about his own work. In describing the hypogastric lesion he mentions that he had demonstrated certain veins in it many times, _mult.i.totiens_.

Mondino was just past fifty when he finished his little book and permitted copies of it to be made. Though the book occurs so early in the history of modern book-making the author offers his excuses to the public for writing it, and quotes the authority of Galen, to whom he turns in other difficult situations, for justification. As prefaces go, Mondino's is so like that of many an author of more recent date that his words have a bibliographic, as well as a personal, interest. He said:

"A work upon any science or art--as saith Galen--is issued for three reasons: first, that one may satisfy his friends.

Second, that he may exercise his best mental powers. Third, that he may be saved from the oblivion incident to old age.

Therefore, moved by these three causes, I have proposed to my pupils to compose a certain work on medicine.

"And because a knowledge of the parts to be subjected to medicine (which is the human body, and the names of its various divisions) is a part of medical science, as saith Averrhoes in his first chapter, in the section on the definition of medicine, for this reason among others, I have set out to lay before you the knowledge of the parts of the human body which is derived from anatomy, not attempting to use a lofty style, but the rather that which is suitable to a manual of procedure."

Some of the early editions of Mondinus' book are said, according to old writers, to have contained ill.u.s.trations. None of these copies have come down to us, but the a.s.sertion is made so definitely that it seems likely to have been the case. The editions that we have contain wood engravings of the method of making a dissection as frontispiece, so that it would not be difficult to think of further such ill.u.s.trations having been employed in the book itself. As we note in the chapter on "Great Surgeons of the Medieval Universities," Mondeville, according to Guy de Chauliac, had pictures of anatomical preparations which he used for teaching purposes. It is easy to understand that the value of such aids would be recognized at a time when the difficulty of preserving bodies made it necessary to do dissections hurriedly so as to get the rapidly decomposing material out of the way.

Beyond his book and certain circ.u.mstances connected with it we know very little about Mondino. What we know, however, enables us to conclude that, like many another great teacher, he must have had the special faculty of inspiring his students with an ardent enthusiasm for the work that they were taking under him. Hence the body-s.n.a.t.c.hing and other stories. Mondino continued to be held in high estimation by the Bolognese for centuries after his death. Dr. Pilcher calls attention to the fact that his sepulchral tablet, which is in the portico of the Church of San Vitari in Bologna, and a replica of which he was allowed to have made in order to bring it to America, is the only one of the sepulchral tablets in the great churches of Florence, San Domenico, San Martino, the Cathedral and the Cloister of San Giacomo degli Ermitani, which has not been removed from its original location and placed in the halls of the Civic Museum. Their removal he considers "a kind of desecration which does violence to one's sense of sanct.i.ty and propriety." "Fortunately, thus far, the Mondino Tablet has escaped the spoiler." Very probably Dr. Pilcher's replica of the tablet which he was required to deposit in the Civic Museum at the time when the copy was made to be brought to America may save the tablet to be seen in its original position for many generations.

Mondino's career is of special interest because it foreshadows the life and accomplishment of many another maker of medicine of the after time.

He did a great new thing in medicine in organizing regular public dissections, and then in making a manual that would facilitate the work.

He waited patiently for years before completing his book in order that it might be the fruit of long experience, and so be more helpful to others. He was so modest as to require urging to secure the publication.

He had the reward of his patience in the popularity of his little work for centuries after his time. The glimpse that we get of his relations to his young a.s.sistants, Agenius and Alessandra, seems to show us a teacher of distinct personal magnetism. Undoubtedly the reputation of his book did much for not only the medical school of the University of Bologna, but also for the medical schools of other north Italian universities, and helped to bring to them the crowds of students that flocked there during the fourteenth and fifteenth centuries.

Taddeo and Mondino turned the attention of the medical students of their generations Bolognawards. Before that time they had mainly gone to Salerno. After their time most of the ardent students of medicine felt that they must study for a time at least at Bologna. Other important medical schools of Italian universities at Padua, at Vicenza, at Piacenza, arose and prospered. During the time when the political troubles of Italy reached a climax about the middle of the fourteenth century, while the Popes were at Avignon, there was a remission in the attendance at all the Italian universities, but with the Popes' return to Rome and the coming of even comparative peace to Italy, Bologna once more became the term of medical pilgrimages for students from all over the world. In the meantime Mondino's book went forth to be the most used text-book of its kind until Vesalius' great work came to replace it. To have ruled in the world of anatomy for two centuries as the best known of teachers is of itself a distinction that shows us at once the teaching power and the scientific ability of this professor of anatomy of Bologna in the early fourteenth century.

X

GREAT SURGEONS OF THE MEDIEVAL UNIVERSITIES

Strange as it may appear to those who have not watched the development of our knowledge of the Middle Ages in recent years the most interesting feature in the medical departments and, indeed, of the post-graduate work generally of the medieval universities, is that in surgery. There is a very general impression that this department of medicine did not develop until quite recent years, and that particularly it failed to develop to any extent in the Middle Ages. A good many of the historians of this period, indeed, though never the special historians of medicine, have even gone far afield in order to find some reason why surgery did not develop at this time. They have insisted that the Church by its prohibition of the shedding of blood, first to monks and friars, and then to the secular clergy, prevented the normal development of surgery.

Besides they add that Church opposition to anatomy completely precluded all possibility of any genuine natural evolution of surgery as a science.

There is probably no more amusing feature of quite a number of supposedly respectable and presumably authoritative historical works written in English than this a.s.sumption with regard to the absence of surgery during the later Middle Ages. Only the most complete ignorance of the actual history of medicine and surgery can account for it. The writers who make such a.s.sertions must never have opened an authoritative medical history. Nothing ill.u.s.trates so well the expression of the editors of the "Cambridge Modern History" referred to more than once in these pages that "in view of changes and of gains such as these [the jointing of original doc.u.ments] it has become impossible for historical writers of the present day to trust without reserve even to the most respected secondary authority. The honest student finds himself continually deserted, r.e.t.a.r.ded, misled by the cla.s.sics of historical literature." Fortunately for us this sweeping condemnation does not hold to any great extent for the medical historical cla.s.sics. All of the cla.s.sic historians of medicine tell us much of the surgery of the thirteenth and fourteenth centuries, and in recent years the republication of old texts and the further study of ma.n.u.script doc.u.ments of various kinds have made it very clear that there is almost no period in the history of the world when surgery was so thoroughly and successfully cultivated as during the rise and development of the universities and their medical schools in the thirteenth and fourteenth centuries.

It is interesting to trace the succession of great contributors to surgery during these two centuries. We know their teaching not from tradition, but from their text-books so faithfully preserved for us by their devoted students, who must have begrudged no time and spared no labor in copying, for many of the books are large, yet exist in many ma.n.u.script copies.