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[Footnote 27: Ja.n.u.s, 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 quant.i.ties, 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 ill.u.s.trated 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 const.i.tutions. 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 ill.u.s.trious 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.

That the policy of the Popes did not change as regards the selection of their physicians on their return from Avignon to Rome, is to be seen from the physician of the Popes whose See was in both places.

This was the famous Francis of Siena, who is known best in history as the intimate friend of Petrarch, and who was physician to Pope Gregory XI. and to his successor, Urban VI. He had been a professor of medicine at the University of Pisa, and by special invitation went to fill the same position in the University of the Papal City, and became at the same time the medical adviser of the Popes. His influence on medicine was not very important, but he occupied a very prominent position among the learned men of the time, and his personal prestige did much to add to the dignity of the profession. In our own time, the medical men who have been best known and whose membership in the profession has added greatly to its popular estimation, have at times not been distinguished for great things in medicine. Francis of Siena was such a man, and the fact that he was medical adviser to the Popes at the same time must be counted as an important factor in the evolution of medical dignity.

One of the first writers on medical cases who did not indulge much in theory was Baverius de Baveriis, of Imola, who died about 1480, and who was the physician to Pope Nicholas V. shortly before and after the middle of the fifteenth century. In the light of the fact that a {214} recent Papal physician, Dr. Lapponi, has written a book on hypnotism and spiritism, it is interesting to find that his predecessor in the post of Papal Physician four centuries and a half ago, discussed the differential diagnosis of hysteria, catalepsy, epilepsy and syncope.

He also discusses certain interesting cases of vertigo due to stomach trouble, and in general antic.i.p.ates very unexpectedly neurotic conditions that are supposed to have been recognized in medicine much later than his time. Perhaps the most startling thing to be found in his works is his recommendation of iron for chlorosis, which he claimed to have treated with the greatest success by means of this remedy. Of course, there was no idea at the time that chlorosis was due in any sense to a lack of iron in the system, and its value as a therapeutic agent must have come entirely from empiric considerations; but then most of our advances in drug therapeutics have come by no better way.

Another of the distinguished Papal Physicians of the fifteenth century was John of Vigo (1460-1520), who, as Professor Allb.u.t.t notes, was attached to the court of the fighting Pontiff, Julius II., and as a consequence saw much of field surgery. His text-book of surgery, printed at Rome in the early part of the sixteenth century, went through an enormous number of editions. No standard surgical treatise had appeared since that of Guy de Chauliac, and Vigo's continued to be the standard for the next full century. He was a shrewd and skilful as well as a learned physician. His surgical ac.u.men deserves to be noted.

He recognized that fracture of the inner table of the skull might take place without that of the outer, and made some very practical remarks with regard to gangrene and its causes. He attributed {215} gangrene in certain cases to faulty bandaging in fractures, and discussed its origin also as the result of severe cold. He treated syphilis with mercurial inunctions, a practice still followed by the best specialists in this line. His greatest claim to fame, however, is founded on the fact that he was the first to write a surgical treatise on wounds made by firearms.

At this time, during the first half of the sixteenth century, the Papal Medical School begins to a.s.sume an importance in the history of medicine which it was to continue to hold for the next two centuries.

After the refoundation of the Sapienza by Pope Alexander VI., and its development under Pope Leo X., special care was taken and no expense spared by their successors, to secure the greatest teachers in anatomy in the world for the medical department of the Papal University. At this time all the great physicians were distinguished for their attainments in anatomy, somewhat as in the nineteenth century great physicians obtained their prestige by original work in pathology. The situations in the two centuries had much more in common than the casual reader of history or even the ordinary student of medicine would appreciate. The list of Papal Physicians, then, becomes to a great extent the roll of the professors of anatomy at the Papal University Medical School. The Popes of this period were wise enough in their generation to realize that the men who devoted themselves to original research in increasing the knowledge of the human body, were also those likely to know most about the diseases of the body and their treatment. These scientific anatomists, with the chastening knowledge of the complexity of the human body before them, probably made less claims to power to cure diseases than many an {216} enthusiastic therapeutist of the time, who thought, as have representatives of this specialty in every generation, that he has many infallible remedies for the cure of disease, though subsequent generations have not agreed with him.

The true significance of the lives of the men who occupied the post of Papal Physician after this time will be best appreciated from our treatment of them in the chapter on The Papal Medical School. It will be sufficient here simply to recall the names of the distinguished men who, besides being professors in the Papal Medical School, were the medical advisers of the Popes.

The first and most important of the great Renaissance professors of anatomy of the Roman Medical School who were also Papal Physicians was Columbus. He had been Vesalius's a.s.sistant at Padua and later his successor. He had lectured also at Bologna. When a special effort was made to give prestige to the University of Pisa, he was tempted by particularly liberal offers to become the professor of anatomy in that city. It was from here, by still more generous patronage, that the Popes obtained him for their medical school. On treating of the Papal Medical School, we shall have more to say of him and his successor in the professorship of anatomy and medicine as well as in the post of Papal Physician, who was the third of the first anatomists of the time--Eustachius. He with Columbus and Vesalius const.i.tute the trinity of great original investigators in anatomy about the middle of the sixteenth century. It is extremely interesting, with the traditions that exist in the matter, to find that the Popes secured two of these great anatomists for their personal physicians as well as for their medical school. The third one, Vesalius, became the body {217} physician first to the Emperor Charles V. and then to his son Philip II., whom many would declare to be as Catholic as the Popes themselves in religious tendencies.

After Eustachius came Varolius, whose name is engraved in the history of medicine because the Pons Varolii or bridge of Varolius, an important structure in the brain now often simply called the pons, was named after him. To Varolius we owe one of the earliest detailed descriptions of the anatomy of the brain. He was the Papal Physician to Gregory XIII., who will be remembered as the Pope under whom the reform of the calendar was made by the great Jesuit mathematician and astronomer, Father Clavius. Pope Gregory's enlightened patronage of medicine in the person of Varolius will be better appreciated if we add that he was chosen as Papal Physician when he was not yet thirty years of age, though he had already given abundant evidence of his talent for original investigation in anatomy. He died at the early age of thirty-two, but not until after he had accomplished a life's work sufficient to give him an enduring place in the history of anatomy.

After Varolius as Papal Physician came Piccolomini and then Caesalpinus, whom the Italians hail as the discoverer of the circulation of the blood before Harvey, and of whom we shall have much to say in the next chapter. Piccolomini was not as great an original thinker and worker as many of his predecessors and successors, but he was a man whose prestige in medicine was scarcely less than theirs.

That this same liberal patronage of distinguished physicians was continued in the next century may be realized from the fact that Malpighi, the great founder of comparative anatomy, became one of the Papal Physicians. His intimate friend, Borelli, to whom we owe the {218} introduction of physics into medicine, had spent some years in Rome, where, having been robbed by his servants, with the consent of the Pope he took up his abode with the Society of the Pious Schools of San Pantaleone. Here he finished his important work De Motu Animalium, in which the principles of mechanics were first definitely introduced into anatomy and physiology. The preface to this book was written by an ecclesiastic, who praises the piety of Borelli during his stay in Rome and chronicles his encouragement by the Popes in his medical work. Malpighi was succeeded as Papal Physician by Tozzi, who is famous for his commentaries on the ancients rather than for original observation, but who was looked upon in his time as one of the most prominent physicians in Italy, and at this period that meant one of the most prominent physicians in the world. At the beginning of the next century, the eighteenth, Lancisi, by many considered the Father of Modern Clinical Medicine, became the Papal Physician.

Among the consultant physicians to the Popes of the eighteenth century, though he never occupied the post of regular medical attendant, was Morgagni. His advice was often sought by a succession of Popes not only with regard to their personal health, but also with regard to the teaching of medicine and other questions of like nature.

Virchow has called Morgagni the Father of Modern Pathology, because he was the first to point out, that for a knowledge of disease it is quite as important to know where the disease has been as to try to learn what it has been. All of the Popes, five in number, of the latter part of Morgagni's life were on terms of intimacy with him.

Pope Benedict XIV., one of the very great Popes of the century, a native of Bologna, was {219} an intimate friend of Morgagni. His scarcely less famous successor, Pope Clement XIII., had known Morgagni before his elevation to the Papacy, and after his election he wrote a.s.suring Morgagni of his continued esteem and friendship, and asks him to consider the Papal palace always open to him on his visits to Rome.

In an extant letter Clement praises his wisdom, his culture, his courtesy, his piety toward G.o.d, his charity toward men, and holds him up as an example to all others for the special reason that, notwithstanding all his qualities, he had not aroused the enmity or envy of those around him, thus showing what a depth of humanity there was in him in addition to his scientific attainments.

At this time Morgagni was looked upon by all the medical world as probably the greatest of living medical scientists. Visitors who came to Italy who were at all interested in science, always considered that their journey had not been quite complete unless they had had an opportunity of meeting Morgagni. He had more personal friends among the scientists of all the countries of Europe than any other man of his time. The fact that this leader in science should be at the same time a great personal friend of the Popes of his time is the best possible evidence of the more than amicable relations which existed between the Church and medicine during this century. Morgagni's life of nearly ninety years indeed, covers most of the eighteenth century, and is of itself, without more ado, an absolute proof that there was not only no friction between religion and medicine, but shows on the contrary that medical science encountered patronage and encouragement as far as ecclesiastics were concerned, while success in it brought honor and emolument. {220} Morgagni's personal relations to the Church are best brought out by the fact that, of his fifteen children, ten of whom lived to adult life, eight daughters became members of religious orders and one of his two surviving sons became a Jesuit. The great physician was very proud and very glad that his children should have chosen what he did not hesitate to call the better part.

After Morgagni's time, the days of the French Revolution bring a cloud over the Papacy. There were political disturbances in Italy and the Popes were shorn of their temporal power. As a consequence their medical school loses in prestige and finally disappears. The Papal Physicians after this, while distinguished among their fellow members of the Roman medical profession, were no longer the world-known discoverers in medicine that had so often been the case before. So long as the Popes had the power and possessed the means, they used both to encourage medicine in every way, as the list of Papal Physicians shows better than anything else, and a study of this chapter of their history will undo all the false a.s.sertions with regard to the supposed opposition between the Church and science.

We have already said, and it seems to deserve repet.i.tion here, that during most of these centuries in which the Papal Physicians were among the most distinguished discoverers in medicine, the term medicine included within itself most of what we now know as physical science. Botany was studied as a branch of medicine, and as we have seen, one of the Papal Physicians, Simon Januensis, compiled a dictionary that a modern German Historian of Botany finds excellent.

Astrology, under which term astronomy was included, was studied for the sake of the supposed influence of the stars on {221} men's const.i.tutions.--Chemistry was a branch of medical study. Mineralogy was considered a science allied to medicine, and the use of antimony and other metals in medicine originated with physicians trying to extend the domain of knowledge to minerals. Comparative anatomy was founded by a Papal Physician. These were the princ.i.p.al physical sciences. To talk of opposition between science and religion, then, with the most distinguished scientists of these centuries in friendly personal and official relations with the Popes, is to indulge in one of those absurdities common enough among those who must find matter for their condemnation of the Popes and the Church, but that every advance in modern history has pushed farther back into the rubbish chamber of outlived traditions.

{222}

THE POPES AND MEDICAL EDUCATION AND THE PAPAL MEDICAL SCHOOL.

After the story of the Papal Physicians, the most important phase of the relations of the Popes to the medical sciences is to be found in the story of the Papal Medical School. While it seems to be generally ignored by those who are not especially familiar with the history of medical education, a medical school existed in connection with the Papal University at Rome during many centuries--according to excellent authorities, from the beginning of the fourteenth century--and this medical school had, as we have said elsewhere, during nearly two centuries some of the most distinguished professors of medicine in its ranks, and boasts among its faculty some of the greatest discoverers in the medical sciences, and especially in anatomy. For these two centuries it had but two important rivals, Padua and Bologna. Both of these were in Italy, and one, that of the University of Bologna, was in a Papal city, that is, was under the political dominion of the Popes. The best medical teaching, then, was to be found in the Papal States and under conditions such, that if there had been the slightest opposition, or indeed anything but the most cordial encouragement for medical study, the medical schools of Rome and Bologna would surely have languished instead of flourishing beyond all others.

Just about the beginning of the fourteenth century {223} Pope Boniface VIII., who was himself one of the distinguished scholars of his time, determined that, besides the university of the Papal Court, which had existed for nearly a century at Rome, but which was mainly occupied with philosophy and theology and mainly attended by ecclesiastics, there should also be a university of the City of Rome for the people of his capital. This determination was reached only a short time before the culmination of the difficulty between Pope Boniface and the King of France, which eventually resulted in what has been called the outrage of Anagni and the subsequent death of the Pope within a short time. It has usually been thought, then, that in spite of certain extant Papal doc.u.ments creating the University of the City of Rome, this university had not been organized before Pope Boniface's death, and as his successor did not take his seat at Rome, but at Avignon, it has usually been a.s.sumed that the University of the City came into existence at most only in an abortive form. Denifle, whose History of the Universities of the Middle Ages is looked upon as the best authority in such matters, however, insists that a complete university of the City of Rome did come into existence as a result of Boniface's decree.

All during the time when the Popes were at Avignon this university continued to exist, and in spite of the fact that at one time, as a consequence of a great earthquake followed by a pestilence, and then serious political troubles because of the absence of the Popes, Rome had only something less than ten thousand inhabitants, the university continued its work. Denifle calls attention to the fact that there are letters of Pope John XXII. which show that he paid out of the Papal revenues {224} the salary of a teacher of physic at the University of the City of Rome while the Papal Court was at Avignon. It is rather interesting to find the names of the two Popes, Boniface VIII. and John XXII., whose Papal decrees are supposed to have prevented the study of anatomy and chemistry, thus cropping up on unquestionable authority as the founder and the patron of medical teaching in the City of Rome. Pope Boniface VIII. is now generally credited with having been the founder of the Sapienza, the medical school of which, at the beginning of the sixteenth century, was to develop into one of the most important schools of its kind in Europe, and to have on its faculty list the greatest teachers of their time, who had been tempted to come to Rome because the Popes wished to enhance the prestige of the medical school of their capital.

While it may be a surprise for those who have been accustomed to think of the Popes as inalterably opposed to all science, and especially to medical science, thus to find them encouraging and fostering medical teaching, it will only be what would naturally be expected by those who know anything of the real history of medicine in the earlier Middle Ages. There is no doubt at all, that during the so-called "dark ages," that is, when the invasion of the barbarians had put out the lights of the older civilizations, it was mainly ecclesiastics who preserved whatever traditions there were of the old medical learning and carried on whatever serious teaching of medicine, in the sense of medical science, that existed during this time. The monks were the most prominent in this; and the Benedictines, after their foundation in the sixth century, added to their duties of caring for the other temporal needs of the poor, who so {225} often appealed to them, that of helping them as far as they could in any bodily ailments with which they might be afflicted. There are even definite traditions that a certain amount of training in medicine, or at least in the care of the sick, was one of the features of the Benedictine monasteries.

Dr. Payne in his article on the History of Medicine in the Encyclopaedia Brittanica said: "In civil history there is no real break. A continuous thread of learning and practice must have connected the last period of Roman medicine with the dawn of science in the Middle Ages. But the intellectual thread is naturally traced with greater difficulty than that which is the theme of civil history; and in periods such as that from the fifth to the tenth century in Europe, it is almost lost. The chief homes of medical as of other learning in these disturbed times were the monasteries. Though the science was certainly not advanced by their labors, it was saved from total oblivion, and many ancient medical works were preserved in Latin or the vernacular versions. It was among the Benedictines that the monastic studies of medicine first received a new direction and aimed at a higher standard. The study of Hippocrates, Galen, and other cla.s.sics was recommended by Ca.s.siodorus (sixth century), and in the original mother abbey of Monte Ca.s.sino medicine was studied, though there was probably not what could be called a medical school there; nor had this foundation any connection (as has been supposed) with the famous school of Salerno."

A review of some of the interesting features of the early history of medical education will serve to show that, not only was there no ecclesiastical interference with the new developing science, but, on the contrary, {226} without the personal aid and the intelligent patronage of ecclesiastics of all degree, and especially of archbishops and Popes, the development of medical teaching that took place at Salerno would probably not have had the significance in history that it now enjoys. While there was no inst.i.tutional connection between the medical school of Salerno and the Benedictine Monastery at Monte Ca.s.sino, it is known that at the end of the seventh century there was a branch Benedictine monastery at Salerno, and some of the prelates and higher clergy occupied posts as teachers in the school, and even became distinguished for medical acquirements.

Though the Salernitan medical school proper was a secular inst.i.tution, there is no doubt that the Benedictines had great influence in it and had fostered its formation. How close the monks of Monte Ca.s.sino 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 Ca.s.sino, 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 a.s.sociated 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 Ca.s.sino, 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 Alpha.n.u.s, Archbishop of Salerno, and Desiderius, while they were both members of the Benedictine Community of Monte Ca.s.sino.

Alpha.n.u.s 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 t.i.tle _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 Alpha.n.u.s 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 inst.i.tutions 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 inst.i.tutions, 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 cla.s.sic, 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 Ja.n.u.s, 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 antic.i.p.ation 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 cla.s.sic 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.

{231}

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 inst.i.tutions 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.

The most important event in the history of the inst.i.tution, after its foundation, was its establishment in the home which it was to occupy down to our own time. Its new habitation was prepared for it by the Pope who has probably been the most maligned in history--Alexander VI.

A magnificent site was appropriated for it, and the construction of suitable buildings begun. A little more than a decade later, Leo X., another one of the misunderstood Popes, came to the conclusion that the two universities in Rome, that of the Papal Court and that of {232} the City, would do better work if combined into one, and accordingly this combination was effected. This made provision for one very strong teaching faculty in Rome. The final steps for the completion of the union of the two universities were taken by Pope Alexander VII., and the buildings which the new university was to occupy were finished in a manner worthy of the great inst.i.tution of learning which it was hoped to create in Rome.

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