the evolution of modern medicine(现代医药的演变)-第24章
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What would have been its fate if the mind of Europe had been ready
for Roger Bacon's ferment； and if men had turned to the profitable studies
of physics； astronomy and chemistry instead of wasting centuries over the
scholastic philosophy and the subtleties of Duns Scotus； Abelard and
Thomas Aquinas？ Who can say？ Make no mistake about the quality of
these mengiants in intellect； who have had their place in the evolution of
the race； but from the standpoint of man struggling for the mastery of this
world they are like the members of Swift's famous college 〃busy distilling
sunshine from cucumbers。〃 I speak； of course； from the position of the
natural man； who sees for his fellows more hope from the experiments of
Roger Bacon than from the disputations of philosophy on the 〃Instants；
Familiarities； Quiddities and Relations；〃 which so roused the scorn of
Erasmus。
MEDIAEVAL MEDICAL STUDIES
IT will be of interest to know what studies were followed at a
mediaeval university。 At Oxford； as at most of the continental universities；
there were three degrees； those of Bachelor； Licentiate and Doctor。 The
books read were the 〃Tegni〃 of Galen； the 〃Aphorisms〃 of Hippocrates；
the 〃De Febribus〃 of Isaac and the 〃Antidotarium〃 of Nicolaus
Salernitanus： if a graduate in arts； six years' study in all was required； in
other faculties； eight。 One gets very full information on such matters from
a most interesting book； 〃Une Chaire de Medecine au XVe Siecle；〃 by Dr。
Ferrari （Paris； 1899）。 The University of Pavia was founded in 1361； and
like most of those in Italy was largely frequented by foreigners； who were
arranged； as usual； according to their nationalities； but the students do not
appear to have controlled the university quite so much as at Bologna。 The
documents of the Ferrari family； on which the work is based； tell the story
of one of its members； who was professor at Pavia from 1432 to 1472。
One is surprised at the range of studies in certain directions； and still more
at the absence of other subjects。 A list is given of the teachers in medicine
for the year 1433； twenty in all； and there were special lectures for the
morning； afternoon and evening。 The subjects are medicine； practical
medicine； physics； metaphysics； logic； astrology； surgery and rhetoric：
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very striking is the omission of anatomy； which does not appear in the list
even in 1467。 The salaries paid were not large； so that most of the teachers
must have been in practice： four hundred and five hundred florins was the
maximum。
The dominance of the Arabians is striking。 In 1467； special lectures
were given on the 〃Almansor〃 of Rhazes； and in the catalogue of the
Ferrari's library more than one half of the books are Arabian commentaries
on Greek medicine。 Still more striking evidence of their influence is found
in the text…book of Ferrari； which was printed in 1471 and had been
circulated earlier in MS。 In it Avicenna is quoted more than 3000 times；
Rhazes and Galen 1000； Hippocrates only 140 times。 Professor Ferrari
was a man who played an important role in the university； and had a large
consultation practice。 You will be interested to know what sort of advice
he gave in special cases。 I have the record of an elaborate consultation
written in his own hand； from which one may gather what a formidable
thing it was to fall into the hands of a mediaeval physician。 Signor John de
Calabria had a digestive weakness of the stomach； and rheumatic cerebral
disease； combined with superfluous heat and dryness of the liver and
multiplication of choler。 There is first an elaborate discussion on diet and
general mode of life； then he proceeds to draw up certain light medicines
as a supplement； but it must have taken an extensive apothecary's shop to
turn out the twenty…two prescriptions designed to meet every possible
contingency。
One of the difficulties in the early days of the universities was to
procure good MSS。 In the Paris Faculty； the records of which are the most
complete in Europe； there is an inventory for the year 1395 which gives a
list of twelve volumes； nearly all by Arabian authors。＇25＇ Franklin gives
an interesting incident illustrating the rarity of medical MSS。 at this period。
Louis XI； always worried about his health； was anxious to have in his
library the works of Rhazes。 The only copy available was in the library of
the medical school。 The manuscript was lent； but on excellent security； and
it is nice to know that it was returned。
＇25＇ Franklin： Recherches sur la Bibliotheque de la Faculte de
Medecine de Paris； 1864。
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It is said that one of the special advantages that Montpellier had over
Paris was its possession of so many important MSS。； particularly those of
the Arabian writers。 Many 〃Compendia〃 were written containing extracts
from various writers； and no doubt these were extensively copied and lent
or sold to students。 At Bologna and Padua； there were regulations as to the
price of these MSS。 The university controlled the production of them； and
stationers were liable to fines for inaccurate copies。 The trade must have
been extensive in those early days； as Rashdall mentions that in 1323 there
were twenty…eight sworn booksellers in Paris； besides keepers of
bookstalls in the open air。
MEDIAEVAL PRACTICE
THE Greek doctrine of the four humors colored all the conceptions of
disease； upon their harmony alone it was thought that health depended。
The four temperaments； sanguine； phlegmatic； bilious and melancholic；
corresponded with the prevalence of these humors。 The body was
composed of certain so…called 〃naturals；〃 seven in number the elements；
the temperaments； the humors； the members or parts； the virtues or
faculties； the operations or functions and the spirits。 Certain 〃non…
naturals；〃 nine in number； preserved the health of the body； viz。） air； food
and drink； movement and repose； sleeping and waking； excretion and
retention； and the passions。 Disease was due usually to alterations in the
composition of the humors； and the indications for treatment were in
accordance with these doctrines。 They were to be evacuated； tenuated；
cooled； heated； purged or strengthened。 This humoral doctrine prevailed
throughout the Middle Ages； and reached far into modern timesindeed；
echoes of it are still to be heard in popular conversations on the nature of
disease。
The Arabians were famous for their vigor and resource in matters of
treatment。 Bleeding was the first resort in a large majority of all diseases。
In the 〃Practice〃 of Ferrari there is scarcely a malady for which it is not
recommended。 All remedies were directed to the regulation of the six non…
naturals； and they either preserved health； cured the disease or did the
opposite。 The most popular medicines were derived from the vegetable
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kingdom； and as they were chiefly those recommended by Galen； they
were； and still are； called by his name。 Many important mineral medicines
were introduced by the Arabians； particularly mercury； antimony； iron； etc。
There were in addition scores of substances； the parts or products of
animals； some harmless； others salutary； others again useless and
disgusting。 Minor surgery was in the hands of the barbers； who performed
all the minor operations； such as bleeding； the more important operations；
few in number； were performed by surgeons。
ASTROLOGY AND DIVINATION
AT this period astrology； which included astronomy； was everywhere
taught。 In the 〃Gouernaunce of Prynces； or Pryvete of Pryveties；〃
translated by James Yonge； 1422；＇26＇ there occurs the statement： 〃As
Galian the lull wies leche Saith and Isoder the Gode clerk； hit witnessith
that a man may not perfitely can the sciens and craft of Medissin but yef
he be an astronomoure。〃
＇26＇ Early English Text Society； Extra Series； No。 LXXIV； p。 195；
1898； Secreta Secretorum； Rawl。 MS。 B。； 490。
We have seen how the practice of astrology spread from Babylonia
and Greece throughout the Roman Empire。 It was carried on into the
Middle Ages as an active and aggressive cult； looked upon askance at
times by the Church； but countenanced by the courts； encouraged at the
universities； and always by the public。 In the curriculum of the mediaeval
university； astronomy made up with music； arithmetic and geometry the
Quadrivium。 In the early faculties； astronomy and astrology were not
separate； and at Bologna； in the early fourteenth century； we meet with a
professorship of astrology。＇27＇ One of the duties of this salaried professor；
was to supply 〃judgements〃 gratis for the benefit of enquiring students； a
treacherous and delicate assignment； as that most distinguished occupant
of the chair at Bologna； Cecco d'Ascoli； found when he was burned at the
stake in 1357； a victim of the Florentine Inquisition。＇28＇
＇27＇ Rashdall： Universities of Europe in the Middle Ages； Vol。 I； p。
240。
＇28＇ Rashdall； l。c。； Vol。 I； p。 244。Rashdall also mentions that in the
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sixteenth century at Oxford there is an instance of a scholar admitted to
practice astrology。 l。c。； Vol。 II； p。 458。
Roger Bacon himself was a warm believer in judicial
