Among the writers it may be sufficient to mention here Gariopontus;
Copho, who wrote the Anatome porci, a well-known medieval book;
Joannes Platearius, first of a family of physicians bearing the same
name, whose Practica, or medical compendium, was afterwards
several times printed; and Trotula, believed to be the wife of the
last-named. All of these fall into the first period before the advent
of Arabian medicine. In the transitional period, when the Arabian
school began to influence European medicine, but before the Salernitans
were superseded, comes Nicolaus Praepositus, who wrote the
Antidotarium, a collection of formulae for compound medicines,
which became the standard work on the subject, and the foundation
of many later compilations. An equally popular writer was Gilles
de Corbeil (Aegidius Corboliensis), at one time a teacher at Salerno,
afterwards court physician to Philip Augustus of France, who
composed several poems in Latin hexameters on medical subjects.
Two of them, on the urine and the pulse respectively, attained the
position of medical classics.
None of these Salernitan works rise much above the rank of compilations, being founded on Hippocrates, Galen and later Greek writers, with an unmistakable mixture of the doctrines of the methodists. But they often show much practical experience, and exhibit the naturalistic method of the Hippocratic school. The general plan of treatment is dietetic rather than pharmaceutical, though the art of preparing drugs had reached a high degree of complexity at Salerno. Anatomy was as little regarded as it was in the later ancient schools, the empiric and methodic, but demonstrations of the parts of the body were given on swine. Although it cannot be said that the science of medicine was advanced at Salerno, still its decline was arrested at a time when every other branch of learning was rapidly falling into decay; and there can be no doubt that the observation of patients in hospitals, and probably clinical instruction, were made use of in learning and teaching. The school of Salerno thus forms a bridge between the ancient and the modern medicine, more direct though less conspicuous than that circuitous route, through Byzantium, Bagdad and Cordova, by which Hippocrates and Galen, in Arabian dress, again entered the European world. Though the glory of Salerno had departed, the school actually existed till it was finally dissolved by an edict of the emperor Napoleon I. in the year 1811.
Introduction of Arabian Medicine: The Scholastic Period.—About the middle of the 11th century the Arabian medical writers began to be known by Latin translations in the Western world. Constantinus Africanus, a monk, was the author of the earliest of such versions (A.D. 1050); his labours were directed chiefly to the less important and less bulky Arabian authors, of whom Haly was the most noted; the real classics were not introduced till later. For some time the Salernitan medicine held its ground, and it was not till the conquest of Toledo by Alphonso of Castile that any large number of Western scholars came in contact with the learning of the Spanish Moors, and systematic efforts were made to translate their philosophical and medical works. Jewish scholars, often under the patronage of Christian bishops, were especially active in the work. In Sicily also the Oriental tendencies of Frederick Barbarossa and Frederick II. worked in the same direction. Gerard of Cremona, a physician of Toledo (1114–1187), made translations, it is said by command of Barbarossa, from Avicenna and others. It is needless to point out the influence of the crusades in making Eastern ideas known in the Western world. The influence of Arabian medicine soon began to be felt even in the Hippocratic city of Salerno, and in the 13th century is said to have held an even balance with the older medicine. After this time the foreign influence predominated; and by the time that the Aristotelian dialectic, in the introduction of which the Arabs had so large a share, prevailed in the schools of Europe, the Arabian version of Greek medicine reigned supreme in the medical world. That this movement coincided with the establishment of some of the older European universities is well known. The history of medicine in the period now opening is closely combined with the history of scholastic philosophy. Both were infected with the same dialectical subtlety, which was, from the nature of the subject, especially injurious to medicine.
At the same time, through the rise of the universities, medical learning was much more widely diffused, and the first definite forward movement was seen in the school of Montpellier, where a medical faculty existed early in the 12th century, afterwards united with faculties of law and philosophy. The medical school owed its foundation largely to Jewish teachers, themselves educated in the Moorish schools of Spain, and imbued with the intellectual independence of the Averroists. Its rising prosperity coincided with the decline of the school of Salerno. Montpellier became distinguished for the practical and empirical spirit of its medicine, as contrasted with the dogmatic and scholastic teaching of Paris and other universities. In Italy, Bologna and Padua were earliest distinguished for medical studies—the former preserving more of the Galenical tradition, the latter being more progressive and Averroist. The northern universities contributed little—the reputation even of Paris being of later growth.
The supremacy of Arabian medicine lasted till the revival of learning, when the study of the medical classics in their original language worked another revolution. The medical writers of this period, who chiefly drew from Arabian sources, have been called Arabists (though it is difficult to give any clear meaning to this term), and were afterwards known as the neoterics.
The medical literature of this period is extremely voluminous, but essentially second-hand, consisting mainly of commentaries on Hippocrates, Galen, Avicenna and others, or of compilations and compendia still less original than commentaries. Among these may be mentioned the Conciliator of Peter of Abano (1250–1315), the Aggregator of Jacob de Dondi (1298–1359), both of the school of Padua, and the Pandectae medicinae of the Salernitan Matthaeus Sylvaticus (d. 1342), a sort of medical glossary and dictionary. But for us the most interesting fact is the first appearance of Englishmen as authors of medical works having a European reputation, distinguished, according to the testimony of Häser, by a practical tendency characteristic of the British race, and fostered in the school of Montpellier.
The first of these works is the Compendium medicinae, also called Laurea or Rosa anglicana, of Gilbert (Gilbertus Anglicus, about 1290), said to contain good observations on leprosy. A more important work, the Practica seu lilium medicinae, of Bernard Gordon, a Scottish professor at Montpellier (written in the year 1307), was more widely spread, being translated into French and Hebrew, and printed in several editions. Of these two physicians the first probably, the latter certainly, was educated and practised abroad, but John Gaddesden (1280?–1361), the author of Rosa anglica seu practica medicinae (between 1305 and 1317), was a graduate in medicine of Merton College, Oxford, and court physician. His compendium is entirely wanting in originality, and perhaps unusually destitute of common sense, but it became so popular as to be reprinted up to the end of the 16th century. Works of this kind became still more abundant in the 14th and in the first half of the 15th century, till the wider distribution of the medical classics in the original put them out of fashion.
In surgery this period was far more productive than in medicine, especially in Italy and France, but the limits of our subject only permit us to mention Gulielmus de Saliceto of Piacenza (about 1275), Lanfranchi of Milan (died about 1306), the French surgeon, Guy de Chauliac (about 1350) and the Englishman, John Ardern (about 1350). In anatomy also the beginning of a new epoch was made by Mondino de Liucci or Mundinus (1275–1326), and his followers. The medical writings of Arnald de Villanova (c. 1235–1313) (if the Breviarium practicae be rightly ascribed to him) rise above the rank of compilations. Finally, in the 13th and especially the 14th century we find, under the name of consilia, the first medieval reports of medical cases which are preserved in such a form as to be intelligible. Collections of consilia were published, among others, by Gentilis Fulgineus before 1348, by Bartolomeo Montagnana (d. 1470), and by Baverius de Baveriis of Imola (about 1450). The last-named contains much that is interesting and readable.
Period of the Revival of Learning.—The impulse which all departments of intellectual activity received from the revival of Greek literature in Europe was felt by medicine among the rest. Not that the spirit of the science, or of its corresponding practice, was at once changed. The basis of medicine through the middle ages had been literary and dogmatic, and it was literary and dogmatic still; but the medical literature now brought to light—including as it did the more important works of Hippocrates and Galen, many of them hitherto unknown, and in addition the forgotten element of Latin medicine, especially the work of Celsus—was in itself far superior to the second-hand compilations and incorrect versions which had formerly been accepted as standards. The classical works, though still regarded with unreasoning reverence, were found to have a germinative and vivifying power that carried the mind out of the region of dogma, and prepared the way for the scientific movement which has been growing in strength up to our own day.
